{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:31:56Z","timestamp":1793417516179,"version":"4.5.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultra-processed foods (UPFs) are increasingly prevalent in global diets and have been linked to various adverse health outcomes. However, evidence regarding their association with disorders of gut-brain interaction (DGBI), such as irritable bowel syndrome (IBS) and functional dyspepsia (FD), remains inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the association between UPFs consumption and the risk of IBS and FD through a comprehensive meta-analysis of observational studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science from inception through December 2025. Observational studies assessing UPFs intake and clinically diagnosed IBS or FD in adults were included. Pooled effect estimates [odds ratios (OR)] were calculated using random-effects models. Heterogeneity was assessed with\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics, and subgroup analyses were performed by exposure type and assessment method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies (\n                      <jats:italic>N<\/jats:italic>\n                      = 232,448) were included. High UPFs consumption was significantly associated with higher odds of IBS (OR\u202f=\u202f1.32, 95% CI: 1.16\u20131.49; based on 9 studies) and FD (OR\u202f=\u202f1.26, 95% CI: 1.07\u20131.49; based on 3 studies). However, the FD finding was primarily driven by a single large cohort and lost statistical significance in sensitivity analysis, indicating the need for cautious interpretation. Subgroup analyses revealed the strongest association for carbonated\/sugar-sweetened beverages (OR\u202f=\u202f1.98, 95% CI: 1.40\u20132.80). Heterogeneity was substantially reduced in studies using standardized NOVA classifications or quartile-based comparisons (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f0%). Sensitivity analyses supported robustness. The Egger test did not reveal significant funnel plot asymmetry for IBS outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.153). Given the limited number of included studies (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f9), this cannot definitively rule out the presence of publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that reducing UPFs intake may be a promising dietary strategy for IBS prevention and management. For FD, the evidence is preliminary and requires confirmation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD420251269914<\/jats:ext-link>\n                      , identifier PROSPERO (CRD420251269914).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1780040","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:24:54Z","timestamp":1774329894000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between ultra-processed food consumption and risk of irritable bowel syndrome and functional dyspepsia: a systematic review and meta-analysis of observational studies"],"prefix":"10.3389","volume":"13","author":[{"given":"Shengkai","family":"Li","sequence":"first","affiliation":[{"name":"Department of Emergency Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weikai","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Cardiovascular Medical Center, Nanjing Drum Tower Hospital","place":["Nanjing, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1038\/s41380-023-01972-w","article-title":"The neurobiology of irritable bowel syndrome","volume":"28","author":"Mayer","year":"2023","journal-title":"Mol Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/MED.0000000000000905","article-title":"Irritable bowel syndrome, the gut microbiome, and diet","volume":"32","author":"Yu","year":"2025","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e10616","DOI":"10.29219\/fnr.v68.10616","article-title":"Ultra-processed foods \u2013 a scoping review for Nordic nutrition recommendations 2023","volume":"68","author":"Juul","year":"2024","journal-title":"Food Nutr Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3567","DOI":"10.3390\/nu17223567","article-title":"Ultra-processed food consumption and irritable bowel syndrome: current evidence and clinical implications","volume":"17","author":"Dale","year":"2025","journal-title":"Nutrients"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1007\/s13679-024-00569-w","article-title":"Ultra-processed food addiction: a research update","volume":"13","author":"LaFata","year":"2024","journal-title":"Curr Obes Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e17444","DOI":"10.1016\/j.heliyon.2023.e17444","article-title":"Jian-pi-yin decoction attenuates lactose-induced chronic diarrhea in rats by regulating GLP-1 and reducing NHE3 ubiquitination and phosphorylation","volume":"9","author":"Ma","year":"2023","journal-title":"Heliyon"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"23","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"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e30134","DOI":"10.1097\/MD.0000000000030134","article-title":"Irritable bowel syndrome and its associated factors among Jordanian medical students: a cross-sectional study","volume":"101","author":"Jadallah","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1002\/jgh3.12757","article-title":"Prevalence of irritable bowel syndrome and its associated risk factors among university students of Bangladesh","volume":"6","author":"Das","year":"2022","journal-title":"JGH Open"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"986","DOI":"10.3390\/nu9090986","article-title":"Western dietary pattern is associated with irritable bowel syndrome in the French NutriNet cohort","volume":"9","author":"Buscail","year":"2017","journal-title":"Nutrients"},{"key":"ref11","doi-asserted-by":"publisher","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"},{"key":"ref12","doi-asserted-by":"publisher","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"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1890\/0012-9658(2002)083[3097:CFHIWS]2.0.CO;2","article-title":"a language and environment for statistical computing","volume":"1","year":"2011","journal-title":"Computing"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R: a practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid Based Mental Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1001\/jama.280.19.1690","article-title":"What\u2019s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes","volume":"280","author":"Zhang","year":"1998","journal-title":"JAMA"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1038\/s41395-018-0137-1","article-title":"Association between ultra-processed food consumption and functional gastrointestinal disorders: results from the French NutriNet-sant\u00e9 cohort","volume":"113","author":"Schnabel","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1016\/j.cgh.2024.01.040","article-title":"Ultra-processed food consumption and long-term risk of irritable bowel syndrome: a large-scale prospective cohort study","volume":"22","author":"Wu","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3968","DOI":"10.1186\/s12889-025-25356-7","article-title":"Irritable bowel syndrome and associated mental health problems among Middle East and north African medical students: a multicentric cross-sectional study","volume":"25","author":"Abdelshafi","year":"2025","journal-title":"BMC Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"73","DOI":"10.5152\/tjg.2015.150238","article-title":"The role of diet in the overlap between gastroesophageal reflux disease and functional dyspepsia","volume":"27","author":"Chirila","year":"2016","journal-title":"Turk J Gastroenterol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1111\/jgh.13465","article-title":"Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population","volume":"32","author":"Ghoshal","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e70071","DOI":"10.1111\/nmo.70071","article-title":"The association between ultra-processed foods consumption and disorders of gut\u2013brain interaction: the Isfahan functional disorders (ISFUN) study","volume":"37","author":"Haghighatdoost","year":"2025","journal-title":"Neurogastroenterol Motil"},{"key":"ref22","first-page":"200","article-title":"Irritable bowel syndrome in adults over 35 years in shiraz, southern Iran: prevalence and associated factors","volume":"16","author":"Khademolhosseini","year":"2011","journal-title":"J Res Med Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1111\/nmo.12895","article-title":"Dietary patterns and prevalence of irritable bowel syndrome in Iranian adults","volume":"28","author":"Khayyatzadeh","year":"2016","journal-title":"Neurogastroenterology Motil"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1186\/s12876-024-03320-w","article-title":"Dietary habits as associated factors with irritable bowel syndrome among medical students: evidence from a cross-sectional study","volume":"24","author":"Mahyoub","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"d4002","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","year":"2011","journal-title":"BMJ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.3390\/nu13041109","article-title":"Mechanisms of food-induced symptom induction and dietary management in functional dyspepsia","volume":"13","author":"Duncanson","year":"2021","journal-title":"Nutrients"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1053\/j.gastro.2013.04.051","article-title":"No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates","volume":"145","author":"Biesiekierski","year":"2013","journal-title":"Gastroenterology"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12937-019-0487-6","article-title":"Adherence to the pro-inflammatory diet in relation to prevalence of irritable bowel syndrome","volume":"18","author":"Salari-Moghaddam","year":"2019","journal-title":"Nutr J"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"4132","DOI":"10.3390\/jcm13144132","article-title":"Evaluation of diet and symptom severity in disorder of gut-brain interaction","volume":"13","author":"Faruga-Lewicka","year":"2024","journal-title":"J Clin Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"8967306","DOI":"10.1155\/2019\/8967306","article-title":"The role of dietary energy and macronutrients intake in prevalence of irritable bowel syndromes","volume":"2019","author":"Zhang","year":"2019","journal-title":"Biomed Res Int"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e077310","DOI":"10.1136\/bmj-2023-077310","article-title":"Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses","volume":"384","author":"Lane","year":"2024","journal-title":"BMJ"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1146\/annurev-food-022811-101118","article-title":"Alternatives to those artificial FD&C food colorants","volume":"3","author":"Wrolstad","year":"2012","journal-title":"Annu Rev Food Sci Technol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1002\/jat.4080","article-title":"Effects of sunset yellow on proliferation and differentiation of intestinal epithelial cells in murine intestinal organoids","volume":"41","author":"Kong","year":"2021","journal-title":"J Appl Toxicol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"114585","DOI":"10.1016\/j.fct.2024.114585","article-title":"Sunset yellow dye effects on gut microbiota, intestinal integrity, and the induction of inflammasomopathy with pyroptotic signaling in male wistar rats","volume":"187","author":"Zahran","year":"2024","journal-title":"Food Chem Toxicol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1038\/nature14232","article-title":"Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome","volume":"519","author":"Chassaing","year":"2015","journal-title":"Nature"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1017\/S0007114516002610","article-title":"Re-evaluation of the mechanisms of dietary fibre and implications for macronutrient bioaccessibility, digestion and postprandial metabolism","volume":"116","author":"Grundy","year":"2016","journal-title":"Br J Nutr"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1111\/ijfs.13192","article-title":"A review of the impact of processing on nutrient bioaccessibility and digestion of almonds","volume":"51","author":"Grundy","year":"2016","journal-title":"Int J Food Sci Technol"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.MBP-0008-2014","article-title":"The roles of inflammation, nutrient availability and the commensal microbiota in enteric pathogen infection","volume":"3","author":"Stecher","year":"2015","journal-title":"Microbiol Spectrum"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3389\/fvets.2019.00048","article-title":"Dietary fiber and intestinal health of monogastric animals","volume":"6","author":"Jha","year":"2019","journal-title":"Front Vet Sci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e13983","DOI":"10.1111\/nmo.13983","article-title":"Changes in fecal short-chain fatty acids following fecal microbiota transplantation in patients with irritable bowel syndrome","volume":"33","author":"El-Salhy","year":"2021","journal-title":"Neurogastroenterol Motil"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"m2382","DOI":"10.1136\/bmj.m2382","article-title":"Food and mood: how do diet and nutrition affect mental wellbeing?","volume":"369","author":"Firth","year":"2020","journal-title":"BMJ"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1038\/s41575-020-00375-4","article-title":"Dietary fibre in gastrointestinal health and disease","volume":"18","author":"Gill","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12876-024-03230-x","article-title":"Fructose malabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome","volume":"24","author":"Sia","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"3815","DOI":"10.1039\/c8fo00883c","article-title":"Artificial sweetener saccharin disrupts intestinal epithelial cells\u2019 barrier function in vitro","volume":"9","author":"Santos","year":"2018","journal-title":"Food Funct"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"9380","DOI":"10.1039\/d1fo01351c","article-title":"Sucralose enhances the susceptibility to dextran sulfate sodium (DSS) induced colitis in mice with changes in gut microbiota","volume":"12","author":"Guo","year":"2021","journal-title":"Food Funct"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2413367","DOI":"10.1080\/19490976.2024.2413367","article-title":"A pathophysiologic framework for the overlap of disorders of gut-brain interaction and the role of the gut microbiome","volume":"16","author":"Shah","year":"2024","journal-title":"Gut Microbes"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1111\/jgh.15410","article-title":"Low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol diet in patients with diarrhea-predominant irritable bowel syndrome: a prospective, randomized trial","volume":"36","author":"Goyal","year":"2021","journal-title":"J Gastroenterol Hepatol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1780040\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:24:56Z","timestamp":1774329896000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1780040\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":47,"alternative-id":["10.3389\/fmed.2026.1780040"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1780040","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]},"article-number":"1780040"}}