Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence

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作   者：

Kent M.P.;  MacFarlane A.J.;  Mullie P.;  Duthie S.;  Little J.;  Theodoratou E.;  Li X.;  Dai S.;  Wellens J.;  Yang N.;  Li D.;  Wang J.;  Wang L.;  Yuan S.;  He Y.;  Song P.;  Munger R.; 

作者机构：

School of Public Health Zhengzhou University;  School of Public Health and Women's Hospital Zhejiang University School of Medicine;  Nutrition Research Division Health Canada;  Centre for Global Health Usher Institute University of Edinburgh;  School of Epidemiology and Public Health Faculty of Medicine University of Ottawa;  School of Pharmacy and Life Sciences The Robert Gordon University;  West China School of Public Health and West China Fourth Hospital Sichuan University;  Department of Nutrition and Food Sciences and the Center for Epidemiologic Studies Utah State;  International Prevention Research Institute;  Department of Big Data in Health Science School of Public Health Center of Clinical Big Data and;  Translational Gastro-Intestinal Unit Nuffield Department of Medicine John Radcliffe Hospital; 

关键词：

Heath outcomes;  NOVA classification;  Ultra-processed foods;  Umbrella review;  Meta-analysis; 

期刊名称：

Clinical nutrition

i s s n：

0261-5614

年卷期：

2024 年 43 卷 6 期

页   码：

1386-1394

页   码：

摘   要：

? 2024 The Author(s)Background & aims: Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. Methods: We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. Results: This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. Conclusions: High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.