{"title":"超加工食品和全因死亡风险：前瞻性队列研究的最新系统评价和剂量反应荟萃分析。","authors":"Shuming Liang, Yesheng Zhou, Qian Zhang, Shuang Yu, Shanshan Wu","doi":"10.1186/s13643-025-02800-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup> = 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; I<sup>2</sup> = 91.0%). Dose-response analysis showed a positive linear association (P<sub>dose-response</sub> < 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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023467226.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"53"},"PeriodicalIF":6.3000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874696/pdf/","citationCount":"0","resultStr":"{\"title\":\"Ultra-processed foods and risk of all-cause mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies.\",\"authors\":\"Shuming Liang, Yesheng Zhou, Qian Zhang, Shuang Yu, Shanshan Wu\",\"doi\":\"10.1186/s13643-025-02800-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup> = 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; I<sup>2</sup> = 91.0%). Dose-response analysis showed a positive linear association (P<sub>dose-response</sub> < 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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023467226.</p>\",\"PeriodicalId\":22162,\"journal\":{\"name\":\"Systematic Reviews\",\"volume\":\"14 1\",\"pages\":\"53\"},\"PeriodicalIF\":6.3000,\"publicationDate\":\"2025-03-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874696/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Systematic Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13643-025-02800-8\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Systematic Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13643-025-02800-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：全球超加工食品（UPF）消费量稳步增长，但相关的全因死亡风险仍不清楚。我们的目的是通过更新的系统评价和剂量反应荟萃分析来评估upf的全因死亡率风险。方法：在PubMed、Embase和Cochrane图书馆中检索到2024年7月2日之前发表的研究，以及之前系统评价中包含的参考研究。纳入了评估NOVA分类定义的UPF消费与全因死亡率之间关系的前瞻性队列研究。采用随机效应模型进行剂量-反应荟萃分析，将结果与风险比（HR）相结合作为效果度量。结果：共纳入18项研究，共纳入1,148,387名参与者（173,107例死亡）。与最低的参与者相比，UPF摄入量最高的参与者全因死亡风险增加了15% (HR = 1.15, 95% CI 1.09-1.22；i2 = 83.0%)。此外，UPF用量每增加10%，全因死亡风险增加10% (HR = 1.10, 95% CI 1.04-1.16；i2 = 91.0%)。结论：我们更新的荟萃分析纳入了大量新发表的队列研究，使用NOVA分类，样本量最大，加强了UPF用量增加与全因死亡风险增加之间的证据。应鼓励制定膳食指南和政策等战略，限制全世界的UPF消费。系统评价注册：PROSPERO CRD42023467226。
Ultra-processed foods and risk of all-cause mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies.
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 (Pdose-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.
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.
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