Ultra-processed foods and early death 

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Research shows that highly processed foods are associated with premature death. (Photo credit: Wikimedia Commons)

There is strong scientific evidence that ultra-processed foods are linked to severe health risks, including cancer, cardiovascular and liver disease, and dementia. The evidence shows that these hyperpalatable foods, which usually include high amounts of sugar, salt, and artificial additives, are also linked to early death, or increased all-cause mortality.

The term “all-cause mortality” refers to deaths in a population from any cause.

What is the evidence linking ultra-processed food and all-cause mortality?

In 2019, a prospective cohort study published in the BMJ found that “a higher consumption of ultra-processed foods was independently associated with 62% relatively increased hazard for all cause mortality. For each additional serving of ultra-processed food, all cause mortality increased by 18%.” Researchers came to these results after examining the data of nearly 20,000 study participants ages 20 to 91 years old, following up every other year between 1999 and 2014. They separated the type of consumption of ultra-processed foods into four categories — low, low-medium, medium-high, and high consumption). The study authors concluded: “Discouraging the consumption of ultra-processed foods; targeting products, taxation, and marketing restrictions on ultra-processed products; and promotion of fresh or minimally processed foods, should be considered part of important health policy to improve global public health.”

In an umbrella review published in 2024 in BMJ, researchers examined the consumption of ultra-processed foods and the risk of various adverse health outcomes. Using data from 45 analyses, researchers found direct associations “between exposure to ultra-processed foods and 32 health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes.” And “based on the pre-specified evidence classification criteria, convincing evidence supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality and type 2 diabetes.” The researchers concluded: “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.”

Published in JAMA Internal Medicine in 2019, an observational prospective cohort study that examined the eating habits of nearly 45,000 middle-aged people in France found that, after adjusting for various confounding factors, “a 10% increase in one’s proportion of ultra-processed food consumption was statistically significantly associated with a 14% higher risk of all-cause mortality.” They concluded: “An increase in ultraprocessed foods consumption appears to be associated with an overall higher mortality risk among this adult population.”

A prospective cohort study published in 2022 in BMJ investigated the rate of all-cause mortality as it related to individual diet and ultra-processed food intake in nearly 23,000 adults. Researchers found that “adults with the lowest quality diet … and the highest ultra-processed food consumption were at the highest risk for all cause and cardiovascular mortality. A significant proportion of the higher mortality risk associated with an elevated intake of nutrient poor foods was explained by a high degree of food processing.”

A 2021 meta-analysis published in the British Journal of Nutrition examined all observational studies that explored the link between eating ultra-processed foods and health status. The researchers wrote: “For prospective cohort studies evaluating a total population of 183,491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies.”

Published in 2019 in Public Health Nutrition, a prospective analysis reported the frequency of ultra-processed food intake between 1988 to 1994 and its associations with all-cause mortality. The results showed that, “over a median follow-up of 19 years, individuals in the highest quartile of frequency of ultra-processed food intake (e.g. sugar-sweetened or artificially sweetened beverages, sweetened milk, sausage or other reconstructed meats, sweetened cereals, confectionery, desserts) had a 31% higher risk of all-cause mortality, after adjusting for demographic and socio-economic confounders and health behaviours.”

An analysis published in the American Journal of Nutrition in 2023 examined consumption of ultra-processed foods and risk of death and major cardiovascular disease from several different regions of the world. The research included data of more than 138,000 people who did not have a medical history of cardiovascular disease on five different continents. The researchers “found a diet high in UPFs was associated with higher risk of mortality and non-cardiovascular mortality.” The researchers concluded: “Globally, limiting the consumption of UPFs should be encouraged.”

A systematic review of observational studies published in Nutrients in 2021 examined data of more than 200,000 people to observe associations between ultra-processed food and adult mortality risk. The results “revealed that each 10% increase in UPF consumption in daily calorie intake was associated with a 15% higher risk of all-cause mortality. The dose–response analysis revealed a positive linear association between UPF consumption and all-cause mortality, CVDs-cause mortality, and heart-cause mortality.” The researchers concluded: “It seems that higher consumption of UPF is significantly associated with an enhanced risk of adult mortality.”

In a 2024 study published in the journal Clinical Nutrition, researchers sought to evaluate the link between ultra-processed food consumption and all-cause mortality, cardiovascular disease, and cancer. Using data from more than 1,500 individuals in Spain, study authors found that, “compared with participants in the lowest tertile of UPF consumption, those in the highest tertile showed 40% higher risk of all-cause mortality, … CVD mortality, and of cancer mortality.” They concluded, “Considering the increase in UPF consumption and their detrimental health effects on mortality, further prospective studies should be carried out to confirm if UPF consumption also increase the incidence of CVD and cancer, and consequently, to enhance more attention should be put in population nutritional education and nutritional policies.”

Researchers in Brazil sought to understand how ultra-processed food affects the risk of premature death by using a comparative risk assessment model, along with diet and demographic and death rate statistics.The data included that of more than half a million people. The results of the 2023 study, published in the American Journal of Preventive Medicine, showed that “the consumption of ultraprocessed foods was responsible for approximately 57,000 premature deaths or 10.5% of all premature deaths in [Brazilian] adults aged 30‒69 years. Reducing the contribution of ultraprocessed foods to the total energy intake by 10%‒50% could potentially prevent 5,900 deaths to 29,300 deaths, respectively.” The study authors concluded: “The consumption of ultraprocessed foods represents a significant cause of premature death in Brazil. Reducing ultraprocessed food intake would promote substantial health gains for the population and should be a food policy priority to reduce premature mortality.”

Journalism and opinion

Nutritional psychiatry professor Felice Jacka: “The global food system is the leading cause of early death, Interview by Callum Bains, Guardian, Oct. 21, 2023

Death Is Not the Enemy, by Dr. George D. Lundberg, Medscape, June 26, 2023

Eating Processed Food Tied to Shorter Life, by Nicholas Bakalar, New York Times, Feb. 12, 2019

More Evidence Links Ultra-Processed Foods to Premature, Preventable Death, by George Citroner, Healthline, Nov. 7, 2022

Ultraprocessed foods contribute to disease and early death. Why do we keep eating them? by Michael LaCorte, Salon, Dec. 12, 2022

Ultraprocessed food are easy, cheap, and could be killing you, by Susan Scutti, CNN, May 30, 2019

We are trapped in a junk food cycle that is making us sick, by Henry Dimbleby and Jemima Lewis, New Scientist, March 29, 2023

Heavily processed food like ready meals and ice-cream linked to early death, by Ian Sample, Guardian, May 29, 2019

We are producing a series that reports on the science behind the health risks of ultra-processed foods. Learn more about ultra-processed foods and their health risks at our other fact sheets on cardiovascular disease, depression, dementia, addiction, Type 2 diabetes, obesity, and cancer, along with our fact sheet offering a general overview of UPFs here. These fact sheets are works in progress and will be updated. Please feel free to email mikaela@usrtk.com with any important research or articles that you feel should be included.

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