Ultra-processed food consumption and risk of multiple chronic diseases among 8,819,894 adults from 51 prospective cohorts: a dose-response meta-analysis.

OBJECTIVE: The consumption of ultra-processed foods (UPFs) has increased globally. This study comprehensively investigated the impact of consuming UPFs on the risk of major chronic diseases in adults. SETTING: A systematic search identified prospective cohort studies up to April 2026 on consumption of UPFs and major chronic outcomes. Consumption of UPFs was assessed by food frequency questionnaires (FFQs), 24-hour recalls, or dietary history. PARTICIPANTS: Adults (≥18 years) without restriction to specific clinical conditions at baseline. RESULTS: Fifty-one prospective cohort studies involving 8 819 894 participants were included. Consumption of UPFs was associated with cardiovascular events (Hazard Ratio (HR) 1.24, 95% Confidence Interval (CI) 1.14 to 1.36), cancer (HR 1.12, 95% CI 1.04 to 1.21), obesity/overweight (HR 1.23, 95% CI 1.17 to 1.30), metabolic syndrome (MetS)/diabetes (HR 1.24, 95% CI 1.08 to 1.42), depression/anxiety (HR 1.27, 95% CI 1.15 to 1.40), digestive diseases (HR 1.31, 95% CI 1.16 to 1.48) and all-cause mortality (HR 1.18, 95% CI 1.10 to 1.26). Dose-response analyses showed each additional 100 g/day associated with higher risks of cardiovascular events (HR 1.14, 95% CI 1.06 to 1.22), cancer (HR 1.04, 95% CI 1.02 to 1.06), all-cause mortality (HR 1.03, 95% CI 1.02 to 1.05), and MetS/diabetes (HR 1.02, 95% CI 1.01 to 1.04). CONCLUSIONS: Consuming UPFs was associated with higher risks of multiple chronic diseases and all-cause mortality with low or moderate evidence. Reducing dietary intake of UPFs may therefore be relevant for chronic disease prevention. PROSPERO REGISTRATION NUMBER: CRD42023421092.