Association between ultra-processed foods consumption and systemic immune-inflammation biomarkers in US Adults: Cross-Sectional results from NHANES 2003–2023

Abstract

Background

Limited studies have directly linked ultra-processed foods (UPFs) consumption to immunity. This study investigated the association between UPFs intake and systemic immune-inflammation biomarkers in US adults.

Methods

This cross-sectional study included 34,016 participants from NHANES (2003–2023). Biomarkers related to complete blood cells and high-density lipoprotein (HDL), including systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-high-density lipoprotein ratio (NHR), lymphocyte-to-HDL ratio (LHR), monocyte-to-HDL ratio (MHR), and platelet-to-HDL ratio (PHR). The percentage of energy from UPFs (%Kcal) was determined. Weighted linear regression models were used to evaluate the associations between UPFs intake and these biomarkers. Subgroup and sensitivity analyses were also performed to verify the consistency of the results.

Results

The mean %Kcal UPFs was 48.82 % with the standard deviation (SD) of 19.05 %. Crude and adjusted models confirmed positive correlations between UPFs consumption and biomarkers. After adjusting for various confounders, per SD increase in %Kcal UPFs was significantly associated with the increases of 12.595 in SII, 0.027 in SIRI, 0.035 in NLR, 0.148 in NHR, 0.044 in LHR, 5.980 in PHR, and 0.014 in MHR (all P < 0.0001). No significant associations were observed for PLR and LMR. Consistent positive results were found in quartile analysis and sensitivity analyses. Subgroup analysis revealed that alcohol and tobacco use may interact with UPFs intake to affect HDL-based biomarkers.

Conclusions

High UPFs intake was associated with elevated levels of immune-inflammation biomarkers in the general healthy population, highlighting the need to promote natural dietary patterns and reduce UPFs consumption.