Ultra-Processed Foods and Metabolic Dysfunction: Mechanisms, Clinical Implications, and Public Health Perspectives. Position Paper of the Italian Association of Dietetics and Clinical Nutrition (ADI)

Purpose of review: This position paper by the Italian Association of Dietetics and Clinical Nutrition (ADI) evaluates the impact of ultra-processed foods (UPFs) on metabolic health and chronic disease risk, with particular attention to the biological and behavioural mechanisms involved. Recent findings: High UPFs consumption has been associated with obesity, insulin resistance, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease (MASLD), cancer, neuroinflammation, and immune dysregulation. Proposed mechanisms include gut microbiota alterations, increased intestinal permeability, mitochondrial dysfunction, oxidative stress, impaired metabolic flexibility, and chronic low-grade inflammation. The hyperpalatable nature of UPFs may also impair appetite regulation and promote overconsumption, especially among children and adolescents. Additional concerns involve food additives, processing-derived contaminants, and endocrine disruptors from packaging materials. Current evidence identifies UPFs as a major modifiable risk factor for non-communicable chronic diseases. Reducing UPFs exposure should therefore represent a public health priority, supported by preventive nutritional strategies, improved food classification systems, and targeted educational and regulatory interventions.