Ultra-processed foods linked to higher mortality

As research into ultra-processed food gains momentum,1 so too does the debate.234 Foods that fall into the ultra-processed category according to the Nova classification are heterogeneous and include carbonated soft drinks, confectionary, extruded snack foods, distilled alcohol (spirits), and mass produced packaged wholegrain bread.5 Ultra-processed foods are typically high in energy, added sugar, saturated fat, and salt, and a major criticism of previous studies is that they have not disentangled the effects of processing, per se, from the nutrient profile of food products. The linked paper by Fang and colleagues (doi:10.1136/bmj-2023-078476) addresses this concern and others, in their evaluation of the relation between ultra-processed food consumption and mortality in two large US cohort studies.6

Fang and colleagues found a modest increase in the risk of total mortality with higher ultra-processed food consumption6; however, this association was no longer apparent after overall diet quality was taken into account. They also showed that the association between ultra-processed food consumption and mortality was somewhat stronger when distilled alcohol, which is a well established risk factor …