ArticleNutrients2021
Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort).
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Article in Nutrients, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Ultra-Processed Food and Chronic Kidney Disease Risk: A Systematic Review, Meta-Analysis, and Recommendations.Nutrients · 2025Pooled it
- Unhealthy Food and Beverage Consumption during Childhood and Risk of Cardiometabolic Disease: A Systematic Review of Prospective Cohort Studies.The Journal of nutrition · 2023Pooled it
- A Systematic Review on Processed/Ultra-Processed Foods and Arterial Hypertension in Adults and Older People.Nutrients · 2022Pooled it
- Metabolomic Profiling of an Ultraprocessed Dietary Pattern in a Domiciled Randomized Controlled Crossover Feeding Trial.The Journal of nutrition · 2023Trial
- Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF).The international journal of behavioral nutrition and physical activity · 2022Trial
- Comparison of food processing classification frameworks in the NHANES 2017-2018.The American journal of clinical nutrition · 2026Article
- Ultra-Processed Foods and the Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, and Translational Evidence.Nutrients · 2026Review
- Association of ultra-processed foods and dental health-results from Bandare-Kong cohort: structural equation modeling.Scientific reports · 2026Article
- Effects of Ultra-Processed Foods and Food Additives on Disease Activity in Adults with Inflammatory Bowel Disease: A Scoping Review.Journal of clinical medicine · 2025Review
- Ultra-processed foods: Implications for gastrointestinal health.World journal of gastroenterology · 2025Review
- Toward Multidimensional Front-of-Pack Labels: Integrating Nutritional, Environmental, and Processing Information.Nutrients · 2025Review
- Should Grain-Based Staple Foods Be Included in Admonitions to "Avoid Processed and Ultra-Processed Food"?Nutrients · 2025Review
- Fifteen Years of NOVA Food-Processing Classification: "Friend or Foe" Among Sustainable Diet Indicators? A Scoping Review.Nutrition reviews · 2025Article
- Definitions of ultra-processed foods beyond NOVA: a systematic review and evaluation.Food & nutrition research · 2025Review
- Association Between Ultra-Processed Food Consumption and Hypertension Incidence: Findings From RaNCD Cohort Project.International journal of hypertension · 2025Article
- Validity and Reliability of the Turkish Version of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF).Nutrients · 2024Article
- Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study.Food science & nutrition · 2024Article
- Ultra-Processed Foods-Dietary Foe or Potential Ally?Nutrients · 2024Review
- [Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study].Korean journal of community nutrition · 2024Article
- Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review.JHEP reports : innovation in hepatology · 2024Article
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Authors and funding
49 authors.
Celia Martinez-PerezNutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.ORCID 0000-0002-3653-9118
Rodrigo San-CristobalCardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.ORCID 0000-0001-8054-6553
Pilar Guallar-CastillonCardiovascular and Nutritional Epidemiology Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.ORCID 0000-0003-4759-6713
Miguel Ángel Martínez-GonzálezCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-3917-9808
Jordi Salas-SalvadóCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0003-2700-7459
Dolores CorellaCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-2366-4104
Olga CastañerCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0003-3169-997X
Jose Alfredo MartinezCardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.ORCID 0000-0001-5218-6941
Ángel M Alonso-GómezCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0003-2945-7509
Julia WärnbergCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-8408-316X
Jesús VioqueCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.ORCID 0000-0002-2284-148X
Dora RomagueraCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-5762-8558
José López-MirandaCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Ramon EstruchCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0003-1260-4445
Francisco J TinahonesCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
José LapetraCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-3873-5737
Lluis Serra-MajemCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-9658-9061
Aurora Bueno-CavanillasCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.ORCID 0000-0002-0649-3016
Josep A TurCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-6940-0761
Vicente Martín SánchezCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.ORCID 0000-0003-0552-2804
Xavier PintóCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-2216-2444
José J GaforioCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.ORCID 0000-0003-2996-9301
Pilar Matía-MartínDepartment of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.ORCID 0000-0001-9844-3755
Josep VidalBiomedical Research Centre for Diabetes and Metabolic Diseases Network (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Clotilde VázquezCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Emilio RosCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Maira Bes-RastrolloCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-9139-4206
Nancy BabioCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0003-3527-5277
Jose V SorlíCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-0130-2006
Camille LassaleCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-9340-2708
Beatriz Pérez-SanzDepartment of Nutrition, Food Sciences and Physiology, University of Navarra, 31009 Pamplona, Spain.
Jessica Vaquero-LunaCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
María Julia Ajejas BazánDepartment of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29016 Málaga, Spain.ORCID 0000-0001-5343-3377
María Concepción Barceló-IglesiasCentro Salud Cabo Huertas, 03540 Alicante, Spain.
Jadwiga KoniecznaCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Antonio García RíosCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
María Rosa Bernal-LópezInternal Medicine Department, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Malaga, 29010 Malaga, Spain.
José Manuel Santos-LozanoCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Estefanía ToledoCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-6263-4434
Nerea Becerra-TomásCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Olga PortolesCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
María Dolores ZomeñoCardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain.
Itziar AbeteCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.ORCID 0000-0002-6475-5387
Anai Moreno-RodriguezCentro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
Oscar Lecea-JuarezAtención Primaria, Osasunbidea, Servicio Navarro de Salud, 31003 Pamplona, Spain.
Stephanie K NishiUnitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain.
Júlia Muñoz-MartínezCardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain.
José M OrdovásNutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
Lidia DaimielNutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.ORCID 0000-0001-9898-6629
Funding
Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332European Research Council #340918
Abstract
The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus ("PREvention with MEDiterranean DIet") trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (
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AgedCardiometabolic Risk FactorsCohort StudiesDietDiet, MediterraneanDiet SurveysFast FoodsFemaleFood HandlingHumansIncidenceLinear ModelsMaleMetabolic SyndromeMiddle AgedSpaincardiometabolic riskclassification systemsdietfood processingIARCIFICNOVAPREDIMED-Plusultra-processed foodUNC
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