A 16-year-old scientist presented results from a study on ultra-processed foods as 'gateway' foods for additional unhealthy choices at the American Heart Association's Hypertension Scientific Sessions and we're encouraged to know her generation is paying attention.

The study was led by Maria Balhara, a 16-year-old student at Broward College in Davie, Florida. She led the study while dual-enrolled and also attending Cooper City High School.

Focusing on teen eating habits, Balhara's research was presented at the recent American Heart Association gathering, and suggested that ultra-processed foods like prepackaged pastries, candy and frozen desserts may act as 'gateway' foods for teens and lead to additional unhealthy food choices.

Balhara said, "Ultra-processed foods are designed to be hyper-palatable, or engineered to be as addictive as possible. They’re also cheap and convenient, which makes them hard to resist. Most people are eating too many of these foods without realizing it.”

According to her research, reducing the intake of key gateway foods could make an impact one's overall and long-term consumption of ultra-processed foods. These foods are high in sugar, salt, unhealthy trans fat, and artificial flavors and colors. Still, these ultra-processed foods (cereals, bread, desserts, sodas, and processed meats) make up more than 60% of the calories Americans consume every day. Previous research shows high consumption of those foods may be linked with weight weight gain, hypertension, risk of heart disease and even premature death.

To conduct the study, she collected data on how often adolescents consumed 12 ultra-processed food products during the previous 8 weeks. These included prepackaged cookies, chips, candy, chocolate, frozen desserts, energy drinks, soda, store-bought pastries, store-bought smoothies, syrup-sweetened coffee or tea, white bread, and processed meat. The participants were 315 teens who were between the ages of 13-19 and recruited from 12 high schools in South Florida between February and April of 2022.

The average BMI among the participants was 22.8 (normal). About half self-identified as white, a quarter self-identified as Hispanic and 7.6% identified as Black. Regarding gender, 52.2% of participants identified as female, 41.6% as male, 3.2% as nonbinary and the rest did not specify their gender.

According to a release from the American Heart Association,

Participants completed a survey Balhara developed called the Processed Intake Evaluation (PIE). The survey assessed the frequency of their consumption of the 12 processed foods during the previous 8 weeks in 2022, and asked questions to gauge their 2022 consumption (after COVID 19 restrictions were lifted) with their estimated consumption in 2019 (before COVID restrictions were implemented). The survey asked the students to report “true” or “false” responses to statements, such as “I often drank soda during the preceding 8 weeks in 2022,” and “I often drank soda prior to the pandemic in 2019.” Their answers were used to compute a PIE score of 0-100, with 8.33 points given for answers of “often” or 0 points otherwise. Their scores for 2022 consumption were compared to their scores for estimated 2019 pre-pandemic consumption.
Based on the results of this data, she concluded that prepackaged pastries, candy and frozen desserts were found to act as possible “gateway” foods that could drive increased (or decreased) consumption of other processed food products. The teens who changed their consumption of those ultra-processed foods (whether they increased them or decreased them) were more likely to change their consumption of all other ultra-processed foods as well, in corresponding ways.

Results also showed that among the identified gateway foods:

  • increased consumption frequency of frozen desserts was associated with an 11% increase in consumption of all other ultra-processed foods;
  • increased consumption of pastries was associated with a 12% increase in consumption of all other ultra-processed foods; and
  • increased consumption of candy was associated with a 31% increase in consumption of all other ultra-processed foods.

Among other foods in the survey, decreased consumption of processed meats among study participants was linked with an 8% decrease in consumption of all other ultra-processed foods. Decreased consumption of white bread was associated with a 9% decrease in consumption of all other ultra-processed foods. Decreased consumption of prepackaged cookies was linked with a 10% decrease in consumption of all other ultra-processed foods.

Balhara said,
The good news is that even small changes, such as reducing how often you eat a few gateway foods, may reduce overall consumption of unhealthy foods and have a big impact on your overall health. For teenagers whose consumption of ultra-processed foods has not yet been established, certain gateway foods such as candy, store-bought pastries and frozen desserts should be avoided, since increased consumption of these foods appears to lead to increased consumption of other processed foods.”
And while the American Heart Association obviously recognizes the limitations of this study as well as it's being a small, preliminary body of research, it certainly corresponds with what many of us already know--if your kids aren't exposed to ultra-processed foods, they likely won't crave them and vice versa.

Worth keeping them at bay as long as possible.