{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:49:20Z","timestamp":1791571760853,"version":"4.3.4"},"reference-count":89,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","nmcd-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.numecd.2026.104855","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:36:29Z","timestamp":1782923789000},"page":"104855","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between ultra-processed food consumption and incidence of cardio-renal-metabolic multimorbidity: Tehran Lipid and Glucose Study"],"prefix":"10.1016","volume":"36","author":[{"given":"Emad","family":"Alem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0210-6787","authenticated-orcid":false,"given":"Somayeh","family":"Hosseinpour-Niazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvin","family":"Mirmiran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereidoun","family":"Azizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12933-023-01937-x","article-title":"The cardio-renal-metabolic connection: a review of the evidence","volume":"22","author":"Marassi","year":"2023","journal-title":"Cardiovasc Diabetol"},{"issue":"8","key":"10.1016\/j.numecd.2026.104855_bib2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.jash.2014.07.003","article-title":"Basic science: pathophysiology: the cardiorenal metabolic syndrome","volume":"8","author":"M Whaley-Connell","year":"2014","journal-title":"J Am Soc Hypertens"},{"issue":"Suppl 1","key":"10.1016\/j.numecd.2026.104855_bib3","article-title":"10. Cardiovascular disease and risk management: standards of care in Diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s12020-016-1014-6","article-title":"Diabetes mellitus as a risk factor for incident chronic kidney disease and end-stage renal disease in women compared with men: a systematic review and meta-analysis","volume":"55","author":"Shen","year":"2017","journal-title":"Endocrine"},{"issue":"13","key":"10.1016\/j.numecd.2026.104855_bib5","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/jama.2023.17002","article-title":"Estimated glomerular filtration rate, albuminuria, and adverse outcomes: an individual-participant data meta-analysis","volume":"330","author":"Grams","year":"2023","journal-title":"JAMA"},{"issue":"11","key":"10.1016\/j.numecd.2026.104855_bib6","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1001\/jamacardio.2023.3241","article-title":"Prevalence and overlap of cardiac, renal, and metabolic conditions in US adults, 1999-2020","volume":"8","author":"Ostrominski","year":"2023","journal-title":"JAMA Cardiol"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib7","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpcardiol.2023.102344","article-title":"Cardiovascular-Kidney-Metabolic (CKM) syndrome: a state-of-the-art review","volume":"49","author":"Sebastian","year":"2024","journal-title":"Curr Probl Cardiol"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013548","article-title":"Multimorbidity as an important issue among women: results of a gender difference investigation in a large population-based cross-sectional study in West Asia","volume":"7","author":"Alimohammadian","year":"2017","journal-title":"BMJ Open"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib9","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1186\/s12889-020-09214-2","article-title":"Predictors of multimorbidity among the Kurdish population living in the Northwest of Iran","volume":"20","author":"Aminisani","year":"2020","journal-title":"BMC Public Health"},{"issue":"4","key":"10.1016\/j.numecd.2026.104855_bib10","doi-asserted-by":"crossref","DOI":"10.1111\/1753-0407.70227","article-title":"Atherogenic index of plasma predicts the onset and progression of cardio-renal-metabolic multimorbidity: evidence from a nationwide prospective cohort study","volume":"18","author":"Jin","year":"2026","journal-title":"J Diabetes"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s41043-026-01313-x","article-title":"Exploring the relationship between sleep patterns and cardio-renal-metabolic multimorbidity in Chinese and European populations","volume":"45","author":"Wang","year":"2026","journal-title":"J Health Popul Nutr"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib12","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1186\/s12933-024-02347-3","article-title":"Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study","volume":"23","author":"Zhang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s40256-025-00761-w","article-title":"Definition, classification, diagnosis, and management of an emerging threat: cardio-Renal-Metabolic syndrome","volume":"26","author":"Koufakis","year":"2026","journal-title":"Am J Cardiovasc Drugs"},{"issue":"12","key":"10.1016\/j.numecd.2026.104855_bib14","doi-asserted-by":"crossref","DOI":"10.1111\/obr.13126","article-title":"Ultra-processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers","volume":"21","author":"Baker","year":"2020","journal-title":"Obes Rev"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib15","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12937-020-00604-1","article-title":"Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies","volume":"19","author":"Chen","year":"2020","journal-title":"Nutr J"},{"issue":"6","key":"10.1016\/j.numecd.2026.104855_bib16","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1001\/jama.2021.10238","article-title":"Trends in consumption of ultraprocessed foods among US youths aged 2-19 years, 1999-2018","volume":"326","author":"Wang","year":"2021","journal-title":"JAMA"},{"issue":"3","key":"10.1016\/j.numecd.2026.104855_bib17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-009892","article-title":"Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study","volume":"6","author":"Mart\u00ednez Steele","year":"2016","journal-title":"BMJ Open"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib18","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1017\/S1368980018003762","article-title":"Ultra-processed foods: what they are and how to identify them","volume":"22","author":"Monteiro","year":"2019","journal-title":"Public Health Nutr"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib19","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1017\/S1368980017001379","article-title":"Household availability of ultra-processed foods and obesity in nineteen European countries","volume":"21","author":"Monteiro","year":"2018","journal-title":"Public Health Nutr"},{"key":"10.1016\/j.numecd.2026.104855_bib20","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2023.1145762","article-title":"The relationship between ultra processed food consumption and premature coronary artery disease: iran premature coronary artery disease study (IPAD)","volume":"10","author":"Ansari","year":"2023","journal-title":"Front Nutr"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib21","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12986-024-00831-x","article-title":"Fruit and vegetable intake modifies the association between ultra-processed food and metabolic syndrome","volume":"21","author":"Hosseinpour-Niazi","year":"2024","journal-title":"Nutr Metab (Lond)"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib22","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1017\/S1368980022002038","article-title":"Association between ultra-processed foods consumption and micronutrient intake and diet quality in Iranian adults: a multicentric study","volume":"26","author":"Haghighatdoost","year":"2023","journal-title":"Public Health Nutr"},{"key":"10.1016\/j.numecd.2026.104855_bib23","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ejim.2025.03.017","article-title":"Ultra-processed foods and cardio-kidney-metabolic syndrome: a review of recent evidence","volume":"136","author":"Kanbay","year":"2025","journal-title":"Eur J Intern Med"},{"issue":"12","key":"10.1016\/j.numecd.2026.104855_bib24","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/j.jacc.2021.01.047","article-title":"Ultra-processed foods and incident cardiovascular disease in the framingham offspring study","volume":"77","author":"Juul","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib25","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.4093\/dmj.2024.0706","article-title":"Ultra-processed food intake and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective studies","volume":"49","author":"Kim","year":"2025","journal-title":"Diabetes Metab J"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib26","doi-asserted-by":"crossref","DOI":"10.1080\/0886022X.2024.2306224","article-title":"Ultra-processed food consumption and the risk of incident chronic kidney disease: a systematic review and meta-analysis of cohort studies","volume":"46","author":"Xiao","year":"2024","journal-title":"Ren Fail"},{"issue":"8","key":"10.1016\/j.numecd.2026.104855_bib27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003256","article-title":"Ultra-processed food intake in association with BMI change and risk of overweight and obesity: a prospective analysis of the French NutriNet-Sant\u00e9 cohort","volume":"17","author":"Beslay","year":"2020","journal-title":"PLoS Med"},{"issue":"6","key":"10.1016\/j.numecd.2026.104855_bib28","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1017\/S1368980019002854","article-title":"Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)","volume":"23","author":"Canhada","year":"2020","journal-title":"Public Health Nutr"},{"issue":"9","key":"10.1016\/j.numecd.2026.104855_bib29","doi-asserted-by":"crossref","first-page":"5079","DOI":"10.1016\/j.clnu.2021.08.009","article-title":"Consumption of ultra-processed foods associated with weight gain and obesity in adults: a multi-national cohort study","volume":"40","author":"Cordova","year":"2021","journal-title":"Clin Nutr"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib30","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.3945\/ajcn.116.135004","article-title":"Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study","volume":"104","author":"Mendon\u00e7a","year":"2016","journal-title":"Am J Clin Nutr"},{"issue":"4","key":"10.1016\/j.numecd.2026.104855_bib31","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1007\/s00394-020-02367-1","article-title":"Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank","volume":"60","author":"Rauber","year":"2021","journal-title":"Eur J Nutr"},{"issue":"18","key":"10.1016\/j.numecd.2026.104855_bib32","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph191811360","article-title":"Ultra-processed food consumption and relation with diet quality and mediterranean diet in Southern Italy","volume":"19","author":"Godos","year":"2022","journal-title":"Int J Environ Res Publ Health"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib33","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1017\/S1368980021003967","article-title":"Ultra-processed food consumption, socio-demographics and diet quality in Australian adults","volume":"25","author":"Marchese","year":"2022","journal-title":"Public Health Nutr"},{"issue":"11","key":"10.1016\/j.numecd.2026.104855_bib34","doi-asserted-by":"crossref","first-page":"3031","DOI":"10.1016\/j.numecd.2021.07.019","article-title":"Ultra-processed foods consumption and diet quality of European children, adolescents and adults: results from the I.Family study","volume":"31","author":"Lauria","year":"2021","journal-title":"Nutr Metabol Cardiovasc Dis"},{"issue":"4","key":"10.1016\/j.numecd.2026.104855_bib35","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1093\/jn\/nxy016","article-title":"A healthy Asian A posteriori dietary pattern correlates with A priori dietary patterns and is associated with cardiovascular disease risk factors in a multiethnic Asian population","volume":"148","author":"Whitton","year":"2018","journal-title":"J Nutr"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib36","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12889-023-17558-8","article-title":"Association between alternative healthy eating index (AHEI) with metabolic health status in adolescents with overweight and obesity","volume":"24","author":"Poursalehi","year":"2024","journal-title":"BMC Public Health"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib37","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1186\/s12889-024-19351-7","article-title":"The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata","volume":"24","author":"Hosseinpour-Niazi","year":"2024","journal-title":"BMC Public Health"},{"issue":"11","key":"10.1016\/j.numecd.2026.104855_bib38","doi-asserted-by":"crossref","DOI":"10.3390\/nu12113507","article-title":"Ultra-processed food intake and smoking interact in relation with colorectal adenomas","volume":"12","author":"Fliss-Isakov","year":"2020","journal-title":"Nutrients"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib39","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/00210860500096345","article-title":"The sofreh: comfort and community among women in Iran","volume":"38","author":"Shirazi","year":"2005","journal-title":"Iran Stud"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib40","doi-asserted-by":"crossref","first-page":"148","DOI":"10.4103\/ijpvm.IJPVM_404_19","article-title":"Assessing the changes in Iranian household food basket using national household budget and expenditure survey data, 1991\u20132017","volume":"12","author":"Sobhani","year":"2021","journal-title":"Int J Prev Med"},{"issue":"4 Suppl","key":"10.1016\/j.numecd.2026.104855_bib41","article-title":"Review of rationale, design, and initial findings: tehran lipid and glucose study","volume":"16","author":"Azizi","year":"2018","journal-title":"Int J Endocrinol Metabol"},{"issue":"4","key":"10.1016\/j.numecd.2026.104855_bib42","doi-asserted-by":"crossref","first-page":"401","DOI":"10.2337\/diacare.13.4.401","article-title":"Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians","volume":"13","author":"Kriska","year":"1990","journal-title":"Diabetes Care"},{"issue":"9","key":"10.1016\/j.numecd.2026.104855_bib43","doi-asserted-by":"crossref","first-page":"S498","DOI":"10.1097\/00005768-200009001-00009","article-title":"Compendium of physical activities: an update of activity codes and MET intensities. Medicine and science in sports and exercise","volume":"32","author":"Ainsworth","year":"2000","journal-title":"Med Sci Sports Exerc"},{"issue":"3 Suppl 1","key":"10.1016\/j.numecd.2026.104855_bib44","first-page":"S29","article-title":"WHO MONICA project: objectives and design","volume":"18","author":"B\u00f6thig","year":"1989","journal-title":"Int J Epidemiol"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib45","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1017\/S1368980009991698","article-title":"Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study","volume":"13","author":"Mirmiran","year":"2010","journal-title":"Public Health Nutr"},{"key":"10.1016\/j.numecd.2026.104855_bib46","series-title":"Reproducibility and validity of food frequency questionnaires: in nutritional epidemiology","author":"Willet Wcl","year":"1998"},{"key":"10.1016\/j.numecd.2026.104855_bib47","series-title":"Iranian food composition table","author":"Esmaeili","year":"2018"},{"key":"10.1016\/j.numecd.2026.104855_bib48","series-title":"Nutritional epidemiology","article-title":"Issues in analysis and presentation of dietary data","author":"WC","year":"1998"},{"issue":"6","key":"10.1016\/j.numecd.2026.104855_bib49","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/oxfordjournals.aje.a009849","article-title":"Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements","volume":"149","author":"Hu","year":"1999","journal-title":"Am J Epidemiol"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib50","doi-asserted-by":"crossref","first-page":"150","DOI":"10.2188\/jea.JE20090083","article-title":"Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study","volume":"20","author":"Esfahani","year":"2010","journal-title":"J Epidemiol"},{"issue":"6","key":"10.1016\/j.numecd.2026.104855_bib51","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1017\/S0007114511006313","article-title":"Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran Lipid and Glucose Study","volume":"108","author":"Asghari","year":"2012","journal-title":"Br J Nutr"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib52","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2337\/dc07-0912","article-title":"Glucose indices, health behaviors, and incidence of diabetes in Australia: the Australian Diabetes, Obesity and Lifestyle Study","volume":"31","author":"Magliano","year":"2008","journal-title":"Diabetes Care"},{"issue":"4 Suppl","key":"10.1016\/j.numecd.2026.104855_bib53","article-title":"Outcomes of a longitudinal population-based cohort study and pragmatic community trial: findings from 20 years of the Tehran lipid and glucose study","volume":"16","author":"Khalili","year":"2018","journal-title":"Int J Endocrinol Metabol"},{"key":"10.1016\/j.numecd.2026.104855_bib54","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1745-6215-10-5","article-title":"Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II","volume":"10","author":"Azizi","year":"2009","journal-title":"Trials"},{"key":"10.1016\/j.numecd.2026.104855_bib55","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2377-12-117","article-title":"Risk factors for ischemic stroke; results from 9 years of follow-up in a population based cohort of Iran","volume":"12","author":"Fahimfar","year":"2012","journal-title":"BMC Neurol"},{"issue":"19","key":"10.1016\/j.numecd.2026.104855_bib56","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New Creatinine- and cystatin C-Based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"issue":"4s","key":"10.1016\/j.numecd.2026.104855_bib57","first-page":"S117","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"issue":"8","key":"10.1016\/j.numecd.2026.104855_bib58","doi-asserted-by":"crossref","first-page":"e587","DOI":"10.1016\/S2468-2667(21)00107-9","article-title":"Examining variation in the measurement of multimorbidity in research: a systematic review of 566 studies","volume":"6","author":"Ho","year":"2021","journal-title":"Lancet Public Health"},{"key":"10.1016\/j.numecd.2026.104855_bib59","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajpc.2025.101353","article-title":"Nonlinear association between glycemic markers and incident cardio-renal-metabolic multimorbidity: two decades of follow-up in the Tehran Lipid and Glucose Study","volume":"24","author":"Ebrahimi","year":"2025","journal-title":"Am J Prev Cardiol"},{"issue":"20","key":"10.1016\/j.numecd.2026.104855_bib60","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1161\/CIR.0000000000001184","article-title":"Cardiovascular-kidney-metabolic health: a presidential advisory from the American heart association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"key":"10.1016\/j.numecd.2026.104855_bib61","doi-asserted-by":"crossref","DOI":"10.1016\/j.scitotenv.2023.163406","article-title":"Ambient air pollution and incidence, progression to multimorbidity and death of hypertension, diabetes, and chronic kidney disease: a national prospective cohort","volume":"881","author":"Wu","year":"2023","journal-title":"Sci Total Environ"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib62","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1136\/bjsports-2024-108955","article-title":"Association of cardiorespiratory fitness with the incidence and progression trajectory of cardiometabolic multimorbidity","volume":"59","author":"Chen","year":"2025","journal-title":"Br J Sports Med"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib63","article-title":"Chronic low-grade inflammation associated with higher risk and earlier onset of cardiometabolic multimorbidity in middle-aged and older adults: a population-based cohort study","volume":"14","author":"Cheng","year":"2024","journal-title":"Sci Rep"},{"issue":"24","key":"10.1016\/j.numecd.2026.104855_bib64","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13247627","article-title":"Incident cardiometabolic comorbidities in smokers with\/without chronic obstructive pulmonary disease: a long-term cohort study","volume":"13","author":"Herrero-Cortina","year":"2024","journal-title":"J Clin Med"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib65","doi-asserted-by":"crossref","first-page":"2694","DOI":"10.1186\/s12889-024-20199-0","article-title":"Pregnancy loss and risk of cardiometabolic multimorbidity in Chinese women: the China Kadoorie biobank study","volume":"24","author":"Huang","year":"2024","journal-title":"BMC Public Health"},{"key":"10.1016\/j.numecd.2026.104855_bib66","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2024.1522212","article-title":"Effect of plasma homocysteine on cardiometabolic multimorbidity among Chinese adults: a population-based and real-world evidence study","volume":"11","author":"Li","year":"2024","journal-title":"Front Nutr"},{"key":"10.1016\/j.numecd.2026.104855_bib67","article-title":"Independent and joint associations of cardiometabolic multimorbidity and depression on cognitive function: findings from multi-regional cohorts and generalisation from community to clinic","volume":"51","author":"Zhao","year":"2024","journal-title":"Lancet Reg Health West Pac"},{"issue":"3","key":"10.1016\/j.numecd.2026.104855_bib68","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1038\/sj.ijo.0803175","article-title":"The definition of weight maintenance","volume":"30","author":"Stevens","year":"2006","journal-title":"Int J Obes (Lond)"},{"key":"10.1016\/j.numecd.2026.104855_bib69","series-title":"Applied logistic regression","author":"Hosmer","year":"2013"},{"issue":"11","key":"10.1016\/j.numecd.2026.104855_bib70","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/oxfordjournals.aje.a116813","article-title":"Simulation study of confounder-selection strategies","volume":"138","author":"Maldonado","year":"1993","journal-title":"Am J Epidemiol"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib71","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s12933-025-02944-w","article-title":"Association of the triglyceride-glucose index and its combination with obesity indices with cardio-renal-metabolic multimorbidity: two decades of follow-up in the Tehran Lipid and Glucose Study","volume":"24","author":"Soraneh","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"10.1016\/j.numecd.2026.104855_bib72","article-title":"Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: a meta-analysis","volume":"10","author":"Li","year":"2023","journal-title":"Front Nutr"},{"issue":"9","key":"10.1016\/j.numecd.2026.104855_bib73","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S2213-8587(24)00179-7","article-title":"Meat consumption and incident type 2 diabetes: an individual-participant federated meta-analysis of 1\u00b797 million adults with 100 000 incident cases from 31 cohorts in 20 countries","volume":"12","author":"Li","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"10","key":"10.1016\/j.numecd.2026.104855_bib74","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1007\/s00125-024-06221-5","article-title":"Ultra-processed food consumption and risk of diabetes: results from a population-based prospective cohort","volume":"67","author":"Du","year":"2024","journal-title":"Diabetologia"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib75","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12986-024-00788-x","article-title":"Higher ultra-processed food intake is associated with an increased incidence risk of cardiovascular disease: the Tehran lipid and glucose study","volume":"21","author":"Jalali","year":"2024","journal-title":"Nutr Metab (Lond)"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib76","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s13098-023-01025-w","article-title":"Metabolic health and adiposity transitions and risks of type 2 diabetes and cardiovascular diseases: a systematic review and meta-analysis","volume":"15","author":"Zhang","year":"2023","journal-title":"Diabetol Metab Syndr"},{"issue":"4","key":"10.1016\/j.numecd.2026.104855_bib77","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabet.2023.101456","article-title":"Relationship of ultra-processed food consumption and new-onset chronic kidney diseases among participants with or without diabetes","volume":"49","author":"Liu","year":"2023","journal-title":"Diabetes Metab"},{"issue":"2","key":"10.1016\/j.numecd.2026.104855_bib78","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1053\/j.ajkd.2023.01.452","article-title":"Ultraprocessed foods and kidney disease progression, mortality, and cardiovascular disease risk in the CRIC study","volume":"82","author":"Sullivan","year":"2023","journal-title":"Am J Kidney Dis"},{"issue":"12","key":"10.1016\/j.numecd.2026.104855_bib79","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.1016\/j.clnu.2023.09.028","article-title":"Associations between ultra-processed food consumption and kidney function in an older adult population with metabolic syndrome","volume":"42","author":"Valle-Hita","year":"2023","journal-title":"Clin Nutr"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib80","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1159\/000445450","article-title":"Aging and the kidneys: anatomy, physiology and consequences for defining chronic kidney disease","volume":"134","author":"Glassock","year":"2016","journal-title":"Nephron"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib81","doi-asserted-by":"crossref","DOI":"10.1053\/j.ajkd.2022.03.016","article-title":"Association between ultraprocessed food consumption and risk of incident CKD: a prospective cohort study","volume":"80","author":"Du","year":"2022","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib82","doi-asserted-by":"crossref","DOI":"10.3390\/nu14010023","article-title":"The role of diet quality in mediating the association between ultra-processed food intake, obesity and health-related outcomes: a review of prospective cohort studies","volume":"14","author":"Dicken","year":"2021","journal-title":"Nutrients"},{"issue":"8","key":"10.1016\/j.numecd.2026.104855_bib83","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0220368","article-title":"The association of multimorbidity within cardio-metabolic disease domains with dietary patterns: a cross-sectional study in 129 369 men and women from the lifelines cohort","volume":"14","author":"Dekker","year":"2019","journal-title":"PLoS One"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib84","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10654-017-0246-y","article-title":"Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies","volume":"32","author":"Schwingshackl","year":"2017","journal-title":"Eur J Epidemiol"},{"issue":"5","key":"10.1016\/j.numecd.2026.104855_bib85","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1093\/advances\/nmab049","article-title":"Ultra-processed foods and cardiovascular diseases: potential mechanisms of action","volume":"12","author":"Juul","year":"2021","journal-title":"Adv Nutr"},{"key":"10.1016\/j.numecd.2026.104855_bib86","first-page":"38","article-title":"Ultra-processed foods and the nutritional dietary profile in Brazil","volume":"49","author":"Costa Louzada","year":"2015","journal-title":"Rev Saude Publica"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib87","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.diabet.2014.10.003","article-title":"The impact of hyperfiltration on the diabetic kidney","volume":"41","author":"Premaratne","year":"2015","journal-title":"Diabetes Metab"},{"issue":"1","key":"10.1016\/j.numecd.2026.104855_bib88","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4196\/kjpp.2014.18.1.1","article-title":"Advanced glycation end products and diabetic complications","volume":"18","author":"Singh","year":"2014","journal-title":"Korean J Physiol Pharmacol"},{"issue":"16","key":"10.1016\/j.numecd.2026.104855_bib89","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1001\/archinte.164.16.1737","article-title":"Diabetes mellitus, the renin-angiotensin-aldosterone system, and the heart","volume":"164","author":"Lim","year":"2004","journal-title":"Arch Intern Med"}],"container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475326003170?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475326003170?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:54:06Z","timestamp":1791568446000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0939475326003170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":89,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S0939475326003170"],"URL":"https:\/\/doi.org\/10.1016\/j.numecd.2026.104855","relation":{},"ISSN":["0939-4753"],"issn-type":[{"value":"0939-4753","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The association between ultra-processed food consumption and incidence of cardio-renal-metabolic multimorbidity: Tehran Lipid and Glucose Study","name":"articletitle","label":"Article Title"},{"value":"Nutrition, Metabolism and Cardiovascular Diseases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.numecd.2026.104855","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104855"}}