Consumption of ultra-processed foods and health status: a systematic review and meta-analysis

Abstract

Increasing evidence suggests that high consumption of ultra-processed foods (UPF) is associated with an increase in non-communicable diseases, overweight and obesity. The present study systematically reviewed all observational studies that investigated the association between UPF consumption and health status. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science and Google Scholar was conducted, and reference lists of included articles were checked. Only cross-sectional and prospective cohort studies were included. At the end of the selection process, twenty-three studies (ten cross-sectional and thirteen prospective cohort studies) were included in the systematic review. As regards the cross-sectional studies, the highest UPF consumption was associated with a significant increase in the risk of overweight/obesity (+39 %), high waist circumference (+39 %), low HDL-cholesterol levels (+102 %) and the metabolic syndrome (+79 %), while no significant associations with hypertension, hyperglycaemia or hypertriacylglycerolaemia were observed. For prospective cohort studies evaluating a total population of 183 491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies (risk ratio (RR) 1·25, 95 % CI 1·14, 1·37; P < 0·00001), increased risk of CVD in three studies (RR 1·29, 95 % CI 1·12, 1·48; P = 0·0003), cerebrovascular disease in two studies (RR 1·34, 95 % CI 1·07, 1·68; P = 0·01) and depression in two studies (RR 1·20, 95 % CI 1·03, 1·40; P = 0·02). In conclusion, increased UPF consumption was associated, although in a limited number of studies, with a worse cardiometabolic risk profile and a higher risk of CVD, cerebrovascular disease, depression and all-cause mortality.

Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts

“…Increase of UPF may have negative long-term effect on health as prior data from longitudinal studies showed that habitual consumption of highly processed foods leads to a higher risk of cardiovascular disease, cancer, diabetes and mortality (12)(13)(14)(15)20).…”

Approaches to Defining Healthy Diets: A Background Paper for the International Expert Consultation on Sustainable Healthy Diets

“…A growing body of evidence is showing that having a large proportion of ultra-processed foods in the diet is associated with certain adverse health outcomes. 80 -82 Observational studies have shown associations between diets containing high proportions of ultra-processed foods and NCDs including CVD and cancer. An RCT reported a causal relationship between a diet containing a high proportion of ultra-processed foods and obesity.…”

Diet Quality and Its Effect on Weight Gain Prevention in Young Adults: A Narrative Review

“…27 This result is consistent with a similar systematic review which reported a significant association between the highest ultra-processed food consumption and increased risk of overweight and obesity in 73,169 adults (odds ratio: 1.39, 95% CI: 1.29, 1.50; p < 0.0001, I 2 ¼ 0%, p ¼ 0.47). 28 This review also reported statistically significant associations between highest ultra-processed food consumption and an increased risk of high waist circumference or abdominal obesity, an increased risk of the metabolic syndrome and reduced highdensity lipoprotein cholesterol levels in adults. 28 Additionally, this review also reported that among the included prospective cohort studies, the highest consumption of ultra-processed foods was significantly associated with an increased risk of all-cause mortality, an increased risk of cardiovascular disease incidence and/or mortality, cerebrovascular disease incidence/ and or mortality, depression, and overweight and obesity in adults.…”

“…28 This review also reported statistically significant associations between highest ultra-processed food consumption and an increased risk of high waist circumference or abdominal obesity, an increased risk of the metabolic syndrome and reduced highdensity lipoprotein cholesterol levels in adults. 28 Additionally, this review also reported that among the included prospective cohort studies, the highest consumption of ultra-processed foods was significantly associated with an increased risk of all-cause mortality, an increased risk of cardiovascular disease incidence and/or mortality, cerebrovascular disease incidence/ and or mortality, depression, and overweight and obesity in adults. 28 The results of these reviews highlight the potential health benefits of limiting consumption of ultra-processed foods in the diet, which may lead to a reduced risk of weight gain, overweight and obesity, and reduced risk of chronic disease development in adults.…”