According to a new study published in the American Journal of Preventive Medicine, a higher intake of ultra-processed foods is linked to higher risks for CVD and all-cause mortality. “The analysis included 41,070 adults in the National Health and Nutrition Examination Survey (1999-2018), 208,051 adults from the UK Biobank database (2006-2010) and 108,714 adults from the United States in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (1993-2001). The researchers collected dietary data from questionnaires and used the NOVA system to classify foods based on their level of processing.”
The researchers “found that higher intake of ultra-processed foods was linked to a higher risk for CVD mortality and all-cause mortality, and several metabolic pathways played mediating roles.” “[T]hose with the highest intake of ultra-processed foods experienced a 17% increase in CVD mortality and a 16% increase in all-cause mortality compared with those who had the lowest intake.”
The researchers “also found that biomarkers of inflammation had the most significant mediating effects on CVD mortality (29.2%) and biomarkers of liver function had the most significant mediating effects on all-cause mortality (20.3%).”
“The proportion of the associations mediated by biological pathways of renal function, liver function, inflammation, lipid metabolism, and glucose metabolism ranged from 12.4% to 20.3% for all-cause mortality and 18% to 29.2% for CVD mortality,” they wrote.
“It is worth mentioning that the mediation effect of liver function biomarkers in the association of [ultra-processed food] consumption and mortality was proposed for the first time, an association which is supported by previously studied links of [ultra-processed food] consumption with higher levels of nonalcoholic fatty liver disease (NAFLD)-related biomarkers and increased risk of NAFLD.”
However, in this study, consumption of ultra-processed foods was not linked to cancer mortality risk.
This finding is in contrast to recent findings from a meta-analysis and systematic review that evaluated the association of ultra-processed foods and cancer risk published in the journal Frontiers in Nutrition. These authors reported that: “high UPFs consumption is associated with a significantly increased risk of certain site-specific cancers, especially the digestive tract and some hormone-related cancers. However, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.” (Lian et al., 2023).
Another meta-analysis published in 2023 in the journal Clinical Nutrition that evaluated associations between the consumption of ultra-processed foods and cancer risk concluded the following: “the available suggestive evidence shows a consistent significant association between intake of UPF and the risk of overall and several cancers, including colorectal-, breast- and pancreatic cancer. These data may inform updated dietary guidelines, policy makers and the public towards improving public health.” (Isaksen et al., 2023)
Finally, a European study that was part of the EPIC cohort study and published in the journal Lancet Planetary Health this year found that, the substitution of 10% of ultra-processed foods with 10% of minimally processed food was associated with a reduced risk of head and neck cancers, colon cancer, and hepatocellular carcinoma (i.e., malignant hepatoma or liver cancer). “Most of these associations remained significant when models were additionally adjusted for BMI, alcohol and dietary intake and quality.” (Kliemann et al., 2023)

With regard to the new findings by Zhao et al. (2023) published in the American Journal of Preventive Medicine (AJPM), Farzaneh Daghigh, PhD, Professor of biochemistry, Director of culinary medicine course, Philadelphia College of Osteopathic Medicine observes that:
“These findings corroborate the existing epidemiological evidence regarding the detrimental impact of ultra-processed foods on health, especially concerning mortality and the risk of cardiovascular disease. This article is part of a growing body of literature that has consistently warned the public about the connection between ultra-processed food consumption and the development of noncommunicable diseases.
The substitution of ultra-processed foods with unprocessed or minimally processed foods has been linked to a notable reduction in mortality risk, underscoring its pivotal role in public health strategies. This highlights the pressing need for the development of fresh nutritional policies and guidelines aimed at curbing ultra-processed food intake while promoting the consumption of healthier, less processed and whole foods. Prioritizing unprocessed foods in dietary choices is imperative in order to alleviate the financial and health care burden associated with preventable diseases.”

If you have not read the book: Ultra-Processed People: The Science Behind Food That Is Not Food (2023) by Chris van Tulleken, MD, check it out at:

To learn more about what individual countries around the world are doing to promote healthful food systems, including the use of fiscal policies (e.g., front of package nutrient warning labelling and food taxes), see: The Global Food Research Program, which works to reduce diet-related disparities and create more healthful food systems and food environments.
Global Food Research Program, University of North Carolina – Chapel Hill: Global Map on Healthful Food Policies/Regulations
https://www.globalfoodresearchprogram.org/
References
Zhao Y, Chen W, Li J, Yi J, Song X, Ni Y, Zhu S, Zhang Z, Xia L, Zhang J, Yang S, Ni J, Lu H, Wang Z, Nie S, Liu L. Ultra-processed food consumption and mortality: three cohort studies in the United States and United Kingdom. American Journal of Preventive Medicine. 2023; S0749-3797(23)00351-3. doi: 10.1016/j.amepre.2023.09.005.
Bascom E. Study shows link between ultraprocessed foods and mortality risk. Healo Primary Care. September 20, 2023. Available at: https://www.healio.com/news/primary-care/20230920/study-shows-link-between-ultraprocessed-foods-and-mortality-risk
Lian Y, Wang G-P, Chen G-Q, et al. Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis. Frontiers in Nutrition. 2023; 10: https://doi.org/10.3389/fnut.2023.1175994
Isaksen IM, Dankel SN. Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis. Clinical Nutrition. 2023;42(6):919-928. doi: 10.1016/j.clnu.2023.03.018
Kliemann N, Rauber F, Bertazzi Levy R, et al. Food processing and cancer risk in Europe: results from the prospective EPIC cohort study. Lancet Planetary Health. 2023;7(3):e219-e232. doi: 10.1016/S2542-5196(23)00021-9.















