Doctoral Candidate, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA.
Department of Medicine, Columbia University Irving Medical Center, New York, USA.
Eur J Clin Nutr. 2023 Jun;77(6):619-627. doi: 10.1038/s41430-022-01225-z. Epub 2022 Oct 24.
Ultra-processed foods (UPF) are ubiquitous in the modern-day food supply and widely consumed. High consumption of these foods has been suggested to contribute to the development of obesity in adults. The purpose of this review is to present and evaluate current literature on the relationship between UPF consumption and adult obesity. Cross-sectional studies (n = 9) among different populations worldwide show a positive association between UPF consumption and obesity. Longitudinal studies (n = 7) further demonstrate a positive association between UPF consumption and development of obesity, suggesting a potential causal influence of UPF consumption on obesity risk. However, only one randomized controlled trial has tested the causality of this association. The study included in this review found greater energy intake and weight gain with consumption of a high UPF diet compared to a high unprocessed food diet. The potential mechanisms by which UPF increase the risk of obesity include increased energy intake due to increased sugar consumption, decreased fiber consumption, and decreased protein density; however, more research is needed. Overall, the evidence identified in the current review consistently support a positive relation between high UPF consumption and obesity. While there is a need for more experimental research to establish causality and elucidate the mechanisms, the sum of the evidence supports a need for research on treatment modalities that include reductions in UPF consumption for the management of adult obesity.
超加工食品(UPF)在现代食品供应中无处不在,广泛消费。高消费这些食品已被认为是导致成年人肥胖的原因之一。本综述的目的是介绍和评估目前关于 UPF 消费与成人肥胖之间关系的文献。来自世界各地不同人群的横断面研究(n=9)表明 UPF 消费与肥胖之间存在正相关关系。进一步的纵向研究(n=7)表明 UPF 消费与肥胖的发展之间存在正相关关系,提示 UPF 消费对肥胖风险可能存在因果影响。然而,只有一项随机对照试验检验了这种关联的因果关系。本综述中包含的研究发现,与食用高未加工食品饮食相比,食用高 UPF 饮食会导致更多的能量摄入和体重增加。UPF 增加肥胖风险的潜在机制包括由于糖消耗增加而导致的能量摄入增加、纤维消耗减少和蛋白质密度降低;然而,还需要更多的研究。总体而言,本综述中确定的证据一致支持 UPF 高消费与肥胖之间的正相关关系。虽然需要更多的实验研究来确定因果关系并阐明机制,但现有证据表明,需要研究包括减少 UPF 消费在内的治疗方法,以管理成人肥胖。