ArticleNutrients2026
Degree of Food Processing and the Risk of Immune-Mediated Inflammatory Diseases: A Prospective Analysis of the SUN Cohort.
Article in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesThe role of diet in the risk and clinical course of immune-mediated inflammatory diseases (IMIDs) is an area of ongoing research, in which prospective evidence regarding the degree of food processing is limited. We prospectively assess the association between ultra-processed food (UPF) and minimally or unprocessed food (MUPF) consumption and incident psoriasis, rheumatoid arthritis and vitiligo, as well as a composite exploratory IMID outcome, in a Spanish cohort.
methodsWe followed 15,874 IMID-free participants from the SUN Project (median follow-up: 15.1 years). Baseline diet was assessed via a validated FFQ and categorized by NOVA classification. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) across consumption tertiles (% g/day).
resultsDuring follow-up, 298 self-reported diagnosed incident IMID cases occurred (1.31/1000 person-years, mostly psoriasis and rheumatoid arthritis). After adjusting for sociodemographic, lifestyle, and clinical factors, the highest UPF consumption was associated with an increased risk of self-reported diagnosed psoriasis (T3 vs. T1: HR = 1.63, 95% CI: 1.08-2.45) and rheumatoid arthritis (T3 vs. T1: HR = 1.97, 95% CI: 1.19-3.26;
conclusionsHigher UPF consumption is associated with an increased risk of self-reported diagnosed psoriasis and rheumatoid arthritis, whereas MUPF intake appears to be inversely associated with self-reported diagnosed psoriasis risk. These findings contribute to the ongoing evidence regarding the degree of food processing as a potential factor in the epidemiological profile of specific autoimmune conditions. However, given the observational design of the study, these findings reflect longitudinal associations and do not imply causation.
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