Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults
14 affiliations
- 1Mary Heersink School of Global Health and Social Medicine, McMaster University, Hamilton, Ontario, Canada
- 2Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
- 3Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- 4VITAM–Centre de recherche en santé durable, Québec City, Quebec, Canada
- 5School of Population and Public Health, University of British Columbia, Canada
- 6Division of Cardiology, McGill University Health Centre, McGill University, Montréal, Quebec, Canada
- 7Atlantic PATH, Dalhousie University, Halifax, Nova Scotia, Canada
- 8Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Quebec, Canada
- 9Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- 10Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- 11Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
- 12Cumming School of Medicine, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
- 13Montreal Heart Institute, Montréal, Quebec, Canada
- 14Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada
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.
Objective: To evaluate associations of UPF consumption with adiposity, magnetic resonance imaging (MRI)–defined VBI, and cognitive performance in middle-aged adults in Canada.
Design, 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.
Exposures: UPF consumption assessed using previously validated semiquantitative food frequency questionnaires and expressed as servings per 2000 kcal/d.
Main 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).
Results: 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.
Conclusions 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.
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BibTeX
@article{souza2026ultraprocessed,
title = {{Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults}},
author = {Russell J. de Souza and Karleen M. Schulze and Dipika Desai and Jean-Pierre Després and Trevor J. B. Dummer and Matthias G. Friedrich and Jason Hicks and Vikki Ho and Scott A. Lear and Douglas S. Lee and Andrew Mente and Victoria Miller and Paul Poirier and Eric E. Smith and Jean-Claude Tardif and Koon K. Teo and Jennifer E. Vena and Salim Yusuf and Sonia S. Anand},
journal = {JAMA network open},
year = {2026},
month = oct,
doi = {10.1001/jamanetworkopen.2026.39118},
url = {https://europepmc.org/article/PMC/PMC13673317},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Ultraprocessed Food Intake and Adiposity, Vascular Brain Injury, and Cognition in Middle-Aged Adults
AU - Russell J. de Souza
AU - Karleen M. Schulze
AU - Dipika Desai
AU - Jean-Pierre Després
AU - Trevor J. B. Dummer
AU - Matthias G. Friedrich
AU - Jason Hicks
AU - Vikki Ho
AU - Scott A. Lear
AU - Douglas S. Lee
AU - Andrew Mente
AU - Victoria Miller
AU - Paul Poirier
AU - Eric E. Smith
AU - Jean-Claude Tardif
AU - Koon K. Teo
AU - Jennifer E. Vena
AU - Salim Yusuf
AU - Sonia S. Anand
PY - 2026
DA - 2026/10/01
JO - JAMA network open
DO - 10.1001/jamanetworkopen.2026.39118
UR - https://europepmc.org/article/PMC/PMC13673317
AB - 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. Objective: To evaluate associations of UPF consumption with adiposity, magnetic resonance imaging (MRI)–defined VBI, and cognitive performance in middle-aged adults in Canada. Design, 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. Exposures: UPF consumption assessed using previously validated semiquantitative food frequency questionnaires and expressed as servings per 2000 kcal/d. Main 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). Results: 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. Conclusions 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.
SN - 2574-3805
ER -