A troubling new peer-reviewed study, the largest of its kind, has revealed that ultra-processed food is linked to 32 harmful health conditions and can significantly increase the risk of cancer, diabetes, and an early grave.

The study, a systematic meta-analysis published Wednesday in the BMJ, the British Medical Association's esteemed journal, found evidence pointing to "direct associations between greater exposure to ultra-processed foods and higher risks of all cause mortality, cardiovascular disease related mortality, common mental disorder outcomes, overweight and obesity, and type 2 diabetes."

The fallout of ultra-processed food exposure may be far-reaching granted the global shift in recent years from unprocessed and minimally processed foods to UPFs. According to the study, the present "share of dietary energy derived from ultra-processed foods ranges from 42% and 58% in Australia and the United States."

The study, involving experts from various top institutions, including Johns Hopkins Bloomberg School of Public Health and Sorbonne University in France, relies on the definition of "ultra-processed foods" advanced in the Nova food classification system.

According to the Nova system, processed foods usually consist of a primary plant or animal substance to which one or more culinary ingredient — such as oil, butter, sugar, or salt — has been added. An ultra-processed food, alternatively, is not a modified primary material but rather an industrial composite of often chemically manipulated substances that have been extracted from foods, derived from food constituents, and/or cooked up in a laboratory.

UPFs appear in virtually every aisle in the grocery store. They include packaged snacks, soft drinks, instant noodles, sweetened cereals, packaged baked goods, frozen fish sticks, oven-ready pizzas, breakfast bars, and ready-made meals.

Researchers examined the findings of 14 meta-analysis studies published over the past three years with 45 distinct pooled analyses. In 87% of the pooled analyses, estimates of UPF exposure were obtained on the basis of food frequency questionnaires, 24-hour dietary recalls, and participants' dietary history.

Researchers found UPF exposure was consistently associated with 32 adverse health outcomes, including all-cause mortality; cancer-related deaths; cardiovascular disease-related deaths; heart disease-related deaths; breast cancer; central nervous system tumors; chronic lymphocytic leukemia; colorectal cancer; pancreatic cancer; prostate cancer; adverse sleep-related outcomes; anxiety; common mental disorder outcomes; depression; asthma; wheezing; Crohn's disease; ulcerative colitis; obesity; hypertension; and type 2 diabetes.

"On the basis of the random effects model, 32 (71%) distinct pooled analyses showed direct associations between greater ultra-processed food exposure and a higher risk of adverse health outcomes," said the study. "Additionally, of these combined analyses, 11 (34%) showed continued statistical significance when a more stringent threshold was applied."

Heart disease-related death, cardiovascular disease-related death, all-cause mortality, type 2 diabetes, wheezing, and depression were among the 11 adverse health outcomes that showed continued statistical significance in the face of the more stringent threshold.

The Guardian noted that evidence graded as "convincing" in the study indicated that higher UPF exposure was linked to a roughly 50% increase in cardiovascular-related death, a 48-53% higher risk of anxiety and mental disorders, and a 12% increase risk of diabetes.

"Across the pooled analyses, greater exposure to ultra-processed foods, whether measured as higher versus lower consumption, additional servings per day, or a 10% increment, was consistently associated with a higher risk of adverse health outcomes," added the study.

In a corresponding editorial in BMJ, a pair of Brazilian academics stressed that UPFs "are engineered to be highly desirable, combining sugar, fat, and salt to maximize reward, and adding flavors that induce eating when not hungry. Many are addictive, judged by the standards set for tobacco products, and aggressively marketed with meal deals, super sizing, and advertising."

The Brazilians suggested that investment management companies and manufacturers would "likely resist" efforts to control and reduce the production and consumption of UPFs. With the tobacco parallel in mind, the Brazilian duo recommended rolling out national dietary guidelines cautioning against UPF consumption; prohibiting sales of junk food near schools and hospitals; and regulating UPF marketing.

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