Answer · confidence: partial
Do studies outside Spain find swapping junk food for real food lowers early death?
Research question: Do other large prospective cohorts outside Spain find the same replacement pattern, where swapping ultra-processed foods for minimally processed foods is linked to lower all-cause mortality, and how large are those reductions when energy and gram-based measures are compared?
The records show that only one large cohort in the set reports the swap pattern for all-cause mortality: a 9-country European analysis of 428,728 participants found that replacing processed and ultra-processed foods with unprocessed or minimally processed foods was associated with lower mortality risk 59. The records do not give the size of that reduction, so an energy-versus-gram comparison for swaps cannot be made from them 5. Other large cohorts, including two US cohorts of nurses and health professionals and a multinational cohort of 428,728 participants, linked higher ultra-processed intake to higher mortality but did not report a food-swap analysis 1217. On the energy-versus-gram question, the US cohort found similar results whichever scale was used 3, and it reported a 4% higher all-cause death risk per 10-percentage-point rise in calories from these foods 17. The newest fact, dated October 17, 2026, is a NIH-AARP swap result showing 2% lower bowel cancer incidence, not mortality 1820.
Checked 2026-10-21. Only documented and supported facts are used.
Dig deeper on this questionSources
[1] supported
A large multinational prospective cohort of 428,728 participants found positive correlations between ultra-processed food consumption and all-cause mortality, as well as circulatory and digestive system disease mortality.
"Besides, a large multinational prospective cohort involving 428,728 participants likewise found positive correlations between UPF consumption and mortality of all-cause, as well as circulatory and digestive system diseases mortality ( 18 )."Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study (2026)
[2] supported
Two large US cohorts of nurses and health professionals, with more than 48,000 deaths over three decades, found higher ultra-processed food intake modestly associated with increased all-cause and non-cancer, non-cardiovascular mortality.
"In two large US cohorts comprising female nurses and male health professionals with more than 48,000 deaths documented over three decades, higher UPF intake was modestly associated with increased all-cause and non-cancer, non-cardiovascular mortality"Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study (2026)
[3] supported
In the US cohort study, expressing ultra-processed food intake as a percentage of energy or as an absolute quantity gave similar results.
"we repeated the primary analysis using either the percentage of energy intake or the absolute quantity to measure UPF intake and observed similar results"Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study (2026)
[4] supported
A meta-analysis found that people with the highest ultra-processed food intake had a higher risk of all-cause mortality than those with the lowest intake.
"A meta-analysis demonstrated that the individuals with the highest UPF intake had a higher risk of all-cause mortality than those with the lowest intake (HR: 1.21, 95% CI: 1.13–1.30)."Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study (2026)
[5] documented
Replacing processed and ultra-processed foods with unprocessed or minimally processed foods was associated with lower mortality risk in a pan-European cohort.
"Replacing processed and UPFs with unprocessed/minimally processed foods was associated with lower mortality risk."Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries (2025)
[6] documented
Ultra-processed food consumption was positively associated with all-cause mortality, with a hazard ratio of 1.04 per one standard deviation increase.
"UPFs (in percentage grams per day [g/d]) were positively associated with all-cause mortality (HRs per 1-SD: 1.04; 95% CI: 1.02,1.05)"Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries (2025)
[7] documented
The study found no association between ultra-processed food consumption and mortality from cancer or Alzheimer's disease.
"No associations were found between UPFs and mortality from cancer or Alzheimer's disease."Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries (2025)
[8] documented
Ultra-processed food consumption was associated with a 23% higher risk of mortality from Parkinson's disease per one standard deviation increase.
"Parkinson's disease (1.23; 95% CI: 1.06,1.42)"Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries (2025)
[9] documented
The analysis included 428,728 participants from 9 European countries with 40,016 deaths documented over 15.9 years of follow-up.
"Overall, 428,728 (71.7% female) participants were included in the analysis and 40,016 deaths were documented after 15.9 years of follow-up."Associations between degree of food processing and all-cause and cause-specific mortality: a multicentre prospective cohort analysis in 9 European countries (2025)
[10] documented
In the UK Biobank cohort, every 10 percentage point increase in plant-sourced non-ultra-processed food consumption was associated with a 7% lower risk of cardiovascular disease.
"Every 10 percentage points increase in plant-sourced non-UPF consumption was associated with a 7% lower risk of CVD (95% CI 0.91–0.95)"Implications of food ultra-processing on cardiovascular risk considering plant origin foods: an analysis of the UK Biobank cohort (2024)
[11] documented
In the UK Biobank cohort, every 10 percentage point increase in plant-sourced non-ultra-processed food consumption was associated with a 13% lower risk of cardiovascular disease mortality.
"Every 10 percentage points increase in plant-sourced non-UPF consumption was associated with a 7% lower risk of CVD (95% CI 0.91–0.95) and a 13% lower risk of CVD mortality (0.80–0.94)."Implications of food ultra-processing on cardiovascular risk considering plant origin foods: an analysis of the UK Biobank cohort (2024)
[12] documented
In the UK Biobank cohort, plant-sourced ultra-processed food consumption was associated with a 5% increased risk of cardiovascular disease and a 12% higher mortality risk.
"Conversely, plant-sourced UPF consumption was associated with a 5% increased risk (1.03–1.07) and a 12% higher mortality (1.05–1.20)."Implications of food ultra-processing on cardiovascular risk considering plant origin foods: an analysis of the UK Biobank cohort (2024)
[13] documented
In a cohort of 632 renal transplant recipients, ultra-processed foods were associated with a hazard ratio of 2.13 for all-cause mortality per doubling of the percentage of total food weight.
"In Cox regression analyses, ultra-processed foods were associated with all-cause mortality (HR per doubling of percentage of total weight: 2.13; 95% CI: 1.46, 3.10; P < 0.001), independently of potential confounders."Ultra-processed foods and risk of all-cause mortality in renal transplant recipients (2022)
[14] documented
The association between ultra-processed food consumption and mortality in renal transplant recipients was independent of adherence to high-quality dietary patterns like the Mediterranean or DASH diets.
"This association was independent from the quality of the overall dietary pattern, expressed by the Mediterranean Diet Score (MDS) or Dietary Approaches to Stop Hypertension (DASH) score."Ultra-processed foods and risk of all-cause mortality in renal transplant recipients (2022)
[15] documented
Among specific ultra-processed food groups, processed meats showed the strongest association with all-cause mortality, with a hazard ratio of 1.87.
"When analyzing ultra-processed foods by groups, only sugar-sweetened beverages (HR: 1.21; 95% CI: 1.05, 1.39; P = 0.007), desserts (HR: 1.24; 95% CI: 1.02, 1.49; P = 0.03), and processed meats (HR: 1.87; 95% CI: 1.22, 2.86; P = 0.004) were associated with all-cause mortality."Ultra-processed foods and risk of all-cause mortality in renal transplant recipients (2022)
[16] documented
Renal transplant recipients in the study had a mean consumption of 721 grams of ultra-processed foods per day, which accounted for 28% of their total food weight intake.
"Mean ± SD consumption of ultra-processed foods was 721 ± 341 g/d (28% of total weight of food intake), whereas the intake of unprocessed and minimally processed foods, processed culinary ingredients, and processed foods accounted for 57%, 1%, and 14%, respectively."Ultra-processed foods and risk of all-cause mortality in renal transplant recipients (2022)
[17] supported
The U.S. study reported a 4% higher risk of death from any cause associated with higher intake of ultra-processed foods, measured per 10-percentage-point increase in calories from these foods. The document does not report any food-swap analysis or results from other cohorts.
"Higher intake was also linked with greater odds of metabolic syndrome and diabetes, along with a 4% higher risk of death from any cause."Ultra-Processed Foods And Your Health: What The June 2026 Study Means
[18] supported
In the NIH-AARP cohort of over 460,000 U.S. adults, replacing 10% of ultra-processed food intake with minimally processed foods was linked to 2% lower bowel cancer incidence.
"replacing 10% of ultra-processed food intake with the equivalent weight of minimally processed foods was linked to a 2% reduction in the incidence of bowel cancer."Replacing Just 10 Percent of Ultra‑processed Foods with Whole Foods ...
[19] supported
Swapping 10% of ultra-processed food by weight for minimally processed options was linked to a 2% lower colorectal cancer rate in the NCI study, not to all-cause mortality.
"Swapping just 10 percent of ultra-processed food by weight for minimally processed options was tied to a 2 percent lower colorectal cancer rate."A huge NCI study just rewrote the ultra-processed food and colon cancer ...
[20] supported
Total ultra-processed food intake was not associated with bowel cancer incidence in the U.S. cohort analysis.
"However, we also found no association between total ultra-processed food intake and bowel cancer incidence."Replacing Just 10 Percent of Ultra‑processed Foods with Whole Foods ...
[21] supported
Earlier research linked each extra 100 grams of ultra-processed food a day to a higher risk of heart disease, cancer and death overall.
"tying each extra 100 grams of ultra-processed food a day to a higher risk of heart disease, cancer and death overall"A huge NCI study just rewrote the ultra-processed food and colon cancer ...