Journals / Anadolu Bil Meslek Yüksekokulu Dergisi / 2026 / Cilt: 21 Sayı: 73

The Nutrition Paradox: A Review on the Biological, Behavioral, and Societal Implications of Ultra Processed Foods

Beslenme paradoksu: ultra-işlenmiş gıdaların biyolojik, davranışsal ve toplumsal yansımaları üzerine bir derleme

Sema Selvi(İSTANBUL AYDIN ÜNİVERSİTESİ)0009-0009-1017-8922
Can Ergün(İSTANBUL AYDIN ÜNİVERSİTESİ)0000-0001-5139-4407
Pages
109–128
Publication Date
2026-07-20
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Future research should focus on the intersection between nutrition and psychopathology to develop more holistic approaches.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This review aims to comprehensively evaluate the biological, behavioral, and societal implications of ultra-processed foods within the framework of the "Nutrition Paradox," assessing the mechanisms driving ultra-processed foods consumption and their health effects.
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Key Findings & Data:Strong links were identified between ultra-processed foods consumption and chronic diseases such as cardiovascular diseases, type 2 diabetes, various cancers, metabolic syndrome, mortality risk, and depression.
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Conclusion & Impact:Future research should focus on the intersection between nutrition and psychopathology to develop more holistic approaches.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Ultra-işlenmiş gıdalar · beslenme Paradoksu · kronik hastalıklar

Abstract

Objective: This review aims to comprehensively evaluate the biological, behavioral, and societal implications of ultra-processed foods within the framework of the "Nutrition Paradox," assessing the mechanisms driving ultra-processed foods consumption and their health effects. Scope: The literature review examined the impact of ultra-processed foods consumption on weight gain, metabolic mechanisms, psychological and social determinants, and the risk of chronic diseases. Classification approaches like the NOVA system were critically appraised. Main Findings: Ultra-processed foods consumption is associated with hormonal imbalances, gut microbiota alterations, addictive potential, and socioeconomic factors. Strong links were identified between ultra-processed foods consumption and chronic diseases such as cardiovascular diseases, type 2 diabetes, various cancers, metabolic syndrome, mortality risk, and depression. Consumer inclination towards ultra-processed foods, despite awareness of potential harms, is explained by economic affordability, accessibility, and aggressive marketing strategies. Conclusion: This review demonstrates an urgent need for multidisciplinary intervention strategies to overcome the "Nutrition Paradox" created by ultra-processed foods. Beyond individual efforts, fundamental changes in food systems and robust public health policies are essential. Future research should focus on the intersection between nutrition and psychopathology to develop more holistic approaches.

Özet

Amaç: Bu derleme, ultra-işlenmiş gıdaların biyolojik, davranışsal ve toplumsal yansımalarını "Beslenme Paradoksu" çerçevesinde ele alarak, ultra-işlenmiş gıda tüketimini belirleyen mekanizmaları ve sağlık üzerindeki etkilerini bütüncül bir yaklaşımla değerlendirmeyi amaçlamaktadır. Kapsam: Literatür taraması, ultra-işlenmiş gıda tüketiminin vücut ağırlığı artışı, metabolik mekanizmalar, psikolojik ve sosyal etkenler ile kronik hastalık riskleri üzerindeki etkilerini incelemiştir. Ayrıca NOVA sistemi gibi sınıflandırma yaklaşımları eleştirel bir perspektifle değerlendirilmiştir. Ana Temalar/Bulgular: Ultra-işlenmiş gıda tüketimi, hormonal dengesizlikler, bağırsak mikrobiyotası değişiklikleri, bağımlılık potansiyeli ve düşük sosyoekonomik durum gibi faktörlerle ilişkilidir. Kardiyovasküler hastalıklar, tip 2 diyabet, bazı kanser türleri, metabolik sendrom, mortalite riski ve depresyon gibi kronik hastalıklarla güçlü bağlantıları tespit edilmiştir. Tüketicinin, ultra-işlenmış gıdaların potansiyel zararlarını bilmesine rağmen ürüne yönelimi, ekonomik uygunluk, ulaşılabilirlik ve pazarlama stratejileri gibi etkenlerle açıklanmaktadır. Sonuç: Bu derleme, ultra-işlenmiş gıdaların yarattığı "Beslenme Paradoksu"nun üstesinden gelmek için multidisipliner müdahale stratejilerine acil ihtiyaç olduğunu göstermektedir. Bireysel çabalardan öte, gıda sistemlerinde köklü değişiklikler ve güçlü halk sağlığı politikaları gereklidir. Gelecek çalışmalar, beslenme ve psikopatoloji arasındaki kesişim noktalarına odaklanarak daha bütüncül yaklaşımlar geliştirmelidir.

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Cite This Article

Selvi, S., Ergün, C. (2026). The Nutrition Paradox: A Review on the Biological, Behavioral, and Societal Implications of Ultra Processed Foods. Anadolu Bil Meslek Yüksekokulu Dergisi, Cilt: 21 Sayı: 73, 109–128. https://ajindex.com/articles/1579890

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References (75)

  1. Asensi, M. T., Napoletano, A., Sofi, F. ve Dinu, M., (2023). Low-grade inflammation and ultra-processed foods consumption: A review. Nutrients, 15, 1546. doi: 10.3390/nu15061546
  2. Babalola, O. O., Akinnusi, E., Ottu, P. O., Bridget, K., Oyubu, G., Ajiboye, S. A.,. Iwaloye, O., (2025). The impact of ultra-processed foods on cardiovascular diseases and cancer: Epidemiological and mechanistic insights. Aspects of Molecular Medicine, 100072. doi: 10.1016/j.amolm.2025.100072
  3. Baker, P., Machado, P., Santos, T. M., Sievert, K., Backholer, K., Hadjikakou, M.,. Lawrence, M., (2020). Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obesity Reviews, 21, e13126. doi: 10.1111/obr.13126
  4. Braesco, V., Souchon, I., Sauvant, P., Haurogné, T., Maillot, M., Féart, C. ve Darmon, N., (2022). Ultra-processed foods: how functional is the NOVA system? European Journal of Clinical Nutrition, 76, 1245-1253. doi: 10.1038/s41430-022-01099-1
  5. Canhada, S., Vigo, Á., Luft, V. C., Levy, R. B., Matos, S. M. A., Molina, M. del C. B.,. Schmidt, M. I., (2023). Ultra-processed food consumption and increased risk of metabolic syndrome in adults: The ELSA-Brasil. Diabetes Care, 46, 369-376. doi: 10.2337/dc22-1505
  6. Çelik, Ö. M., Güler, Ü. ve Ekici, E. M., (2025). Factors affecting ultraprocessed food consumption: Hedonic hunger, food addiction, and mood. Food Science & Nutrition, 13, e70248. doi: 10.1002/fsn3.70248
  7. Chen, X., Zhang, Z., Yang, H., Qiu, P., Wang, H., Wang, F.,. Nie, J., (2020). Consumption of ultra-processed foods and health outcomes: A systematic review of epidemiological studies. Nutrition Journal, 19, 86. doi: 10.1186/s12937-020-00604-1
  8. Crimarco, A., Landry, M. J. ve Gardner, C. D., (2022). Ultra-processed foods, weight gain, and co-morbidity risk. Current Obesity Reports, 11, 80-92. doi: 10.1007/s13679-021-00460-y
  9. Dai, S., Wellens, J., Yang, N., Li, D., Wang, J., Wang, L.,. Li, X., (2024). Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence. Clinical Nutrition, 43, 1386-1402. doi: 10.1016/j.clnu.2024.04.016
  10. Dailey-Chwalibóg, T., Freemark, M., Roberfroid, D., Kemokai, I. A., Mostak, M. R., Alim, M.,. Guesdon, B., (2020). Signification clinique du diagnostic anthropométrique de la malnutrition aiguë sévère de l'enfant: résultats préliminaires de l'étude multicentrique OptiDiag et implications en terme de santé publique. Nutrition Clinique et Métabolisme, 34, 86-95. doi: 10.1016/j.nupar.2020.02.425
  11. Dicken, S. J. ve Batterham, R. L., (2022). 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. Nutrients, 14, 23. doi: 10.3390/nu14010023
  12. Dicken, S. J. ve Batterham, R. L., (2024). Ultra-processed food and obesity: What is the evidence? Current Nutrition Reports, 13, 23-38. doi: 10.1007/s13668-024-00517-z
  13. Dicken, S. J., Qamar, S. ve Batterham, R. L., (2024). Who consumes ultra-processed food? A systematic review of sociodemographic determinants of ultra-processed food consumption from nationally representative samples. Nutrition Research Reviews, 37, 416-461. doi: 10.1017/s0954422423000240
  14. Eaton, J., (2020). Pillars of the nutrition transition: The global impacts of ultra-processed foods and beverages on overweight and obesity and national nutrient supplies. (Doktora tezi), Johns Hopkins Üniversitesi, Baltimore. doi: 10.7936/kgvt-v980
  15. Elizabeth, L., Machado, P., Zinöcker, M. K., Baker, P. ve Lawrence, M., (2020). Ultra-processed foods and health outcomes: A narrative review. Nutrients, 12, 1955. doi: 10.3390/nu12071955
  16. García-Blanco, L., de la O, V., Santiago, S., Pouso, A., Martínez- González, M. Á. ve Martín-Calvo, N., (2023). High consumption of ultra-processed foods is associated with increased risk of micronutrient inadequacy in children: The SENDO project. European Journal of Pediatrics, 182, 3537-3547. doi: 10.1007/s00431-023-05026-9
  17. Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Múrcia, S. ve Fernández-Aranda, F., (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, 383, e075354. doi: 10.1136/bmj-2023-075354
  18. Gearhardt, A. N. ve DiFeliceantonio, A. G., (2023). Highly processed foods can be considered addictive substances based on established scientific criteria. Addiction, 118, 589-601. doi: 10.1111/add.16065
  19. Gonçalves, H. V. B., Batista, L. S., Amorim, A. L. B. de ve Bandoni, D. H., (2023). Association between consumption of ultra-processed foods and sociodemographic characteristics in Brazilian adolescents. Nutrients, 15, 2027. doi: 10.3390/nu15092027
  20. Hall, E., (2020). Give convenience foods a healthy makeover. Journal of Nutrition Education and Behavior, 52, 1079-1080. doi: 10.1016/j. jneb.2020.03.008
  21. Hebebrand, J. ve Gearhardt, A. N., (2021). The concept of "food addiction" helps inform the understanding of overeating and obesity: NO. American Journal of Clinical Nutrition, 113, 268-273. doi: 10.1093/ajcn/ nqaa344
  22. Jung, S., Kim, J. Y. ve Park, S., (2024). Eating patterns in Korean adults, 1998–2018: Increased energy contribution of ultra-processed foods in main meals and snacks. European Journal of Nutrition, 63, 279-293. doi: 10.1007/s00394-023-03258-x
  23. Kabasakal, E., Arslan, Ü., Üner, S., Ünlü, H. K., Bilir, N., Yardim, M. S.,. Özcebe, H., (2020). Çocuklar için sağlıklı yeme öz-yeterlik ölçeğinin Türkçe geçerlik ve güvenirlik çalışması. Turkish Journal of Pediatric Disease, 15, 72-79. doi: 10.12956/tchd.556078
  24. Karataş, B. ve Küşümler, A. S., (2021). Assessment of processed meat consumption in children (6-10 years old): Sample of an elementary school in Istanbul, Turkey. Revista Española de Nutrición Humana y Dietética, 26, 1332. doi: 10.14306/renhyd.26.s2.1332
  25. Koios, D., Machado, P. ve Lacy-Nichols, J., (2022). Representations of ultra-processed foods: A global analysis of how dietary guidelines refer to levels of food processing. International Journal of Health Policy and Management. doi: 10.34172/ijhpm.2022.6443
  26. LaFata, E. M., Allison, K. C., Audrain-McGovern, J. ve Forman, E. M., (2024). Ultra-processed food addiction: A research update. Current Obesity Reports, 13, 214-226. doi: 10.1007/s13679-024-00569-w
  27. Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S.,. Marx, W., (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, 384, e077310. doi: 10.1136/bmj-2023-077310
  28. Leary, M., Pursey, K., Verdejo-García, A. ve Burrows, T., (2021). Current intervention treatments for food addiction: A systematic review. Behavioral Sciences, 11, 80. doi: 10.3390/bs11060080
  29. Leite, F. H. M., Khandpur, N., Souza, G. C. R. M. de, Anastasiou, K., Baker, P., Lawrence, M. ve Monteiro, C. A., (2022). Ultra-processed foods should be central to global food systems dialogue and action on biodiversity. BMJ Global Health, 7, e008269. doi: 10.1136/bmjgh-2021-008269
  30. Liang, S., Zhou, Y., Zhang, Q., Yu, S. ve Wu, S., (2025). Ultraprocessed foods and risk of all-cause mortality: An updated systematic review and dose-response meta-analysis of prospective cohort studies. Systematic Reviews, 14, 53. doi: 10.1186/s13643-025-02800-8
  31. Louie, J. C. Y., (2025). Are all ultra-processed foods bad? A critical review of the NOVA classification system. Proceedings of the Nutrition Society, 1-11. doi: 10.1017/s0029665125100645
  32. Lutz, M., Arancibia, M., Morán, J. ve Manterola, M., (2025). Ultraprocessed foods and neuropsychiatric outcomes: Putative mechanisms. Nutrients, 17, 1215. doi: 10.3390/nu17071215
  33. Medin, A. C., Gulowsen, S. R., Berget, I., Grini, I. S. ve Varela, P., (2025). Definitions of ultra-processed foods beyond NOVA: A systematic review and evaluation. Food & Nutrition Research, 69, 12217. doi: 10.29219/fnr.v69.12217
  34. Meseri, R. ve Akanalçı, C., (2020). Food addiction: A key factor contributing to obesity? Journal of Research in Medical Sciences, 25, 71. doi: 10.4103/jrms.jrms_971_19
  35. Monteiro, C. A., Steele, E. M. ve Cannon, G., (2024). Impact of food ultra-processing on cardiometabolic health: Definitions, evidence, and implications for dietary guidance. Journal of the American Heart Association. doi: 10.1161/jaha.124.035986
  36. Okyar, S., Tosun, Ö., Bezdegümeli, E., Küçükakça, B. N., Erattır, A., Karahan, H.,. Ekerbiçer, H. Ç., (2022). Ultra işlenmiş gıdaların yaygın etkileri. Arşiv Kaynak Tarama Dergisi, 32, 68-83. doi: 10.17827/ aktd.1123330
  37. Passeri, A., Municchi, D., Cavalieri, G., Babicola, L., Ventura, R. ve Segni, M. D., (2023). Linking drug and food addiction: An overview of the shared neural circuits and behavioral phenotype. Frontiers in Behavioral Neuroscience, 17, 1240748. doi: 10.3389/fnbeh.2023.1240748
  38. Pereira, T. N., Bortolini, G. A. ve Campos, R. de F., (2023). Barriers and facilitators related to the adoption of policies to reduce ultraprocessed foods consumption: A scoping review. International Journal of Environmental Research and Public Health, 20, 4729. doi: 10.3390/ijerph20064729
  39. Principato, L., Pice, G. ve Pezzi, A., (2024). Understanding food choices in sustainable healthy diets – A systematic literature review on behavioral drivers and barriers. Environmental Science & Policy, 163, 103975. doi: 10.1016/j.envsci.2024.103975
  40. Pu, J.-Y., Xu, W., Zhu, Q., Sun, W., Hu, J., Cai, D.,. Zhong, G., (2023). Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: A large prospective multicenter study. Frontiers in Nutrition, 10, 1258242. doi: 10.3389/fnut.2023.1258242
  41. Ranjbar, M., Avini, N. A. ve Shab-Bidar, S., (2024). The association between ultra-processed food consumption and adiposity indexes in adults living in Tehran: A dose-response analysis within a cross-sectional study. Research Square. doi: 10.21203/rs.3.rs-5694977/v1
  42. Robinson, E., Cummings, J. R., Gough, T., Jones, A. ve Evans, R., (2024). Consumer awareness, perceptions and avoidance of ultraprocessed foods: A study of UK adults in 2024. Foods, 13, 2317. doi: 10.3390/foods13152317
  43. Román, S., Campos-Medina, L. ve Leal-Mercado, L., (2024). Personalized nutrition: The end of the one-diet-fits-all era. Frontiers in Nutrition, 11, 1370595. doi: 10.3389/fnut.2024.1370595
  44. Rondinella, D., Raoul, P., Valeriani, E., Venturini, I., Cintoni, M., Severino, A.,. Ianiro, G., (2025). The detrimental impact of ultraprocessed foods on the human gut microbiome and gut barrier. Nutrients, 17, 859. doi: 10.3390/nu17050859
  45. Samuthpongtorn, C., Nguyen, L. H., Okereke, O. I., Wang, D. D., Song, M., Chan, A. T. ve Mehta, R. S., (2023). Consumption of ultraprocessed food and risk of depression. JAMA Network Open, 6, e2334770. doi: 10.1001/jamanetworkopen.2023.34770
  46. Silva, C. G., Saunders, C., Rangel, L. F. da C., Matos, A. A. de, Teixeira, F. M. ve Ribeiro, B. G., (2024). Impact of ultra-processed foods on excess weight and dyslipidemia in schoolchildren. Nutrition, 131, 112638. doi: 10.1016/j.nut.2024.112638
  47. Thompson, S. P. ve Thaw, A. K., (2024). The badly behaving brain: How ultra-processed food addiction thwarts sustained weight loss. IntechOpen. doi: 10.5772/intechopen.1004428
  48. Y. T. ve İçen, S., (2021). Food addiction in children and adolescents. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 31, 103-114. doi: 10.4274/tjcamh.galenos.2021.44227
  49. Trumbo, P. R., Bleiweiss-Sande, R., Campbell, J. K., Decker, E. A., Drewnowski, A., Erdman, J. W.,. Yu, L., (2024). Toward a sciencebased classification of processed foods to support meaningful research and effective health policies. Frontiers in Nutrition, 11, 1389601. doi: 10.3389/ fnut.2024.1389601
  50. Visioli, F., Marangoni, F., Fogliano, V., Rio, D. D., Martínéz, J. A., Kuhnle, G.,. Poli, A., (2023). The ultra-processed foods hypothesis: A product processed well beyond the basic ingredients in the package. Nutrition Research Reviews, 36, 340-363. doi: 10.1017/s0954422422000117
  51. Vitale, M., Costabile, G., Testa, R., D'Abbronzo, G., Nettore, I. C., Macchia, P. E. ve Giacco, R., (2023). Ultra-processed foods and human health: A systematic review and meta-analysis of prospective cohort studies. Advances in Nutrition, 15, 100121. doi: 10.1016/j.advnut.2023.09.009
  52. Whelan, K., Bancil, A., Lindsay, J. O. ve Chassaing, B., (2024). Ultra-processed foods and food additives in gut health and disease. Nature Reviews Gastroenterology & Hepatology, 21, 406-427. doi: 10.1038/ s41575-024-00893-5
  53. Williams, D., (2024). Ultra-processed foods and the strategic manipulation of our evolved motivational tendencies. Preventive Medicine Reports, 47, 102902. doi: 10.1016/j.pmedr.2024.102902
  54. Wiss, D. A. ve LaFata, E. M., (2024). Ultra-processed foods and mental health: Where do eating disorders fit into the puzzle? Nutrients, 16, 1955. doi: 10.3390/nu16121955
  55. Wolde, H. F., Derso, T., Biks, G. A., Yitayal, M., Ayele, T. A., Gelaye, K. A.,. Atnafu, A., (2020). High hidden burden of diabetes mellitus among adults aged 18 years and above in urban Northwest Ethiopia. Journal of Diabetes Research, 2020, 9240398. doi: 10.1155/2020/9240398
  56. Yardım, N., Ilgaz, S., Aydın, F. B. ve Kaya, M., (2020). Ulusal yayın yapan bazı uluslararası çocuk televizyon kanallarında çocuklara yönelik gıda ve içecek reklamlarının Sağlık Bakanlığı besin profili rehberine göre değerlendirilmesi. Türk Kardiyoloji Derneği Arşivi, 48, 278-285.
  57. Zhang, H., Tong, T., Gao, Y., Liang, C., Yu, H., Li, S.,. Wang, L., (2021). Translation of the Chinese version of the modified Yale Food Addiction Scale 2.0 and its validation among college students. Journal of Eating Disorders, 9, 86. doi: 10.1186/s40337-021-00471-z
  58. Can, T. E. ve Özpınar, H., (2023). İstanbul İlinde Bir Ortaöğretim Okulundaki 11-13 Yaş Arası Çocukların Beslenme Durumlarının Sağlıklı Yeme İndeksi İle Değerlendirilmesi. https://dergipark.org.tr/tr/pub/ arsagbil/issue/80873/1319851, (Erişim tarihi: 02 Ocak 2026).
  59. Çağıran Yılmaz, F., (2022). Çocuk ve adölesanları hedef alan besinlerin içeriklerinin incelenmesi. Sağlık Bilimleri ve Yaşam Dergisi, 6(1), 1-15. https://izlik.org/JA93UR68KH, (Erişim tarihi: 15 Ocak 2026).
  60. Babalola, O. O., Akinnusi, E., Ottu, P. O., Bridget, K., Oyubu, G., Ajiboye, S. A.,. Iwaloye, O., (2025). The impact of ultra-processed foods on cardiovascular diseases and cancer: Epidemiological and mechanistic insights. Aspects of Molecular Medicine, 100072. doi: 10.1016/j.amolm.2025.100072
  61. Baker, P., Machado, P., Santos, T. M., Sievert, K., Backholer, K., Hadjikakou, M.,. Lawrence, M., (2020). Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obesity Reviews, 21, e13126. doi: 10.1111/obr.13126
  62. Canhada, S., Vigo, Á., Luft, V. C., Levy, R. B., Matos, S. M. A., Molina, M. del C. B.,. Schmidt, M. I., (2023). Ultra-processed food consumption and increased risk of metabolic syndrome in adults: The ELSA-Brasil. Diabetes Care, 46, 369-376. doi: 10.2337/dc22-1505
  63. Chen, X., Zhang, Z., Yang, H., Qiu, P., Wang, H., Wang, F.,. Nie, J., (2020). Consumption of ultra-processed foods and health outcomes: A systematic review of epidemiological studies. Nutrition Journal, 19, 86. doi: 10.1186/s12937-020-00604-1
  64. Dai, S., Wellens, J., Yang, N., Li, D., Wang, J., Wang, L.,. Li, X., (2024). Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence. Clinical Nutrition, 43, 1386-1402. doi: 10.1016/j.clnu.2024.04.016
  65. Dailey-Chwalibóg, T., Freemark, M., Roberfroid, D., Kemokai, I. A., Mostak, M. R., Alim, M.,. Guesdon, B., (2020). Signification clinique du diagnostic anthropométrique de la malnutrition aiguë sévère de l'enfant: résultats préliminaires de l'étude multicentrique OptiDiag et implications en terme de santé publique. Nutrition Clinique et Métabolisme, 34, 86-95. doi: 10.1016/j.nupar.2020.02.425
  66. García-Blanco, L., de la O, V., Santiago, S., Pouso, A., Martínez- González, M. Á. ve Martín-Calvo, N., (2023). High consumption of ultra-processed foods is associated with increased risk of micronutrient inadequacy in children: The SENDO project. European Journal of Pediatrics, 182, 3537-3547. doi: 10.1007/s00431-023-05026-9
  67. Kabasakal, E., Arslan, Ü., Üner, S., Ünlü, H. K., Bilir, N., Yardim, M. S.,. Özcebe, H., (2020). Çocuklar için sağlıklı yeme öz-yeterlik ölçeğinin Türkçe geçerlik ve güvenirlik çalışması. Turkish Journal of Pediatric Disease, 15, 72-79. doi: 10.12956/tchd.556078
  68. Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S.,. Marx, W., (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, 384, e077310. doi: 10.1136/bmj-2023-077310
  69. Okyar, S., Tosun, Ö., Bezdegümeli, E., Küçükakça, B. N., Erattır, A., Karahan, H.,. Ekerbiçer, H. Ç., (2022). Ultra işlenmiş gıdaların yaygın etkileri. Arşiv Kaynak Tarama Dergisi, 32, 68-83. doi: 10.17827/ aktd.1123330
  70. Pu, J.-Y., Xu, W., Zhu, Q., Sun, W., Hu, J., Cai, D.,. Zhong, G., (2023). Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: A large prospective multicenter study. Frontiers in Nutrition, 10, 1258242. doi: 10.3389/fnut.2023.1258242
  71. Rondinella, D., Raoul, P., Valeriani, E., Venturini, I., Cintoni, M., Severino, A.,. Ianiro, G., (2025). The detrimental impact of ultraprocessed foods on the human gut microbiome and gut barrier. Nutrients, 17, 859. doi: 10.3390/nu17050859
  72. Trumbo, P. R., Bleiweiss-Sande, R., Campbell, J. K., Decker, E. A., Drewnowski, A., Erdman, J. W.,. Yu, L., (2024). Toward a sciencebased classification of processed foods to support meaningful research and effective health policies. Frontiers in Nutrition, 11, 1389601. doi: 10.3389/ fnut.2024.1389601
  73. Visioli, F., Marangoni, F., Fogliano, V., Rio, D. D., Martínéz, J. A., Kuhnle, G.,. Poli, A., (2023). The ultra-processed foods hypothesis: A product processed well beyond the basic ingredients in the package. Nutrition Research Reviews, 36, 340-363. doi: 10.1017/s0954422422000117
  74. Wolde, H. F., Derso, T., Biks, G. A., Yitayal, M., Ayele, T. A., Gelaye, K. A.,. Atnafu, A., (2020). High hidden burden of diabetes mellitus among adults aged 18 years and above in urban Northwest Ethiopia. Journal of Diabetes Research, 2020, 9240398. doi: 10.1155/2020/9240398
  75. Zhang, H., Tong, T., Gao, Y., Liang, C., Yu, H., Li, S.,. Wang, L., (2021). Translation of the Chinese version of the modified Yale Food Addiction Scale 2.0 and its validation among college students. Journal of Eating Disorders, 9, 86. doi: 10.1186/s40337-021-00471-z