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Association Between Consumption of Ultraprocessed Foods and Cognitive Decline
Gomes Gonçalves N, Vidal Ferreira N, Khandpur N, Martinez Steele E, Bertazzi Levy R, Andrade Lotufo P, et al.. JAMA Neurology, 2023-02-01
Topic: Risk, prevention and care in population studies
Importance Although consumption of ultraprocessed food has been linked to higher risk of cardiovascular disease, metabolic syndrome, and obesity, little is known about the association of consumption of ultraprocessed foods with cognitive decline. Objective To investigate the association between ultraprocessed food consumption and cognitive decline in the Brazilian Longitudinal Study of Adult Health. Design, setting, and participants This was a multicenter, prospective cohort study with 3 waves, approximately 4 years apart, from 2008 to 2017. Data were analyzed from December 2021 to May 2022. Participants were public servants aged 35 to 74 years old recruited in 6 Brazilian cities. Participants who, at baseline, had incomplete food frequency questionnaire, cognitive, or covariate data were excluded. Participants who reported extreme calorie intake ( 6000 kcal/day) and those taking medication that could negatively interfere with cognitive performance were also excluded. Exposures Daily ultraprocessed food consumption as a percentage of total energy divided into quartiles. Main outcomes and measures Changes in cognitive performance over time evaluated by the immediate and delayed word recall, word recognition, phonemic and semantic verbal fluency tests, and Trail-Making Test B version. Results A total of 15 105 individuals were recruited and 4330 were excluded, leaving 10 775 participants whose data were analyzed. The mean (SD) age at the baseline was 51.6 (8.9) years, 5880 participants (54.6%) were women, 5723 (53.1%) were White, and 6106 (56.6%) had at least a college degree. During a median (range) follow-up of 8 (6-10) years, individuals with ultraprocessed food consumption above the first quartile showed a 28% faster rate of global cognitive decline (β = -0.004; 95% CI, -0.006 to -0.001; P = .003) and a 25% faster rate of executive function decline (β = -0.003, 95% CI, -0.005 to 0.000; P = .01) compared with those in the first quartile. Conclusions and relevance A higher percentage of daily energy consumption of ultraprocessed foods was associated with cognitive decline among adults from an ethnically diverse sample. These findings support current public health recommendations on limiting ultraprocessed food consumption because of their potential harm to cognitive function.
Key findings
- Importance Although consumption of ultraprocessed food has been linked to higher risk of cardiovascular disease, metabolic syndrome, and obesity, little is known about the association of consumption of ultraprocessed foods with cognitive decline.
- Results A total of 15 105 individuals were recruited and 4330 were excluded, leaving 10 775 participants whose data were analyzed.
- During a median (range) follow-up of 8 (6-10) years, individuals with ultraprocessed food consumption above the first quartile showed a 28% faster rate of global cognitive decline (β = -0.004; 95% CI, -0.006 to -0.001; P = .003) and a 25% faster rate of executive function decline (β = -0.003, 95% CI, -0.005 to 0.000; P = .01) compared with those in the first quartile.
- Conclusions and relevance A higher percentage of daily energy consumption of ultraprocessed foods was associated with cognitive decline among adults from an ethnically diverse sample.
- These findings support current public health recommendations on limiting ultraprocessed food consumption because of their potential harm to cognitive function.
Why it matters
This Brazilian cohort found that people with the highest ultraprocessed food consumption showed faster cognitive decline than those with the lowest. It is observational, so it cannot prove that these foods cause cognitive decline.
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Study details
- Study designcohort
- Participants10,775
- Effect size28% faster global cognitive decline above the lowest quartile (beta -0.004; 95% CI -0.006 to -0.001)
- Evidence strengthModerate
Limitations
Observational; food-frequency questionnaire at baseline only; absolute differences in test scores are small.
How this study scored 72/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 71 of the 98 points we could judge it on, which is 72 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Neurology) |
| Journal's citation record | 2 / 4 | JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 10,775 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 130 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 4 / 6 | Cited 17.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 3 / 4 | Cited 113 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Cláudia Kimie Suemoto: h-index 48 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36469335) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 71 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 71 of the 98 points we could judge it on is 72 out of 100. |
| Total | 72 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamaneurol.2022.4397
- PubMed: 36469335
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Gomes Gonçalves, N., Vidal Ferreira, N., Khandpur, N., Martinez Steele, E., Bertazzi Levy, R., Andrade Lotufo, P., et al. (2023). Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2022.4397
Vancouver
Gomes Gonçalves N, Vidal Ferreira N, Khandpur N, Martinez Steele E, Bertazzi Levy R, Andrade Lotufo P, et al. Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. JAMA Neurology. 2023. doi:10.1001/jamaneurol.2022.4397. PMID: 36469335.
BibTeX
@article{gomesgoncalves2023-36469335,
author = {Gomes Gonçalves, N. and Vidal Ferreira, N. and Khandpur, N. and Martinez Steele, E. and Bertazzi Levy, R. and Andrade Lotufo, P. and others},
title = {{Association Between Consumption of Ultraprocessed Foods and Cognitive Decline}},
journal = {JAMA Neurology},
year = {2023},
doi = {10.1001/jamaneurol.2022.4397},
pmid = {36469335},
url = {https://doi.org/10.1001/jamaneurol.2022.4397}
}
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