ArticleJournal of the Academy of Nutrition and Dietetics2025
Association Between Ultra-processed Food Consumption and Mortality Among US Adults: Prospective Cohort Study of the National Health and Nutrition Examination Survey, 2003-2018
Article in Journal of the Academy of Nutrition and Dietetics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999-2018.American journal of public health · 2026Article
- Article
- Rethinking fussiness in commercial food contexts.Health promotion international · 2026Article
- Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study.Frontiers in nutrition · 2026Article
- Review
- Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society.Obesity (Silver Spring, Md.) · 2025Article
- Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society.The American journal of clinical nutrition · 2025Article
- Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society.American journal of lifestyle medicine · 2025Article
- Clinician Guidance on the Benefits of Healthy Nutrition and Increased Physical Activity for People With Type 2 Diabetes Following Glucagon-Like Peptide 1 Receptor Agonist Initiation.Clinical diabetes : a publication of the American Diabetes Association · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundIntake of ultra-processed foods (UPF) provides more than half of the daily energy US adults consume. Still, the prospective association of UPF consumption with mortality in the general US population remains understudied.
objectiveTo investigate the prospective association of UPF consumption with mortality in a nationally representative sample of US adults.
designA prospective cohort analysis was conducted by linking baseline measurement from the National Health and Nutrition Examination Survey with mortality information from the National Death Index. The percentage of total energy consumed from UPF, defined by the Nova classification system, was computed based on dietary data collected using 24-hour diet recalls. PARTICIPANTS/
settingThis study included 38 148 nationally representative US adults aged 20 years and older who participated in National Health and Nutrition Examination Survey between 2003-2004 and 2017-2018 and provided dietary intake data, with linkage to mortality data.
main outcome measuresInformation on all-cause and cause-specific mortality was obtained from linkage to the National Death Index through December 31, 2019. STATISTICAL ANALYSIS PERFORMED: Cox proportional hazard models estimated the multivariable-adjusted hazard ratios and 95% CIs for the association between UPF intake and mortality.
resultsDuring a median follow-up of 8.0 years, 4611 deaths were confirmed, including 2064 deaths from cardiometabolic disorders and 1046 deaths from cancer. After multivariable adjustments, each 10-point increment in usual percentage of total energy from UPF was associated with a 9% higher risk of all-cause mortality (hazard ratio 1.09, 95% CI 1.04 to 1.14). The association remained significant after adjusting for the overall diet quality measured by the Health Eating Index 2015 (hazard ratio 1.06, 95% CI 1.00 to 1.11; P < .05). Among subgroups, sugar-sweetened beverages, ready-to-eat or -heat mixed dishes, ultra-processed dairy products, and ultra-processed oil/fat, condiments, and sauces were associated with an increased risk of all-cause or cause-specific mortality. Ultra-processed vegetables and legumes were associated with a reduced risk.
conclusionsIn this nationally representative study of US adults, higher consumption of UPF was associated with a higher risk of all-cause mortality, and this association was not fully explained by overall diet quality.
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