Additives in ultra-processed foods linked to higher death risk in major study

A major new study found that eating more ultra-processed foods (UPFs) – especially those with certain additives – is tied to higher mortality from any cause over about 11 years of follow-up.

Published in the journal eClinicalMedicine, researchers looked at nearly 187,000 adults in the U.K. ages 40 to 75 using data gathered from the U.K. Biobank, and tracked their diets and health for 11 years.

Participants filled out multiple online food diaries describing what they ate in a 24-hour period. To figure out how much UPF and which additives (MUPs) people were really eating, the team matched those reported foods to actual supermarket products, checking ingredient labels for 57 potential markers of MUPs, only some of which are traditional additives.

Each food was scored based on how likely it was to contain a given additive. Then, for every person, researchers calculated what percentage of their total daily food intake came from UPFs or specific additives.

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Finally, the team compared these dietary patterns with death records from national health registries to see which additives, and how much of them, were linked with increased mortality during the study period.

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Which additives were riskiest?

Five additive categories showed significant links with higher all-cause mortality (relative to the study’s lowest-risk intake point):

• Flavors – risk rose steadily when flavored foods made up more of the total diet
• Flavor enhancers
• Coloring agents
• Sweeteners – not sugar – like acesulfame, saccharin and sucralose
• Varieties of sugar – in this category, fructose, inverted sugar, lactose, maltodextrin were linked to higher risk

One exception was gelling agents, which were actually linked to lower risk of mortality. The study measured the percent of total food intake by weight.

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When people’s diet consisted of more than 18% UPFs, the risk of mortality began increasing. At 30% of total intake, risk rose by 6%. Risk was 14% higher at 40% of diet, and 19% higher at 50% of diet. 

For flavors, risk was about 20% higher when flavored foods made up 40% of their food intake versus 10%. Colorings were associated with roughly a 24% higher risk at 20% versus 3%. 

Sweeteners were linked to about a 14% higher risk at 20% compared with none.

These estimates come from models adjusted for age, sex, smoking, BMI, blood pressure, alcohol, exercise, income, and more.

Caveats

This is observational research, so it cannot prove that additives cause earlier death. People who eat more UPFs may differ in other health behaviors that also influence outcomes, and the dietary data rely on self-reported 24-hour recalls matched to product ingredient lists, which can introduce error. 

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The findings address all-cause mortality rather than specific diseases, and although the researchers adjusted for many factors, residual confounding is still possible.

So, what can people do about it? To keep an eye on UPFs in your own life, health institutions like Mayo Clinic offer some tips.

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“While the overconsumption of ultra processed foods has been linked to adverse health outcomes, that doesn’t necessarily mean all processed foods are bad for all people in all situations,” Tara Schmidt, M. Ed., RDN, lead dietitian for the Mayo Clinic Diet, said on the Clinic’s website.

“Reducing the intake of something you eat in large portions daily will make more of a health impact than eliminating something you consume rarely,” Schmidt suggests.

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The American Heart Association recommends limiting intake of ultra-processed foods and focusing instead on a diet rich in “vegetables, fruits, whole grains, beans, nuts, seeds, healthy non-tropical oils, and lean proteins.”