Ultraprocessed Food Linked to Vascular Brain Injury in Midlife

Higher ultraprocessed food (UPF) intake has been linked to greater adiposity and higher odds of vascular brain injury (VBI) in middle-aged adults in Canada, although it has not been associated with cognitive performance, according to a new cross-sectional study.

Ultraprocessed Food Consumption

Ultraprocessed foods, defined by the NOVA classification, account for a substantial and increasing proportion of dietary intake in Canada. Although UPFs have been consistently associated with adiposity and cardiometabolic disease, their associations with subclinical VBI and cognitive performance in midlife have been unclear.

Study Population and Outcome Measures

This cross-sectional study included 8,783 adults aged 35 to 69 years without cardiovascular disease, enrolled in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and Prospective Urban and Rural Epidemiology-MIND (PURE-MIND) studies. The mean age was 57.7 years (SD: 8.7) and 4,917 participants (56.6%) were female.

UPF consumption was assessed using previously validated semiquantitative food frequency questionnaires and expressed as servings per 2000 kcal/d. Outcomes were body fat percentage, visceral adipose tissue volume, hepatic fat fraction, MRI-defined VBI (covert brain infarcts or high white matter hyperintensities), and cognitive performance on the Montreal Cognitive Assessment (MOCA) and the Digital Symbol Substitution Test (DSST).

Adiposity and Vascular Brain Injury

Higher UPF intake was associated with greater adiposity: the highest quartile had a BF percentage 1.7 percentage points higher (95% CI: 1.2 to 2.2) and a VAT volume 5.7 mL greater (95% CI: 3.2 to 8.3) than the lowest quartile, with no significant difference in HFF.

The analysis revealed that the highest quartile had higher odds of vascular brain injury (adjusted OR: 1.40; 95% CI: 1.10 to 1.77; P for trend=0.009).

However, no significant associations were observed between UPF intake and MOCA or DSST performance. The authors suggested this is because the metabolic and cerebrovascular changes related to UPF consumption may appear earlier in the life course than observable cognitive decline.

Future Research

These findings have demonstrated that in middle-aged adults in Canada, higher UPF intake is consistently associated with greater adiposity and subclinical vascular brain injury, although longitudinal studies are needed to establish temporality and clarify clinical significance.

Reference

de Souza RJ et al. Ultraprocessed food intake and adiposity, vascular brain injury, and cognition in middle-aged adults. JAMA Netw Open. 2026;9(10):e2639118.

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