Summary:
UK data show that ultra-processed foods make up a substantial part of the diet and account for roughly one-quarter to over half of total food intake in adults, and even higher proportions in adolescents in some surveys. This study is a large prospective cohort study which examined whether intake of ultra-processed foods is associated with bone health outcomes in adults. Data were obtained from 163,855 participants in a UK population cohort, with an average age of 56 years, who were followed for approximately 12 years. Bone health was assessed using bone mineral density measurements and fracture outcomes were identified through hospital records, including over 1,000 hip fractures and nearly 8,000 total fractures during follow-up. Dietary intake of ultra-processed foods was analysed in relation to both bone density and fracture risk. The findings showed that higher consumption of ultra-processed foods was associated with lower bone mineral density in areas such as the hip, spine, and whole body. In addition to bone density findings, this study identified an increased risk of fractures with greater ultra-processed food consumption. For each increase in intake, there was a measurable rise in the likelihood of both hip fractures and overall fractures. The associations were stronger in individuals under 65 years of age and those who were underweight, suggesting that these populations may be more vulnerable to the negative effects of dietary patterns high in ultra-processed foods. These results may be explained by several mechanisms, including lower intake of essential nutrients such as calcium, vitamin D, and protein, as well as higher consumption of additives, sodium, and unhealthy fats commonly found in ultra-processed foods. These dietary patterns may contribute to reduced bone quality and increased fragility over time. Overall, this study provides evidence that higher consumption of ultra processed foods is linked to poorer bone health and a greater risk of fractures, supporting the importance of dietary strategies that prioritise minimally processed, nutrient-dense foods to maintain skeletal health.
Abstract:
Given there is no prospective research evidence on the association between ultra-processed food intake (UPF) and human bone health, this study aimed to analyze the associations of UPF intake with bone mineral density (BMD) and risk of fractures using data from 163855 participants in the UK Biobank. Multiple linear regression assessed BMD, and Cox regression models estimated fracture risk. Restricted cubic splines were used to evaluate non-linearity. Participants’ average age was 56.0 years, with 1097 hip fractures and 7889 all fractures recorded over 12.0 years of follow-up. Complex inverted U-shaped associations between UPF intake and BMD were found at the femur trochanter. Compared with the lowest UPF intake, the highest UPF intake was linked to a reduction in BMD at the femoral neck (β [SE] = –0.0061 [0.0024], P < .05), femur trochanter (β [SE] = –0.0083 [0.0024], P < .001), lumbar spine (β [SE] = –0.0114 [0.0036], P < .01), and total body (β [SE] = –0.0095 [0.0021], P < .001). The link was more pronounced in participants under 65 and those who were underweight (Pinteraction < .01). Per standard deviation increment of UPF intake was linked to 10.5% and 2.7% higher risks of incident hip fractures (HR, 95% CI: 1.105, 1.029-1.186; P < .01) and all fractures (HR, 95% CI: 1.027, 1.000-1.055; P < .05), respectively. Our results suggest that higher UPF intake is associated with lower BMD and increased risk of fractures captured in hospital inpatient records, highlighting the need for dietary interventions to protect bone health.
Article Publication Date: 06/03/2026
DOI: 10.1017/S0007114526106710
