Ultra-processed foods contribute two thirds of energy intake and are associated with poorer nutrient profiles in New Zealand adolescents

• First study to quantify ultra-processed food (UPF) intake in New Zealand adolescents • UPFs contribute a median of ∼65 (25 th , 75 th percentile 45, 83) % of energy intake • Higher UPF intake is associated with increased sugar, saturated fat and sodium intake • UPF consumption is inversely associated with protein and key micronutrient intakes • UPF intake in New Zealand adolescents exceeds levels reported in Australia and France Ultra-processed food (UPF) consumption is rising globally, as is evidence showing its association with poor health outcomes. No studies have assessed UPF intake in New Zealand adolescents. Our cross-sectional study aimed to quantify UPF consumption among New Zealand adolescents and examine associations between UPF consumption and nutrient intake. Dietary intake was assessed using Intake24, an online 24-hour dietary recall, in 631 adolescents (aged 10–19 years) from schools in Auckland, Waikato, and Bay of Plenty, New Zealand. Foods consumed were grouped as either ultra-processed, processed, minimally processed, or processed culinary ingredients, according to the NOVA classification. Participants were stratified into tertiles of UPF consumption (as % of daily energy intake). Nutrient intakes were compared across tertiles using Kruskal-Wallis tests and for linear associations using adjusted linear regression models. On average, UPFs contributed a median 64.8% of daily energy intake. After adjustment for total energy intake and participant sex, UPF consumption had a positive linear association with intakes of saturated fat (P<0.001, adj R 2 =0.03), sugar (P<0.001, adj R 2 =0.05), and sodium (P<0.001, adj R 2 =0.09), and a negative linear association with protein (P<0.001, adj R 2 =0.17), beta-carotene equivalents (P<0.001, adj R 2 =0.10), tryptophan (P<0.001, adj R 2 =0.22), magnesium (P<0.001, adj R 2 =0.11), potassium (P<0.001, adj R 2 =0.06), zinc (P<0.001, adj R 2 =0.10), phosphorous (P<0.001, adj R 2 =0.10), and vitamin E (P<0.001, adj R 2 =0.04). The top three food groups contributing to UPF intake were bread and bread products; pastries and fried foods; and biscuits and desserts. These findings suggest UPF consumption is associated with poorer nutrient profiles among New Zealand adolescents and may inform future discussion around adolescent nutrition and the food environment This study quantified ultra-processed food (UPF) consumption among New Zealand adolescents and examined their association with nutrient intake. UPFs contributed a median 65 (25 th , 75 th percentile 45, 83) % of daily energy intake. Higher protein and key micronutrients intakes were associated with a lower UPF consumption. These findings may inform future discussion around adolescent nutrition and the food environment to reduce UPF consumption. This may include improving school food environments.