Ultra-Processed Foods and Metabolic Dysfunction: Mechanisms, Clinical Implications, and Public Health Perspectives. Position Paper of the Italian Association of Dietetics and Clinical Nutrition (ADI).

purpose of reviewThis position paper by the Italian Association of Dietetics and Clinical Nutrition (ADI) evaluates the impact of ultra-processed foods (UPFs) on metabolic health and chronic disease risk, with particular attention to the biological and behavioural mechanisms involved. RECENT

findingsHigh UPFs consumption has been associated with obesity, insulin resistance, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease (MASLD), cancer, neuroinflammation, and immune dysregulation. Proposed mechanisms include gut microbiota alterations, increased intestinal permeability, mitochondrial dysfunction, oxidative stress, impaired metabolic flexibility, and chronic low-grade inflammation. The hyperpalatable nature of UPFs may also impair appetite regulation and promote overconsumption, especially among children and adolescents. Additional concerns involve food additives, processing-derived contaminants, and endocrine disruptors from packaging materials. Current evidence identifies UPFs as a major modifiable risk factor for non-communicable chronic diseases. Reducing UPFs exposure should therefore represent a public health priority, supported by preventive nutritional strategies, improved food classification systems, and targeted educational and regulatory interventions.