Meta-Analysis Study: Every 100 Grams of Ultra-Processed Food Raises Risk of Chronic Disease

High consumption of ultra-processed food (UPF) is consistently linked to an increased risk of various chronic diseases and premature death, according to a large meta-analysis published in the journal Family Medicine and Community Health. The study, which analyzed 51 prospective cohort studies from the Americas, Europe, Asia, and Oceania, involved nearly 9 million participants aged 23 to 77.

The research, led by David Xiao Liu of the Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, found that people with the highest UPF intake had a greater risk of cardiovascular disease, cancer, obesity, metabolic syndrome, diabetes, depression, anxiety, digestive disorders, hypertension, and death from various causes. The findings reinforce growing evidence that a diet high in industrially processed products has systemic effects on health.

Notably, a dose-response analysis revealed that every additional 100 grams of UPF per day—equivalent to about two packets of instant noodles or one large bottle of soda—was associated with a 14% higher risk of hypertension, 12% for heart disease, and 10% for cancer. Meanwhile, every 10% increase in energy intake from UPF raised the risk of metabolic syndrome or diabetes by up to 16%. These figures show that the higher the share of UPF in the diet, the greater the disease burden.

Nevertheless, Liu stressed that the findings do not prove a causal relationship. "We cannot say UPF directly causes disease," he said. "This is an observational study showing an association, and there are still many confounding factors that may play a role." He added that the main limitations lie in dietary measurement that relies on participants' recall, as well as the exclusion of individuals under 18, so the results cannot be generalized to children and adolescents.

"Ultra-processed food affects the body through multiple pathways at once—excess sugar, salt, calories; food additives; loss of nutrients during processing; and contaminants from packaging—so it is natural that the consequences appear in many organ systems," Liu explained.

One mechanism highlighted is the "cocktail effect" of additive combinations. Liu cited a French cohort study of 100,000 people that found additive exposure tends to cluster in certain patterns, and these combinations can be more harmful than single substances. "Mixtures of food dyes and sodium benzoate, for example, are associated with increased ADHD symptoms in children. Animal studies also show that combinations of dyes and artificial sweeteners can have greater neurotoxic effects," he explained.

In addition, physical and chemical changes during processing can affect the gut microbiota, triggering chronic inflammation and insulin resistance. Compounds such as acrylamide and acrolein formed during heating are also linked to cardiovascular disease and cancer. Liu also highlighted the presence of microplastics from packaging that are now widely accumulated in the human body and may contribute to cardiovascular disease.

For Indonesia, these findings are relevant given that public UPF consumption continues to rise, especially instant noodle products, packaged snacks, and sweetened beverages. Data from the National Socio-Economic Survey (Susenas) show that household spending on processed food and prepared beverages has risen significantly over the past decade. Without intervention, the burden of non-communicable diseases such as diabetes and hypertension, already high in the country, could swell, eroding productivity and straining the National Health Insurance (JKN) system.

Liu recommends a practical approach: increase consumption of vegetables, fruit, nuts, whole grains, and minimally processed foods, and reduce fast food, fried foods, and ready-to-eat processed products. "This is not about strict rules, but a gradual shift toward food that is closer to its natural form," he said. He also highlighted the scarcity of labels that explicitly mark UPF—only Colombia has such a national label—making it difficult for consumers to distinguish levels of processing.

Going forward, the key question that remains is how much of the risk is purely caused by the processing itself, beyond nutritional content and lifestyle. Will UPF labeling regulations follow in other countries, including Indonesia? And will the food industry change their product formulations to reduce risky additives? The answers will shape the direction of nutrition and public health policy in the years ahead.