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processed food; ultraprocessed food

- highly modified products created through industrial processes for long sheld life - thet typically contain multiple additives, preservatives, & artificial ingredients Includes: - mass-produced desserts including flavored yogurts, packaged bread, processed meats, snack foods & breakfast cereals, ready-to-eat sauces, cheeses, spreads, gravies, carbonated drinks - the classification system is sometimes ambiguous & confusing, including otherwise healthy food such as veggi-burgers Adverse effects: - accelerated biological aging [17] - increased risk of cancer (RR=1.13); RR=1.02 [8]; cancer mortality (RR=1.06) [8] - increased risk of breast cancer (RR=1.13) [1]; mortality (RR=1.16) [8] - increased risk of ovarian cancer (RR=1.2); mortality (RR=1.3) [8] - increased risk of colorectal cancer & pancreatic cancer [13] - increased risk of early-onset colorectal adenomas in women [20] - increased risk of head & neck cancer & esophageal adenocarcinoma associated with ultra-processed foods [10] - proportion mediated via adiposity was small - increased mortality [2]; RR=1.2 [7] - 14% increase in mortality with each 10% increase in processed food - increased risk of cancer mortality (RR=1.06) [8] - higher intake of ultra-processed foods associated with increased mortality in long-term cancer survivors [21] - ultra-processed foods leads to greater calorie consumption, weight gain & obesity [3,13] - ultra-processed foods associated with increase risk for cardiovascular disease & mortality [4] - each 10% increase of ultra-processed food consumed is associated with 11%-13% increased risk for cardiovascular disease [4] & death [11] (50%) - ultra-processed foods associated with increased risk for type 2 diabetes [5] - ultra-processed foods associated with increased risk for cognitive impairment [6] - ultra-processed foods associated with increased risk for anxiety [11] & depression [6] 48-53% [11] - increased risk of Crohn's disease (RR=1.7) [13] - ultra-processed foods associated with active psoriasis - a pro-inflammatory effect of ultra-processed foods separate from high BMI [15] - ultra-processed foods associated with increased risk for all-cause death (21%) [11] - ultra-processed meat, poultry & seafood-based foods most strongly associated with mortality (RR=1.13) [12] - overall diet quality more important than ultra-processed foods [12] - ultra-processed foods associated with prodromal Parkinson features [18] - ultra-processed foods associated with REM sleep disorder, constipation, pain, depression [18] Laboratory: - polymetabolite scores obtained from blood or urine may predict ultraprocessed food intake [19] Notes: - processed foods tend to have more calories, sodium, fat, additives, sugar, & contaminants like acrylamide & bisphenol A, & less fiber & micronutrients - when foods are processed under high temperatures, potentially carcinogenic contaminants form [2] Management: - Mediterranean diet recommended to break addiction to ultraprocessed foods [13] - also see healthy diet

Specific

plant-based meat alternative (PBMA) refined grain

General

food

References

  1. Fiolet T, Srour B, Sellem L et al Consumption of ultra-processed foods and cancer risk: results from NutriNet-Sante prospective cohort. BMJ 2018;360:k322 PMID: 29444771 http://www.bmj.com/content/360/bmj.k322 - Monge A, Lajous M Ultra-processed foods and cancer. BMJ 2018;360:k599 PMID: 29444772 http://www.bmj.com/content/360/bmj.k599
  2. Schnabel L, Kesse-Guyot E, Alles B et al Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France. JAMA Intern Med. Published online February 11, 2019. PMID: 30742202 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723626
  3. Hall KD, Ayuketah S, Brychta R Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metabolism. May 16, 2018 PMID: 31105044 https://www.cell.com/cell-metabolism/fulltext/S1550-4131(19)30248-7#%20
  4. Srour B et al Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Sante) BMJ 2019;365:l1451 PMID: 31142457 https://www.bmj.com/content/365/bmj.l1451 - Lawrence MA, Baker PI Ultra-processed food and adverse health outcomes. BMJ 2019;365:l2289 PMID: 31142449 https://www.bmj.com/content/365/bmj.l2289
  5. Srour B et al Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Sante Prospective Cohort. JAMA Intern Med. Published online December 16, 2019 PMID: 31841598 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2757497
  6. Gomes Goncalves N, Vidal Ferreira N, Khandpur N et al JAMA Neurol. 2022 Dec 5. Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. PMID: 36469335 https://jamanetwork.com/journals/jamaneurology/fullarticle/2799140
  7. Suksatan W, Moradi S, Naeini F et al Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants. Nutrients. 2021 Dec 30;14(1):174. PMID: 35011048 Free PMC article. Review.
  8. Worcester S Ultraprocessed Food and Increased Risk of Cancer: UK Study. Medscape. Feb 2, 2023 https://www.medscape.com/viewarticle/987795 - Chang K, Gunter MJ, Rauber F et al Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank. eClinicalMedicine. 2023. Jan 31. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00017-2/fulltext
  9. Samuthpongtorn C, Nguyen LH, Okereke OI et al Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770 PMID: 37728928 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809727
  10. Morales-Bernstein F, Biessy C, Viallon V et al Ultra-processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study: a mediation analysis. Eur J Nutr. 2023. Nov 22 PMID: 37989797 https://link.springer.com/article/10.1007/s00394-023-03270-1
  11. Lane MM, Gamage E, Du S et al Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384:e077310 PMID: 38418082 PMCID: PMC10899807 Free PMC article https://www.bmj.com/content/384/bmj-2023-077310
  12. Fang Z et al. Association of ultra-processed food consumption with all cause and cause specific mortality: Population based cohort study. BMJ 2024 May 8; 385:e078476 PMID: 38719536 PMCID: PMC11077436 Free PMC article. https://www.bmj.com/content/385/bmj-2023-078476
  13. Watson J Ultraprocessed Food and GI Health: Have We Bitten Off More Than We Can Chew? Medscape. May 10, 2024' https://www.medscape.com/viewarticle/ultraprocessed-food-and-gi-health-have-we-bitten-more-than-2024a10008z1
  14. Mendoza K, Smith-Warner SA, Rossato SL et al Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies. Lancet Reg Health Am. 2024 Sep 2;37:100859. . PMID: 39286398 PMCID: PMC11403639 Free PMC article. https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(24)00186-8/fulltext
  15. Kneisel K Ultraprocessed Foods Implicated in Psoriasis Activity. Association believed to be related to inflammation. MedPage Today November 27, 2024 https://www.medpagetoday.com/dermatology/psoriasis/113163 - Penso L, Touvier M, Srour B, Ezzedine K, Sbidian E. Ultraprocessed Food Intake and Psoriasis. JAMA Dermatol. 2024 Nov 27. PMID: 39602129 https://jamanetwork.com/journals/jamadermatology/fullarticle/2827133
  16. Zaltz DA The What, How, and Why of Ultraprocessed Foods. The topic of UPF regulation may be just as irresistible as the foods it targets. MedPage Today. Jan 13, 2025 https://www.medpagetoday.com/opinion/second-opinions/113754
  17. Talwadekar M Ultraprocessed Foods Linked to Faster Biological Aging. Mesdcape. Nove 20, 2024 https://www.medscape.com/viewarticle/ultraprocessed-foods-linked-faster-biological-aging-2024a1000l7u
  18. George J Ultraprocessed Foods Tied to Early Parkinson's Disease Symptoms. Analysis finds link between diet and prodromal Parkinson's features MedPage Today May 8, 2025 https://www.medpagetoday.com/neurology/parkinsonsdisease/115495 - Chen X, Wang P, Luo W, Wang J, Sun L, Li Y, Zhang F, Gao X. Association of ultra-processed food consumption with prodromal, incident Parkinson's disease and mortality. J Neurol Neurosurg Psychiatry. 2025 Jul 17:jnnp-2025-336045. PMID: 40675802
  19. Mallapaty S How much ultra-processed food do you eat? Blood and urine record it. Samples could provide an objective measure of diets and help to unravel their contribution to disease. Nature News. May 20, 2025 https://www.nature.com/articles/d41586-025-01600-3 - Abar L, Steele EM, Lee SK et al Identification and validation of poly-metabolite scores for diets high in ultra-processed food: An observational study and post-hoc randomized controlled crossover-feeding trial. PLoS Med. 2025 May 20;22(5):e1004560. PMID: 40392756 Free PMC article. Clinical Trial. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004560
  20. Wang C, Du M, Kim H, Nguyen LH et al Ultraprocessed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors Among Women. JAMA Oncol. 2025 Nov 13:e254777. PMID: 41231486 PMCID: PMC12616530 (available on 2026-11-13) https://jamanetwork.com/journals/jamaoncology/fullarticle/2841354
  21. Bonaccio M, Di Castelnuovo A, Costanzo S et al Ultra-processed food and mortality among long-term cancer survivors from the Moli-sani Study: prospective findings and analysis of biological pathways. Cancer Epidemiol Biomarkers Prev. 2026 Feb 4. PMID: 41634927