Table 2.
Characteristics of prospective cohort studies evaluating ultra-processed food (UPF) consumption and different health outcomes
| Author (year) | Country (cohort) |
n/N | Follow-up (years) | Age (years) | Sex | Outcome | Assessment of UPF intake | Comparison | Exposure | Reference | RR | 95 % CI | Adjustment | Study quality |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mendonça et al. (2016)(27) | Spain (SUN) |
1939/8451 | 8·9 | 37·6 | M/F | Overweight/obesity | 136-item FFQ | Q4 v. Q1 | 6·1 servings/d | 1·5 servings/d | 1·26 | 1·10, 1·45 | Age, sex, marital status, educational status, physical activity, TV watching, siesta sleep, smoking status, snacking between meals, following a special diet at baseline, baseline BMI and consumption of fruits and vegetables | Good |
| Mendonça et al. (2017)(28) | Spain (SUN) |
1702/14 790 | 9·1 | ≥18 | M/F | Hypertension | 136-item FFQ | T3 v. T1 | 5·0 servings/d | 2·1 servings/d | 1·21 | 1·06, 1·37 | Age, sex, physical activity, hours of TV watching, baseline BMI, smoking status, use of analgesics, following a special diet at baseline, family history of hypertension, hypercholesterolaemia, alcohol consumption, total energy intake, olive oil intake and consumption of fruits and vegetables | Good |
| Fiolet et al. (2018)(16) | France (NutriNet-Santé) |
2228/104 980 | 5·4 | 42·8 | M/F | Overall cancer risk | 24-h dietary recall | Q4 v. Q1 | ≥23·3 % of TE | ≤11·8 % of TE | 1·23 | 1·08, 1·40 | Age, sex, energy intake without alcohol, number of 24-h dietary records, smoking status, educational level, physical activity, height, BMI, alcohol intake, family history of cancers, intakes of lipids, sodium, and carbohydrates, Western dietary pattern, menopausal status, hormonal treatment for menopause, oral contraception and number of children | Good |
| 739/104 980 | Breast cancer risk | 1·13 | 0·89, 1·42 | |||||||||||
| 281/104 980 | Prostate cancer risk | 0·93 | 0·61, 1·40 | |||||||||||
| 153/104 980 | Colorectal cancer risk | 1·23 | 1·08, 1·40 | |||||||||||
| Adjibade et al. (2019)(15) | France (NutriNet-Santé) |
2221/26 730 | 5·4 | 18–86 | M/F | Depressive symptoms | 24-h dietary recall | Q4 v. Q1 | 19–76 % of TE | 0–10 % of TE | 1·13 | 1·00, 1·28 | Age, sex, BMI, marital status, educational level, occupational categories, household income per consumption unit, residential area, number of 24-h dietary records, inclusion month, energy intake without alcohol, alcohol intake, smoking status, physical activity, use of antidepressants during follow-up, baseline CES-D score and CDS score | Good |
| Blanco-Rojo et al. (2019)(29) | Spain (ENRICA) |
44/11 898 | 7·7 | 46·9 | M/F | All-cause mortality | Computer-based dietary history | Q4 v. Q1 | 42·83 % of TE | 8·68 % of TE | 1·44 | 1·01, 2·07 | Age, sex, educational level, living alone, smoking status, former drinker, physical activity index, time of watching TV, time devoted to other sedentary activities, number of medications per d and specific chronic conditions diagnosed by a physician | Good |
| Canhada et al. (2019)(34) | Brazil (ELSA-Brazil) |
972/11 827 | 3·8 | 35–74 | M/F | Overweight/Obesity | 114-item FFQ | Q4 v. Q1 | 30·84–73·84 % of TE | 0–17·79 % of TE | 1·20 | 1·03, 1·40 | Age, sex, colour/race, centre, income, school achievement, smoking status, physical activity, baseline BMI and WC at baseline | Good |
| 1183/11 827 | WC gain | 1·33 | 1·12, 1·58 | |||||||||||
| Gómez-Donoso et al. (2020)(30) | Spain (SUN) |
774/14 907 | 10·3 | 36·7 | M/F | Depression | 136-item FFQ | Q4 v. Q1 | 489 g/d | 119 g/d | 1·33 | 1·07, 1·64 | Age, sex, year of entrance to the cohort, baseline BMI, total energy intake, physical activity, smoking status, marital status, living alone, employment status, working hours per week, health-related career, years of education, MedDiet Score, baseline self-perception of competitiveness, anxiety and dependence levels | Good |
| Kim et al. (2019)(36) | USA (NHANES III) |
648/11 898 | 19 | ≥20 | M/F | CVD mortality | 81-item FFQ and 24-h dietary recall | Q4 v. Q1 | 5·2–29·8 times/d | 0–2·6 times/d | 1·13 | 0·74, 1·71 | Age, sex, race/ethnicity, total energy intake, poverty level, education level, smoking status, physical activity, alcohol intake, BMI, hypertension status, total cholesterol and estimated glomerular filtration rate | Good |
| 2451/11 898 | All-cause mortality | 1·30 | 1·08, 1·57 | |||||||||||
| Rico-Campà et al. (2019)(31) | Spain (SUN) |
355/19 899 | 10·4 | 37·6 | M/F | All-cause mortality | 136-item FFQ | Q4 v. Q1 | >4 servings/d | <2 servings/d | 1·62 | 1·13, 2·33 | Age, sex, marital status, baseline BMI, total energy intake, smoking status, family history of CVD, alcohol consumption, CVD, cancer, diabetes, depression, hypertension, educational level, self-reported hypercholesterolaemia, snacking, following a special diet at baseline, physical activity and smoking status | Good |
| Sandoval-Insausti et al. (2020)(32) | Spain (Seniors-ENRICA) |
132/1822 | 3·5 | ≥60 | M/F | Incident frailty | Computer-based dietary history | Q4 v. Q1 | 34·9 % of TE | 6·5 % of TE | 3·67 | 2·00, 6·73 | Age, sex, level of education, marital status, tobacco consumption, former-drinker status, chronic respiratory disease, coronary disease, stroke, osteoarthritis/arthritis, cancer, depression requiring treatment and number of medications used | Fair |
| Schnabel et al. (2019)(33) | France (NutriNet-Santé) |
602/44 551 | 7·1 | ≥45 | M/F | All-cause mortality | 24-h dietary recall | Q4 v. Q1 | >18·0 % of TE | <9·3 % of TE | 1·25 | 0·99, 1·57 | Age, sex, income level, education level, marital status, residence, BMI, physical activity, smoking status, energy intake, alcohol intake, season of food records, first-degree family history of cancer or CVD, number of food records and mPNNS-GS | Good |
| Srour et al. (2019)(13) | France (NutriNet-Santé) |
1409/105 159 | 5·2 | ≥18 | M/F | CVD risk | 24-h dietary recall | Q4 v. Q1 | >22 % of TE | <11 % of TE | 1·23 | 1·04, 1·45 | Age, sex, energy intake, number of 24-h dietary records, smoking status, educational level, physical activity, BMI, alcohol intake, family history of CVD, baseline prevalent type 2 diabetes, dyslipidaemia, hypertension, hypertriacylglycerolaemia and treatments for these conditions | Good |
| 665/105 159 | CHD risk | 1·18 | 0·93, 1·52 | |||||||||||
| 892/105 159 | CV risk | 1·23 | 1·00, 1·53 | |||||||||||
| Bonaccio et al. (2020)(35) | Italy (Moli-sani Study) |
1235/22 810 | 8·3 | 55 | M/F | All-cause mortality | 188-item FFQ | Q4 v. Q1 | >4 servings/d | <2 servings/d | 1·15 | 1·00, 1·34 | NA | NA |
| NA | CVD mortality | 1·50 | 1·18, 1·92 | |||||||||||
| NA | IHD/CV mortality | 1·56 | 1·13, 2·14 |
CDS, Cognitive Difficulties Scale; CES-D, Center for Epidemiologic Studies Depression Scale; CV, cerebrovascular; ELSA, Brazilian Longitudinal Study of Adult Health; ENRICA, Study on Nutrition and Cardiovascular risk factors in Spain; F, female; F-up, follow-up; M, male; mPNNS-GS, Modified Programme National Nutrition Santé Guideline Score; NA, not available; NHANES, National Health and Nutrition Examination Survey; RR, risk ratio; TV, television; SUN, University of Navarra Follow-Up Project; WC, waist circumference.