Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Ultra-processed foods (UPFs) and some food additives have been associated with adverse health outcomes, but underlying biological mechanisms remain unclear. We examined associations of UPFs and food additives with biomarkers of inflammation, oxidative stress, and metabolism, and assessed their mediating role in chronic disease risk. Methods Among 6101 adults from the NutriNet-Santé cohort (2009–2022; 66.8% women; mean age 54.0 years), dietary intakes were assessed using repeated 24-hour records including branded products. UPFs were defined using NOVA. Additive exposures were estimated from composition databases and laboratory assays; mixtures were derived using non-negative matrix factorisation. Cross-sectional associations between UPFs (main analysis), additives (individual and mixtures; exploratory), and biomarkers were assessed using multivariable Spearman correlations. Mediation analyses evaluated the role of these biomarkers in associations with hypertension, type 2 diabetes, cardiovascular disease, and cancer. Results Mean UPF intake was 15.0% (SD 7.0) of total diet weight. Higher UPF consumption was associated with higher CRP, triglycerides, bile acids (deoxycholic and glycoursodeoxycholic acids), and LysoPC(12:0), and lower LysoPC(15:0) and LysoPC(17:0). Several biomarkers were identified as potential mediators of associations with type 2 diabetes, cardiovascular disease, coronary heart disease, and hypertension. Exploratory analyses identified multiple associations between additives and biomarkers, and potential mediators of chronic disease risk. Conclusions UPF consumption and exposure to multiple food additives were associated with distinct inflammatory and metabolic biomarker profiles. These biomarkers partly mediated associations with chronic disease risk, providing insight into biological pathways. Although confirmation is needed, these findings strengthen the plausibility of a causal link by supporting biologically plausible mechanisms. Key messages • Inflammation, microbiota, and metabolic changes may partly mediate links between ultra-processed foods, additives, and increased risk of multiple chronic diseases. • These findings support biologically plausible mechanisms, reinforcing recommendations to limit ultra-processed foods and additives and to implement policies reducing population exposure.
Institutions: Inserm, Université Paris Cité, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Sorbonne Paris Nord, Centre de Recherche Épidémiologie et Statistique, Centre international de recherche sur le cancer, Aix-Marseille Université, Centre de Recherche en CardioVasculaire et Nutrition, Fundación Medina
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7223683445