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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.
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Analysis found weak to no evidence for an association between ultra-processed food exposure and hyperglycaemia (odds ratio 1.10, 95% confidence interval 0.34 to 3.52; credibility class V; GRADE very low).
“We found weak to no evidence for associations between exposure to ultra-processed foods and hyperglycaemia (odds ratio 1.10, 0.34 to 3.52; class V; very low)”
From Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses (2024) · cites this paper as [17]
Overall confidence in the results of seven meta-analysis studies was low owing to lack of clarity as to whether the review methods were established before the conduct of the review (AMSTAR critical item 2).
“we considered the overall confidence in the results of seven meta-analysis studies to be low owing to lack of clarity as to whether the review methods were established before the conduct of the review (AMSTAR critical item 2)”
From Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses (2024) · cites this paper as [17]
Analysis found weak to no evidence for an association between ultra-processed food exposure and hypertriglyceridaemia (odds ratio 0.95, 95% confidence interval 0.60 to 1.50; credibility class V; GRADE very low).
“We found weak to no evidence for associations between exposure to ultra-processed foods and hypertriglyceridaemia (odds ratio 0.95, 0.60 to 1.50; class V; very low)”
From Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses (2024) · cites this paper as [17]
Analysis found weak to no evidence for an association between ultra-processed food exposure and low high density lipoprotein concentrations (odds ratio 2.02, 95% confidence interval 1.27 to 3.21; credibility class IV; GRADE very low).
“and low high density lipoprotein concentrations (odds ratio 2.02, 1.27 to 3.21; class IV; very low)”
From Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses (2024) · cites this paper as [17]
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Cites
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“…it was also hypothesised that UPF can adversely affect health by modifying the gut microbiome in such a way that it disturbs the energy balance and promotes the selection of microbes that promote inflammation-related diseases such as CVD and metabolic diseases and even depression (48,49) .”
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“In addition, results from a large French prospective cohort study, the NutriNet-Santé study, found that high UPF consumption led to a significant increase in the risk of CVD (13) , diabetes (14) , depressive symptoms (15) and cancer (16) .”
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Metadata
- Authors
- Pagliai, G., Dinu, M., Madarena, M. P., Bonaccio, M., Iacoviello, L., & Sofi, F.
- ORCID
- Dinu, M.
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-08-14
- Volume
- 125
- Issue
- 3
- Pages
- 308-318
- ISSN
- 0007-1145
- 1475-2662
- PMC
- PMC7844609
- Cited by
- 918
- References
- 14
- Language
- en
- Update notices
- addendum (2020-08-14)
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