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The Impact of Ultra-Processed Food Consumption on Health

초가공식품 섭취가 건강에 미치는 영향

  • Ha Eun Ryu (Department of Family Medicine, Yongin Severance Hospital) ;
  • Min-Young Nam (Department of Family Medicine, Yongin Severance Hospital) ;
  • Yu-Jin Kwon (Department of Family Medicine, Yongin Severance Hospital)
  • 류하은 (용인세브란스병원 가정의학과) ;
  • 남민영 (용인세브란스병원 가정의학과) ;
  • 권유진 (용인세브란스병원 가정의학과)
  • Received : 2024.04.13
  • Accepted : 2024.06.16
  • Published : 2024.06.30

Abstract

Ultra-processed foods, falling under group 4 of the Nova classification system, are manufactured from processed food ingredients such as oils, fats, sugars, starch, and protein isolates, containing minimal to no whole food. They commonly incorporate flavorings, colorings, emulsifiers, and various cosmetic additives to enhance their palatability. Ultra-processed foods have become increasingly prevalent in contemporary society owing to their convenience, affordability, extended shelf life, and enhanced taste and aroma through additives. This surge in the consumption of ultra-processed foods has sparked discussions regarding its adverse health effects. Numerous studies have highlighted that an increased intake of ultra-processed foods elevates the risk of metabolic disorders, such as cardiovascular diseases, obesity, and diabetes, along with an increased risk of various cancers. Moreover, its association with an increased mortality risk underscores the importance of recognizing that opting for these foods based solely on taste and convenience is risky. Thus, by recognizing dietary habits as modifiable factors that can prevent health issues, maintaining a balanced diet with diverse nutrient intakes is crucial for overall health. Therefore, raising awareness and understanding of ultra-processed food consumption can significantly contribute to promoting healthy lifestyles.

Keywords

References

  1. Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr 2019;22:936-41. https://doi.org/10.1017/S1368980018003762
  2. Baker P, Machado P, Santos T, et al. Ultra-processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers. Obes Rev 2020;21:e13126.
  3. Wang Z, Lu C, Cui L, et al. Consumption of ultra-processed foods and multiple health outcomes: an umbrella study of meta-analyses. Food Chem 2024;434:137460.
  4. Barbaresko J, Broder J, Conrad J, Szczerba E, Lang A, Schlesinger S. Ultra-processed food consumption and human health: an umbrella review of systematic reviews with meta-analyses. Crit Rev Food Sci Nutr 2024. doi: 10.1080/10408398.2024.2317877. [Epub ahead of print]
  5. Monteiro CA, Cannon G, Levy R, et al. NOVA. The star shines bright. World Nutr 2016;7:28-38.
  6. Henney AE, Gillespie CS, Alam U, Hydes TJ, Boyland E, Cuthbertson DJ. Ultra-processed food and non-communicable diseases in the United Kingdom: a narrative review and thematic synthesis of literature. Obes Rev 2024;25:e13682.
  7. Davidou S, Christodoulou A, Fardet A, Frank K. The holistico-reductionist Siga classification according to the degree of food processing: an evaluation of ultra-processed foods in French supermarkets. Food Funct 2020;11:2026-39. https://doi.org/10.1039/C9FO02271F
  8. Marino M, Puppo F, Del Bo' C, et al. A systematic review of worldwide consumption of ultra-processed foods: findings and criticisms. Nutrients 2021;13:2778.
  9. Juul F, Vaidean G, Parekh N. Ultra-processed foods and cardiovascular diseases: potential mechanisms of action. Adv Nutr 2021;12:1673-80. https://doi.org/10.1093/advances/nmab049
  10. Kim L, Choi YH, Huh DA, Moon KW. Associations of minimally processed and ultra-processed food intakes with cardiovascular health in Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013-2015. J Expo Sci Environ Epidemiol 2024. doi: 10.1038/s41370-024-00646-1. [Epub ahead of print]
  11. Zhang Z, Jackson SL, Steele EM, Gillespie C, Yang Q. Relationship between ultraprocessed food intake and cardiovascular health among U.S. adolescents: results from the National Health and Nutrition Examination Survey 2007-2018. J Adolesc Health 2022;70:249-57.
  12. Juul F, Vaidean G, Lin Y, Deierlein AL, Parekh N. Ultra-processed foods and incident cardiovascular disease in the Framingham Offspring Study. J Am Coll Cardiol 2021;77:1520-31. https://doi.org/10.1016/j.jacc.2021.01.047
  13. Zhong GC, Gu HT, Peng Y, et al. Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study. Int J Behav Nutr Phys Act 2021;18:21.
  14. Chen X, Chu J, Hu W, et al. Associations of ultra-processed food consumption with cardiovascular disease and all-cause mortality: UK Biobank. Eur J Public Health 2022;32:779-85. https://doi.org/10.1093/eurpub/ckac104
  15. Yuan L, Hu H, Li T, et al. Dose-response meta-analysis of ultra-processed food with the risk of cardiovascular events and all-cause mortality: evidence from prospective cohort studies. Food Funct 2023;14:2586-96. https://doi.org/10.1039/D2FO02628G
  16. Qu Y, Hu W, Huang J, et al. Ultra-processed food consumption and risk of cardiovascular events: a systematic review and dose-response meta-analysis. EClinicalMedicine 2024;69:102484.
  17. Du S, Kim H, Rebholz CM. Higher ultra-processed food consumption is associated with increased risk of incident coronary artery disease in the atherosclerosis risk in communities study. J Nutr 2021;151:3746-54. https://doi.org/10.1093/jn/nxab285
  18. Guo L, Li F, Tang G, et al. Association of ultra-processed foods consumption with risk of cardio-cerebrovascular disease: a systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2023;33:2076-88. https://doi.org/10.1016/j.numecd.2023.07.005
  19. Romero Ferreiro C, Martin-Arriscado Arroba C, Cancelas Navia P, Lora Pablos D, Gomez de la Camara A. Ultra-processed food intake and all-cause mortality: DRECE cohort study. Public Health Nutr 2022;25:1854-63. https://doi.org/10.1017/S1368980021003256
  20. Suksatan W, Moradi S, Naeini F, et al. Ultra-processed food consumption and adult mortality risk: a systematic review and dose-response meta-analysis of 207,291 participants. Nutrients 2021;14:174.
  21. Pagliai G, Dinu M, Madarena MP, Bonaccio M, Iacoviello L, Sofi F. Consumption of ultra-processed foods and health status: a systematic review and meta-analysis. Br J Nutr 2021;125:308-18. https://doi.org/10.1017/S0007114520002688
  22. Torres-Collado L, Rychter A, Gonzalez-Palacios S, et al. A high consumption of ultra-processed foods is associated with higher total mortality in an adult Mediterranean population. Clin Nutr 2024;43:739-46. https://doi.org/10.1016/j.clnu.2024.01.014
  23. Taneri PE, Wehrli F, Roa-Diaz ZM, et al. Association between ultra-processed food intake and all-cause mortality: a systematic review and meta-analysis. Am J Epidemiol 2022;191:1323-35. https://doi.org/10.1093/aje/kwac039
  24. Dehghan M, Mente A, Rangarajan S, et al. Ultra-processed foods and mortality: analysis from the Prospective Urban and Rural Epidemiology study. Am J Clin Nutr 2023;117:55-63. https://doi.org/10.1016/j.ajcnut.2022.10.014
  25. Bonaccio M, Costanzo S, Di Castelnuovo A, et al. Ultra-processed food intake and all-cause and cause-specific mortality in individuals with cardiovascular disease: the Moli-sani Study. Eur Heart J 2022;43:213-24. https://doi.org/10.1093/eurheartj/ehab783
  26. Zhao Y, Chen W, Li J, et al. Ultra-processed food consumption and mortality: three cohort studies in the United States and United Kingdom. Am J Prev Med 2024;66:315-23. https://doi.org/10.1016/j.amepre.2023.09.005
  27. World Health Organization (WHO). Physical status: the use of and interpretation of anthropometry, report of a WHO expert committee. Geneva: WHO; 1995. p. 1-452.
  28. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894:i-xii, 1-253.
  29. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63. https://doi.org/10.1016/S0140-6736(03)15268-3
  30. World Health Organization (WHO). The Asia-Pacific perspective: redefining obesity and its treatment. Geneva: WHO; 2000.
  31. Dicken SJ, Batterham RL. Ultra-processed food and obesity: what is the evidence? Curr Nutr Rep 2024;13:23-38. https://doi.org/10.1007/s13668-024-00517-z
  32. Askari M, Heshmati J, Shahinfar H, Tripathi N, Daneshzad E. Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies. Int J Obes (Lond) 2020;44:2080-91. https://doi.org/10.1038/s41366-020-00650-z
  33. Moradi S, Entezari MH, Mohammadi H, et al. Ultra-processed food consumption and adult obesity risk: a systematic review and dose-response meta-analysis. Crit Rev Food Sci Nutr 2023;63:249-60.
  34. Lane MM, Davis JA, Beattie S, et al. Ultraprocessed food and chronic noncommunicable diseases: a systematic review and meta-analysis of 43 observational studies. Obes Rev 2021;22:e13146.
  35. Rauber F, Chang K, Vamos EP, et al. Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank. Eur J Nutr 2021;60:2169-80. https://doi.org/10.1007/s00394-020-02367-1
  36. De Amicis R, Mambrini SP, Pellizzari M, et al. Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review. Eur J Nutr 2022;61:2297-311. https://doi.org/10.1007/s00394-022-02873-4
  37. Petridi E, Karatzi K, Magriplis E, Charidemou E, Philippou E, Zampelas A. The impact of ultra-processed foods on obesity and cardiometabolic comorbidities in children and adolescents: a systematic review. Nutr Rev 2024;82:913-28. https://doi.org/10.1093/nutrit/nuad095
  38. Cordova R, Kliemann N, Huybrechts I, et al. Consumption of ultra-processed foods associated with weight gain and obesity in adults: a multi-national cohort study. Clin Nutr 2021;40:5079-88. https://doi.org/10.1016/j.clnu.2021.08.009
  39. Beslay M, Srour B, Mejean C, et al. Ultra-processed food intake in association with BMI change and risk of overweight and obesity: a prospective analysis of the French NutriNet-Sante cohort. PLoS Med 2020;17:e1003256.
  40. Moradi S, Hojjati Kermani MA, Bagheri R, et al. Ultra-processed food consumption and adult diabetes risk: a systematic review and dose-response meta-analysis. Nutrients 2021;13:4410.
  41. Levy RB, Rauber F, Chang K, et al. Ultra-processed food consumption and type 2 diabetes incidence: a prospective cohort study. Clin Nutr 2021;40:3608-14. https://doi.org/10.1016/j.clnu.2020.12.018
  42. Duan MJ, Vinke PC, Navis G, Corpeleijn E, Dekker LH. Ultraprocessed food and incident type 2 diabetes: studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort. BMC Med 2022;20:7.
  43. Delpino FM, Figueiredo LM, Bielemann RM, et al. Ultraprocessed food and risk of type 2 diabetes: a systematic review and meta-analysis of longitudinal studies. Int J Epidemiol 2022;51:1120-41. https://doi.org/10.1093/ije/dyab247
  44. Lv JL, Wei YF, Sun JN, et al. Ultra-processed food consumption and metabolic disease risk: an umbrella review of systematic reviews with meta-analyses of observational studies. Front Nutr 2024;11:1306310.
  45. Paula WO, Patriota ESO, Goncalves VSS, Pizato N. Maternal consumption of ultra-processed foods-rich diet and perinatal outcomes: a systematic review and meta-analysis. Nutrients 2022;14:3242.
  46. Chen Z, Khandpur N, Desjardins C, et al. Ultra-processed food consumption and risk of type 2 diabetes: three large prospective U.S. cohort studies. Diabetes Care 2023;46:1335-44. https://doi.org/10.2337/dc22-1993
  47. Cho Y, Ryu S, Kim R, Shin MJ, Oh H. Ultra-processed food intake and risk oftype 2 diabetes in Korean adults. J Nutr 2024;154:243-51. https://doi.org/10.1016/j.tjnut.2023.11.021
  48. Chang K, Gunter MJ, Rauber F, et al. Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank. EClinicalMedicine 2023;56:101840.
  49. Lian Y, Wang GP, Chen GQ, Chen HN, Zhang GY. Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis. Front Nutr 2023;10:1175994.
  50. Caceres-Matos R, Castro-Mendez A, Garcia-Dominguez M, Pabon-Carrasco D, Pabon-Carrasco M. The influence of ultraprocessed food on colorectal cancer: a systematic review. Gastrointest Disord 2024;6:164-79.
  51. da Silva Scaranni PO, Cardoso LO, Chor D, et al. Ultraprocessed foods, changes in blood pressure and incidence of hypertension: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr 2021;24:3352-60. https://doi.org/10.1017/S136898002100094X
  52. Wang M, Du X, Huang W, Xu Y. Ultra-processed foods consumption increases the risk of hypertension in adults: a systematic review and meta-analysis. Am J Hypertens 2022;35:892-901. https://doi.org/10.1093/ajh/hpac069
  53. Tan LJ, Hwang SB, Shin S. The longitudinal effect of ultraprocessed food on the development of dyslipidemia/obesity as assessed by the NOVA system and food compass score. Mol Nutr Food Res 2023;67:e2300003.
  54. Mozaffarian D, El-Abbadi NH, O'Hearn M, et al. Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nat Food 2021;2:809-18. https://doi.org/10.1038/s43016-021-00381-y
  55. Mozaffarian D, El-Abbadi NH, O'Hearn M, et al. Author Correction: Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nat Food 2022;3:664.
  56. da Silva Scaranni PO, de Oliveira Cardoso L, Griep RH, Lotufo PA, Barreto SM, da Fonseca MJM. Consumption of ultra-processed foods and incidence of dyslipidemias: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Br J Nutr 2022. doi: 10.1017/S0007114522001131. [Epub ahead of print]
  57. Donat-Vargas C, Sandoval-Insausti H, Rey-Garcia J, et al. High consumption of ultra-processed food is associated with incident dyslipidemia: a prospective study of older adults. J Nutr 2021;151:2390-8. https://doi.org/10.1093/jn/nxab118
  58. Mehrabani S, Shoaei N, Shateri Z, et al. Consumption of ultraprocessed foods could influence the metabolic syndrome odds: a cross-sectional study. Food Sci Nutr 2024;12:2567-77.
  59. Zhao L, Clay-Gilmour A, Zhang J, Zhang X, Steck SE. Higher ultra-processed food intake is associated with adverse liver outcomes: a prospective cohort study of UK Biobank participants. Am J Clin Nutr 2024;119:49-57. https://doi.org/10.1016/j.ajcnut.2023.10.014
  60. Henney AE, Gillespie CS, Alam U, Hydes TJ, Cuthbertson DJ. Ultra-processed food intake is associated with non-alcoholic fatty liver disease in adults: a systematic review and metaanalysis. Nutrients 2023;15:2266.
  61. Narula N, Chang NH, Mohammad D, et al. Food processing and risk of inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2023;21:2483-95.e1.
  62. Lane MM, Gamage E, Du S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384:e077310.
  63. Srour B, Kordahi MC, Bonazzi E, Deschasaux-Tanguy M, Touvier M, Chassaing B. Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. Lancet Gastroenterol Hepatol 2022;7:1128-40. https://doi.org/10.1016/S2468-1253(22)00169-8
  64. Tobias DK, Hall KD. Eliminate or reformulate ultra-processed foods? Biological mechanisms matter. Cell Metab 2021;33:2314-5. https://doi.org/10.1016/j.cmet.2021.10.005
  65. Martini D, Godos J, Bonaccio M, Vitaglione P, Grosso G. Ultraprocessed foods and nutritional dietary profile: a meta-analysis of nationally representative samples. Nutrients 2021;13:3390.
  66. Machado P, Cediel G, Woods J, et al. Evaluating intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. Eur J Nutr 2022;61:1801-12. https://doi.org/10.1007/s00394-021-02740-8
  67. Coletro HN, Bressan J, Diniz AP, et al. Habitual polyphenol intake of foods according to NOVA classification: implications of ultra-processed foods intake (CUME study). Int J Food Sci Nutr 2023;74:338-49.
  68. Martinez Steele E, Monteiro CA. Association between dietary share of ultra-processed foods and urinary concentrations of phytoestrogens in the US. Nutrients 2017;9:209.
  69. Fardet A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food Funct 2016;7:2338-46. https://doi.org/10.1039/C6FO00107F
  70. Debras C, Chazelas E, Srour B, et al. Artificial sweeteners and cancer risk: results from the NutriNet-Sante population-based cohort study. PLoS Med 2022;19:e1003950.
  71. Debras C, Chazelas E, Sellem L, et al. Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Sante cohort. BMJ 2022;378:e071204.
  72. Suez J, Cohen Y, Valdes-Mas R, et al. Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance. Cell 2022;185:3307-28.e19. https://doi.org/10.1016/j.cell.2022.07.016
  73. Bettini S, Boutet-Robinet E, Cartier C, et al. Food-grade TiO2 impairs intestinal and systemic immune homeostasis, initiates preneoplastic lesions and promotes aberrant crypt development in the rat colon. Sci Rep 2017;7:40373.
  74. Srour B, Chazelas E, Druesne-Pecollo N, et al. Dietary exposure to nitrites and nitrates in association with type 2 diabetes risk: results from the NutriNet-Sante population-based cohort study. PLoS Med 2023;20:e1004149.
  75. Chassaing B, Compher C, Bonhomme B, et al. Randomized controlled-feeding study of dietary emulsifier carboxymethylcellulose reveals detrimental impacts on the gut microbiota and metabolome. Gastroenterology 2022;162:743-56. https://doi.org/10.1053/j.gastro.2021.11.006
  76. Lane M, Howland G, West M, et al. The effect of ultra-processed very low-energy diets on gut microbiota and metabolic outcomes in individuals with obesity: a systematic literature review. Obes Res Clin Pract 2020;14:197-204. https://doi.org/10.1016/j.orcp.2020.04.006
  77. World Health Organization (WHO). Use of non-sugar sweeteners: WHO guideline. Geneva: WHO; 2023.
  78. Riboli E, Beland FA, Lachenmeier DW, et al. Carcinogenicity of aspartame, methyleugenol, and isoeugenol. Lancet Oncol 2023;24:848-50. https://doi.org/10.1016/S1470-2045(23)00341-8
  79. Chazelas E, Druesne-Pecollo N, Esseddik Y, et al. Exposure to food additive mixtures in 106,000 French adults from the NutriNet-Sante cohort. Sci Rep 2021;11:19680.
  80. Martinez Steele E, Buckley JP, Monteiro CA. Ultra-processed food consumption and exposure to acrylamide in a nationally representative sample of the US population aged 6 years and older. Prev Med 2023;174:107598.
  81. Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metab 2019;30:67-77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
  82. Fazzino TL, Courville AB, Guo J, Hall KD. Ad libitum meal energy intake is positively influenced by energy density, eating rate and hyper-palatable food across four dietary patterns. Nat Food 2023;4:144-7. https://doi.org/10.1038/s43016-022-00688-4
  83. Adams J, Hofman K, Moubarac JC, Thow AM. Public health response to ultra-processed food and drinks. BMJ 2020;369:m2391.