Comprehensive analysis of the relationship between ultra-processed food consumption and food addiction at one-year follow-up in older adults with metabolic syndrome.

Background: Ultra-processed foods (UPFs) are theorised to exhibit addictive properties within the framework of the Food Addiction (FA) model, attributable to their high palatability, sugars, salt, saturated/trans fats, and caloric density. Aims: To evaluate the association between UPFs consumption and FA presence, and to examine whether reducing UPFs intake after one year of intervention is associated to decreased FA scores. Methods: The sample included 429 Mediterranean older adults with overweight/obesity and metabolic syndrome from the PREDIMED-Plus-Cognition sub-study. FA presence was evaluated with the Yale Food Addiction Scale 2.0, and the nutritional information through validated food frequency questionnaires. UPFs was categorised according to the NOVA system and divided into consumption tertiles. Data were analysed using repeated measures ANOVA, structural equation modelling, and logistic regression to compare FA changes across tertiles of UPF reduction after one-year follow-up. Results: Baseline YFAS categorisation into three levels (positive-probable-negative) showed significant differences between the second and third tertile of UPFs consumption, with the highest tertile of consumption having greater likelihood of worse FA status. After one year, the likelihood of change in the FA levels was higher only for individuals within the highest decreases in the UPFs consumption (OR = 1.67, p = 0.040). Discussion and Conclusions: These findings indicate that a reduction in the consumption of UPFs may contribute to the improvement of FA symptoms, providing novel insights into the association between UPFs and the presence of FA. Future research should focus on populations with higher UPFs consumption and investigating the long-term effects of dietary quality on FA symptoms.