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Research papers on Ultra-processed foods and health

Recent and highly-cited academic work on ultra-processed foods and health, gathered from Semantic Scholar, CrossRef and OpenAlex.

1. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing

   Carlos Augusto Monteiro, Geoffrey Cannon, Jean‐Claude Moubarac, et al. · 2017 · Public Health Nutrition · 2,285 citations

   Given evident multiple threats to food systems and supplies, food security, human health and welfare, the living and physical world and the biosphere, the years 2016-2025 are now designated by the UN as the Decade of Nutrition, in support of the UN Sustainable Development Goals. For these initiatives to succeed, it is necessary to know which foods contribute to health and well-being, and which are unhealthy. The present commentary outlines the NOVA system of food classification based on the nature, extent and purpose of food processing. Evidence that NOVA effectively addresses the quality of diets and their impact on all forms of malnutrition, and also the sustainability of food systems, has

2. Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers

   Phillip Baker, Priscila Machado, Thiago M. Santos, et al. · 2020 · Obesity Reviews · 1,170 citations

   Understanding the drivers and dynamics of global ultra-processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but

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

   Giuditta Pagliai, Monica Dinu, Maria Pia Madarena, et al. · 2020 · British Journal Of Nutrition · 1,045 citations

   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 reg

4. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort

   Thibault Fiolet, Bernard Srour, Laury Sellem, et al. · 2018 · BMJ · 1,021 citations

   OBJECTIVE: To assess the prospective associations between consumption of ultra-processed food and risk of cancer. DESIGN: Population based cohort study. SETTING AND PARTICIPANTS: 104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants' usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. MAIN OUTCOME MEASURES: Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable

5. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé)

   Bernard Srour, Léopold Fezeu, Emmanuelle Kesse‐Guyot, et al. · 2019 · BMJ · 926 citations

   OBJECTIVE: To assess the prospective associations between consumption of ultra-processed foods and risk of cardiovascular diseases. DESIGN: Population based cohort study. SETTING: NutriNet-Santé cohort, France 2009-18. PARTICIPANTS: 105 159 participants aged at least 18 years. Dietary intakes were collected using repeated 24 hour dietary records (5.7 for each participant on average), designed to register participants' usual consumption of 3300 food items. These foods were categorised using the NOVA classification according to degree of processing. MAIN OUTCOME MEASURES: Associations between intake of ultra-processed food and overall risk of cardiovascular, coronary heart, and cerebrovascular

6. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses

   Melissa M. Lane, Elizabeth Gamage, Shutong Du, et al. · 2024 · BMJ · 794 citations

   OBJECTIVE: To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes. DESIGN: Systematic umbrella review of existing meta-analyses. DATA SOURCES: MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing ("class I"),

7. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study

   Anaïs Rico-Campà, Miguel Ángel Martínez‐González, Ismael Álvarez‐Álvarez, et al. · 2019 · BMJ · 539 citations

   OBJECTIVE: To evaluate the association between consumption of ultra-processed foods and all cause mortality. DESIGN: Prospective cohort study. SETTING: Seguimiento Universidad de Navarra (SUN) cohort of university graduates, Spain 1999-2018. PARTICIPANTS: 19 899 participants (12 113 women and 7786 men) aged 20-91 years followed-up every two years between December 1999 and February 2014 for food and drink consumption, classified according to the degree of processing by the NOVA classification, and evaluated through a validated 136 item food frequency questionnaire. MAIN OUTCOME MEASURE: Association between consumption of energy adjusted ultra-processed foods categorised into quarters (low, lo

8. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies

   Xiaojia Chen, Zhang Zhang, Huijie Yang, et al. · 2020 · Nutrition Journal · 515 citations

   BACKGROUND: Consumption of ultra-processed foods (UPFs) plays a potential role in the development of obesity and other diet-related noncommunicable diseases (NCDs), but no studies have systematically focused on this. This study aimed to summarize the evidence for the association between UPFs consumption and health outcomes. METHODS: A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies. Epidemiological studies were included, and identified studies were evaluated for risk of bias.A narrative review of the synthesized findings was provided to assess the association between UPFs consumption and health outcomes. RESULTS: 20 studies (12 cohort

9. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study

   Larissa Galastri Baraldi, Eurídice Martínez Steele, Daniela Silva Canella, et al. · 2018 · BMJ Open · 506 citations

   OBJECTIVES: To compare ultra-processed food consumption across sociodemographic groups and over time (2007-2008, 2009-2010, 2011-2012) in the USA. DESIGN: Cross-sectional study. SETTING: National Health and Nutrition Examination Survey (NHANES) 2007-2012. PARTICIPANTS: All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847). MAIN OUTCOME MEASURES: Average dietary contribution of ultra-processed foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification. DATA ANALYSIS: Linear regression was used to evaluate the

10. Ultra-processed food consumption and excess weight among US adults

    Filippa Juul, Eurídice Martínez Steele, Niyati Parekh, et al. · 2018 · British Journal Of Nutrition · 481 citations

    Ultra-processed foods provide 58 % of energy intake and 89 % of added sugars in the American diet. Nevertheless, the association between ultra-processed foods and excess weight has not been investigated in a US sample. The present investigation therefore aims to examine the association between ultra-processed foods and excess weight in a nationally representative sample of US adults. We performed a cross-sectional analysis of anthropometric and dietary data from 15 977 adults (20-64 years) participating in the National Health and Nutrition Examination Survey 2005-2014. Dietary data were collected by 24-h recall. Height, weight and waist circumference (WC) were measured. Foods were classified

11. Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review

    Caroline S. Costa, Bianca Del‐Ponte, Maria Cecília Formoso Assunção, et al. · 2017 · Public Health Nutrition · 387 citations

    OBJECTIVE: To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence. DESIGN: A systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible. SUBJECTS: Healthy children and adolescents. RESULTS: Twenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat

12. A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

    Mirko Marino, Federica Puppo, Cristian Del Bo’, et al. · 2021 · Nutrients · 321 citations

    A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of

13. Energy contribution of NOVA food groups and sociodemographic determinants of ultra-processed food consumption in the Mexican population

    Joaquín A Marrón-Ponce, Tania G Sánchez-Pimienta, Maria Laura da Costa Louzada, et al. · 2018 · Public Health Nutrition · 192 citations

    AbstractObjectiveTo identify the energy contributions of NOVA food groups in the Mexican diet and the associations between individual sociodemographic characteristics and the energy contribution of ultra-processed foods (UPF).DesignWe classified foods and beverages reported in a 24 h recall according to the NOVA food framework into: (i) unprocessed or minimally processed foods; (ii) processed culinary ingredients; (iii) processed foods; and (iv) UPF. We estimated the energy contribution of each food group and ran a multiple linear regression to identify the associations between sociodemographic characteristics and UPF energy contribution.SettingMexican National Health and Nutrition Survey 20

14. Ultra-processed food consumption and human health: an umbrella review of systematic reviews with meta-analyses

    J. Barbaresko, Janine Bröder, Johanna Conrad, et al. · 2024 · Critical Reviews in Food Science and Nutrition · 45 citations

    Abstract Recently, ultra-processed foods received a lot of attention, but also criticism. Our aim was to provide an overview of the existing evidence of ultra-processed food consumption on human health. We conducted a systematic search in four databases until January 5th, 2024. Systematic reviews with meta-analyses on ultra-processed food consumption as defined by the NOVA classification system were included. The certainty of evidence was evaluated by the GRADE approach. We identified 16 publications. Moderate certainty of evidence was found for all-cause mortality (Summary Risk Ratio per 50 g: 1.02; 95% confidence Interval (CI): 1.01, 1.03), cardiovascular disease incidence and mortality (p

15. Ultra-Processed Food Consumption and Depressive Symptoms in a Mediterranean Cohort

    J. Godos, M. Bonaccio, W. AL-QAHTANI, et al. · 2023 · Nutrients · 37 citations

    Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of this study was to investigate the relationship between the consumption of UPFs and depressive symptoms in a sample of younger Italian adults. A cross-sectional study was conducted on 596 individuals (age 18–35 y) recruited in southern Italy. Food frequency questionnaires and the NOVA classification were used to assess dietary factors; the Center for the Epidemiological Studies of Depressio

16. Consumption of ultra-processed foods and multiple health outcomes: An umbrella study of meta-analyses

    Ziyi Wang, Cuncun Lu, Lu Cui, et al. · 2024 · Food Chemistry · 34 citations

17. The Association Between Ultra-Processed Food Consumption and Chronic Insomnia in the NutriNet-Santé Study

    P. Duquenne, Julia Capperella, L. Fezeu, et al. · 2024 · Journal of the Academy of Nutrition and Dietetics · 23 citations

    Background The consumption of ultra-processed foods (UPF) is on the rise worldwide, and it has been linked to numerous health conditions, such as diabetes, obesity, and cancer. Few studies have focused on the effect of UPF consumption on sleep health and even fewer on chronic insomnia. Objective This study investigated the association between UPF intake and chronic insomnia in a large population-based sample. Design This was a cross-sectional analysis using the NutriNet-Santé study data, an ongoing Web cohort in France. Participants/setting Thirty-eight thousand five hundred seventy adult males and females who had completed a sleep questionnaire (2014) and at least two 24-hour dietary record

18. The risk associated with ultra-processed food intake on depressive symptoms and mental health in older adults: a target trial emulation

    B. Mengist, M. Lotfaliany, Julie A. Pasco, et al. · 2025 · BMC Medicine · 18 citations

    Longitudinal cohort studies across the lifespan suggest an association between ultra-processed food (UPF) and depression. However, the effect of UPF on depression and mental health in older adults has not been determined. Therefore, this study investigated the effect of UPF on depressive symptoms and mental health in community-dwelling older adults. A pragmatic target trial was designed and emulated using the ASPirin in Reducing Events in the Elderly longitudinal data. Participants were community-dwelling older adults (≥ 70 years) in Australia. We specified and emulated the protocol of a two-arm randomised pragmatic clinical trial using the level of UPF consumption as the intervention. Great

19. Ultra-Processed Food Intakes and Health Outcomes in Adults Older Than 60 Years: A Systematic Review

    F. Shahatah, T. R. Hill, A. Fairley, et al. · 2025 · Nutrition Reviews · 13 citations

    Abstract Context Relationships between ultraprocessed food (UPF) intakes and health have been well described in adults, but evidence of these relationships in older adults is rather limited. Demographic shifts in aging emphasize the importance of understanding the role of diet in maintaining health during later life. Objective The aim of this systematic review was to identify health outcomes associated with UPF consumption in those aged ≥60 years. Data Sources The Medline, Web of Science, Scopus, and Embase databases were searched from inception until June 2023, using search terms representing UPF and any health outcome. Observational studies restricted to individuals aged ≥60 years using th

20. Exposure to ultra-processed food and risk of cardiovascular mortality: a prospective cohort study.

    Sarah Gauci, M. Lotfaliany, P. Machado, et al. · 2025 · European journal of preventive cardiology · 12 citations

    AIMS There has been a global shift from nutrient-dense diets to an ultra-processed food pattern, which is linked to adverse health outcomes, including cardiovascular mortality. However, there is limited evidence in an Australian setting. Furthermore, many people in Australia have emigrated from countries with heart-healthy diets. This study explored the association between ultra-processed food exposure and cardiovascular mortality in an Australian cohort. METHOD AND RESULTS Data were derived from the Melbourne Collaborative Cohort Study. Food frequency questionnaire data collected at baseline were used to estimate ultra-processed food consumption according to the Nova classification system

21. Food consumption by NOVA food classification, metabolic outcomes, and barriers to healthy food consumption among university students

    Elizabeth Sekyi, Nana Ama Frimpomaa Agyapong, Guy Eshun · 2024 · Food Science & Nutrition · 10 citations

    AbstractThe NOVA food classification system is a simple tool that can be used to assess the consumption levels of different categories of foods based on their level of processing. The degree to which food is processed has a significant impact on health outcomes. In Ghana, no study exists on the consumption of the different NOVA food groups among tertiary students and how it relates to their metabolic outcomes. This study assessed the frequency of food intake according to the NOVA classification and how they relate to body mass index, waist circumference, and blood pressure. The barriers to the consumption of healthy foods among students were also assessed. This was a cross‐sectional study co

22. Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis

    Alexandra Katidi, Stefania Xanthopoulou, Antonis Vlassopoulos, et al. · 2023 · Nutrients · 10 citations

    Ultra-processed foods’ (UPFs’) consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1–4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of case

23. Ten-year trajectories of ultra-processed food intake and prospective associations with cardiovascular diseases and all-cause mortality: findings from the Whitehall II cohort study

    Mengmei E. Wang, C. LIewellyn, M. Katsoulis, et al. · 2025 · Nutrition Journal · 9 citations

    Ultra-processed food (UPF) intake has been associated with adverse health outcomes; however, research on UPF intake and cardiovascular disease (CVD) prognosis has largely neglected its longitudinal pattern over time. This study investigated trajectories of UPF intake over a decade and their prospective associations with the risk of fatal and non-fatal CVD, as well as all-cause mortality, using data spanning from 16 to 19 years. This study utilized data from the British Whitehall II cohort study, including 7,138 participants (68.3% male; median baseline age 60.4 years), all free of CVD at baseline. Dietary intake was assessed using a validated 127-item food frequency questionnaire at three ti

24. Ultra-processed food consumption and cardiometabolic risk in Canada: a cross-sectional analysis of the Canadian health measures survey

    Angelina Baric, Vasanti S. Malik, Anthea Christoforou · 2025 · Nutrition & Metabolism · 8 citations

    Ultra-processed food (UPF) contributes to nearly 50% of Canadians’ diets. Research in other countries has begun to implicate high intakes of UPFs and negative health outcomes, including body mass index, waist circumference, blood pressure, and unfavourable lipid profiles. There have been no population level examinations of the relationship between UPF consumption and cardiometabolic risk in Canada. Drawing on the Canadian Health Measures Survey (2016/17 and 2018/19), this study investigates the relationship between UPF consumption and cardiometabolic risk factors among Canadians (ages 19–79, n = 6517). Dietary data collected by Food Frequency Questionnaire was classified as UPF or not using