Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta-analysis of 43 observational studies
Corresponding Author
Melissa M. Lane
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Correspondence
Melissa Lane, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.
Email: [email protected]
Search for more papers by this authorJessica A. Davis
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorSally Beattie
The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia
Search for more papers by this authorClara Gómez-Donoso
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Search for more papers by this authorAmy Loughman
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorAdrienne O'Neil
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorFelice Jacka
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
Black Dog Institute, Randwick, New South Wales, Australia
College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
Search for more papers by this authorMichael Berk
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorRichard Page
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia
School of Medicine, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorWolfgang Marx
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorTetyana Rocks
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorCorresponding Author
Melissa M. Lane
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Correspondence
Melissa Lane, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.
Email: [email protected]
Search for more papers by this authorJessica A. Davis
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorSally Beattie
The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia
Search for more papers by this authorClara Gómez-Donoso
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Search for more papers by this authorAmy Loughman
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorAdrienne O'Neil
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorFelice Jacka
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
Black Dog Institute, Randwick, New South Wales, Australia
College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
Search for more papers by this authorMichael Berk
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorRichard Page
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia
School of Medicine, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorWolfgang Marx
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorTetyana Rocks
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorWolfgang Marx and Tetyana Rocks share senior authorship.
Summary
This systematic review and meta-analysis investigated the association between consumption of ultraprocessed food and noncommunicable disease risk, morbidity and mortality. Forty-three observational studies were included (N = 891,723): 21 cross-sectional, 19 prospective, two case-control and one conducted both a prospective and cross-sectional analysis. Meta-analysis demonstrated consumption of ultraprocessed food was associated with increased risk of overweight (odds ratio: 1.36; 95% confidence interval [CI], 1.23-1.51; P < 0.001), obesity (odds ratio: 1.51; 95% CI, 1.34-1.70; P < 0.001), abdominal obesity (odds ratio: 1.49; 95% CI, 1.34-1.66; P < 0.0001), all-cause mortality (hazard ratio: 1.28; 95% CI, 1.11-1.48; P = 0.001), metabolic syndrome (odds ratio: 1.81; 95% CI, 1.12-2.93; P = 0.015) and depression in adults (hazard ratio: 1.22; 95% CI, 1.16-1.28, P < 0.001) as well as wheezing (odds ratio: 1.40; 95% CI, 1.27-1.55; P < 0.001) but not asthma in adolescents (odds ratio: 1.20; 95% CI, 0.99-1.46; P = 0.065). In addition, consumption of ultraprocessed food was associated with cardiometabolic diseases, frailty, irritable bowel syndrome, functional dyspepsia and cancer (breast and overall) in adults while also being associated with metabolic syndrome in adolescents and dyslipidaemia in children. Although links between ultraprocessed food consumption and some intermediate risk factors in adults were also highlighted, further studies are required to more clearly define associations in children and adolescents.
Study registration
Prospero ID: CRD42020176752.
Supporting Information
| Filename | Description |
|---|---|
| obr13146-sup-0001-Figure_S1.pdfPDF document, 127 KB |
Figure S1: PRIMSA flowchart |
| obr13146-sup-0002-Figure_S2.zipapplication/x-zip-compressed, 283.3 KB |
Figure S2: Search terms |
| obr13146-sup-0003-Figure_S3.tifTIFF image, 6.8 MB |
Figure S3: Forest plot of meta-analysis for consumption of ultra-processed food and risk of abdominal obesity |
| obr13146-sup-0004-Figure_S4.tifTIFF image, 6.5 MB |
Figure S4: Forest plot of meta-analysis for consumption of ultra-processed food and risk of all-cause mortality |
| obr13146-sup-0005-Figure_S5.tifTIFF image, 6.2 MB |
Figure S5: Forest plot of meta-analysis for consumption of ultra-processed food and risk of metabolic syndrome |
| obr13146-sup-0006-Figure_S6.tifTIFF image, 8 MB |
Figure S6: Forest plot of meta-analysis for consumption of ultra-processed food and risk of depression |
| obr13146-sup-0007-Figure_S7.tifTIFF image, 7.4 MB |
Figure S7: Forest plot of meta-analysis for consumption of ultra-processed food and risk of wheezing |
| obr13146-sup-0008-Figure_S8.tifTIFF image, 7.4 MB |
Figure S8: Forest plot of meta-analysis for consumption of ultra-processed food and risk of wheezing |
| obr13146-sup-0009-Table_S1-S7.docxWord 2007 document , 215 KB |
Table S1: Details of exposure variable and average ultra-processed food consumption across studies according to chronic disease and population Table S2: Study characteristics and key findings for overweight and obesity separated by age (children, adolescents and adults) Table S3: Study characteristics and key findings for all-cause mortality in adults Table S4: Study characteristics and key findings for metabolic diseases separated by age (adolescents and adults) Table S5: Study characteristics and key findings for depression, frailty, functional gastrointestinal disorders and respiratory diseases separated by age (children, adolescents and adults) Table S6: Study characteristics and key findings for cardiovascular diseases and risk factors separated by age (children, adolescents and adults) Table S7: Study characteristics and key findings for cancer in adults |
| obr13146-sup-0010-Table_S8-S10.docxWord 2007 document , 25.1 KB |
Table S8: Critical Appraisal Checklist for Cohort Studies Table S9: Critical Appraisal Checklist for Cross-Sectional Studies Table S10: Critical Appraisal Checklist for Case-Control Studies |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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