Early life and Cumulative Ultra-Processed Food Exposure as Disease Flare Risk in an Immune-mediated inflammatory diseases: An Overview

Abstract

Background: “Immune-mediated inflammatory diseases (IMIDs), such as “Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA), are characterized by episodic disease flares influenced by changeable environmental factors. Among these, the increasing global consumption of ultra-processed foods (UPF) has garnered heightened mechanistic and epidemiological interest. No exhaustive synthesis has ever investigated UPF exposure across the entire range of inflammatory “immune-mediated inflammatory diseases (IMIDs).
Objective: To conduct a comprehensive review and meta-analysis of the data connecting ultra-processed food (UPF) intake and dietary pattern quality with disease activity, flare frequency, inflammatory biomarkers, and patient-reported outcomes in people with “immune-mediated inflammatory diseases (IMIDs).
Methods: A comprehensive search of MEDLINE (PubMed), Embase, Cochrane Library, Scopus, and Web of Science was performed from January 2010 to March 2025. The Newcastle-Ottawa Scale and the Cochrane Risk of Bias 2.0 tool were used to rate the quality of the study.(16,17) Using the DerSimonian-Laird method, random-effects meta-analyses were done for outcomes that were reported in three or more trials.(21) Dose-response modeling and subgroup analyses were performed based on disease type, sex, and body mass index.
Results: Fifty-three studies (41,820 people) satisfied the inclusion criteria. Increased UPF intake correlated with a markedly heightened risk of illness flare (pooled OR 2.14, 95% CI 1.67–2.74; I² = 61%) and raised C-reactive protein levels (weighted mean difference +4.8 mg/L, 95% CI 2.1–7.5). Adherence to the Mediterranean diet was negatively correlated with disease activity (OR 0.52; 95% CI 0.38–0.71).(7,18) Subgroup analysis validated more robust relationships in female patients and individuals with a BMI ≥ 25 kg/m².
Conclusions: The consumption of UPF is consistently and independently linked to increased activity in “immune-mediated inflammatory diseases (IMIDs). The existing data supports the incorporation of organized dietary counseling into rheumatology practice.