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Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999–2018.

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Title: Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999–2018.
Authors: Hatta-Langedyk, Juna, Wang, Lu, Fan, Bingbing, Shi, Peilin, Mozaffarian, Dariush
Source: American Journal of Public Health. Jul2026, Vol. 116 Issue 7, p1015-1024. 10p.
Subjects: Obesity risk factors, Hypertension risk factors, Mortality risk factors, Packaged foods, Risk assessment, Cross-sectional method, HDL cholesterol, Research funding, Glycosylated hemoglobin, Data analysis, Questionnaires, Multiple regression analysis, Nutritional assessment, Cardiovascular diseases risk factors, Disease prevalence, Descriptive statistics, LDL cholesterol, Surveys, Odds ratio, Chronic diseases, Metabolic syndrome, Statistics, Tumors, Confidence intervals, Diabetes, Proportional hazards models, Diet
Geographic Terms: United States
Abstract: Objectives. To examine associations of ultraprocessed foods (UPFs, defined by Nova) with cardiometabolic risk factors, prevalent conditions, and mortality, before and after comprehensively adjusting for nutritional quality. Methods. We analyzed data from 47 999 adults in the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Survey-weighted, multivariable adjusted linear or logistic regression evaluated cross-sectional associations with risk factors and disease prevalence, and Cox models evaluated prospective associations with all-cause mortality. Models were compared before and after adjustment for each individual's Food Compass Score (i.FCS) to test independence from nutritional quality. Results. Every 10% of energy supplied from UPFs was associated with higher body mass index, HbA1c, diastolic blood pressure, total-to-high-density lipoprotein cholesterol (HDL-C); lower HDL-C and low-density lipoprotein cholesterol (LDL-C); greater prevalence of metabolic syndrome (odds ratio [OR] = 1.07; 95% confidence interval [CI] = 1.05, 1.09), diabetes (OR = 1.03; 95% CI = 1.00, 1.07), and cancer (OR = 1.05; 95% CI = 1.02, 1.08); and higher risk of all-cause mortality (hazard ratio = 1.04; 95% CI = 1.02, 1.07). When we adjusted for i.FCS, associations were only partly attenuated, remaining significant. By comparison, adjustment for saturated fat, added sugar, or sodium had little effect. Findings were consistent in population subgroups, except for stronger associations among lower-income adults. Conclusions. UPF consumption is associated with adverse risk factors, disease conditions, and all-cause mortality, only partly explained by nutritional quality. (Am J Public Health. 2026;116(7):1015–1024. https://doi.org/10.2105/AJPH.2026.308499) [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999–2018.
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  Data: <searchLink fieldCode="AR" term="%22Hatta-Langedyk%2C+Juna%22">Hatta-Langedyk, Juna</searchLink><br /><searchLink fieldCode="AR" term="%22Wang%2C+Lu%22">Wang, Lu</searchLink><br /><searchLink fieldCode="AR" term="%22Fan%2C+Bingbing%22">Fan, Bingbing</searchLink><br /><searchLink fieldCode="AR" term="%22Shi%2C+Peilin%22">Shi, Peilin</searchLink><br /><searchLink fieldCode="AR" term="%22Mozaffarian%2C+Dariush%22">Mozaffarian, Dariush</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Public+Health%22">American Journal of Public Health</searchLink>. Jul2026, Vol. 116 Issue 7, p1015-1024. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Obesity+risk+factors%22">Obesity risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension+risk+factors%22">Hypertension risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Mortality+risk+factors%22">Mortality risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Packaged+foods%22">Packaged foods</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22HDL+cholesterol%22">HDL cholesterol</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Glycosylated+hemoglobin%22">Glycosylated hemoglobin</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+regression+analysis%22">Multiple regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Nutritional+assessment%22">Nutritional assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+diseases+risk+factors%22">Cardiovascular diseases risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+prevalence%22">Disease prevalence</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22LDL+cholesterol%22">LDL cholesterol</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+diseases%22">Chronic diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Metabolic+syndrome%22">Metabolic syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Tumors%22">Tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Diabetes%22">Diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink><br /><searchLink fieldCode="DE" term="%22Diet%22">Diet</searchLink>
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  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives. To examine associations of ultraprocessed foods (UPFs, defined by Nova) with cardiometabolic risk factors, prevalent conditions, and mortality, before and after comprehensively adjusting for nutritional quality. Methods. We analyzed data from 47 999 adults in the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Survey-weighted, multivariable adjusted linear or logistic regression evaluated cross-sectional associations with risk factors and disease prevalence, and Cox models evaluated prospective associations with all-cause mortality. Models were compared before and after adjustment for each individual's Food Compass Score (i.FCS) to test independence from nutritional quality. Results. Every 10% of energy supplied from UPFs was associated with higher body mass index, HbA1c, diastolic blood pressure, total-to-high-density lipoprotein cholesterol (HDL-C); lower HDL-C and low-density lipoprotein cholesterol (LDL-C); greater prevalence of metabolic syndrome (odds ratio [OR] = 1.07; 95% confidence interval [CI] = 1.05, 1.09), diabetes (OR = 1.03; 95% CI = 1.00, 1.07), and cancer (OR = 1.05; 95% CI = 1.02, 1.08); and higher risk of all-cause mortality (hazard ratio = 1.04; 95% CI = 1.02, 1.07). When we adjusted for i.FCS, associations were only partly attenuated, remaining significant. By comparison, adjustment for saturated fat, added sugar, or sodium had little effect. Findings were consistent in population subgroups, except for stronger associations among lower-income adults. Conclusions. UPF consumption is associated with adverse risk factors, disease conditions, and all-cause mortality, only partly explained by nutritional quality. (Am J Public Health. 2026;116(7):1015–1024. https://doi.org/10.2105/AJPH.2026.308499) [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.2105/AJPH.2026.308499
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      – Code: eng
        Text: English
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        PageCount: 10
        StartPage: 1015
    Subjects:
      – SubjectFull: Obesity risk factors
        Type: general
      – SubjectFull: Hypertension risk factors
        Type: general
      – SubjectFull: Mortality risk factors
        Type: general
      – SubjectFull: Packaged foods
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: HDL cholesterol
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Glycosylated hemoglobin
        Type: general
      – SubjectFull: Data analysis
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Nutritional assessment
        Type: general
      – SubjectFull: Cardiovascular diseases risk factors
        Type: general
      – SubjectFull: Disease prevalence
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: LDL cholesterol
        Type: general
      – SubjectFull: Surveys
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      – SubjectFull: Odds ratio
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      – SubjectFull: Chronic diseases
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      – SubjectFull: Metabolic syndrome
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      – SubjectFull: Statistics
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      – SubjectFull: Tumors
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      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Diabetes
        Type: general
      – SubjectFull: Proportional hazards models
        Type: general
      – SubjectFull: Diet
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999–2018.
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              Text: Jul2026
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              Y: 2026
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