Ultra-processed foods and health: a comprehensive review

Abstract

Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.

Keywords:

• Body composition and fat deposition
• cancer
• cardiovascular disease
• characteristics of consumers
• diabetes
• gastrointestinal diseases
• mortality
• nutrient profile and nutrient displacement
• overweight and obesity
• trends
• ultra-processed foods

Authors’ contributions

Concept and design: Zhang, Giovannucci. Drafting of the manuscript: Zhang. Critical revision of the manuscript for important intellectual content: Giovannucci. Obtained funding: Zhang. Supervision: Giovannucci. All authors reviewed and approved the manuscript before submission.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

Dr. Zhang is supported by Irene M. & Fredrick J. Stare Nutrition Education Fund Doctoral Scholarship and Mayer Fund Doctoral Scholarship.