A large analysis pooling 51 prospective cohort studies reported associations between greater consumption of ultra-processed foods (UPFs) and higher risks across multiple chronic conditions and all-cause mortality. The pooled dataset included 8,819,894 participants from studies conducted in the Americas, Europe, Asia, and Oceania. Participants’ average ages across studies ranged from 23 to 77 years, and follow-up periods varied from 2 to 32 years.
Researchers assessed UPF intake using diverse dietary methods, including food-frequency questionnaires, 24-hour dietary recalls, and dietary histories. Compared with lower UPF consumption, higher intake was associated with increased risks in several outcome categories: 24% higher risk of cardiovascular events, 12% higher risk of cancer, 23% higher risk of overweight or obesity, 24% higher risk of metabolic syndrome or diabetes, 27% higher risk of depression or anxiety, 31% higher risk of digestive diseases, and 18% higher risk of death from any cause.
The analysis also examined dose–response relationships. For every additional 100 grams per day of UPFs consumed, the pooled estimates indicated a 14% higher risk of cardiovascular events, 11% higher risk of high blood pressure, 4% higher risk of cancer, 3% higher risk of death from any cause, and 2% higher risk of metabolic syndrome or diabetes. The investigators additionally reported that a 10% increase in weight or energy intake was associated with a 16% higher risk of metabolic syndrome or diabetes.
The authors emphasize that these figures describe associations observed across studies rather than proof of a causal relationship between UPF intake and specific diseases.
The researchers and quoted experts outlined several plausible pathways linking UPF consumption with adverse health outcomes. Nutritional composition is a central concern: many UPFs are relatively high in calories, added sugars, and salt and lower in dietary fiber, protein, vitamins, and minerals compared with minimally processed foods.
Beyond macronutrient and micronutrient profiles, processing introduces additional factors. UPFs frequently contain multiple food additives and preservatives. The analysis discusses a potential “cocktail effect,” in which combined exposure to multiple additives may have interactive or additive biological effects that differ from the effects of individual additives alone. Evidence cited includes cohort and animal studies suggesting certain additive combinations can have greater neurologic or behavioral effects than single agents.
Extensive processing also alters physical and chemical properties of foods in ways that may affect the gut microbiome. Changes to microbial composition could promote chronic inflammation or insulin resistance, mechanisms implicated in cardiometabolic and other systemic diseases. The authors note that additives and preservatives in UPFs may have particularly strong effects on gut bacterial communities.
Compounds formed during high-temperature processing, such as acrylamide and acrolein, are mentioned as potentially relevant to cardiovascular disease and cancer risk. Packaging-related contaminants, including microplastics, are also raised as a possible contributor to disease, although quantifying the relative contribution of packaging, additives, nutrient loss, and macronutrient composition remains challenging.
The authors state that processing can reduce beneficial nutrients and that some commonly used additives may influence physiologic pathways — for example, evidence that certain artificial sweeteners can affect platelet aggregation and clotting. However, they caution that UPF is a heterogeneous category: products vary widely in additives, processing methods, and packaging, which complicates efforts to isolate the effects of any single factor.
The analysis highlights several limitations that affect interpretation. All included studies relied on participants’ dietary assessments, such as food-frequency questionnaires and recalls, which are subject to recall bias and measurement error. These methods can make precise quantification of UPF intake difficult.
Studies in the pooled analysis excluded people younger than 18, so the findings cannot be generalized to children or adolescents. In addition, people who consume higher levels of UPFs may differ from lower consumers in other lifestyle factors that contribute to disease risk (for example, physical activity, smoking, socioeconomic factors), and included studies may not fully account for residual confounding. Consequently, the observed associations do not establish causation.
The authors also note heterogeneity across studies in how UPF exposure was measured and across the types of UPFs consumed, the additives present, and processing and packaging practices. This heterogeneity limits the ability to pinpoint mechanisms or the degree to which specific components of UPFs drive observed associations.
These findings add weight to an expanding literature linking higher UPF consumption to worse long-term health outcomes. While causality is not established, the authors and experts cited recommend reducing UPF consumption as a prudent public-health and clinical strategy.
At the individual level, that recommendation translates to emphasizing minimally processed alternatives such as vegetables, fruits, legumes, whole grains, nuts, seeds, and other whole foods, and to considering the frequency and quantity of UPFs in overall dietary patterns. The analysis suggests that replacing UPFs with minimally processed foods may be relevant for chronic disease prevention and primary care counseling.
The authors also point out practical challenges: most countries lack clear labeling to identify foods as ultra-processed, and UPFs span a broad range of products with differing risk profiles. The study highlights the need for more research that can better differentiate the contributions of additives, processing-generated compounds, packaging contaminants, and nutrient composition to long-term disease risk, and for studies designed to test causal pathways.
In summary, higher intake of ultra-processed foods was associated with a range of increased health risks across multiple organ systems in this large pooled analysis, but limitations inherent to observational dietary research mean further study is required to clarify causation and mechanisms.