Ultra-processed foods associated with worse health and lower Vitamin D - several studies

---

Ultra-processed food and adverse health outcomes – BMJ meta-analysis Jan 2024

Credible increased risk of 9 health problems (a subset of table)

Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses
BMJ 2024;384:e077310 http://dx.doi.org/10.1136/bmj-2023-077310
Melissa M Lane,1 Elizabeth Gamage,1 Shutong Du,2,3 Deborah N Ashtree,1 Amelia J McGuinness,1 Sarah Gauci,1,4 Phillip Baker,5 Mark Lawrence,6 Casey M Rebholz,2,3 Bernard Srour,7 Mathilde Touvier,7 Felice N Jacka,1,8,9 Adrienne O’Neil,1 Toby Segasby,10 Wolfgang Marx1

WHAT THIS STUDY ADDS

• This umbrella review found consistent evidence of a higher risk of adverse health outcomes associated with greater ultra-processed food exposure Convincing and highly suggestive evidence (classes I and II) related to early death and adverse cardiometabolic and mental health
• These findings support urgent mechanistic research and public health actions that seek to target and minimise ultra-processed food consumption for improved population health

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”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality.

RESULTS
The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non­dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I)

WHAT IS ALREADY KNOWN ON THIS TOPIC
Multiple meta-analyses have aimed to consolidate original epidemiological research investigating associations between ultra-processed food and adverse health outcomes
However, no comprehensive umbrella review has been conducted to provide a broad perspective and evaluate the meta-analytic evidence in this area supported direct associations between greater ultra- processed food exposure and higher risks of incident

• cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and
• type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of
• prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined
• common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low).

Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident

• all cause mortality (risk ratio 1.21, 1.15 to 1.27; low),
• heart disease-related mortality (hazard ratio 1.66, 1.51 to 1.84; low),
• type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and
• depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent
• adverse sleep-related outcomes (odds ratio 1.41, 1.24 to 1.61; low),
• wheezing (risk ratio 1.40, 1.27 to 1.55; low), and
• obesity (odds ratio 1.55, 1.36 to 1.77; low).

Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V).
Overall, using the GRADE framework,

• 22 pooled analyses were rated as low quality, with
• 19 rated as very low quality and
• 4 rated as moderate quality.

CONCLUSIONS
Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research.
 Download the PDF from VitaminDWiki

---

The Perils of Ultra-processed foods (article and book) - July 2023

The Perils of Highly Processed Food

• "In the new book “Ultra-Processed People” (Norton), the British doctor and medical journalist Chris van Tulleken bravely turns himself into a" guinea pig to explore the ins and outs of ultra-processed food (U.P.F.)—basically, food made up of substances that you would never find at home.
• ...."he reports of his U.P.F. diet. “But at the same time, I was no longer enjoying it. Meals took on a uniformity: everything seemed similar, regardless of whether it was sweet or savoury. I was never hungry. But I was also never satisfied.” He gained weight, and so did his family: “It was impossible to stop the kids from eating my Coco Pops, slices of pizza, oven chips, lasagne, chocolate.” Sacrificing his health for science’s sake, he drinks a can of Diet Coke every morning for breakfast “and gradually began craving Diet Coke with every meal and between meals.”
• ..."we seek out the now hard-to-find, tart, low-sugar heirloom Winesap, and regard the Honeycrisp as a sensory lie of another kind, a poisoned apple. "
• "Technical names can make the familiar seem alien. We’d be put off if something were described as a concoction of luteolin, hydroxytyrosol, apigenin, oleic acid, and oleocanthal—but they’re all natural components of your extra-virgin olive oil."

Amazon Books include:

• Ultra-Processed People: The Science Behind Food That Isn't Food $15 Kindle June 2023
• Summary of Ultra-Processed People: A guide to Chris van Tulleken’s book: The Science Behind the Food That Isn't Food $3 Kindle June 2023

---

VitaminDWiki - Ultra-processed food consumption: 2X increased risk of vitamin D deficiency – Dec 2023

---

Ultra-processed foods increase the risk of metabolic syndromes - Jan 2024

Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study
Food Science & Nutrition January 2024 https://doi.org/10.1002/fsn3.3938
Sanaz Mehrabani, Niloofar Shoaei, Zainab Shateri, Moein Askarpour, Mehran Nouri, Parisa Keshani, Behnam Honarvar, Reza Homayounfar

Metabolic syndrome (MetS) prevalence has augmented globally during recent decades. Over the past years, the consumption of ultra-processed foods (UPFs) has grown significantly worldwide. So, the present research investigated the association between UPFs and MetS in an Iranian sample. This cross-sectional research was conducted on people (n = 8841) in the Fasa cohort study, Fars province, Iran. The participants' dietary consumption over a year, UPF consumption, and MetS diagnosis were evaluated through a 125-item modified food frequency questionnaire, the NOVA food group classification, and the Adult Treatment Panel III of the National Cholesterol Education Program, respectively. The association between the quartiles (Q) of UPF intake and the odds of MetS was estimated using the backward LR method of multivariate analysis.
In the multivariate model, after adjusting potential confounders, the association between UPF intake and the

• odds of MetS was significant (Q4: odds ratio (OR = 3.27; 95% confidence interval (CI): 2.76–3.89). Also, the
• odds of increasing triglycerides (TG), blood pressure, and fasting blood sugar (FBS) and decreasing high-density lipoprotein cholesterol (HDL-C) were significantly higher in the last quartile compared to the first quartile of UPFs (TG: OR = 1.71; 95% CI: 1.49–1.97,
• blood pressure: OR = 1.53; 95% CI: 1.30–1.79,
• FBS: OR = 1.30; 95% CI: 1.10–1.54, and
• HDL-C: OR = 1.22; 95% CI: 1.08–1.39).

The current research found a relationship between UPF intake and MetS and its components, indicating a diet-containing UPFs can be related to the occurrence of noncommunicable diseases.
 Download the PDF from VitaminDWiki

---

Increased Ultra-processed foods increase risks of Cancer and CVD by 9% - Lancet Dec 2023

Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
Lancet Regional Health Europe VOL 35, 100771, DEC 2023 DOI:https://doi.org/10.1016/j.lanepe.2023.100771

Background
It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes.
Methods
This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases.
Findings
After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.
Interpretation
Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.
 Download the PDF from VitaminDWiki

---

Ultra-processed foods can be as addictive as cocaine or smoking - Feb 2024

https://childrenshealthdefense.org/defender/ultra-processed-foods-disease-early-death-rtk/Hundreds of Studies Confirm: Ultra-Processed Foods Linked to Higher Risk of Disease, Early Death Childrens Health Defense

• " Today, more than half of our calories come from ultra-processed foods."
• "Research shows that Americans are among those who eat the most ultra-processed food in the world. In 2018, 57% of calories that the average American ate came from ultra-processed foods, up from 53.5% in 2002."

---

Perplexity AI on ultra-processed foods - March 2024

Definition of ultra-processed foods

Ultra-processed foods are industrially manufactured food products made from substances extracted from foods or synthesized from other organic compounds. These foods are characterized by high amounts of sugar, oils, fats, salt, and other additives such as preservatives, colorings, and flavorings. They are designed to be highly profitable, convenient, and hyper-palatable, often with long shelf lives and sophisticated packaging 3 .

• Examples of ultra-processed foods include frozen meals, soft drinks, hot dogs, cold cuts, fast food, packaged cookies, cakes, and salty snacks 1 .
• These foods are distinct from unprocessed or minimally processed foods, which are whole foods with their vitamins and nutrients intact and may be altered only by removal of inedible parts, drying, crushing, roasting, boiling, freezing, or pasteurization to make them safe to consume and suitable to store 1 .
• The NOVA food classification system categorizes foods into four groups, with ultra-processed foods being one of them. This system focuses on the extent and purpose of food processing rather than food types or nutrients 3.
• Consumption of ultra-processed foods has been associated with higher risks of
  • obesity,
  • type 2 diabetes,
  • cardiovascular diseases, and
  • certain types of cancer.
• Studies suggest that limiting the intake of ultra-processed foods may be an effective strategy for preventing and treating obesity and other health issues 1 3.

References, images, videos

---

Describe UP foods in as few words as possible

Ultra-processed foods are industrially made products with

• numerous ingredients, including added sugars, fats, and artificial additives,
• designed for convenience and long shelf-life,
• often lacking nutritional value 1 3 .

References, images, videos

---

How do ultra-processed foods affect gut health?

Ultra-processed foods (UPFs) negatively impact gut health by altering the gut microbiota, leading to inflammation and increasing the risk of chronic diseases. High consumption of UPFs is associated with changes in the composition of gut microbiota, favoring the development of inflammation. This inflammation is linked to a range of non-communicable diseases, including cancer, diabetes, and cardiovascular diseases 1 3.
UPFs often contain ingredients that can disrupt the gut microbiome, such as emulsifiers and artificial sweeteners, which may alter the microbiota composition and promote gut inflammation 1.
Additionally, diets high in UPFs are associated with lower adherence to healthier dietary patterns, like the Mediterranean diet, and can lead to an increase in energy intake and obesity, further exacerbating gut health issues 2.
The consumption of UPFs is also linked to higher levels of harmful chemicals like phthalates and bisphenols, which can further impact gut health and overall well-being 1 .
References, images, videos