Ultraprocessed foods reduce longevity among Asians

Consuming ultraprocessed foods (UPFs) in large quantities can shorten the life expectancy of Asians, being associated with elevated risks of mortality from all causes, cardiovascular diseases (CVDs), and respiratory diseases, as shown in a study from Singapore.

In a large cohort of middle-aged and older Chinese adults, the risks of mortality was higher by 6 percent to 10 percent among participants in the highest vs lowest quintile of UPF consumption (all causes: hazard ratio [HR], 1.06, 95 percent confidence interval [CI], 1.02–1.10; CVDs: HR, 1.08, 95 percent CI, 1.01–1.15; respiratory diseases: HR, 1.10, 95 percent CI, 1.02–1.19). [Nutr J 2025;24:146]

Notably, increasing the weight proportion of UPFs in the diet by just 10 percent raised the risk of dying from all causes, cardiovascular disease, and respiratory disease by 4 percent to 6 percent. UPF intake was not associated with cancer mortality.

“The associations remained essentially unchanged after further adjusting for diet quality measured using the Alternative Healthy Eating Index-2010 and antioxidant capacity using the Vitamin C Equivalent Antioxidant Capacity,” the authors noted.

Among the subgroups of UPFs, pronounced associations with all-cause mortality were observed for greater consumption of sweetened beverages such as soft drinks (quartile 4 vs 1: HR, 1.05, 95 percent CI, 1.02–1.08) and sugary products such as crackers and western cakes (quintile 5 vs 1: HR, 1.04, 95 percent CI, 1.01–1.08).

Subgroup analysis showed that the association between UPF intake and the risk of all-cause mortality was stronger among nonsmokers (quintile 5 vs 1: HR, 1.08, 95 percent CI, 1.03–1.13) than smokers (quintile 5 vs 1: HR, 1.01, 95 percent CI, 0.94–1.08; p=0.03 for interaction).

“Since nonsmokers generally start with a lower baseline risk for mortality compared with smokers, the ill effects of UPFs on health could be more apparent in nonsmokers,” according to the authors, who also acknowledged the need to validate their hypothesis in future studies.

Health hazard

“UPFs are industrial formulations that typically include ingredients such as preservatives, sweeteners, colourings, flavourings, and emulsifiers, and which are manufactured from a series of industrial processes (eg, hydrogenation and extrusion),” the authors said. [Public Health Nutr 2019;22:936-941

They emphasized that it’s not just the poor nutritional content of UPFs that poses health risks but the combination of chemicals, additives, and packaging.

First, thermal processing of foods or heat treatment could produce toxic chemicals such as advanced glycation end products, which promote inflammation and oxidative stress, both of which are pivotal risk factors for cardiovascular and respiratory disease. [Compr Rev Food Sci Food Saf 2020;19:2559-2587; J Am Coll Cardiol 2022;79:837-847; Int J Chronic Obstr Pulm Dis 2011;6:413-421]

Second, additives such as emulsifiers have been shown to alter the composition of gut microbiota, contributing to low-grade inflammation and metabolic syndrome, which is particularly associated with impaired lung function and worsening respiratory conditions like asthma. [Nature 2015;519:92-96]

Finally, food packaging contains endocrine-disrupting chemicals such as bisphenol A that could migrate into food. These endocrine disruptors have been linked to obesity and diabetes and can affect lung function by potentially stimulating metastasis in cancer and inducing fibrosis. [J Steroid Biochem Mol Biol 2011;127:118-127; Endocr Rev 2015;36:593-602; Ecotoxicol Environ Saf 2023;264:115479]

Overall, the present study suggests that it could be beneficial to reduce the consumption of UPFs, especially sweetened beverages and sugary products, in Asians, according to the authors.

The analysis included 62,197 middle-aged and older Chinese adults recruited for the Singapore Chinese Health Study from 1993 to 1998. UPF consumption was determined using the items in the semi-quantitative food frequency questionnaire. Mortality from all causes, CVDs, cancer, and respiratory diseases were ascertained via linkage to a nationwide registry through 2022.

Over a median follow-up of 24.9 years, 29,472 deaths were recorded.