Ultra-processed foods and risk of all-cause mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies.

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews Pub Date : 2025-03-03 DOI:10.1186/s13643-025-02800-8

Shuming Liang, Yesheng Zhou, Qian Zhang, Shuang Yu, Shanshan Wu

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引用次数: 0

Abstract

Background: Ultra-processed food (UPF) consumption has been steadily increasing globally, yet the associated risk of all-cause mortality remains unclear. We aimed to assess the risk of all-cause mortality of UPFs via an updated systematic review and dose-response meta-analysis.

Methods: A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library for studies published until July 2, 2024, in addition to referred studies included in the previous systematic review. Prospective cohort studies assessing the association between NOVA classification-defined UPF consumption and all-cause mortality were included. Dose-response meta-analysis via a random-effect model was used to combine the results with hazard ratio (HR) as an effect measure.

Results: Overall, 18 studies with 1,148,387 participants (173,107 deaths) were identified. Compared to the lowest, participants with the highest UPF consumption had a 15% increased risk of all-cause mortality (HR = 1.15, 95% CI 1.09-1.22; I² = 83.0%). Furthermore, a 10% higher risk of all-cause mortality was detected with each 10% increment in UPF consumption (HR = 1.10, 95% CI 1.04-1.16; I² = 91.0%). Dose-response analysis showed a positive linear association (P_{dose-response} < 0.001). Moreover, subgroups and sensitivity analyses indicated consistent findings, while meta-regression analyses suggested sex distributions partially explained heterogeneity, with a higher risk of all-cause mortality in males.

Conclusions: Our updated meta-analysis, incorporating a greater number of newly published cohort studies using NOVA classification with the largest sample size to date, strengthens the evidence linking higher UPF consumption to increased all-cause mortality risk. Strategies such as dietary guidelines and policies for limiting UPF consumption worldwide should be encouraged.

Systematic review registration: PROSPERO CRD42023467226.

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来源期刊

Systematic Reviews Medicine-Medicine (miscellaneous)

CiteScore

8.30

自引率

0.00%

发文量

241

审稿时长

11 weeks

期刊介绍： Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.