Consumption of Ultra‐Processed Food and Risk of Non‐Alcoholic Fatty Liver Disease: A Prospective Analysis of the Korean Genome and Epidemiology Study

The association between ultra-processed foods (UPFs) consumption and non-alcoholic fatty liver disease (NAFLD) remains unclear; therefore, we investigated the association between UPF consumption and the risk of NAFLD among Korean adults. This cohort study included 44 642 Korean adults aged 40-69 years, utilizing data from the Health Examinees database. UPF were categorized according to the NOVA classification system based on the degree of processing. A multivariable Cox proportional hazards model assessed the association between UPF consumption and NAFLD risk. Over a 4.2-year follow-up period, 1562 (3.5%) participants developed NAFLD. After adjusting for potential confounders, higher UPF consumption was associated with a 35% (6%, 71%) and 48% (19%, 86%) increased risk of NAFLD in men and women, respectively. Similar results were observed in both continuous and sensitivity analyses. Among the diverse UPF subtypes, ramen consumption showed the strongest adverse association with NAFLD risk in both men and women (hazard ratio = 2.05 [1.59, 2.65] in men; 1.80 [1.48, 2.19] in women). Our findings suggest that higher UPF consumption is linked to an increased risk of NAFLD. Further comprehensive investigations in a broader spectrum of populations are warranted to corroborate and fortify these results.