Beyond dietary habits: ultra-processed food consumption reveals the association with HPV infection in U.S. women

PURPOSE: Persistent high-risk human papillomavirus (HR-HPV) infection is a major cause of cervical cancer, yet the association between ultra-processed food (UPF) intake and HPV infection remains unclear. METHODS: We analysed 7,555 women aged 18-59 years from NHANES 2003-2016. UPF intake was estimated from 24-hour dietary recalls and expressed as a percentage of total energy using the NOVA classification. HPV status was determined by genotyping self-collected vaginal swabs. Weighted logistic regression, restricted cubic spline models, and subgroup analyses were applied. RESULTS: 3,154 women (39%) were HPV-positive. Higher UPF intake was associated with greater odds of overall HPV infection per interquartile range increase (OR = 1.18; 95% CI: 1.07-1.32) and across quartiles (Q4 vs. Q1: OR = 1.26; 95% CI: 1.04-1.53; P for trend = 0.004). Spline analyses showed a positive linear association. UPF intake was not associated with a clear dose-response relationship with HR-HPV, although subgroup differences were noted. CONCLUSION: Higher UPF intake was positively associated with HPV infections among U.S. women, suggesting a potential role of diet quality in HPV-related outcomes.