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Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses

Objective To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.

Design Systematic umbrella review of existing meta-analyses.

Data sources MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.

Eligibility criteria for selecting studies Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality.

Results The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.

Conclusions Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research.

Systematic review registration PROSPERO CRD42023412732.

To access additional data from this study, the code repository corresponding to the online version of the R statistical package, metaumbrella , can be found on GitHub at <https://github.com/cran/metaumbrella>. The raw data are available on the Open Science Framework at <https://osf.io/8j2gt/>, and a step-by-step analysis using metaumbrella usage is provided in supplementary table B. For further assistance or inquiries, please contact the corresponding author at m.lane@dealin.edu.au.

Mexico , United-states , Colombia , Italy , Barwon , Victoria , Australia , Fernwood , Western-australia , United-kingdom , Malaysia , South-korea

Oborevwori inaugurates multi-million naira Norsworthy palm oil mill

Gov. Sherrif Oborevwori of Delta, on Tuesday, inaugurated a multi-million naira palm oil company in Akwukwu-Igbo Community, Oshimili North Local Government Area. The News Agency of Nigeria (NAN) reports that the project has a production capacity of 10 metric tonnes of palm oil per hour. It is owned by Norsworthy Farms and Allied Industries Ltd.

Nigeria , Akwukwu-igbo , Delta , Malaysia , Sherrif-oborevwori , Ifeanyi-okowa , Gabriel-ogbechie , Akwukwu-igbo-community , Industries-ltd , Agricultural-organisation-of-the-united-nations , News-agency-of-nigeria , Oshimili-north-local-government

New Year Honours 2024: Dr Megan Balks recognised for services to Antarctic soil science

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Woodville , New-zealand-general- , New-zealand , Antarctica , Waikato , Te-awamutu , Otago , Ross-sea , Oceans-general- , Oceans , Ngutunui , Jackie-aislabie

Where the Costa del Sol meets the Costa Tropical

Go east to find a fruit for every season and discover markets and restaurants where traditional muscatel grapes, almonds and olives are combined with locally grown mangoe

La-herradura , Andalucísp , Spain , Torrox , Japan , Periana , Cadiz , Nerja , Costa-del-sol , Spain-general- , Frigiliana , Algarrobo

Climate change: A pandemic in disguise - The Nation Newspaper

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Israel , Russia , Gaza , Israel-general- , Ukraine , Nigeria , Nigerians , Bola-tinubu , Muhammadu-buhari , Olaogun-michael-sunkanmi , Medium-enterprises-smes , Ecological-fund

Crawford Fund Forum highlights need for more investment in research and development | The Land

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Sydney , New-south-wales , Australia , Philippines , China , Cambodia , Laos , Crawford , Queensland , India , Vietnam , Republic-of

Bird flu could be eradicated by editing the genes of chickens -- our study shows how

EconoTimes is a fast growing non-partisan source of news and intelligence on global economy and financial markets, providing timely, relevant, and critical insights for market professionals and those who want to make informed investment decisions.

South-africa , South-african , United-states-department-of-agriculture , African-poultry-association , World-health-organization , World-organisation-for-animal-health , Agricultural-organisation-of-the-united-nations , United-states-department , South-african-poultry-association , World-organisation , Animal-health

Embracing sustainable fashion in a materialistic world

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India , Bangladesh , Sonargaon , Bangladesh-general- , Nobonita-chowdhury , Nawshin-khair , Ruby-ghuznavi , Sazzad-ibne-sayed , Nakshi-kantha , Sonia-yeasmin-isha , World-crafts-council , Agricultural-organisation-of-the-united-nations

Bird flu could be eradicated by editing the genes of chickens - our study shows how

The three flu pandemics of the 20th century originated from birds, making it critical to fight bird flu. Breakthroughs in gene-editing chickens show promise for eliminating the disease in the future.

South-africa , South-african , Agricultural-organisation-of-the-united-nations , World-health-organization , United-states-department-of-agriculture , African-poultry-association , World-organisation-for-animal-health , United-states-department , South-african-poultry-association , World-organisation , Animal-health

South Africa: Bird Flu Could Be Eradicated By Editing the Genes of Chickens - Our Study Shows How

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South-africa , South-african , African-poultry-association , World-health-organization , Agricultural-organisation-of-the-united-nations , World-organisation-for-animal-health , United-states-department-of-agriculture , United-states-department , South-african-poultry-association , World-organisation , Animal-health