Ultra-processed food consumption is linked to an increased risk of chronic respiratory diseases: A systematic review and meta-analysis of prospective cohort studies
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Date
2025
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Mekonnen, T.C.
Shi, Z.
Gebremichael Menota, B.
Melaku, Y.A.
Gill, T.K.
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Clinical Nutrition ESPEN, 2025; 68:647-659
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Tefera Chane Mekonnen, Zumin Shi, Bereket Gebremichael, Yohannes Adama Melaku, Tiffany K. Gill
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Abstract
Background: Chronic respiratory diseases (CRDs) are a leading cause of global mortality, with dietary factors, including ultra-processed food (UPF) consumption, contributing to their burden. The relationship between UPF intake and CRD risk in adults remains unclear. Objectives: This study evaluates epidemiological evidence linking UPF exposure to overall CRD risk and cause-specific respiratory conditions. Methods: A systematic review and meta-analysis were conducted using PubMed, Embase, PsycINFO, Scopus, ProQuest, Web of Science, and Cochrane Library databases, covering studies from 2009 to January 2024. Cohort studies examining UPF exposure and CRD risk were included. Risk of bias was assessed using the National Institute of Health tool, and NutriGrade scoring evaluated the quality of meta-evidence. Adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis. Results: Six cohort studies (k = 18) involving 948,428 participants and 11,341 CRD events were analyzed. Higher UPF exposure was associated with an increased CRD risk but not lung cancer. Each 10 % increase in UPF intake corresponded to a 19 % higher CRD risk (relative risk [RR] = 1.19; 95 % confidence interval [CI]:1.004–1.40; NutriGrade = moderate) but showed no significant association with lung cancer (RR = 1.09; 95 % CI: 0.88–1.38; NutriGrade = very low). Results were consistent across sensitivity analyses. Conclusions: Greater UPF consumption is linked to higher CRD risk, underscoring the need for public health interventions to reduce UPF exposure and mitigate CRD burden. High study heterogeneity highlights the need for further mechanistic research. Systematic review registration: PROSPERO CRD42022345920.
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© 2025 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).