Table 2.
Prospective cohort studies assessing the association between UPF intake and obesity indicators, adjusting for diet quality
| Author date | Location | Cohort | Sample | Diet assessment method | Outcome | Significant before diet adjustment (Yes/No) | Significant after diet adjustment (Yes/No) | Diet adjustments made |
|---|---|---|---|---|---|---|---|---|
| Mendonça et al. [57] | Spain | Seguimiento Universidad de Navarra (SUN) | Middle-aged University graduates | FFQ | Overweight/obesity | Y | Y | Fruit and vegetables |
| Rohatgi et al. [58] | MO, USA | Women’s Health Center and Obstetrics & Gynecology Clinic | Pregnant females and neonates | FFQ | Gestational weight gain (kg) | Not computed | Y | Fat intake |
| Neonate thigh skinfold thickness (mm) | Not computed | Y | ||||||
| Neonate subscapular skinfold thickness (mm) | Not computed | Y | ||||||
| Neonate body fat percentage (%) | Not computed | Y | ||||||
| Canhada et al. [59] | Brazil | Brazilian Longitudinal Study of Adult Healt (ELSA-Brazil) | Civil servants aged 35–74 | FFQ | Large weight gain (≥ 90th percentile: ≥ 1.68 kg/year) | Y | Y | Fruit and vegetables |
| Large WC gain (≥ 90th percentile: ≥ 2.42 cm/year) | Y | Y | ||||||
| Incident overweight/obesity | Y | Y | ||||||
| Incident obesity | N | N | ||||||
| Beslay et al. [35] | France | Nutri-Net Santé | Adults ≥ 18 | 24-h recall | BMI change (kg/m2) | Y | Y | (1) Sugar, sodium, SFAs, and dietary fibre; (2) healthy and Western dietary patterns; (3) fruit and vegetables and sugary drinks |
| Overweight | Y | Y | ||||||
| Obesity | Y | Y | ||||||
| Sandoval-Insausti et al. [60] | Spain | Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain (ENRICA) Seniors-ENRICA-1 | Older adults | 7-day diet history | Abdominal obesity | Y | Y | Fibre, very-long-chain omega-3 fatty acids and Mediterranean diet |
| Li and Shi [61] | China | China Health and Nutrition Survey (CHNS) | Adults > 20 | Three 24-h recalls | Overweight/obesity | Y | Y | Fat intake and dietary pattern (traditional pattern characterised by high intake of rice, pork and vegetables, and low intake of wheat and a modern dietary pattern characterised by high intake of fruit, soy milk, egg, milk and deep-fried products) |
| Central obesity | Y | Y | ||||||
| Koniecnzna et al. [62] | Spain | PREDIMED-Plus | Adults aged 55–75 with overweight/obesity and metabolic syndrome | FFQ | Total fat mass (z-score) | Y | Y | (1) Sodium, saturated and trans fats, alcohol, fibre, glycaemic index, Mediterranean Diet; (2) changes in fruit intake; (3) changes in vegetable intake; (4) changes in fibre intake |
| Visceral fat mass (z-score) | Y | Y | ||||||
| Android/gynoid fat ratio (z-score) | Y | N | ||||||
| Cordova et al. [36] | Multi-national (nine countries) | European Prospective Investigation into Cancer and Nutrition (EPIC) | Adults aged 25–70 | FFQ, s-FFQ and diet record | Weight gain (kg) | Y | Y | Mediterranean diet |
| Overweight/obesity | Y | Y | ||||||
| Obesity | Y | Y | ||||||
| Chang et al. [63] | England | Avon Longitudinal Study of Parents and Children (ALSPAC) | Children | Three-day food diary | BMI change (kg/m2)/year | Y | Y | (1) Fruit and vegetables; (2) saturated fat, sugar, fibre, and sodium |
| Fat mass index change (kg/m2)/year | Y | Y | ||||||
| Lean mass index change (kg/m2)/year | N | N | ||||||
| Body fat percentage change (%)/year | N | N | ||||||
| Costa et al. [64] | Brazil | Pelotas-Brazil 2004 Birth Cohort | 6–11-year-olds | FFQ | Fat mass index (kg/m2) | Y | Y | Food sources other than ultra-processed food |
| Wang et al. [51] | USA | Nurses’ Health Study II (NHSII) and the Growing Up Today Study (GUTS I and II) | Mother-child (aged 7–17 years at enrolment) pairs | FFQ | Offspring Overweight | Y | Y | Maternal Alternative Healthy Eating Index 2010, offspring consumption of ultra-processed foods |
| Offspring Obesity | Y | Y | ||||||
| Offspring BMI percentile | Y | Y | ||||||
| González-Palacios et al. [53] | Spain | Prevención con Dieta Mediterránea (PREDIMED)-Plus | Adults aged 55–75 without baseline cardiovascular disease | FFQ | Weight | Y | Y | Mediterranean diet |
| BMI | Y | Y | ||||||
| WC | Y | Y | ||||||
| Pan et al. [52] | China | China Health and Nutrition Survey (CHNS) | Adults ≥ 18 | Three 24-h recalls | Central obesity | Y | Y | Protein, fat, carbohydrate and sodium |
| Tan et al. [37] | South Korea | Health Examinees (HEXA) | Adults ≥ 40 years | FFQ | Obesity | Y females/N males | Y females/N males | Carbohydrate, protein, fat, processed food, unprocessed or minimally processed food, and processed culinary ingredients. |
| dos Santos et al. [55] | Brazil | NutriNet-Brasil | Adults ≥ 18 | Three non-consecutive NOVA 24-h screener recalls | BMI gain (%) | Y | Y | Unprocessed or minimally processed whole plant foods |
| BMI increase (≥ 5%) | Y | Y | ||||||
| Pang et al. [54] | USA | Coronary Artery Calcification in Type 1 Diabetes (CACTI) | T1DM and non-diabetic controls | FFQ | Weight | Y | Y | Unprocessed food (i.e. mainly fruits and vegetables) |
| WC | Y | Y | ||||||
| BMI (kg/m2) | Y | Y | ||||||
| Overweight | Y | Y | ||||||
| Obesity | Y | Y | ||||||
| Pan et al. [56] | China | Chinese Food Consumption Survey 2017–2020 | Adults ≥ 18 | Three 24-h recalls | Overweight/obesity | Y | N | Protein, fat, carbohydrate, vitamin A, vitamin C, calcium, and sodium |
| Overweight | Y | N | ||||||
| Obesity | N | N |
BMI body mass index, FFQ food frequency questionnaire, UPF ultra-processed food, WC waist circumference