{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:11:40Z","timestamp":1788880300893,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"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. Nutr."],"abstract":"\n Background<\/jats:title>\n Ultra-processed food (UPF) consumption has been linked to cardiometabolic diseases, but the association with non-alcoholic fatty liver disease (NAFLD) remains unclear. Moreover, whether all UPFs confer similar risk is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To systematically review and meta-analyze the association between total UPF intake (strictly defined by NOVA classification) and selected UPF-related food-group exposures [red\/processed meat and sugar-sweetened beverages (SSBs)] and NAFLD risk in adults.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We searched PubMed, Web of Science, and Cochrane Library up to March 31, 2026, for observational studies reporting adjusted effect estimates for total UPF intake or selected food-group exposures and NAFLD. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) or AHRQ criteria. Random-effects models pooled odds ratios (ORs) comparing highest vs. lowest intake categories. Subgroup and sensitivity analyses explored heterogeneity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty-four studies were included in the systematic review. Of these,\n nine<\/jats:bold>\n studies (5 prospective cohorts, 4 cross-sectional) comprising 250,349 participants were included for total UPF intake. Higher total UPF consumption was associated with a 26% increased NAFLD risk (pooled OR = 1.26; 95% CI: 1.16\u20131.37; I\n 2<\/jats:sup>\n = 53%;\n P<\/jats:italic>\n &lt; 0.001). Red\/processed meat consumption (6 studies) showed a stronger association (pooled OR = 1.70; 95% CI: 1.29\u20132.24; I\n 2<\/jats:sup>\n = 76%;\n P<\/jats:italic>\n &lt; 0.001). SSB consumption (3 studies) was associated with a 50% increased risk (pooled OR = 1.50; 95% CI: 1.23\u20131.84; I\n 2<\/jats:sup>\n = 0%;\n P<\/jats:italic>\n &lt; 0.001). Sensitivity analyses confirmed robustness.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Total UPF intake is associated with a moderate increase in NAFLD risk. Red\/processed meat and sugar-sweetened beverages show stronger associations, suggesting that dietary recommendations may prioritize these high-risk food groups, although blanket avoidance of all UPFs is not directly supported by the current data.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1876449","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:43:25Z","timestamp":1788878605000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Total ultra-processed food intake and selected food-group exposures in relation to non-alcoholic fatty liver disease: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Dongmei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Health Management, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital","place":["Chengdu, China"]},{"name":"Department of International Medical Service, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Health Management, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital","place":["Chengdu, China"]},{"name":"Department of International Medical Service, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenglong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu Second People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1002\/hep.30702","article-title":"Unexpected rapid increase in the burden of NAFLD in China from 2008 to 2018: a systematic review and 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