Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Mostly true True only under certain conditions Certainty of evidence: low provisional C-UPF-03

Ultra-processed foods raise the risk of cardiovascular disease, type 2 diabetes, cancer and all-cause mortality; an umbrella review found 'convincing' evidence for cardiovascular mortality and type 2 diabetes.

In short: This claim is mostly true as a statement about associations: in many large cohorts people who eat more ultra-processed food have more cardiovascular disease, type 2 diabetes and earlier death, and the umbrella review is quoted correctly; links with cancer are weak, and it is not proven that processing itself is the cause.
Conclusion: Higher UPF intake is consistently linked to chronic disease and mortality; certainty of causation is low.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

في NutriNet-Santé الفرنسية، كل زيادة 10% في حصة الأطعمة فائقة المعالجة رفعت خطر السرطان الكلي 12% (Fiolet 2018)، وأمراض القلب 12% (Srour 2019 BMJ)، والسكري 15% (Srour 2020). ... المراجعة المظلية الأحدث في BMJ (Lane 2024) لخّصت 45 تحليلاً تلوياً على نحو عشرة ملايين مشارك: دليل «مُقنع» يربط الأطعمة فائقة المعالجة بوفيات القلب والأوعية، السكري النوع الثاني، اضطرابات الصحة النفسية.

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Ultra-processed foods raise the risk of cardiovascular disease, type 2 diabetes, cancer and all-cause mortality; an umbrella review found 'convincing' evidence for cardiovascular mortality and type 2 diabetes.

Origin

Source status
Archive editors
Attribution
Archive editors (study selection and narrative are the archive's, not necessarily Elawady's)
Origin
https://eltayebat.com/rule/ultra-processed-foods/
Attribution uncertainty
The archive homepage states that the forbidden-food section is supported by research 'independently of Dr. Diaa's words'. No evidence was found that Elawady himself cited these studies.
Claimed mechanism

Nutrient profile, additives, contact materials, neo-formed contaminants.

Claimed health effect

CVD, T2D, cancer, mortality.

Population concerned

Adults

Geographic restriction by Elawady

none found

Scientific assessment

Mostly true – Correct at its core, but with limitations or minor inaccuracies.

Certainty of evidence: low – Further research is likely to change the assessment considerably.

1. What was claimed?

UPF raises CVD, diabetes, cancer and death risk; Lane 2024 'convincing'.

2. What is demonstrably correct?

Fiolet 2018 cancer HR 1.12 per 10%; Srour 2019 CVD HR 1.12; Srour 2020 T2D HR 1.15; Rico-Campa 2019 HR 1.62 for >4 servings/day; Schnabel 2019 HR 1.14 per 10%; Bonaccio 2021 CVD mortality HR 1.58; Pagliai 2021 all-cause RR 1.25; Lane 2024 class I for CVD mortality (RR 1.50) and T2D (dose-response RR 1.12).

3. What is wrong or exaggerated?

The archive says these foods 'raise' risk; the studies show associations. Lane 2024 graded CVD mortality evidence GRADE 'very low' despite class I credibility, and common mental disorders 'low'; the archive mentions only 'convincing'. The archive's featured headline wrongly includes obesity among 'convincing' outcomes. Outcomes differ: Lane 2024 (A-UPF-13) gives moderate certainty only for the T2D dose-response, low/very low for all-cause and CVD mortality, and weak or no evidence for cancer mortality (HR 1.00, 0.81-1.24; class V) and breast and prostate cancer; only 4 of 45 outcomes reached moderate GRADE. SUN (A-UPF-03) supports only all-cause mortality (335 deaths; CVD and cancer deaths not significant; significance lost when excluding baseline hypertension or depression). Several cohort results overlap (NutriNet-Santé is the source of many single studies), so they are not independent confirmations.

4. What remains unclear?

Causality; contribution of nutrients vs processing vs additives.

5. Which studies support it?

A-UPF-02 to A-UPF-07, A-UPF-13, A-UPF-14; Mendoza 2024 (I-UPF-106; CVD HR 1.11 in US cohorts, +17% in meta-analysis); EPIC mortality (I-UPF-107; circulatory mortality HR 1.09 per SD); EPIC type 2 diabetes (I-UPF-108; HR 1.17 per 10%).

6. Which studies contradict it?

Fang 2024 (I-UPF-105): over about 30 years in US health professionals, only a small all-cause mortality association (HR 1.04), none for cardiovascular or cancer mortality, and no consistent association within diet-quality strata. EPIC (I-UPF-107) found no association with cancer mortality. Several UPF subgroups (breads, cereals, yoghurt, some sweets) were neutral or inversely associated (I-UPF-106, I-UPF-108). I-UPF-03 (critique of NOVA).

7. What applies to Germany and Europe?

European cohorts dominate the evidence; EU policy does not regulate UPF as a category.

8. What is known about Egypt?

No Egyptian cohort reviewed; PURE (A-UPF-12) included Middle Eastern participants for IBD only.

9. What practical conclusion is appropriate?

Limiting UPF is consistent with several national dietary guidelines; the evidence is strongest for cardiometabolic outcomes.

Assessment details

Rationale for certainty of evidence

Consistent associations across many cohorts in several countries, summarised in umbrella reviews; GRADE certainty in Lane 2024 is mostly low or very low (moderate only for the T2D dose-response). Residual confounding and NOVA misclassification limit causal inference; no RCTs on hard outcomes.

Source quality

Archive numbers match abstracts; it omits GRADE ratings (CVD mortality 'convincing' class I but GRADE very low) and uses causal verbs. Its featured headline lists obesity as 'convincing' though Lane graded obesity as class II (highly suggestive).

Regional transferability

High for Europe: NutriNet-Santé (France), SUN (Spain), Moli-sani (Italy).

Individual exceptions

Associations vary by UPF subgroup in several studies.

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

True only under certain conditions – The claim holds only for certain doses, groups of people, preparations or circumstances.

Research question: In adults, is higher UPF intake associated with (and does it cause) higher risk of CVD, type 2 diabetes, cancer and all-cause mortality?

Research question in detail (PECO)
Population
Adults
Intervention or exposure
Higher UPF intake (NOVA 4)
Comparison
Lower UPF intake
Geographic scope
universal biology
Outcomes
  • CVD incidence and mortality
  • Type 2 diabetes
  • Cancer
  • All-cause mortality

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Higher UPF intake is consistently associated with CVD, T2D and all-cause mortality (small relative risks); associations with cancer are weak or absent; causation is not established and effects differ by UPF subgroup.

Why some studies weigh more

Large, independent cohorts in Europe and the US agree on direction for cardiometabolic outcomes; heterogeneity by subgroup and attenuation by diet quality limit causal reading.

Is a causal relationship established? Possible, not established Consistent dose-response but observational; residual confounding and NOVA misclassification.

Remaining uncertainty

Causality; role of processing vs nutrient profile.

Justified conclusion

Correct as an association for cardiometabolic outcomes and mortality; the cancer part and causal wording are overstated.

Why do studies seem to disagree?

US (Fang: no CVD mortality link) vs Europe (EPIC, Moli-sani: CVD mortality link): different diets, UPF composition (processed meat, beverages), FFQ classification and follow-up.

Does this depend on the country?
General biological effects
Biological mechanisms (energy density, eating rate, additives) are universal.
Eating habits
Mostly European and US diets studied; Egyptian UPF intake not quantified in the literature found (PubMed search: 2 hits, neither relevant).
Origin of the food
Not relevant.
Contaminants
Not relevant.
National production conditions
Product formulations differ by country.
Legal rules
No legal UPF category in EU or (as far as checked) Egypt.
Actual monitoring data
No Egyptian monitoring data.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • Absolute rate difference – 64 deaths per 100,000 person-years between extreme quarters (crude RR 1.04). recalculated
  • CI symmetry – Asymmetry from rounding of a narrow interval. recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
CVD, T2D and mortality associations with UPF
Starting level
low (observational studies)
Reasons for downgrading
  • risk of bias (residual confounding)
  • inconsistency (subgroups; cancer)
Reasons for upgrading
  • dose-response
Result
low

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
Europe PMC26 October 2026("ultra-processed" OR "ultraprocessed") AND (TITLE:mortality OR TITLE:"cardiovascular" OR TITLE:"type 2 diabetes" OR TITLE:cancer) AND (PUB_TYPE:"Meta-Analysis" OR TITLE:"prospective cohort") AND PUB_YEAR:[2024 TO 2026]both directions75
Europe PMC26 October 2026TITLE:"ultra-processed" AND TITLE:"mortality" AND AUTH:"Fang Z" AND PUB_YEAR:2024both directions2
PubMed26 October 2026(ultra-processed[ti] OR ultraprocessed[ti]) AND (mortality[ti] OR cardiovascular[ti] OR diabetes[ti]) AND (cohort[ti] OR meta-analysis[pt]) AND 2023:2026[dp]supporting evidence45
PubMed26 October 2026(ultra-processed[ti] OR ultraprocessed[ti]) AND (null[tiab] OR "no association"[tiab] OR heterogeneity[tiab] OR "diet quality"[tiab]) AND (mortality[tiab] OR cardiovascular[tiab] OR diabetes[tiab]) AND 2022:2026[dp]contradicting evidence64

How deeply was this checked?

14 linked studies: 4 checked in full text (4 of them with a structured risk-of-bias assessment), 10 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Mostly true (low)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly true (low)
    New large cohorts confirm cardiometabolic associations and show heterogeneity; verdict and low certainty unchanged. Evidence status 'conditionally_true' chosen because the statement holds as an association for cardiometabolic outcomes, not for cancer and not causally.
    New sources: I-UPF-105 I-UPF-106 I-UPF-107 I-UPF-108

In plain language

Many large studies in Europe and elsewhere find that people who eat more ultra-processed food have more heart disease, diabetes, cancer and earlier death. The archive quotes these numbers correctly. But most of this evidence comes from observing people, and reviewers rate its certainty as low. It is not yet clear whether processing itself, or the sugar, salt and fat in these foods, is responsible.

Studies on this claim

Studies supporting the claim (11)

  • Ultra-processed food and death in France

    Schnabel L et al.. JAMA Intern Med 2019 · PMID 30742202 · DOI 10.1001/jamainternmed.2018.7289
    Cohort studycited by the Tayebat archiveabstract checked

    Each 10% more ultra-processed food was linked with 14% higher death risk.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF consumption associated with all-cause mortality?

    How was the study done?

    Prospective cohort (NutriNet-Santé), web 24-h records.

    How many people, animals or samples were studied?

    44,551; 602 deaths; Adults >=45 y, 73% women

    What was actually found?

    HR per 10% increment 1.14 (1.04-1.27); UPF 14.4% of weight, 29.1% of energy; higher UPF linked to lower income/education, living alone, higher BMI, lower activity.

    How large was the observed effect?

    HR 1.14 per 10%

    What do the results mean in everyday life?

    Association only.

    What are the study's limitations?

    Volunteer cohort, mostly women; Few deaths; NOVA misclassification possible; Residual confounding; Self-reported diet

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High (France).

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and death in Spanish graduates

    Rico-Campà A et al.. BMJ 2019 · PMID 31142450 · DOI 10.1136/bmj.l1949
    Cohort studycited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    More than four servings a day was linked with 62% higher death risk.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF consumption associated with all-cause mortality?

    How was the study done?

    Prospective cohort of Spanish university graduates; FFQ every 2 years.

    How many people, animals or samples were studied?

    19,899; 335 deaths; University graduates aged 20-91

    What was actually found?

    Highest vs lowest quarter HR 1.62 (1.13-2.33); P trend 0.005; per additional serving HR 1.18 (1.05-1.33).

    How large was the observed effect?

    HR 1.62 (1.13-2.33)

    What do the results mean in everyday life?

    Association with uncertainty.

    What are the study's limitations?

    Only 335 deaths, so estimates are imprecise; diet questionnaire not designed for processing levels; people eating most UPF also smoked more and had more illness at baseline; results for heart and cancer deaths were not significant.

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High (Spain).

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and heart disease in France

    Srour B et al.. BMJ 2019 · PMID 31142457 · DOI 10.1136/bmj.l1451
    Cohort studycited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    Each 10% more ultra-processed food was linked with 12% more cardiovascular disease.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF intake associated with CVD?

    How was the study done?

    Population-based prospective cohort with repeated 24-h records.

    How many people, animals or samples were studied?

    105,159; 1,409 CVD cases; Adults >=18

    What was actually found?

    CVD HR 1.12 (1.05-1.20); CHD 1.13 (1.02-1.24); cerebrovascular 1.11 (1.01-1.21); incidence 277 vs 242 per 100,000 PY (high vs low quarter); robust to nutritional-quality adjustment.

    How large was the observed effect?

    HR 1.12 (1.05-1.20); 277 vs 242/100,000 PY

    What do the results mean in everyday life?

    Small absolute difference.

    What are the study's limitations?

    Observational; only about 5 years of follow-up; volunteers, mostly women; almost half of the heart and brain events were short 'mini-strokes' (TIA); people eating more UPF were younger and smoked more.

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and type 2 diabetes in France

    Srour B et al.. JAMA Intern Med 2020 · PMID 31841598 · DOI 10.1001/jamainternmed.2019.5942
    Cohort studycited by the Tayebat archiveabstract checked

    Each 10% more ultra-processed food was linked with 15% more diabetes.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF consumption associated with T2D?

    How was the study done?

    Prospective cohort with repeated 24-h records.

    How many people, animals or samples were studied?

    104,707; 821 T2D cases; Adults >=18, 79% women

    What was actually found?

    HR 1.15 (1.06-1.25) per 10-point increment; robust to adjustment for comorbidities (1.13) and weight change (1.13); per 100 g/day 1.05; absolute rates 113 vs 166 per 100,000 PY.

    How large was the observed effect?

    HR 1.15 (1.06-1.25)

    What do the results mean in everyday life?

    Association.

    What are the study's limitations?

    NOVA misclassification possible; Residual confounding; Self-reported diet

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and cancer in France

    Fiolet T et al.. BMJ 2018 · PMID 29444771 · DOI 10.1136/bmj.k322
    Cohort studycited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    Each 10% more ultra-processed food was linked with 12% more cancer.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF intake associated with cancer risk?

    How was the study done?

    Population-based prospective cohort with repeated 24-h records.

    How many people, animals or samples were studied?

    104,980; 2,228 cancer cases; Adults >=18 (median age 42.8)

    What was actually found?

    Overall cancer HR 1.12 (1.06-1.18); breast cancer 1.11 (1.02-1.22); robust to nutritional-quality adjustment.

    How large was the observed effect?

    HR 1.12 (1.06-1.18)

    What do the results mean in everyday life?

    Association only.

    What are the study's limitations?

    Observational; only about 5 years of follow-up, which is short for cancer; volunteers, mostly women; no link found for prostate or bowel cancer; may reflect other lifestyle differences.

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and death in Italy

    Bonaccio M et al.. Am J Clin Nutr 2021 · PMID 33333551 · DOI 10.1093/ajcn/nqaa299
    Cohort studycited by the Tayebat archiveabstract checked

    Highest consumers had 58% higher cardiovascular death risk; sugar content explained about a third of the heart/stroke link.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF associated with mortality; which factors mediate?

    How was the study done?

    Prospective cohort, FFQ.

    How many people, animals or samples were studied?

    22,475; Adults mean age 55

    What was actually found?

    Q4 vs Q1: CVD mortality HR 1.58 (1.23-2.03); IHD/cerebrovascular 1.52 (1.10-2.09); all-cause 1.26 (1.09-1.46); sugar content explained 36.3% of IHD/cerebrovascular association; renal biomarkers 20.1%.

    How large was the observed effect?

    HR 1.58 CVD mortality

    What do the results mean in everyday life?

    Sugar in UPF may be a key factor.

    What are the study's limitations?

    NOVA misclassification possible; Residual confounding; Self-reported diet

    What does it say about Elawady's specific claim?

    Supports C-UPF-03.

    Do the results apply to Germany and Europe?

    High (Italy).

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Umbrella review: ultra-processed food and health

    Lane MM et al.. BMJ 2024 · PMID 38418082 · DOI 10.1136/bmj-2023-077310
    Systematic reviewcited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    UPF was linked to 32 of 45 health outcomes; certainty was mostly low.

    Archive omits GRADE (very low for CVD mortality) and wrongly lists obesity as 'convincing' in its headline.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What is the credibility of associations between UPF and health outcomes?

    How was the study done?

    Umbrella review of 45 pooled analyses with credibility classes and GRADE.

    How many people, animals or samples were studied?

    45 pooled analyses; n=9,888,373; Pooled populations

    What was actually found?

    Class I: CVD mortality RR 1.50 (1.37-1.63; GRADE very low); T2D dose-response RR 1.12 (1.11-1.13; moderate); prevalent anxiety OR 1.48 (low); common mental disorders OR 1.53 (low). Class II: all-cause mortality RR 1.21 (low), heart-disease mortality HR 1.66 (low), T2D OR 1.40 (very low), depression HR 1.22 (low), sleep OR 1.41, wheezing RR 1.40, obesity OR 1.55 (low). GRADE overall: 22 low, 19 very low, 4 moderate.

    How large was the observed effect?

    CVD mortality RR 1.50; T2D 1.12 per dose

    What do the results mean in everyday life?

    Consistent links, low certainty.

    What are the study's limitations?

    All the studies behind it are observational; many results rest on only 2-4 studies; for most outcomes the certainty is low or very low; the mental-health results come mainly from one-time surveys that cannot show what came first.

    What does it say about Elawady's specific claim?

    Core summary for C-UPF-03 and C-UPF-04.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed food and health: meta-analysis

    Pagliai G et al.. Br J Nutr 2021 · PMID 32792031 · DOI 10.1017/S0007114520002688
    Meta-analysiscited by the Tayebat archiveabstract checked

    Highest consumers had 25% higher death risk and 29% higher CVD risk in cohorts.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is UPF associated with health status?

    How was the study done?

    Systematic review and meta-analysis of cross-sectional and cohort studies.

    How many people, animals or samples were studied?

    23 studies (10 cross-sectional, 13 cohorts; 183,491 in cohorts); Adults

    What was actually found?

    Cohorts: all-cause mortality RR 1.25 (1.14-1.37); CVD 1.29 (1.12-1.48); cerebrovascular 1.34 (1.07-1.68); depression 1.20 (1.03-1.40). Cross-sectional: overweight/obesity +39%, low HDL +102%, metabolic syndrome +79%.

    How large was the observed effect?

    RR 1.25 mortality

    What do the results mean in everyday life?

    Association.

    What are the study's limitations?

    Few studies per outcome

    What does it say about Elawady's specific claim?

    Supports C-UPF-03; mixed for C-UPF-04.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Ultra-processed foods and heart disease

    Mendoza K et al.. Lancet Reg Health Am 2024 · PMID 39286398 · DOI 10.1016/j.lana.2024.100859
    Cohort studyindependent cross-checkabstract checked

    People eating the most ultra-processed food had 11% more cardiovascular disease; sweet drinks and processed meats drove the link, while some UPF like cereals and yoghurt did not.

    CVD HR 1.11 (cohorts) and +17% (meta-analysis); heterogeneity by UPF subgroup.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    To link UPF with cardiovascular disease.

    How was the study done?

    Three cohorts plus meta-analysis.

    How many people, animals or samples were studied?

    About 207,000 adults; 22 studies.

    What was actually found?

    Higher CVD and CHD risk with more UPF; differences by food group.

    How large was the observed effect?

    CVD HR 1.11 (1.06-1.16).

    What do the results mean in everyday life?

    Cutting sugary drinks and processed meat matters most.

    What are the study's limitations?

    Observational.

    What does it say about Elawady's specific claim?

    Supports C-UPF-03 for CVD.

    Do the results apply to Germany and Europe?

    Includes European data.

    What can explicitly not be concluded from this study?

    Cannot prove causation.

    Scientific details →

  • Ultra-processed food and death in 9 European countries

    González-Gil EM et al.. Lancet Reg Health Eur 2025 · PMID 39867840 · DOI 10.1016/j.lanepe.2024.101208
    Cohort studyindependent cross-checkabstract checked

    In 429,000 Europeans, more UPF was linked to more deaths from heart and circulation diseases, but not from cancer.

    Circulatory mortality HR 1.09 per SD; no cancer mortality association.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    To link processing level with causes of death.

    How was the study done?

    Large European cohort (EPIC).

    How many people, animals or samples were studied?

    428,728 adults.

    What was actually found?

    More circulatory and digestive deaths; no link with cancer deaths.

    How large was the observed effect?

    Circulatory HR 1.09 per SD.

    What do the results mean in everyday life?

    Relevant to European diets.

    What are the study's limitations?

    Observational; one diet measurement.

    What does it say about Elawady's specific claim?

    Supports C-UPF-03 except cancer.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Cannot prove causation.

    Scientific details →

  • Food processing and type 2 diabetes in Europe

    Dicken SJ et al.. Lancet Reg Health Eur 2024 · PMID 39529810 · DOI 10.1016/j.lanepe.2024.101043
    Cohort studyindependent cross-checkabstract checked

    Each 10% more of the diet from UPF was linked to 17% more type 2 diabetes, but some UPF groups such as breads and cereals were linked to less.

    T2D HR 1.17 per 10% UPF in 311,892 Europeans; heterogeneous by UPF subgroup.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    To link processing level with diabetes.

    How was the study done?

    Large European cohort.

    How many people, animals or samples were studied?

    311,892 adults.

    What was actually found?

    More UPF, more diabetes; heterogeneity by food group.

    How large was the observed effect?

    HR 1.17 (1.14-1.19) per 10%.

    What do the results mean in everyday life?

    Specific UPF matter more than the label.

    What are the study's limitations?

    Observational.

    What does it say about Elawady's specific claim?

    Supports T2D part of C-UPF-03.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Cannot prove causation.

    Scientific details →

Studies contradicting or limiting the claim (1)

  • A critical view of ultra-processed food research

    Gibney MJ et al.. Am J Clin Nutr 2017 · PMID 28793996 · DOI 10.3945/ajcn.117.160440
    Narrative reviewindependent cross-checkabstract checked

    Critics argue the UPF category is too broad and adds little beyond nutrients.

    Does the study support the specific claim? No · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Critique of NOVA framework.

    How was the study done?

    Critical commentary.

    How many people, animals or samples were studied?

    Not applicable; Not applicable

    What was actually found?

    Argues no evidence that UPF are hyperpalatable/quasi-addictive; EU/US data do not show UPF-dominated diets are low in micronutrients; NOVA definition too broad for food-based dietary guidelines; little advantage over nutrient-based epidemiology.

    How large was the observed effect?

    Not applicable

    What do the results mean in everyday life?

    The UPF concept is debated.

    What are the study's limitations?

    Opinion piece; predates RCTs (Hall 2019, Dicken 2025)

    What does it say about Elawady's specific claim?

    Limits C-UPF-01, C-UPF-03.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    That UPF are harmless.

    Scientific details →

Studies with mixed or unclear results (2)

  • Trans fats and heart disease (review)

    Mozaffarian D et al.. N Engl J Med 2006 · PMID 16611951 · DOI 10.1056/NEJMra054035
    Narrative reviewcited by the Tayebat archiveabstract checked

    A review of trans fats and heart disease; no abstract was available to assess.

    Does the study support the specific claim? Unclear · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Effects of trans fatty acids on CVD.

    How was the study done?

    Narrative review.

    How many people, animals or samples were studied?

    Not applicable; Not applicable

    What was actually found?

    No abstract available in PubMed; content not reviewed.

    How large was the observed effect?

    Not applicable

    What do the results mean in everyday life?

    Not assessable.

    What are the study's limitations?

    Content not reviewed (no abstract)

    What does it say about Elawady's specific claim?

    Indirect context for C-UPF-03 (industrial trans fats are one historical UPF component).

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Anything specific without full text.

    Scientific details →

  • Ultra-processed food and death in 114,000 US health workers

    Fang Z et al.. BMJ 2024 · PMID 38719536 · DOI 10.1136/bmj-2023-078476
    Cohort studyindependent cross-checkabstract checked★ key study

    Over about 30 years, people eating the most ultra-processed food had a 4% higher death rate; processed meat and sweet drinks drove most of it, while cancer and heart deaths were not linked.

    All-cause HR 1.04 only; no CVD or cancer mortality association; heterogeneity by UPF subgroup.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    To link UPF intake with causes of death.

    How was the study done?

    Two long-running cohort studies.

    How many people, animals or samples were studied?

    114,064 adults.

    What was actually found?

    Slightly higher overall mortality; no link for cancer or heart deaths; strong links for processed meat.

    How large was the observed effect?

    HR 1.04 (1.01-1.07).

    What do the results mean in everyday life?

    Not all ultra-processed foods are equal; processed meat and sugary drinks matter most.

    What are the study's limitations?

    Observational; questionnaire-based.

    What does it say about Elawady's specific claim?

    Limits the breadth of C-UPF-03.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Cannot prove that processing causes death.

    Scientific details →

Regional context

Germany / EU

European cohorts dominate the evidence; EU policy does not regulate UPF as a category.

Egypt

No Egyptian cohort reviewed; PURE (A-UPF-12) included Middle Eastern participants for IBD only.

What applies in my country?

General scientific assessment

Mostly true Higher UPF intake is consistently linked to chronic disease and mortality; certainty of causation is low.

The following areas of food safety are relevant to this statement:

  • Additives and processing
  • Controls, imports, recalls, labelling

Choose a country to see the checked information for it.

Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.

Country of residence or purchase Compare with another country

References

  1. Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France.. Schnabel L et al.. JAMA Intern Med 2019 · PMID 30742202 · DOI 10.1001/jamainternmed.2018.7289
  2. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study.. Rico-Campà A et al.. BMJ 2019 · PMID 31142450 · DOI 10.1136/bmj.l1949
  3. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé).. Srour B et al.. BMJ 2019 · PMID 31142457 · DOI 10.1136/bmj.l1451
  4. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort.. Srour B et al.. JAMA Intern Med 2020 · PMID 31841598 · DOI 10.1001/jamainternmed.2019.5942
  5. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort.. Fiolet T et al.. BMJ 2018 · PMID 29444771 · DOI 10.1136/bmj.k322
  6. Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study.. Bonaccio M et al.. Am J Clin Nutr 2021 · PMID 33333551 · DOI 10.1093/ajcn/nqaa299
  7. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses.. Lane MM et al.. BMJ 2024 · PMID 38418082 · DOI 10.1136/bmj-2023-077310
  8. Consumption of ultra-processed foods and health status: a systematic review and meta-analysis.. Pagliai G et al.. Br J Nutr 2021 · PMID 32792031 · DOI 10.1017/S0007114520002688
  9. Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies.. Mendoza K et al.. Lancet Reg Health Am 2024 · PMID 39286398 · DOI 10.1016/j.lana.2024.100859
  10. Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries.. González-Gil EM et al.. Lancet Reg Health Eur 2025 · PMID 39867840 · DOI 10.1016/j.lanepe.2024.101208
  11. Food consumption by degree of food processing and risk of type 2 diabetes mellitus: a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC).. Dicken SJ et al.. Lancet Reg Health Eur 2024 · PMID 39529810 · DOI 10.1016/j.lanepe.2024.101043
  12. Ultra-processed foods in human health: a critical appraisal.. Gibney MJ et al.. Am J Clin Nutr 2017 · PMID 28793996 · DOI 10.3945/ajcn.117.160440
  13. Trans fatty acids and cardiovascular disease.. Mozaffarian D et al.. N Engl J Med 2006 · PMID 16611951 · DOI 10.1056/NEJMra054035
  14. Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study.. Fang Z et al.. BMJ 2024 · PMID 38719536 · DOI 10.1136/bmj-2023-078476

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