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The authors thank all PREDIMED-Plus participants and investigators. CIBEROBN, CIBERESP, and CIBERDEM are initiative of the Instituto de Salud Carlos III (ISCIII), Madrid, Spain. The authors also thank the PREDIMED-Plus Biobank Network as a part of the National Biobank Platform of the ISCIII for storing and managing the PREDIMED-Plus biological samples.

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Munné Cuevas, José CarlosAuthorAtzeni, AlessandroCorresponding AuthorBabio, NancyAuthorSalas-Salvado, JordiCorresponding Author

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May 10, 2025
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The link between ultra-processed food consumption, fecal microbiota, and metabolomic profiles in older mediterranean adults at high cardiovascular risk

Publicated to:Nutrition Journal. 24 (1): 62- - 2025-04-17 24(1), DOI: 10.1186/s12937-025-01125-5

Authors: Atzeni, Alessandro; Hernandez-Cacho, Adrian; Khoury, Nadine; Babio, Nancy; Belzer, Clara; Vioque, Jesus; Corella, Dolores; Fito, Montserrat; Clish, Clary; Vidal, Josep; Konstanti, Prokopis; Gonzales-Palacios, Sandra; Coltell, Oscar; Goday, Albert; Moreno Indias, Isabel; Carlos Chilleron, Silvia; Ruiz-Canela, Miguel; Tinahones, Francisco J; Hu, Frank B; Salas-Salvado, Jordi

Affiliations

Broad Inst MIT & Harvard, Metabol Platform, Boston, MA USA - Author
Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Dept Med, Boston, MA USA - Author
Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA - Author
Hosp Univ Virgen Victoria, Dept Endocrinol & Nutr, Inst Invest Biomed Malaga IBIMA, Malaga, Spain - Author
Inst Hosp Mar Invest Med Municipal Invest Med IMIM, Unit Cardiovasc Risk & Nutr, Barcelona, Spain - Author
Inst Invest Sanitaria Navarra IdiSNA, Epidemiol & Salud Publ, Pamplona, Spain - Author
Inst Invest Sanitaria Pere Virgili IISPV, Tarragona, Spain - Author
Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metab CIBERDEM, Madrid, Spain - Author
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain - Author
Inst Salud Carlos III, Ctr Invest Biomed Red Fisiopatol Obes & Nutr, CIBEROBN, Madrid, Spain - Author
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Inst Investigac Biomed August Pi Sunyer IDIBAPS, Dept Endocrinol, Barcelona, Spain - Author
Univ Jaume 1, Dept Comp Languages & Syst, Castellon de La Plana, Spain - Author
Univ Miguel Hernandez ISABIAL UMH, Inst Invest Sanitaria & Biomed Alicante, Alicante, Spain - Author
Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain - Author
Univ Rovira i Virgili, Desenvolupament I Salut Mental ANUT DSM Dept Bioqu, Unitat Nutricio Humana, Alimentacio Nutr, Reus, Spain - Author
Univ Valencia, Dept Prevent Med, Valencia, Spain - Author
Wageningen Univ, Lab Microbiol, Wageningen, Netherlands - Author
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Abstract

BackgroundUltra-processed food (UPF) consumption has been linked to adverse metabolic outcomes, potentially mediated by alterations in gut microbiota and metabolite production.ObjectiveThis study aims to explore the cross-sectional and longitudinal associations between NOVA-classified UPF consumption, fecal microbiota, and fecal metabolome in a population of Mediterranean older adults at high cardiovascular risk.MethodsA total of 385 individuals, aged between 55 and 75 years, were included in the study. Dietary and lifestyle information, anthropometric measurements, and stool samples were collected at baseline and after 1-year follow-up. Fecal microbiota and metabolome were assessed using 16 S rRNA sequencing and liquid chromatography-tandem mass spectrometry, respectively.ResultsAt baseline, higher UPF consumption was associated with lower abundance of Ruminococcaceae incertae sedis (beta = - 0.275, P = 0.047) and lower concentrations of the metabolites propionylcarnitine (beta = - 0.0003, P = 0.013) and pipecolic acid (beta = - 0.0003, P = 0.040) in feces. Longitudinally, increased UPF consumption was linked to reduced abundance of Parabacteroides spp. after a 1-year follow-up (beta = - 0.278, P = 0.002).ConclusionsHigh UPF consumption was associated with less favorable gut microbiota and metabolite profiles, suggesting a possible link to reduced short-chain fatty acid (SCFA) production, altered mitochondrial energy metabolism, and impaired amino acid metabolism. These findings support the reduction of UPF consumption and the promotion of dietary patterns rich in fiber for better gut health. Further research is needed to confirm these associations and clarify the underlying mechanisms.Trial registration: ISRCTN89898870 (https://doi.org/10.1186/ISRCTN89898870).

Keywords

AgedCardiovascular diseasCardiovascular diseaseCardiovascular diseasesCross-sectional studiesDietFast foodsFecal metabolitesFecal microbiotaFecesFemaleFood, processedGastrointestinal microbiomeGut microbiotaHeart disease risk factorsHumansLongitudinal studiesMaleMediterranean dietMetabolomeMetabolomicsMiddle agedPopulatioUltra-processed foods

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrition Journal due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category .

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 13.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 10 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 25.2.
  • The number of mentions on the social network X (formerly Twitter): 13 (Altmetric).
  • The number of mentions in news outlets: 2 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Netherlands; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Atzeni, Alessandro) and Last Author (Salas Salvadó, Jorge).

the authors responsible for correspondence tasks have been Atzeni, Alessandro and Salas Salvadó, Jorge.