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Review
. 2021 Dec 30;14(1):174.
doi: 10.3390/nu14010174.

Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants

Wanich Suksatan  1 , Sajjad Moradi  2   3 , Fatemeh Naeini  4 , Reza Bagheri  5 , Hamed Mohammadi  4 , Sepide Talebi  4 , Sanaz Mehrabani  6 , Mohammad Ali Hojjati Kermani  7 , Katsuhiko Suzuki  8
Affiliations
Review

Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants

Wanich Suksatan et al. Nutrients. .

Abstract

We performed a systematic review and dose-response meta-analysis of observational studies assessing the association between UPF consumption and adult mortality risk. A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE, and Scopus electronic databases from inception to August 2021. Data were extracted from seven cohort studies (totaling 207,291 adults from four countries). Using a random-effects model, hazard ratios (HR) of pooled outcomes were estimated. Our results showed that UPF consumption was related to an enhanced risk of all-cause mortality (HR = 1.21; 95% CI: 1.13, 1.30; I2 = 21.9%; p < 0.001), cardiovascular diseases (CVDs)-cause mortality (HR = 1.50; 95% CI: 1.37, 1.63; I2 = 0.0%; p < 0.001), and heart-cause mortality (HR = 1.66; 95% CI: 1.50, 1.85; I2 = 0.0%; p = 0.022), but not cancer-cause mortality. Furthermore, our findings revealed that each 10% increase in UPF consumption in daily calorie intake was associated with a 15% higher risk of all-cause mortality (OR = 1.15; 95% CI: 1.09, 1.21; I2 = 0.0%; p < 0.001). The dose-response analysis revealed a positive linear association between UPF consumption and all-cause mortality (Pnonlinearity = 0.879, Pdose-response = p < 0.001), CVDs-cause mortality (Pnonlinearity = 0.868, Pdose-response = p < 0.001), and heart-cause mortality (Pnonlinearity = 0.774, Pdose-response = p < 0.001). It seems that higher consumption of UPF is significantly associated with an enhanced risk of adult mortality. Despite this, further experimental studies are necessary to draw a more definite conclusion.

Keywords: dose–response; meta-analysis; mortality risk; systematic review; ultra-processed food.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the process of the study selection.
Figure 2
Figure 2
Forest plots demonstrating OR and 95% CI of pooled results from the random effects models to evaluate the relationship between ultra-processed food consumption and risk of mortality: (A) all-cause, (B) CVD-cause, (C) heart-cause, and (D) cancer-cause. The study-specific HR and 95 % CI are represented by black squares and horizontal lines, respectively; the area of the grey square is proportional to the specific-study weight to the overall meta-analysis. The center of the open diamond and the vertical dashed line represent the pooled HR, and its width represents the pooled 95 % CI.
Figure 2
Figure 2
Forest plots demonstrating OR and 95% CI of pooled results from the random effects models to evaluate the relationship between ultra-processed food consumption and risk of mortality: (A) all-cause, (B) CVD-cause, (C) heart-cause, and (D) cancer-cause. The study-specific HR and 95 % CI are represented by black squares and horizontal lines, respectively; the area of the grey square is proportional to the specific-study weight to the overall meta-analysis. The center of the open diamond and the vertical dashed line represent the pooled HR, and its width represents the pooled 95 % CI.
Figure 3
Figure 3
Forest plots showing the linear dose–response meta-analysis of mortality risk for 10% change in ultra-processed food consumption in daily intake. The study-specific HR and 95 % CI are represented by black squares and horizontal lines, respectively; the area of the grey square is proportional to the specific-study weight to the overall meta-analysis. The center of the open diamond and the vertical dashed line represent the pooled HR, and its width represents the pooled 95 % CI.
Figure 4
Figure 4
Dose–response association between ultra-processed food consumption and risk of mortality: (A) all-cause, (B) CVD-cause, (C) heart-cause, and (D) cancer-cause. It has been revised.
Figure 4
Figure 4
Dose–response association between ultra-processed food consumption and risk of mortality: (A) all-cause, (B) CVD-cause, (C) heart-cause, and (D) cancer-cause. It has been revised.
Figure 5
Figure 5
Forest plots showing sensitivity analysis results.
Figure 6
Figure 6
Funnel plot for evaluation publication bias.
See this image and copyright information in PMC

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