Higher consumption of ultra-processed foods may increase the risk for chronic kidney disease (CKD), a new study finds. Ultra-processed foods and drinks are made from various industrial processes and are typically ready to eat, drink, or heat.

In the prospective Atherosclerosis Risk in Communities (ARIC) study, which included 14,679 US adults aged 45-64 years (55% women; 25% Black), those with the highest vs lowest quartile of ultra-processed food intake based on food frequency questionnaires had a significant 24% increased risk of developing CKD, Casey M. Rebholz, PhD, MS, MPH, of Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues reported in the American Journal of Kidney Diseases. Individuals in the highest vs lowest quartile consumed 8.4 vs 3.6 ultra-processed food servings per day. Each additional serving above 3.9 servings per day was significantly associated with a 5% increased risk of CKD. Results were similar by sex, race, body mass index, hypertension status, and diabetes status.

Ultra-processed foods contain a high amount of added sugar, refined carbohydrates, saturated and trans fats, and sodium, the investigators explained. Food additives are common. The foods typically contain little fiber and protein and few micronutrients. In this study, the top ultra-processed food groups were sugar-sweetened beverages (27%), margarine (18%), bakery goods (15%), and ultra-processed meats such as hot dogs and bologna (11%). Other common ultra-processed food items included cereals, fried foods (eg, chips, French fries), sugary snacks, hard liquor, and ice cream. Substituting 1 serving of ultra-processed foods with fresh or minimally processed foods was significantly associated with a 6% lower risk of CKD.

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“Given the rise of ultra-processed foods in the global food supply, our study provides further support to avoid ultra-processed foods and to replace ultra-processed foods with minimally processed or unprocessed foods,” Dr Rebholz’s team wrote.

More research is needed to identify potential mechanisms by which greater ultra-processed food consumption harms kidney health.

Cardiovascular Disease, Cancer, and Death

Consumption of ultra-processed foods has been recently linked to cardiovascular disease, cancer, and early death. In a French study of 105,159 adults from the 2009-2018 NutriNet-Santé cohort published in the BMJ, each 10% increase in ultra-processed foods as a proportion of the total diet was significantly associated with a 12% increased risk for overall cardiovascular disease, a 13% increased risk for coronary heart disease, and a 11% increased risk for cerebrovascular disease.

“Various factors in processing, such as nutritional composition of the final product, additives, contact materials, and neoformed contaminants might play a role in these associations, and further studies are needed to understand better the relative contributions,” Bernard Srour, PhD candidate at the University of Paris in Bobigny, France, and colleagues wrote.

In a similar study of 104,980 adults in France from the 2009-2017 NutriNet-Santé cohort also published in the BMJ, investigators found that each 10% increase in ultra-processed food intake as a proportion of the total diet was significantly associated with a 12% increased risk for overall cancer and a 11% increased risk for breast cancer.

Beyond nutritional composition, Srour and colleagues noted that neoformed contaminants from industrial processing may have carcinogenic properties (eg, acrylamide, heterocyclic amines, and polycyclic aromatic hydrocarbons).

In a Spanish study of 19,899 adults published in the BMJ, investigators found that those with the highest vs lowest quartile of ultra-processed foods consumption had a significant 62% increased risk for all-cause mortality. Each additional serving of ultra-processed foods above 4 servings per day increased the risk for early death by 18%.

“Discouraging the consumption of ultra-processed foods; targeting products, taxation, and marketing restrictions on ultra-processed products; and promotion of fresh or minimally processed foods, should be considered part of important health policy to improve global public health,” Maira Bes-Rastrollo, PhD, of the University of Navarra in Pamplona, Spain, and colleagues wrote.


Du S, Kim H, Crews DC, et al. Association between ultraprocessed food consumption and risk of incident CKD: a prospective cohort study. Am J Kidney Dis. Published online June 6, 2022. doi:10.1053/j.ajkd.2022.03.016

Rey-García J, Donat-Vargas C, Sandoval-Insausti H, et al. Ultra-processed food consumption is associated with renal function decline in older adults: A prospective cohort study. Nutrients. 2021; 13:428. doi:10.3390/nu13020428

Srour B, Fezeu LK, Kesse-Guyot E, et al. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ. 2019; 365: l1451. doi:10.1136/bmj.l1451

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