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Ultraprocessed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial

Dicken, Samuel J., Jassil, Friedrich C., Brown, Adrian, Kalis, Monika, Stanley, Chloe, Ranson, Chaniqua, Ruwona, Tapiwa, Qamar, Sulmaaz, Buck, Caroline, Mallik, Ritwika, Hamid, Nausheen, Bird, Jonathan M., Brown, Alanna, Norton, Benjamin, Gandini Wheeler-Kingshott, Claudia A. M., Hamer, Mark, van Tulleken, Chris, Hall, Kevin D., Fisher, Abigail, Makaronidis, Janine, Batterham, Rachel L.·2025·Nature Medicine
DOI 10.1038/s41591-025-03842-0PMC PMC12532614
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Abstract

Ultraprocessed food (UPF) consumption is associated with noncommunicable disease risk, yet no trial has assessed its health impact within the context of national dietary guidelines. In a 2 × 2 crossover randomized controlled feeding trial, 55 adults in England (body mass index ≥25 to <40 kg m −2 , habitual UPF intake ≥50% kcal day −1 ) were provided with two 8-week ad libitum diets following the UK Eatwell Guide: (1) minimally processed food (MPF) and (2) UPF, in a random order. Twenty-eight people were randomized to MPF then UPF, and 27 to UPF then MPF; 50 participants comprised the intention-to-treat sample. The primary outcome was the within-participant difference in percent weight change (%WC) between diets, from baseline to week 8. Participants were blinded to the primary outcome. MPF (%WC, −2.06 (95% confidence interval (CI), −2.99, −1.13) and UPF (%WC, −1.05 (95% CI, −1.98, −0.13)) resulted in weight loss, with significantly greater %WC on MPF (Δ%WC, −1.01 (95% CI, −1.87, −0.14), P = 0.024; Cohen’s d , −0.48 (95% CI, −0.91, −0.06)). Mild gastrointestinal adverse events were common on both diets. Findings indicate greater weight loss on MPF than UPF diets and needing dietary guidance on food processing in addition to existing recommendations. Clinicaltrials.gov registration: NCT05627570 .

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  • Two crossover RCTs on disease precursors confirmed the association with obesity, which was further reinforced by two similar trials published shortly before this Series paper was accepted.

    “As noted earlier, two crossover RCTs on disease precursors confirmed the association with obesity, which was further reinforced by two similar trials published shortly before this Series paper was accepted.227,228”

    From Ultra-processed foods and human health: the main thesis and the evidence (2025) · cites this paper as [227]

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Metadata

Authors
Dicken, S. J., Jassil, F. C., Brown, A., Kalis, M., Stanley, C., Ranson, C., Ruwona, T., Qamar, S., Buck, C., Mallik, R., Hamid, N., Bird, J. M., Brown, A., Norton, B., Gandini Wheeler-Kingshott, C. A. M., Hamer, M., van Tulleken, C., Hall, K. D., Fisher, A., Makaronidis, J., & Batterham, R. L.
ORCID
Venue
Nature Medicine
Publisher
Springer Science and Business Media LLC
Published
2025-08-04
Volume
31
Issue
10
Pages
3297-3308
ISSN
  • 1078-8956
  • 1546-170X
DOI
10.1038/s41591-025-03842-0
PMC
PMC12532614
Cited by
129
References
12
Language
en
Licence

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