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area of ongoing research, in which prospective evidence regarding the degree of food processing is limited. We prospectively assess the association between ultra-processed food (UPF) and minimally or unprocessed food (MUPF) consumption and incident psoriasis, rheumatoid arthritis and vitiligo, as well as a composite exploratory IMID outcome, in a Spanish cohort. Methods: We followed 15,874 IMID-free participants from the SUN Project (median follow-up: 15.1 years). Baseline diet was assessed via a validated FFQ and categorized by NOVA classification. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) across consumption tertiles (% g\/day). Results: During follow-up, 298 self-reported diagnosed incident IMID cases occurred (1.31\/1000 person-years, mostly psoriasis and rheumatoid arthritis). After adjusting for sociodemographic, lifestyle, and clinical factors, the highest UPF consumption was associated with an increased risk of self-reported diagnosed psoriasis (T3 vs. T1: HR = 1.63, 95% CI: 1.08\u20132.45) and rheumatoid arthritis (T3 vs. T1: HR = 1.97, 95% CI: 1.19\u20133.26; p-trend = 0.006), whereas no significant association was observed for vitiligo. Similar trends were observed for the exploratory composite IMID endpoint (T3 vs. T1: HR = 1.80, 95% CI: 1.31\u20132.45). Conversely, higher MUPF intake was associated with a lower risk of self-reported diagnosed psoriasis (T3 vs. T1: HR = 0.60, 95% CI: 0.40\u20130.92; p-trend = 0.014) and exploratory composite IMID endpoints (T3 vs. T1: HR = 0.64, 95% CI: 0.47\u20130.87; p-trend = 0.003). Conclusions: Higher UPF consumption is associated with an increased risk of self-reported diagnosed psoriasis and rheumatoid arthritis, whereas MUPF intake appears to be inversely associated with self-reported diagnosed psoriasis risk. These findings contribute to the ongoing evidence regarding the degree of food processing as a potential factor in the epidemiological profile of specific autoimmune conditions. However, given the observational design of the study, these findings reflect longitudinal associations and do not imply causation.<\/jats:p>","DOI":"10.3390\/nu18121969","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:25:34Z","timestamp":1781778334000},"page":"1969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Degree of Food Processing and the Risk of Immune-Mediated Inflammatory Diseases: A Prospective Analysis of the SUN Cohort"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4497-5358","authenticated-orcid":false,"given":"Luiz","family":"Menezes-J\u00fanior","sequence":"first","affiliation":[{"name":"Post-Graduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto 35400-000, Brazil"},{"name":"Department of Epidemiological Analysis and Surveillance of Non-Communicable Diseases, Ministry of Health, Brasilia 70058-900, Brazil"},{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-9808","authenticated-orcid":false,"given":"Miguel A.","family":"Martinez-Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, 31008 Pamplona, Spain"},{"name":"IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5648-4934","authenticated-orcid":false,"given":"Ainara","family":"Mart\u00ednez-Tabar","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, 31008 Pamplona, Spain"},{"name":"IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Gonz\u00e1lez-Cantero","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Universitario Ramon y Cajal, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitarian (IRYCIS), 28034 Madrid, Spain"},{"name":"Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0589-5718","authenticated-orcid":false,"given":"Alejandro","family":"Mart\u00edn-Gorgojo","sequence":"additional","affiliation":[{"name":"Madrid City Council, STI\/Dermatology Department, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-4206","authenticated-orcid":false,"given":"Maira","family":"Bes-Rastrollo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, 31008 Pamplona, Spain"},{"name":"IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103610","DOI":"10.1016\/j.autrev.2024.103610","article-title":"Auto-immuno-deficiency syndromes","volume":"23","author":"Houen","year":"2024","journal-title":"Autoimmun. 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