The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake, Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies

Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional qua...

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Bibliographic Details
Published in:Nutrients 2021-12, Vol.14 (1), p.23
Main Authors: Dicken, Samuel J, Batterham, Rachel L
Format: Article
Language:English
Subjects:
Cancer
Cardiovascular disease
Cardiovascular diseases
Classification
Cohort analysis
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diet
Diet - standards
diet quality
dietary pattern
Eating
Energy
Food
Food Handling
Food intake
Food processing
Health Status
Humans
Hypertension
Legumes
NOVA classification
Nutrients
Obesity
Obesity - etiology
Processed foods
Review
Seafood
Sodium
Sugar
ultra-processed food
Weight control
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Summary:Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional quality, is debated. Higher UPF intakes are inversely associated with fruit, vegetables, legumes and seafood consumption. Therefore, the association between UPFs and poor health could simply be from excess nutrient intake or from a less healthful dietary pattern. If so, adjustment for dietary quality or pattern should explain or greatly reduce the size of the significant associations between UPFs and health-related outcomes. Here, we provide an overview of the literature and by using a novel approach, review the relative impact of adjusting for diet quality/patterns on the reported associations between UPF intake and health-related outcomes in prospective cohort studies. We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern. Our findings suggest that the adverse consequences of UPFs are independent of dietary quality or pattern, questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu14010023