Ultra Processed Food Consumption and Adolescent Health Outcomes: A Systematic Review

Abstract

Ultra‑processed foods (UPFs; NOVA Group 4) are increasingly consumed by adolescents worldwide. This developmental stage is marked by rapid physical growth, hormonal changes, and the establishment of lifelong dietary patterns, making adolescents particularly vulnerable to the nutritional and health consequences of UPFs. There is limited evidence in Sub-Saharan Africa (SSA) in the face of a rapid shift in diet because the region is exposed more to UPFs by urbanization, marketing, and shifting food environments, adolescents are exposed to UPFs more and more.The study evaluated the relationship of UPF consumption and adolescent health outcomes. The review was done according to PRISMA 2020, five databases (PubMed, Scopus, Web of Science, Embase, AJOL) were searched. Eligible studies included adolescents aged 10-19 years that reported UPF consumption and health outcomes. The reviewers screened and extracted data and determined risk of bias using Newcastle-Ottawa Scale and Cochrane RoB 2. The GRADE was used to grade certainty of evidence. UPFs contributed 20–60% of total energy intake among adolescents. Higher UPF consumption was consistently associated with poorer diet quality and micronutrient adequacy, and with increased risk of depressive symptoms. Associations with overweight/obesity and metabolic syndrome were mixed in cross‑sectional studies, but stronger in longitudinal and simulation models (ORs 1.4–1.8 for overweight/obesity; OR 1.8, 95% CI 1.3–2.5 for metabolic syndrome). Evidence from SSA reflected global patterns but with less pronounced effect sizes, likely due to methodological and contextual differences. The consumption of UPFs is consistently associated with poor health outcomes among adolescents in different regions, including SSA. There is an urgent need to conduct longitudinal studies and intervention programs that are regionally specific.