Associations of nova-defined ultra-processed food intake and cardiometabolic health among Korean adults from 2007 to 2023

Abstract

The consumption of ultra-processed foods (UPFs) has been increased worldwide. Given its association with adverse health outcomes, monitoring long-term trends in UPF intake is important. However, evidence among Asian adults on UPF intake and health outcomes is limited. We analyzed data from the 2007–2023 Korea National Health and Nutrition Examination Survey. Dietary intake was assessed using 24-hour dietary recall data, and foods were classified using a Korean-adapted Nova classification framework. Weighted logistic regression models were used to estimate secular trends in UPF consumption and associations with cardiometabolic health among Korean adults. Over the past 17 years, UPF consumption increased while unprocessed/minimally processed food intake decreased, mainly in younger adults. Among men, higher UPF intake was associated with increased odds of hypertension (OR = 1.27, 95% CI: 1.15–1.41), hypercholesterolemia (OR = 1.33, 95% CI: 1.21–1.46), high LDL cholesterol (OR = 1.16, 95% CI: 1.05–1.28), abdominal obesity (OR = 1.22, 95% CI: 1.11–1.34), and overall obesity (OR = 1.17, 95% CI: 1.07–1.28), but was inversely associated with low HDL cholesterol (OR = 0.68, 95% CI: 0.62–0.75). Among women, higher UPF intake was associated with hypercholesterolemia (OR = 1.30, 95% CI: 1.20–1.41), high LDL cholesterol (OR = 1.24, 95% CI: 1.14–1.35), and abdominal obesity (OR = 1.11, 95% CI: 1.02–1.21), but was inversely associated with low HDL cholesterol (OR = 0.57, 95% CI: 0.50–0.64) and hypertriglyceridemia (OR = 0.87, 95% CI: 0.80–0.96). These findings add population-based evidence from an Asia population. However, the heterogeneous associations observed in this cross-sectional study should be confirmed n prospective studies.