{ "abstract": "Importance: Ultraprocessed foods (UPFs) account for a substantial and increasing proportion of dietary intake in Canada. Although UPFs are consistently associated with adiposity and cardiometabolic disease, their associations with subclinical vascular brain injury (VBI) and cognitive performance in midlife are unclear.\n\nObjective: To evaluate associations of UPF consumption with adiposity, magnetic resonance imaging (MRI)–defined VBI, and cognitive performance in middle-aged adults in Canada.\n\nDesign, Setting, and Participants: This cross-sectional study included 8783 adults aged 35 to 69 years without cardiovascular disease who were enrolled in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and Prospective Urban and Rural Epidemiology-MIND (PURE-MIND) studies. Participants from CAHHM were recruited from January 1, 2014, to December 31, 2018, and participants from PURE-MIND were recruited from January 1, 2010, to December 31, 2018. Data analyses were conducted between July 16, 2024, and August 16, 2026.\n\nExposures: UPF consumption assessed using previously validated semiquantitative food frequency questionnaires and expressed as servings per 2000 kcal/d.\n\nMain Outcomes and Measures: The main outcomes were body fat (BF) percentage (bioelectrical impedance), visceral adipose tissue (VAT) volume, hepatic fat fraction (HFF), VBI defined as covert brain infarcts or high white matter hyperintensities (HWMHs) (measured by MRI), and cognitive performance measured by the Montreal Cognitive Assessment (MOCA) and the Digital Symbol Substitution Test (DSST).\n\nResults: In this cross-sectional study of 8783 participants (mean [SD] age, 57.7 [8.7] years; 4917 females [56.6%]), those in the highest quartile of UPF intake had a BF percentage that was 1.7 (95% CI, 1.2-2.2) percentage points higher and a 5.7 (95% CI, 3.2-8.3) mL greater VAT volume compared with those in the lowest quartile, but no significant difference in HFF. Compared with the lowest quartile, the highest UPF quartile had higher odds of VBI (adjusted OR, 1.40; 95% CI, 1.10-1.77; P for trend = .009). No significant associations were observed between UPF intake and MOCA or DSST performance.\n\nConclusions and Relevance: In this cross-sectional study of middle-aged adults in Canada, higher UPF intake was associated with greater adiposity and higher odds of MRI-defined VBI but not cognitive performance. Associations with VBI were sensitive to UPF exposure definition. Longitudinal studies are needed to establish temporality.", "abstract_shown": true, "affiliations": [ "Mary Heersink School of Global Health and Social Medicine, McMaster University, Hamilton, Ontario, Canada", "Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada", "Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada", "VITAM–Centre de recherche en santé durable, Québec City, Quebec, Canada", "School of Population and Public Health, University of British Columbia, Canada", "Division of Cardiology, McGill University Health Centre, McGill University, Montréal, Quebec, Canada", "Atlantic PATH, Dalhousie University, Halifax, Nova Scotia, Canada", "Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Quebec, Canada", "Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada", "Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada", "Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada", "Cumming School of Medicine, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada", "Montreal Heart Institute, Montréal, Quebec, Canada", "Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada" ], "article_type": "research article", "arxiv": null, "author_total": 19, "authors": [ { "affs": [ 0 ], "name": "Russell J. de Souza" }, { "affs": [ 1 ], "name": "Karleen M. Schulze" }, { "affs": [ 2 ], "name": "Dipika Desai" }, { "affs": [ 3 ], "name": "Jean-Pierre Després" }, { "affs": [ 4 ], "name": "Trevor J. B. Dummer" }, { "affs": [ 5 ], "name": "Matthias G. Friedrich" }, { "affs": [ 6 ], "name": "Jason Hicks" }, { "affs": [ 7 ], "name": "Vikki Ho" }, { "affs": [ 8 ], "name": "Scott A. Lear" }, { "affs": [ 9 ], "name": "Douglas S. Lee" }, { "affs": [ 2 ], "name": "Andrew Mente" }, { "affs": [ 1 ], "name": "Victoria Miller" }, { "affs": [ 10 ], "name": "Paul Poirier" }, { "affs": [ 11 ], "name": "Eric E. Smith" }, { "affs": [ 12 ], "name": "Jean-Claude Tardif" }, { "affs": [ 1 ], "name": "Koon K. Teo" }, { "affs": [ 13 ], "name": "Jennifer E. Vena" }, { "affs": [ 1 ], "name": "Salim Yusuf" }, { "affs": [ 0 ], "name": "Sonia S. Anand" } ], "bibtex": "https://research.draconitic.com/paper/d284am7tjez0r.bib", "cited_by": 0, "doi": "10.1001/jamanetworkopen.2026.39118", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673317/?tool=EBI", "id": "d284am7tjez0r", "issns": [ "2574-3805" ], "landing_url": "https://europepmc.org/article/PMC/PMC13673317", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2739|Consumer Attitudes and Food Labeling" ] ], "openalex": "W7221880008", "pdf_url": null, "pmcid": "PMC13673317", "pmid": null, "published": "2026-10-01", "publisher": "American Medical Association (AMA)", "ris": "https://research.draconitic.com/paper/d284am7tjez0r.ris", "sources": [ { "first_seen": "2026-10-30T12:18:29Z", "native_id": "PMC:PMC13673317", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13673317" }, { "first_seen": "2026-10-30T12:19:46Z", "native_id": "10.1001/jamanetworkopen.2026.39118", "source": "crossref", "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855351" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2739|Consumer Attitudes and Food Labeling", "subfield": "epidemiology-public-health" } ], "title": "Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults", "title_text": "Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults", "type": "peer-reviewed", "updated_at": "2026-10-30T12:19:46Z", "url": "https://research.draconitic.com/paper/d284am7tjez0r", "venue": "JAMA network open", "versions": [] }