INTRODUCTION: Consumption of ultra-processed food (UPF) is associated with poor diet quality and a risk for non-communicable diseases (NCDs). This study explores the energy contribution of NOVA foods and the nutrient gaps.

METHODS: The study sourced data from the previous Ethiopian National Food Consumption Survey (NFCS). It covered 8254 households, 8254 women of reproductive age (15-45 years old), and 7272 children (6-45 months old).

RESULTS: The most consumed UPF in children were biscuits, cookies, soft drinks, and semi-solid palm oil; while cow and human milk, whole wheat bread, a range of legumes, tubers, and cereal-based foods were among NOVA1. In both children and women, the largest dietary energy intake was from NOVA1 (74.6% and 79.0%), processed culinary ingredients (18.3% and 14.0%), processed foods (1.9% and 3.5%), and UPF (5.1% and 3.5%), respectively. Higher intake of energy from UPF was found in urban residences, wealthier households, and women with higher education. However, NOVA1 was more dominantly consumed in rural than in urban areas. Micronutrient and macronutrient gaps were observed compared to the recommended nutrient intake (RNI). The intake of fruits and vegetables was also considerably low compared to the WHO recommendation (≥400 g/day for adults, and ≥250 g/day for children).

CONCLUSIONS: Adequate intake of micronutrients, fruits, and vegetables is essential to meet the RNI and could have reduced existing body micronutrient deficiencies, such as vitamin A, zinc, iodine, calcium, vitamin D, and selenium prevalence. Whether UPF intake in urban areas is associated with insufficient availability and access to NOVA1 foods or just due to the higher provision of UPF and gained popularity needs additional investigation. Further study is recommended to simulate the impact of increased fruits and vegetables and/or reduced intake of selected UPF, salts, and oils on NCD markers or mortality in the country.