Who hasn't been tempted by supermarket aisles full of cookies, chips and other snackable treats, or lured by the ease of prepackaged meals?

But those highly processed foods come at a cost to your health. Consistent evidence shows diets high in ultra-processed foodare associated with an increased risk of 32 damaging health outcomes, according to a new review of 45 meta-analyses.

The research, published in The BMJ journal Wednesday,

https://www.bmj.com/content/384/bmj-2023-077310

found higher exposure to these foods can be harmful to health in a variety of ways, including higher risk for cancer, major heart and lung conditions, gastrointestinal issues, obesity, type 2 diabetes, sleep issues, mental health disorders and early death.

Ultra-processed foods, which "undergo multiple industrial processes and often contain colors, emulsifiers, flavors, and other additives," a news release explains, include products such as:

• Packaged baked goods and snacks
• Carbonated soft drinks
• Sugary cereals
• Instant noodles
• Other ready-to-eat or ready-to-heat meals

"These products also tend to be high in added sugar, fat, and/or salt, but are low in vitamins and (fiber)," the release notes.

Just how much do these foods increase your health risk? It depends. The authors organized their findings based on the strength of evidence for different issues. 

For example, they found "convincing" evidence that higher intake of ultra-processed foods was associated with 50% increased risk of cardiovascular disease-related death, a 48% to 53% higher risk of anxiety and common mental disorders, and a 12% greater risk of type 2 diabetes. "Highly suggestive" evidence indicated a 21% greater risk of death from any cause; a 40% to 66% increased risk of heart disease-related death, obesity, type 2 diabetes and sleep problems; and a 22% increased risk of depression.

However, evidence of a potential connection to asthma and gastrointestinal health, for example — while still showing a association between ultra-processed foods and adverse health outcomes — remains more limited.

Previous research has pointed to the negative health affects and addictive qualityof processed foods, but this research provides a broad review of evidence in this area by incorporating the findings of dozens of studies all published in the past three years with nearly 10 million participants total. 

"Undertaking such a comprehensive review has the potential to enhance our understanding of these associations and provide valuable insights for better informing public health policies and strategies," the authors write. 

The findings could also serve as a wake-up call for consumers in the United States and other high-income countries, where ultra-processed foods account for up to 58% of total daily calorie consumption, the review points out. 

"Notably, over recent decades, the availability and variety of ultra-processed products sold has substantially and rapidly increased in countries across diverse economic development levels," the authors write.

They urge officials to prioritize public health through steps like front-of-the-pack food labelsand economic policies that make fresh and minimally-processed foods more accessible and affordable.

From www.medscape.com

Abstract

ObjectiveTo evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.

DesignSystematic umbrella review of existing meta-analyses.

Data sourcesMEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.

Eligibility criteria for selecting studiesSystematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality.

ResultsThe search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.

ConclusionsGreater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research.

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