Ultra-processed foods (UPFs) have been linked to 32 harmful health effects, including heart disease, type 2 diabetes, cancer and mental health problems, according to the largest review into their impact.

A systematic umbrella review published in the BMJ looked at the risks of exposure to UFPs such as sugary cereals, ready meals and fizzy drinks could have on physical and mental health.

The researchers used data from 9.9 million people, coming from food questionnaires and dietary history.

UPFs are usually higher in fat, sugar and salt and contain chemicals, colourings, sweeteners and preservatives that extend shelf life.

Researchers said “convincing” evidence showed a higher UPF intake was associated with a 50% greater risk of death from cardiovascular disease, a 12% greater risk of type 2 diabetes, and a 48-53% greater risk of developing anxiety.

There was also “highly suggestive” evidence that eating more UPFs could increase the risk of obesity, type 2 diabetes, sleep problems and dying from heart disease by 40-66%, as well as a 22% greater risk of developing depression and a 21% greater risk of death from any cause.

Researchers said that the evidence between UPF intake and “asthma, gastrointestinal health, some cancers, and intermediate cardiometabolic risk factors remains limited and warrants further investigation”.

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They added their findings “provide a rationale to develop and evaluate the effectiveness of using population-based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health”.

“They also inform and provide support for urgent mechanistic research,” the researchers said.

In a linked editorial, academics from Brazil said “no reason exists to believe that humans can fully adapt” to UPFs, which they say are “often chemically manipulated cheap ingredients” and “made palatable and attractive by using combinations of flavours, colours, emulsifiers, thickeners, and other additives”.

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They added: “It is now time for United Nations agencies, with member states, to develop and implement a framework convention on ultra-processed foods analogous to the framework on tobacco.”

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