Exploring the relationship between consumption of ultra-processed foods and osteoporosis risk: a prospective cohort study.

BACKGROUND

In the UK, more than half of the food supply is composed of ultra-processed foods (UPF). However, the association between UPF intake and osteoporosis risk remains unclear. This study aimed to investigate this association and explore potential mediating biomarkers.

METHODS

This prospective cohort study enrolled 141,577 eligible participants from the UK Biobank. UPF intake was defined based on the NOVA classification, and dietary data were obtained via 24-h recall. Osteoporosis incidence was identified through linkage with primary care records. To assess the relationship between UPF consumption and osteoporosis risk, Cox proportional hazards models and restricted cubic spline analyses were applied. Mediation analyses examined the potential mediating roles of inflammatory and bone-related biomarkers. We also assessed the interaction between UPF intake and osteoporosis-related polygenic risk scores (PRS).

RESULTS

During a median follow-up period of 13.3 years, 3562 individuals developed osteoporosis. The highest tertile of UPF intake was associated with a fully adjusted hazard ratio (HR) of 1.09 (95% CI 1.01-1.19) versus the reference group. Each standard deviation increase in UPF intake was associated with a 5% higher risk of osteoporosis. Mediation analysis indicated that inflammatory markers accounted for 2.76-3.30% of this association. No significant interaction was detected between UPF and genetic factors. Sensitivity analyses yielded results consistent with the main findings.

CONCLUSION

Higher intake of UPF is associated with an elevated risk of osteoporosis, with inflammation playing a partially mediating role. Reducing UPF consumption may help mitigate osteoporosis risk.