Evidence mapPaperPMID 39286398Full record

ArticleLancet regional health. Americas2024

Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies.

Kenny Mendoza, Stephanie A Smith-Warner, Sinara Laurini Rossato, Neha Khandpur, JoAnn E Manson, Lu Qi, Eric B Rimm, Kenneth J Mukamal, Walter C Willett, Molin Wang and 3 more

Registry-linked trialAbstract read
In one paragraph

Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07175701 (Effects of Ultra-processed Food Reduction Intervention on Postprandial Glucose and Glycemic Variability in Korean Young Adults), which is not on this map. Cited by 73 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 3 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07175701 narecruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Ultra-processed Food Reduction Intervention on Postprandial Glucose and Glycemic Variability in Korean Young Adults: Study Protocol for the ULTRA-CGM Randomized Controlled Trial

TypeinterventionalSponsorKorea UniversityRan2025 to 2026Enrolled50ConditionsPostprandial Glucose, Glucose Levels, HyperglycemiasArms40-minute one-on-one dietary counseling and nutrition education aimed at reducing ultra-processed food consumption, Standard dietary counseling and nutrition education based on national guidelines
3 · Its place in the literature

Who cites it

73 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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13 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kenny MendozaDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Stephanie A Smith-WarnerDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Sinara Laurini RossatoDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Neha KhandpurWageningen University, Wageningen, Netherlands.
JoAnn E MansonDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Lu QiTulane University Obesity Research Center, Tulane University, New Orleans, LA, USA.
Eric B RimmDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Kenneth J MukamalBeth Israel Deaconess Medical Center, Boston, MA, USA.
Walter C WillettDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Molin WangDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Frank B HuDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Josiemer MatteiDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Qi SunDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Prospective associations between total and groups of ultra-processed foods (UPF) and cardiovascular disease (CVD) remained to be characterised. Our aim was to assess the association of total and group-specific UPF intakes with CVD, coronary heart disease (CHD), and stroke in three large prospective cohorts of US adults. Additionally, we conducted a systematic review and meta-analyses on the existing evidence on the associations of total UPF intake with these outcomes. Methods: UPF intake was assessed through food frequency questionnaires in the Nurses' Health Study (NHS; Findings: The baseline mean (SD) age was 50.8 years (7.2) for the NHS, 36.7 years (4.6) for the NHSII, and 53.4 years (9.6) for the HPFS. The proportion of participants of White race was 97.7% in the NHS, 96.4% in the NHSII, and 94.9% in the HPFS. Among the three cohorts, multivariable-adjusted hazard ratios [HRs (95% CIs)] for CVD, CHD, and stroke for the highest (vs. lowest) total UPF intake quintile were 1.11 (1.06-1.16), 1.16 (1.09-1.24), and 1.04 (0.96-1.12), respectively. UPF groups demonstrated divergent associations. Sugar-/artificially-sweetened drinks and processed meats were associated with higher CVD risk, whereas inverse associations were observed for bread/cold cereals, yoghurt/dairy desserts, and savoury snacks. Meta-analysing 22 prospective studies showed that total UPF intake at the highest category (vs. lowest) was associated with 17% (11%-24%), 23% (12%-34%), and 9% (3%-15%) higher CVD, CHD, and stroke risk. Meta-evidence quality was high for CHD, moderate for CVD, and low for stroke. Interpretation: Total UPF intake was adversely associated with CVD and CHD risk in US adults, corroborated by prospective studies from multiple countries, also suggesting a small excess stroke risk. Nutritional advice for cardiovascular health should consider differential consequences of group-specific UPF. Replication is needed in racially/ethnically-diverse populations. Funding: National Institutes of Health (NIH) grants supported the NHS, NHSII, and HPFS.

Indexed as

Cardiovascular diseaseCohort studiesMeta-analysisNurses’ health studySystematic analysisUltra-processed foods

Identifiers

PMID39286398
PMCPMC11403639

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.