ArticleLancet regional health. Americas2024
Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies.
Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07175701 (Effects of Ultra-processed Food Reduction Intervention on Postprandial Glucose and Glycemic Variability in Korean Young Adults), which is not on this map. Cited by 84 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Effects of Ultra-processed Food Reduction Intervention on Postprandial Glucose and Glycemic Variability in Korean Young Adults: Study Protocol for the ULTRA-CGM Randomized Controlled Trial
Who cites it
84 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Digital health interventions for promoting physical activity among adolescents: a systematic review.Frontiers in public health · 2026Pooled it
- The Association of Food Insecurity and Risk of Mortality: A Systematic Review and Meta-Analysis of Large-Scale Cohorts.Nutrients · 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
- 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
- Changes in Ultra-Processed Food Intake During a Single-Arm Behavioral Weight Management Intervention: A Secondary Analysis.Obesity (Silver Spring, Md.) · 2026Trial
- Eating rate has sustained effects on energy intake from ultraprocessed diets: a 2-week ad libitum dietary randomized controlled crossover trial.The American journal of clinical nutrition · 2026Trial
- Ultra-processed Food Intake and Long-Term Risk of Cardiovascular Disease Mortality among Patients with Myocardial Infarction: A Prospective Analysis of the Alpha Omega Cohort.Current developments in nutrition · 2026Article
- Toward AI-Assisted Methodological Evaluations of Health Risk Analyses Using Diverse Types of Evidence.Risk analysis : an official publication of the Society for Risk Analysis · 2026Article
- When Ultra-Processed Foods are Eaten: The Missing Dimension in Exposure Measurement for Obesity Research.Current obesity reports · 2026Review
- Article
- Preferences for Meat and Meat Alternatives in Different Meal Scenarios: A Dutch Discrete Choice Experiment.Current developments in nutrition · 2026Article
- 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).Current nutrition reports · 2026Review
- Recognition of Food Processing and Its Association with Consumption Patterns and Nutrient Intake Among Saudi University Students.Foods (Basel, Switzerland) · 2026Article
- Treatment of Cardiometabolic Risk Factors Among U.S. Adults With Cardiovascular-Kidney-Metabolic Syndrome.Journal of the American College of Cardiology · 2026Article
- Metabolomic Pattern of Ultra-Processed Food Intake and Risk of Colorectal Cancer Precursors.Gastroenterology · 2026Article
- Interpreting ultraprocessed food trial evidence: evidentiary limits, reporting practices, and policy relevance.The American journal of clinical nutrition · 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
- Review
- Food Service Directors' Knowledge and Beliefs About Ultraprocessed Foods in California's San Joaquin Valley Schools.Preventing chronic disease · 2026Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Prospective associations between total and groups of ultra-processed foods (UPF) and cardiovascular disease (CVD) remained to be characterised. Our aim was to assess the association of total and group-specific UPF intakes with CVD, coronary heart disease (CHD), and stroke in three large prospective cohorts of US adults. Additionally, we conducted a systematic review and meta-analyses on the existing evidence on the associations of total UPF intake with these outcomes. Methods: UPF intake was assessed through food frequency questionnaires in the Nurses' Health Study (NHS; Findings: The baseline mean (SD) age was 50.8 years (7.2) for the NHS, 36.7 years (4.6) for the NHSII, and 53.4 years (9.6) for the HPFS. The proportion of participants of White race was 97.7% in the NHS, 96.4% in the NHSII, and 94.9% in the HPFS. Among the three cohorts, multivariable-adjusted hazard ratios [HRs (95% CIs)] for CVD, CHD, and stroke for the highest (vs. lowest) total UPF intake quintile were 1.11 (1.06-1.16), 1.16 (1.09-1.24), and 1.04 (0.96-1.12), respectively. UPF groups demonstrated divergent associations. Sugar-/artificially-sweetened drinks and processed meats were associated with higher CVD risk, whereas inverse associations were observed for bread/cold cereals, yoghurt/dairy desserts, and savoury snacks. Meta-analysing 22 prospective studies showed that total UPF intake at the highest category (vs. lowest) was associated with 17% (11%-24%), 23% (12%-34%), and 9% (3%-15%) higher CVD, CHD, and stroke risk. Meta-evidence quality was high for CHD, moderate for CVD, and low for stroke. Interpretation: Total UPF intake was adversely associated with CVD and CHD risk in US adults, corroborated by prospective studies from multiple countries, also suggesting a small excess stroke risk. Nutritional advice for cardiovascular health should consider differential consequences of group-specific UPF. Replication is needed in racially/ethnically-diverse populations. Funding: National Institutes of Health (NIH) grants supported the NHS, NHSII, and HPFS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.