Association between ultra-processed foods consumption and systemic immune-inflammation biomarkers in US Adults: Cross-Sectional results from NHANES 2003–2023

Objective: To assess the consumption of ultra-processed food and sugar-sweetened beverages and to identify the association of this consumption with overweight among vegetarians. Methods: A cross-sectional study with a convenience sampling method was conducted. Data were collected using an online questionnaire from 8/24/2015 to 10/8/2015. Subjects were male and female vegetarians aged >16 years. Using a food frequency questionnaire, we assessed the weekly consumption of ultra-processed food and sugar-sweetened beverages and described the frequency of daily consumption overall and according to type of vegetarianism. The association between overweight and excessive daily intake of ultra-processed food was analyzed by multiple logistic regression (OR [95CI%]). Results: Information was retrieved from 503 individuals (29.8±8.5 years old); 83.7% were women. The most frequent types of vegetarianism in our sample were ovo-lacto (45.5%) and vegan (41.7%), and the median time of vegetarianism was 5.3 years. The consumption of sugar-sweetened beverages (≥2x/day) and ultra-processed food (≥3x/day) was 21.0% and 16.0%, respectively, and regarding the different vegetarianism types, vegans showed the lowest frequency of excessive daily sugar-sweetened beverages and ultra-processed food consumption. In the multivariable analysis, consumption of ultra-processed food ≥3x/day (2.33 [1.36-4.03]), male sex (1.73 [1.01-2.96]), age ≥35 years (2.03 [1.23-3.36]) and not preparing one’s food (1.67 [0.95-2.94]) were independently associated with overweight. Conclusion: Although vegetarianism is frequently associated with a healthier diet and, consequently, prevention of poor health outcomes, this study found that the excessive consumption of sugar-sweetened beverages and ultra-processed food was associated with overweight.

Background: Many low- and middle-income countries are now facing the “double burden” of malnutrition, one of them is overweight/obesity. Over 340 million children and adolescents were overweight and obesity in 2016. Obesity among adolescents may increase, in part due to changes in the food system, which now offers a wide range of ultra-processed foods (UPF) that minimize preparation time. Indonesia has also a large and rapidly growing market for unhealthy drinks, which are sold in various places including schools and hospitals.
 Objective: This study aimed to investigate the association of UPF and beverages consumption and other related factors with nutritional status of senior high school students in Pontianak, West Kalimantan, Indonesia.
 Methods: This cross-sectional study conducted in Pontianak investigated the association between UPF consumption and nutritional status of SHS students. Data collection was conducted at Imanuel and Petrus SHS Pontianak in June 2023, involving 273 students from grades 10th and 11th. Weight and height measurement was obtained for calculating the BMI for age Z-scores, while UPF and beverages consumption was obtained by FFQ. Structured questionnaire, 24-hours recall, and IPAQ-S were used for assessing sociodemographic status, Total Energy Intake and Physical Activity Level. Data analysis used SPSS version 26.
 Results: The result found 40.3% of students were overweight-obesity; 51.6% consumed excessive UPF and beverages. It showed an inverse association between UPF consumption and nutritional status. The study identifies UPF and beverages consumption, gender, mother's education level, and family income as factors associated with nutritional status among adolescents.
 Conclusion: The consumption of ultra-processed Foods was high, with the highest UPF intake came from snacks and sweets (22.4%). There was inverse association between UPF and beverages consumption with nutritional status. There was also significant association between UPF and beverages, gender, mother education level and family income with nutritional status.

Impact of Fortified Ultra-Processed Foods on Risk of Anemia: A New Perspective for Pediatric Nutrition

Predictors of ultra-processed foods consumption in 4-year-old Spanish children.

Ultra-processed food (UPF) consumption has been linked to increased risks of negative health outcomes such as type 2 diabetes, obesity, and all-cause mortality. Some studies have shown an increase of UPF consumption with acculturation, whereas the influence of the Western diet on non-US born individuals is an area of increasing interest. The aim of this work was to investigate UPF consumption with an acculturation index and to assess whether there was an interaction of UPF consumption with race/ethnicity in non-US born adults. Dietary intake of non-US born adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018 was assessed using day one of 24-h dietary recall, and the relative daily energy intake comprised of UPFs was used as the outcome of interest. The effect of acculturation assessed by an acculturation index (AcI) on UPF consumption was investigated after controlling for significant covariates. Complex survey sample regression analyses were used to evaluate the association between UPF consumption and AcI. Population sample (n = 3,639) was comprised of non-US born adults (50% male) between 19 and 70 (43.1 ± 0.40) years of age. Of the adults assessed, 42.2% had lower AcI scores of 0 to 2, whereas 57.8% were more accultured (AcI scores of 3-5). Overall, dietary energy from UPFs was about 43.3%. When controlling for co-variates, acculturation was significantly associated with UPF consumption (β = 0.03, s.e. = 0.004, p < 0.001), meaning that for every unit increase in AcI score, there was a 3 % increase in mean UPF consumption. When the interaction between AcI and race/ethnicity was assessed, there was no difference in the impact of AcI on UPF consumption among race/ethnicity groups (p = 0.052). Our findings indicate that greater acculturation is associated with higher UPF consumption. Given the links between high UPF consumption and adverse health outcomes, targeted interventions that promote healthier dietary choices-while preserving culturally relevant eating habits-are essential to support the well-being of non-US born populations.

This study aimed to examine the interactions between ultraprocessed food (UPF) consumption and genetic predisposition with the risk of gout. This prospective cohort study analysed 181 559 individuals from the UK Biobank study who were free of gout at baseline. UPF was defined according to the NOVA classification. Assessment of genetic predisposition for gout was developed from a genetic risk score of 33 single nucleotide polymorphisms. Cox proportional hazards were used to estimate the associations between UPF consumption, genetic predisposition and the risk of gout. Among the 181 559 individuals in the study, 1558 patients developed gout over 1 648 167 person-years of follow-up. In the multivariable adjustment model, compared with the lowest quartile of UPF consumption, the hazard ratio (HR) and 95% CI of the highest UPF consumption was 1.16 (1.01, 1.33) for gout risk, and there was a non-linear correlation between UPF consumption and the development of gout. In substitution analyses, replacing 20% of the weight of UPF in the daily intake with an equal amount of unprocessed or minimally processed food resulted in a 13% lower risk of gout (HR: 0.87; 95% CI: 0.79, 0.95). In the joint-effect analysis, the HR (95% CI) for gout was 1.90 (1.39, 2.60) in participants with high genetic predisposition and high UPF consumption, compared with those with low genetic predisposition and low UPF consumption. In summary, UPF consumption was found to be associated with a higher risk of gout, particularly in those participants with genetic predisposition to gout. Our study indicated that reducing UPF consumption is crucial for gout prevention.

BackgroundAlterations in the gastrointestinal (GI) microbiome (i.e., dysbiosis) are a feature of systemic sclerosis (SSc). Diet is a known modifier of the GI microbiome, and ultra-processed food (UPF) consumption has been associated with adverse changes in GI microbial composition. This study aimed to determine whether UPF consumption affects the GI microbiota and GI symptoms in patients with SSc.MethodsAdult SSc patients provided stool samples and completed both the Diet History Questionnaire II (DHQ-2) and the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument (GIT 2.0). Shotgun metagenomics were performed using the Illumina NovaSeq 6000 with a target depth of 10 million 150x2 sequences per sample. UPF items (N=54) on the DHQ-2 were identified using the NOVA scale of food classification, and UPF intake was calculated as gram-per-week consumption according to patient reported frequency. General linear models were created to identify differentially abundant species based on UPF consumption and to evaluate the relationship between UPF consumption and GI symptoms as measured by the GIT 2.0. These models adjusted for body mass index (BMI), current proton pump inhibitor (PPI) use, current probiotic use, current or prior immunomodulatory therapy, and presence of small intestinal bacterial overgrowth (SIBO).ResultsOf the 65 total SSc patients included, 84.6% were female. The mean age was 53.83 ± 13.19 years, and the mean BMI was 25.25 ± 4.75. The median UPF consumption was 2395.82 g/week. Increased UPF consumption was significantly associated with increased GI symptoms in our multivariate model (β=0.34; p<0.01). Among 257 species analyzed, 5 bacterial species were significantly associated with UPF consumption in the multivariate models, including Limosilactobacillus fermentum (β=0.32; p<0.01) and Faecalicatena fissicatena (β= -0.36; p-value<0.01), while the abundance of 6 bacterial species was significantly associated with GI symptom severity after adjusting for the aforementioned covariates.ConclusionsSSc patients reporting a higher UPF consumption demonstrated alterations in GI microbial composition as well as increased GI symptoms, even after adjusting for factors known to affect the microbiota of patients with SSc. Future studies are needed to determine whether interventions aimed at lowering UPF consumption may improve GI outcomes for patients with SSc.

Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis

Introduction: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives: To characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption. Methods: The National Health and Nutrition Examination Survey (NHANES) is an annual, cross-sectional survey representative of the US population. We examined NHANES dietary data, combining years in which AAs were over-sampled (2011-2018). We included 2,404 AAs ≥ 18 years old with valid 24-hour dietary recall data. Using day 1 dietary recalls, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. This framework classifies foods from any culture based on degree of industrial processing. Acculturation was characterized by nativity, nativity/years in the US, home language, and an acculturation index (based on a sum of levels related to nativity/years in the US and home language). We assessed the relationship between each acculturation measure and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality. All analyses accounted for the complex survey design. Results: Among all AAs, the percentage of caloric intake attributable to UPFs was 39.3% (95% CI: 38.1-40.5). In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5-17.5; p&lt;0.05) greater among those with the highest vs. lowest acculturation index score, 12% (95% CI: 8.5-14.7: p&lt;0.05) greater among those who speak English only vs. non-English only in the home, 12% (95% CI: 8.6-14.7: p&lt;0.05) greater among US-born vs. foreign-born AAs, and 15% (95% CI: 10.7-18.3: p&lt;0.05) greater among US-born vs. foreign-born AAs with less than ten years in the US. Conclusions: Among AAs, UPF consumption was common, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research is necessary to characterize trends in dietary patterns across disaggregated AA subgroups to better inform culturally tailored dietary interventions.

Background: Global ultra-processed food (UPF) consumption has risen rapidly. The development and prognosis of depression and anxiety remain unclarified. Herein, we aimed to examine the association between UPF consumption and the incidence and progression trajectory of depression and anxiety. Methods: In our study, participants were recruited between 2006 and 2010. UPF consumption was expressed as UPF servings, energy ratio, and weight ratio. The relationships between UPF consumption and depression or anxiety were assessed using the Cox proportional hazards model. Multi-state models were used to explore the association between UPF consumption and the risks of all transitions from a healthy state to depression or anxiety and then to all-cause mortality. Results: Among the 183 474 participants, 5453 were diagnosed with depression and 6763 with anxiety during the follow-up of 13.1 years. The participants in the highest quartile (Q4) of UPF servings, energy ratio, and weight ratio had an increased risk of depression compared to those in the lowest quartile (Q1), with hazard ratios (HRs) and 95% confidence intervals [CIs] of 1.22 (1.13-1.31), 1.13 (1.05-1.22), and 1.26 (1.17-1.36), respectively. Similarly, participants in Q4 of UPF consumption had a higher risk of anxiety, with HRs (95% CIs) of 1.13 (1.06-1.21), 1.13 (1.05-1.21), and 1.11 (1.04-1.19), compared to those in Q1. The study also found a significant association between UPF consumption and all-cause mortality, which disappeared for participants with depression or anxiety. Conclusions: Our findings revealed that UPF consumption is associated with depression or anxiety.

Study question Is men’s ultra-processed food (UPF) consumption associated with conventional semen quality parameters? Summary answer UPF consumption is unrelated to semen quality parameters among men attending a fertility clinic. What is known already In the USA, UPF comprise more than half of all calories consumed, rising from 51% in 2003 to 54% in 2018 constituting a significant and growing component of the global food supply. Several recent studies have reported an association between UPF consumption and several chronic diseases such as obesity, diabetes, and cardiovascular diseases, among others, however, their impact on semen quality has been scarcely studied. Study design, size, duration We analyzed the relation between UPF intake and semen quality in samples collected for clinical purposes among men who enrolled in the Environment and Reproductive Health (EARTH) study, which enrolled couples seeking fertility care at an academic medical center in Boston (Massachusetts, USA) between 2007 and 2019. Participants/materials, setting, methods 343 men provided a total of 896 semen samples (mean=2.15 semen samples). A 131-item food frequency questionnaire assessed men’s diet, and the NOVA classification system were used to estimate the UPF consumption. Semen volume, total sperm count, sperm concentration, total motility, progressive motility, and normal morphology were set as the main outcomes. Multivariable generalized linear mixed models were used to estimate the associations between UPF consumption, in quartiles, and semen quality parameters. Main results and the role of chance Median (P25, P75) age and BMI was 36.0 (33.6, 38.6) years and 27.0 (24.3, 28.9) kg/m2, respectively. The median consumption of UPF in the study population as 5.7 (4.2, 7.7) servings per day. In general, the UPF consumption was not related to any of the sperm quality parameters examined. The mean differences (95% confidence intervals) between the lowest (reference quartile) and the highest quartile of UPF consumption were: -0.23 mL (-0.63, 0.16) for ejaculate volume, 0.25 x106 sperm (-0.46, 0.95) for total sperm count, 0.34 x106 sperm/mL (-0.36, 1.04) for sperm concentration, 1.54% (-5.61, 8.68) for total motility, 1.66% (-2.94, 6.26) for progressive motility, and 0.28% (-0.73, 1.29) for normal morphology. These associations were adjusted by age, education, BMI, physical activity, ethnicity, smoking status, sexual abstinence and the remaining NOVA groups (unprocessed or minimally processed foods or NOVA1, processed culinary ingredients or NOVA2, and processed foods or NOVA3). Limitations, reasons for caution Our population includes men from a fertility center, so the findings may not be directly translated to the general population. The observational nature of the study limits causality inference. We did not explore possible changes in diet over time, because diet was only assessed once. Wider implications of the findings While we did not find associations between the consumption of UPF and semen quality parameters, due to the rising consumption and heterogeneity of UPF worldwide, further studies regarding the role of UPF in reproductive health would be worthwhile and recommended. Trial registration number No

To investigate the relationship between ultra-processed food (UPF) consumption and dental caries in adolescents. Data from 996 adolescents aged 12-13 years who participated in an oral health sub-study of the 2004 Pelotas Birth Cohort in southern Brazil were analysed. The main exposure was daily UPF consumption at age 10-11 years, measured by a food frequency questionnaire containing 24 UPF items defined based on the NOVA system. UPF consumption was calculated in frequency, grams and calories, in general and for six types of food (biscuits, savoury snacks and sugar-sweetened cereals; ultra-processed meats and fats; sweets; fast food and instant noodles; soft drinks and artificially flavoured drinks; and sweetened milk and powdered chocolate). The outcome was dental caries, measured according to the decayed, missing and filled indexes (DMFS and dmfs) at age 12-13 years. Poisson regression models were used to analyse the association between UPF consumption and dental caries, adjusting for socioeconomic and demographic variables, dental visits and oral hygiene. Overall, the daily UPF consumption in frequency, grams and calories was associated with caries. The findings were consistent for UPF consumption for all six food groups. The higher the UPF consumption, the higher the probability of having caries in adolescence. The associations between ultra-processed meats and fats, and fast food and instant noodles intake with dental caries alert to the cariogenic potential of such UPF foods. Ultra-processed food consumption was associated with greater caries burdens in young adolescents. The findings reinforce the need for interventions and public policies to reduce UPF consumption in adolescence.

BackgroundUltra-processed food (UPF) consumption is rising globally, posing significant health and environmental risks. While studies have extensively examined ultra-processed food (UPF) consumption, they often overlook the factors influencing awareness and behavioral shifts toward sustainable and healthy eating. This study aims to examine the relationship between UPF consumption, carbon footprint awareness, and sustainable and healthy eating behaviors in adults.MethodsThis cross-sectional study was conducted with 1748 adults aged 18–65 years. Participants’ Eating Behaviors and awareness levels were assessed using three validated scales: the Sustainable and Healthy Eating Behaviors Scale (SHEBS), the Highly Processed Food Consumption Screening Questionnaire (sQ-HPF), and the Carbon Footprint Awareness Scale (CFAS). Pearson correlation and Linear regression analyses were used to assess associations.ResultsThe mean age of participants was 29.4 ± 12.16 years and 55.7% had high UPF consumption. Participants’ general characteristics were assessed through a questionnaire.Pearson correlation analyses revealed that UPF consumption (sQ-HPF score) was negatively correlated with carbon footprint awareness (CFAS) (r = -0.184, p < 0.001) and sustainable and healthy eating behaviors (SHEBS) (r =-0.296, p < 0.001). A strong positive correlation was observed between CFAS and SHEBS scores (r = 0.653, p < 0.001), including all SHEBS sub-dimensions (r = 0.325–0.911, p < 0.001). Linear regression analysis indicated that age (β = -0.293), CFAS (β = -0.264), and SHEBS (β=-0.230) significantly predicted UPF consumption (R²=0.373, p < 0.001). Furthermore, CFAS was predicted by SHEBS (β = 0.658) and UPF consumption (β = -0.141) (R² = 0.672), while SHEBS was predicted by CFAS (β = 0.644) and UPF consumption (β = -0.142) (R² = 0.680, p < 0.001).ConclusionsUPF consumption is inversely associated with both carbon footprint awareness and sustainable, healthy eating behaviors. Strengthening environmental awareness and promoting sustainable eating practices may be effective strategies for reducing UPF intake in adults. These findings underscore the importance of integrative public health efforts targeting both nutritional and environmental dimensions.

The joint associations of physical activity and ultra-processed food consumption with depression: A cohort study in the UK Biobank

Associations between ultra-processed food consumption and kidney function in an older adult population with metabolic syndrome