超加工食品(UPFs)在全球范围内的消费越来越多,并与几种慢性疾病有关。本文旨在描述与健康相关结果有关的UPFs的现有证据的总和,作为为2023年北欧营养建议制定基于食物的饮食指南的基础。进行了系统的文献检索,以确定系统评价,荟萃分析,随机对照试验(RCT),和前瞻性队列研究,研究UPF摄入与非传染性疾病或死亡率之间的关联。共纳入12项系统评价(包括5项荟萃分析)和44项原始研究(43项前瞻性队列研究和1项RCT)。所有原始研究都被认为具有良好的方法学质量。目前的证据支持,更多的UPFs消费与体重增加和肥胖风险增加有关。心血管疾病,2型糖尿病,和全因死亡率。现有文献还支持UPFs和高血压之间的关联,癌症,和抑郁症;然而,有限的研究和研究对象无法得出有力的结论。由于UPFs的高度多样性,额外的研究是必要的,特别强调解开调解机制,无论是营养的还是非营养的。然而,关于UPFs与体重增加有关的现有证据,CVD,2型糖尿病,全因死亡率被认为足够强,以支持饮食建议,以限制其消费。
Ultra-processed foods (UPFs) are increasingly consumed worldwide and have been linked to several chronic diseases. This paper aims to describe the totality of the available evidence regarding UPFs in relation to health-related outcomes as a basis for setting food-based dietary guidelines for the Nordic Nutrition Recommendations 2023. Systematic literature searches were conducted to identify systematic reviews, meta-analyses, randomized controlled trials (RCTs), and prospective cohort studies examining the association between UPF intake and non-communicable diseases or mortality. A total of 12 systematic reviews (including five meta-analyses) and 44 original research studies (43 prospective cohort studies and one RCT) were included. All original research studies were deemed to be of good methodological quality. The current evidence supports that greater consumption of UPFs is associated with weight gain and increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. The available literature also supports an association between UPFs and hypertension, cancer, and depression; however, the limited number of studies and subjects investigated preclude strong conclusions. Due to the highly diverse nature of UPFs, additional studies are warranted, with special emphasis on disentangling mediating mechanisms, whether nutritional or non-nutrient based. Nevertheless, the available evidence regarding UPFs in relation to weight gain, CVD, type 2 diabetes, and all-cause mortality is considered strong enough to support dietary recommendations to limit their consumption.