Alimentos ultraprocesados

Referencias

1. Independiente

   Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them Public Health Nutrition, 2019.

   doi:10.1017/S1368980018003762PubMed 30744710

   Financiación y resultado

   Financiación

   This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; grant number 2015/14900-9). The conclusions and opinions in this article are those of the authors and do not necessarily reflect those of FAPESP.

   Resultado

   Commentary by the authors of NOVA. Ultra-processed foods are formulations of ingredients, mostly of exclusive industrial use, that result from a series of industrial processes: fractioning of whole foods into substances, chemical modification of these substances, assembly of modified and unmodified food substances, frequent use of cosmetic additives and sophisticated packaging. A product is identified as ultra-processed when its ingredient list contains at least one food substance never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, hydrolysed proteins) or a class of additive designed to make the product palatable or more appealing (flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).

2. Independiente

   Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses BMJ, 2024.

   doi:10.1136/bmj-2023-077310PubMed 38418082

   Financiación y resultado

   Registro

   PROSPERO CRD42023412732

   Financiación

   This work was not funded.

   Resultado

   Direct associations for 32 of 45 pooled analyses (71%). Convincing (class I): cardiovascular disease mortality RR 1.50 (95% CI 1.37 to 1.63; GRADE very low), type 2 diabetes RR 1.12 per 10% increment (1.11 to 1.13; moderate), prevalent anxiety OR 1.48 (1.37 to 1.59; low) and common mental disorders OR 1.53 (1.43 to 1.63; low). Highly suggestive (class II): all-cause mortality RR 1.21 (1.15 to 1.27; low), obesity OR 1.55 (1.36 to 1.77; low). Cancer mortality HR 1.00 (0.81 to 1.24). GRADE: 4 moderate, 22 low, 19 very low. No included meta-analysis was funded by a producer of ultra-processed food; none reported the funding sources of its primary studies (AMSTAR 2 item 10).

3. Independiente

   Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake Cell Metabolism, 2019.

   doi:10.1016/j.cmet.2019.05.008PubMed 31105044

   Financiación y resultado

   Registro

   NCT03407053

   Participantes

   20

   Seguimiento

   14 days on each diet, 28 days as inpatients, crossover without washout

   Financiación

   This work was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Diabetes & Digestive & Kidney Diseases.

   Resultado

   Meals matched for presented energy, energy density including beverages, macronutrients, sugars, sodium and fibre; non-beverage energy density 1.957 kcal/g (ultra-processed) versus 1.057 kcal/g (unprocessed). Ad libitum energy intake 508 ± 106 kcal/day higher on the ultra-processed diet (carbohydrate 280 ± 54, fat 230 ± 53, protein −2 ± 12 kcal/day); weight +0.9 ± 0.3 kg versus −0.9 ± 0.3 kg; body fat +0.4 ± 0.1 kg versus −0.3 ± 0.1 kg; eating rate 17 ± 1 kcal/min and 7.4 ± 0.9 g/min faster; fibre intake 48.5 versus 45.8 g/day (P = 0.41); insoluble share of presented fibre about 16% versus 77%. Fasting PYY 25.1 versus 34.3 pg/ml (baseline 28.9); active ghrelin 54.1 versus 48.3 pg/ml (baseline 61.4). Mean ± SE. A 2019 erratum corrected meal-specific intakes; a 2020 erratum was not read.

4. Independiente

   Martínez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study Population Health Metrics, 2017.

   doi:10.1186/s12963-017-0119-3PubMed 28193285

   Financiación y resultado

   Participantes

   9317

   Financiación

   This research received funding from Conselho Nacional de Desenvolvimento Científico e Tecnológico, Edital MCTI/CNPq/Universal (Processo CNPq nº 443477/2014-0) and from Fundação de Amparo à Pesquisa do Estado de São Paulo (Processo FAPESP nº 2015/14900-9).

   Resultado

   Ultra-processed foods supplied 57.5% of energy (mean intake 2,069.9 kcal/day). From the lowest to the highest quintile of the ultra-processed share (means 32.6% and 80.7% of energy): protein 17.9% to 13.1% of energy, carbohydrate 46.5% to 53.4%, added sugars 7.7% to 19.2%, saturated fat 10.1% to 10.9%; fibre 9.6 to 6.7 g/1,000 kcal, potassium 1.6 to 1.0 g/1,000 kcal, magnesium 173.3 to 117.3 mg/1,000 kcal, vitamin C 58.2 to 32.4 mg/1,000 kcal; sodium 1.74 to 1.63 g/1,000 kcal (trend not significant).

5. Independiente

   Vital M, Howe AC, Tiedje JM. Revealing the bacterial butyrate synthesis pathways by analyzing (meta)genomic data mBio, 2014.

   doi:10.1128/mBio.00889-14PubMed 24757212

   Financiación y resultado

   Financiación

   Financial support was provided by the NIH Human Microbiome Project Demonstration Project (UH3 DK083993).

   Resultado

   225 genomes carried a butyrate synthesis pathway. Four pathways (acetyl-CoA, glutarate, 4-aminobutyrate, lysine) converge on the conversion of crotonyl-CoA to butyryl-CoA by the butyryl-CoA dehydrogenase–electron-transferring flavoprotein complex, a step postulated to conserve energy through ferredoxin reduction. In the acetyl-CoA pathway, thiolase, β-hydroxybutyryl-CoA dehydrogenase and crotonase precede this step, and butyryl-CoA:acetate CoA-transferase or phosphate butyryltransferase with butyrate kinase forms butyrate. In stool metagenomes the acetyl-CoA pathway made up a mean 79.7% of butyrate pathways; for that pathway the terminal genes but and buk had median abundances of 77.2% and 21.8%. Butyrate is described as the main energy source for colonocytes.

6. Independiente

   Dicken SJ, Jassil FC, Brown A, Kalis M, Stanley C, Ranson C, et al. Ultraprocessed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial Nature Medicine, 2025.

   doi:10.1038/s41591-025-03842-0PubMed 40760353

   Financiación y resultado

   Registro

   NCT05627570

   Participantes

   55

   Seguimiento

   8 weeks on each diet, 2 × 2 crossover with a 4-week washout

   Financiación

   The trial was supported by a National Institute for Health and Care Research UCLH Biomedical Research Centre grant and a Rosetrees Trust grant (PGL22/100041). The Sponsor and funders were not involved in the design, conduct or analysis of the trial.

   Resultado

   Both diets followed the UK Eatwell Guide and were delivered to participants' homes for ad libitum intake. Weight change at 8 weeks −2.06% (95% CI −2.99 to −1.13) on minimally processed food and −1.05% (−1.98 to −0.13) on ultra-processed food; difference −1.01 percentage points (−1.87 to −0.14; P = 0.024), −0.96 kg (−1.76 to −0.17). Fat mass difference −0.98 kg; triglycerides −0.25 mmol/l (−0.42 to −0.09) in favour of minimally processed food; LDL cholesterol fell more on ultra-processed food (difference 0.25 mmol/l, 0.05 to 0.45). Corrected energy density 1.25 kcal/g (minimally processed) versus 1.60 kcal/g (ultra-processed). Diet order interacted significantly with diet (P < 0.001).

7. Independiente

   Fang Z, Rossato SL, Hang D, Khandpur N, Wang K, Lo CH, et al. Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study BMJ, 2024.

   doi:10.1136/bmj-2023-078476PubMed 38719536

   Financiación y resultado

   Participantes

   114.064

   Seguimiento

   median 34 years (women) and 31 years (men)

   Financiación

   This work was supported by the US National Institutes of Health grants (UM1 CA186107; P01 CA87969; U01 CA167552; U01 CA261961; R01 CA263776; and K99 CA283146). The funders had no role in considering the study design or in the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication.

   Resultado

   48,193 deaths. Highest versus lowest quarter of ultra-processed food intake (whole grains and alcohol excluded from the exposure): all-cause mortality HR 1.04 (95% CI 1.01 to 1.07), 1536 versus 1472 deaths per 100,000 person-years; mortality from causes other than cancer or cardiovascular disease HR 1.09 (1.05 to 1.13); no association with cancer or cardiovascular mortality. Meat, poultry and seafood based ready-to-eat products HR 1.06 to 1.43 across mortality outcomes. Within quarters of Alternative Healthy Eating Index-2010 score, ultra-processed food showed no consistent association with mortality; adjustment for that score attenuated the association toward null, and removal of smoking pack-years from the model strengthened it.

8. Financiado por la industria

   Forde CG, Heuven LA, van Bruinessen M, Liu Z, Stieger M, de Graaf K, et al. Eating rate has sustained effects on energy intake from ultraprocessed diets: a 2-week ad libitum dietary randomized controlled crossover trial American Journal of Clinical Nutrition, 2026.

   doi:10.1016/j.ajcnut.2025.11.012PubMed 41314613

   Financiación y resultado

   Registro

   NCT06113146

   Participantes

   41

   Seguimiento

   14 days on each diet with a 14-day washout

   Financiación

   This research is supported by the Dutch Top-Consortium for Knowledge and Innovation Agri & Food (TKI-Agri-food) Project Restructure (TKI 22.150). The Restructure project is a public–private partnership on precompetitive research on the influence of food texture and eating rate on energy intake.

   Resultado

   Single-blind crossover of two diets with about 95% of energy from ultra-processed food, matched for palatability, portion size, energy served, non-beverage energy density and meal variety, differing in texture-derived eating rate. Daily energy intake was 369 kcal/day (95% CI 221 to 517) lower on the slow-eating-rate diet, consistently across the 14 days; body weight did not differ between diets; fat mass decreased by 0.43 kg on the slow-eating-rate diet.

9. Consenso

   Guasti L, Bonaccio M, Abreu A, Asteggiano R, Bes-Rastrollo M, Christodorescu R, et al. Ultra-processed foods, lifestyle management, and cardiovascular diseases: a clinical consensus statement of the European Society of Cardiology Council for Cardiology Practice and the European Association of Preventive Cardiology of the European Society of Cardiology European Heart Journal, 2026.

   doi:10.1093/eurheartj/ehag226PubMed 42091095

   Financiación y resultado

   Financiación

   Funding: nothing to declare.

   Resultado

   Associations of ultra-processed food intake with cardiovascular risk factors, incidence and mortality derive predominantly from observational studies, to be interpreted with caution because residual confounding and reverse causation cannot be fully excluded; trials are scarce, short-term and limited to surrogate outcomes, and trials of reduced intake on hard cardiovascular endpoints are lacking. Proposed non-nutrient mechanisms (additives, processing contaminants, packaging migrants, altered food matrix) support biological plausibility without demonstrating causal effects. General cardiologists are advised to assess intake of ultra-processed food and include it in counselling.

10. Consenso

    2025 Dietary Guidelines Advisory Committee. Scientific report of the 2025 Dietary Guidelines Advisory Committee: advisory report to the Secretary of Health and Human Services and Secretary of Agriculture US Department of Health and Human Services and US Department of Agriculture, 2024.

    doi:10.52570/dgac2025

    Financiación y resultado

    Financiación

    Federal advisory committee convened under the Federal Advisory Committee Act; HHS chartered the Committee and served as administrative lead, and HHS and USDA support development of the Dietary Guidelines. The Departments proposed the scientific questions and worked with the Committee to refine them.

    Resultado

    Systematic review question on dietary patterns with varying amounts of ultra-processed food and growth, body composition and risk of obesity. Children and adolescents, and adults and older adults: patterns with more food classified as ultra-processed are associated with greater adiposity (fat mass, waist circumference, BMI) and greater risk of overweight or obesity (grade limited). Infants and young children, pregnancy and postpartum: grade not assignable. The evidence was difficult to assess because definitions of ultra-processed food varied between studies, many such foods were higher in saturated fat, sodium and added sugars, and food frequency questionnaires do not distinguish processing levels.

11. Financiación no determinada

    Robinson E, Jones A, Evans R, Finlay A, Brealey J, Gough T, et al. A systematic review and meta-analysis of randomized controlled trials examining the effect of ultra-processed food on energy intake and weight gain Critical Reviews in Food Science and Nutrition, 2026.

    doi:10.1080/10408398.2026.2731838PubMed 42746678

    Financiación y resultado

    Financiación

    Funding statement not read: the publisher's full text returned HTTP 403 to automated access, and the article is absent from PubMed Central and Europe PMC full text. Crossref metadata list no funder.

    Resultado

    Pre-registered. Standardised mean differences for energy intake 0.18 to 0.44 in ultra-processed arms, with statistical significance varying between models; weight gain SMD 0.65 and eating rate SMD 0.96, both significant; palatability and appetite did not differ. Diets were not matched for nutrient profile. Energy intake SMD 0.71 when ultra-processed diets were more energy dense and 0.02 when energy density was similar. Certainty of evidence low. Results read from the PubMed abstract.