Ultra-processed food consumption and pro-inflammatory potential of the diet: a cross-sectional analysis of the NutriNet-Brasil study, 2020-2025.
Abstract
Background
The consumption of ultra-processed foods (UPF) has been associated with diseases in which inflammation plays a key role. The Dietary Inflammatory Index (DII) was developed as a tool to estimate the inflammatory potential of the diet; however, the association between UPF consumption and higher DII scores remains insufficiently explored.
Objective
To investigate the association between UPF consumption and the DII.
Design
This was a cross-sectional study.
Participants
/Setting: Data from 36,669 adults enrolled in the NutriNet-Brasil cohort between 2020 and 2025 were analyzed. MAIN OUTCOME MEASURES The outcome was the DII, calculated as proposed in previous studies, based on dietary components such as macronutrients, vitamins, minerals, and bioactive compounds STATISTICAL ANALYSES: UPF contribution to energy intake was estimated using the mean of 2-3 24-hour recalls (Nova24h). Associations between UPF consumption (percentage of energy, in quintiles and as a continuous variable) and the DII were analyzed using multiple linear regression models.
Results
The mean DII was 1.31 (95% CI: 1.28-1.33) and mean UPF contribution was 22.7%, ranging from an average of 7.50% (Q1) to 41.14% (Q5). In adjusted models, the DII increased linearly across quintiles of UPF intake (p for linear trend < 0.001). The estimated DII score in the highest quintile (Q5: 2.57) was eleven times higher than in the lowest quintile (Q1: 0.22), demonstrating a strong positive association between UPF consumption and the pro-inflammatory potential of the diet. As a continuous variable, each 10% increase in UPF energy was associated with a 0.70-point higher DII (p <0.001).
Conclusions
Higher UPF consumption was associated with a more pro-inflammatory dietary pattern. These findings highlight the potential role of UPF consumption in shaping the inflammatory potential of the diet and support further research on its implications for diet-related health outcomes.