ArticleThe Lancet regional health. Europe2023
Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study.
Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 143 papers, 8 of them syntheses that pooled it.
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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.
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Who cites it
143 citing papers in PubMed, 8 syntheses or guidelines pooled it, 185 citations in OpenAlex.
- Healthful and unhealthful plant-based diets and site-specific cancer risk: a systematic review and meta-analysis of observational studies.European journal of nutrition · 2026Pooled it
- Cardiovascular Prevention in Children, Adolescents, and Young Adults. A Call-to-Action of the Italian Societies of Pediatrics (SIP), Hypertension (SIIA), Study of Atherosclerosis (SISA), and Cardiovascular Prevention (SIPREC).High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Guideline
- Ultra-Processed Food Intakes and Health Outcomes in Adults Older Than 60 Years: A Systematic Review.Nutrition reviews · 2025Pooled it
- Ultra-Processed Food Intake and Risk of Type 2 Diabetes Mellitus: A Dose-Response Meta-Analysis of Prospective Studies.Diabetes & metabolism journal · 2025Pooled it
- A Systematic Review of Evidence on the Role of Ready-to-Eat Cereals in Diet and Non-Communicable Disease Prevention.Nutrients · 2025Pooled it
- Unveiling the Potential of Large Language Models in Transforming Chronic Disease Management: Mixed Methods Systematic Review.Journal of medical Internet research · 2025Pooled it
- Impact of ultra-processed foods consumption on the burden of obesity and type 2 diabetes in Belgium: a comparative risk assessment.BMC public health · 2025Pooled it
- Associations Between Ultra-Processed Food (UPF) Consumption and Weight Change and Obesity Risk Among Consumers of Plant-Based Diets: A Systematic Review.Journal of the American Nutrition AssociationPooled it
- Identification and validation of poly-metabolite scores for diets high in ultra-processed food: An observational study and post-hoc randomized controlled crossover-feeding trial.PLoS medicine · 2025Trial
- Ultraprocessed food intake and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.Journal of the National Cancer Institute · 2026Article
- Associations of food processing and dietary risk factors with colorectal cancer incidence in the NIH-AARP Diet and Health Study: A cohort study.PLoS medicine · 2026Article
- Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact-A Narrative Review.Sports medicine - open · 2026Review
- Short- and long-term shifts in food purchasing behaviours and nutrition disparities in the USA during and after the COVID-19 pandemic.Nature human behaviour · 2026Article
- A Frequency-Based Proxy Score for Ultra-Processed Food Consumption Among Adolescents: Associations with Lifestyle Factors and Tinnitus.Nutrients · 2026Article
- The 24/7 lifestyle and male hormonal health: how sleep deprivation and ultra-processed foods impact testosterone and reproduction.Reviews in endocrine & metabolic disorders · 2026Review
- The Gut-brain-adipose Axis in Ultra-processed Food and Obesity: A Mechanistic Synthesis and Its Implications for Food Classification.Current obesity reports · 2026Review
- Are All Ultra-Processed Foods Created Equal? Descriptive Analysis of Nutritional Composition, Nutritional Quality, Energy Density and Hyperpalatability in Relation to Non-Communicable Disease Risk.Foods (Basel, Switzerland) · 2026Article
- How Complex Dietary Fibers Can Be Used to Shape the Human Gut Microbiome Toward Reduced Inflammatory Potential: A Pilot Study.Molecules (Basel, Switzerland) · 2026Article
- Discrepancies between validated and selected dietary exposures for association analysis: a meta-research study of cohorts examining diet-cardiovascular disease associations.European journal of epidemiology · 2026Article
- Review
83 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
35 authors at 19 institutions in 12 countries.
Funding
Abstract
Background: It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes. Methods: This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases. Findings: After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk. Interpretation: Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity. Funding: Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
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