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Ultra-processed foods and human health: an umbrella review and updated meta-analyses of observational evidence.

Dai, Shuhui; Wellens, Judith; Yang, Nan; Li, Doudou; Wang, Jingjing; Wang, Lijuan; Yuan, Shuai; He, Yazhou; Song, Peige; Munger, Ron; Kent, Monique Potvin; MacFarlane, Amanda J.; Mullie, Patrick; Duthie, Susan; Little, Julian; Theodoratou, Evropi; Li, Xue


Shuhui Dai

Judith Wellens

Nan Yang

Doudou Li

Jingjing Wang

Lijuan Wang

Shuai Yuan

Yazhou He

Peige Song

Ron Munger

Monique Potvin Kent

Amanda J. MacFarlane

Patrick Mullie

Julian Little

Evropi Theodoratou

Xue Li


Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.


DAI, S., WELLENS, J., DUTHIE, S., LI, X., et al. 2024. Ultra-processed foods and human health: an umbrella review and updated meta-analyses of observational evidence. Clinical nutrition [online], 43(6), pages 1386-1394. Available from:

Journal Article Type Article
Acceptance Date Apr 11, 2024
Online Publication Date Apr 18, 2024
Publication Date Jun 30, 2024
Deposit Date May 6, 2024
Publicly Available Date May 6, 2024
Journal Clinical Nutrition
Print ISSN 0261-5614
Electronic ISSN 1532-1983
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 43
Issue 6
Pages 1386-1394
Keywords Ultra-processed foods; NOVA classification; Heath outcomes; Meta-analysis; Umbrella review
Public URL
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.


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