Older US adults — particularly women — who entered adolescence or early adulthood as ultraprocessed foods (UPFs) emerged in the marketplace, showed significantly higher rates of UPF addiction (UPFA) in their later adulthood than the generation before them in a new study.

In addition, UPF intake addictive patterns appeared to be associated with poorer health outcomes and social well-being.

While UPFA is not currently recognized as an official diagnosis, researchers used the Yale Food Addiction Scale 2.0 to assess diagnostic criteria for UPFA. The scale is a validated measurement that applies the diagnostic criteria for substance use disorders, such as the loss of control over intake, intense craving, and continued use despite negative consequences, to UPF overconsumption.

The mechanisms behind the causes of UPFA and various poorer health outcomes remain unclear, but signs point to how the foods were deliberately developed, said Ashley Gearhardt, PhD, professor of psychology at the University of Michigan, Ann Arbor, Michigan, and senior author of the study.

“The problem isn’t only what’s in ultraprocessed foods, it’s how they’re made and marketed,” she told Medscape Medical News. “These products are industrially engineered to be irresistible.”

These findings — published in Addiction — “examine UPFA prevalence rates in a nationally representative sample of older adults,” the study authors wrote.

Online and Telephone Survey Results

The researchers looked at data from a cross-sectional online and telephone survey of adults older than 50 years, who were assessed in 2022 as a part of the broader University of Michigan National Poll on Healthy Aging.

The survey included questions such as whether participants had “strong urges” to eat certain foods that represented UPFs.

UPFs that can trigger cravings can range from chocolate to salty snacks (such as potato chips), sugar-sweetened beverages, or other products with high levels of refined carbohydrates and/or added fats.

Of 2038 participants in the survey, 51% were female, with 49.4% aged 50-64 years and 50.6% aged 65-80 years, with a mean age of 63 years.

Based on the assessment, the overall prevalence of UPFA was 12.4%, which is consistent with other studies that have looked at the issue.

Notably, UPFA rates were more than twice as high among women than men (16.9% vs 7.5%), with the highest rates among women aged 50-64 years (21%), compared with women aged 65-80 years (12%), who came into adolescence before UPFs gained momentum.

While the corresponding rates among men were lower overall, men in the 50- to 64-year-old group also had higher rates of UPFA than those in the 65- to 80-year-old group (10.3% vs 3.7%), consistent with the generational differences seen with women.

UPFA Linked to Poor Physical and Mental Health

Additionally, 16.75% of men who reported being overweight met the criteria for UPFA vs 0.9% in men who reported being “about the right weight.” For women who were overweight, as many as 32.7% met the UPFA criteria vs 2.5% of those who reported being at the right weight.

Women reporting worse overall physical health were 1.93 times more likely to meet the criteria for UPFA than those reporting normal physical health; for men, the rate was 2.99 times higher.

Furthermore, women with worse mental health were 2.78 times more likely to meet the criteria for UPFA than those without worsened mental health; men with worse mental health were 4.02 times more likely to have UPFA.

Those reporting social isolation also had much higher rates of UPFA, with rates 3.40 times higher among women and 3.35 times higher among men than those without isolation.

The authors note that the higher rates of UPFA in the 50- to 64-year-old group than the older generation are consistent with known effects of exposure to an addictive substance at a younger age.

“Exposure to addictive substances earlier in development has been associated with an increased risk of developing a future substance use disorder,” they reported. “Delaying regular exposure to addictive substances until the age of 25 years or older is associated with a substantially reduced likelihood of developing an addiction to that substance.”

The ‘Bliss Factor’ of UPFs

Companies manufacture UPFs by combining refined carbs, fats, flavorings, and textures designed to trigger the brain’s reward system. This results in a “bliss point” encouraging people to eat more than intended,” Gearhardt told Medscape Medical News.

Along with overeating, the additives and packaging chemicals can alter the gut microbiome.

“When much of a diet comes from factory formulations instead of real food, it crowds out nutrients and fiber that protect long-term health,” she added.

Meanwhile, studies show that health — including lowering the risk for early death, an improving mood, and easier weight management — improves across the board when UPFs are minimized, Gearhardt noted.

For example, a tightly controlled feeding study showed that “people who ate real food, naturally consumed fewer calories even when meals were matched for nutrients, simply because they felt satisfied sooner,” she said.

In terms of mental health, the satisfaction from the “bliss factor” of UPFs can lead to a vicious cycle.

“When people feel down, stressed, or lonely, ultraprocessed foods offer quick relief,” said Gearhardt. “But the crash that follows — blood sugar swings, inflammation, and fatigue — can worsen mood and make people reach for the same foods again.”

Efforts to turn subsequent generations away from such craving cycles got a boost recently, with California becoming the first state in the US to pass a law banning certain UPFs from school meals. Set to take effect in 2029, the law phases out foods with high levels of additives, such as synthetic food dyes and emulsifiers, high saturated fats, sodium, and/or added sugars.

In the meantime, clinicians can be proactive in raising awareness of UPF consumption, Gearhardt suggested.

“Ask patients not just what they eat, but how processed it is,” she recommended.

“UPFs hijack normal appetite control, making healthy eating feel like an uphill battle.”

Clinicians can further encourage healthier food choices, such as swapping one or two habitual UPFs for real-food alternatives, such as plain yogurt with fruit instead of flavored cups or homemade oatmeal instead of instant packets.

“Clinicians should remember the broader context: people aren’t failing; they’re up against products designed to override self-control,” she pointed out. “Changing the food environment is as important as individual counseling.”

A Word of Caution

Commenting on the research, Mingyang Song, MBBS, associate professor, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, noted that a key consideration with UPFs — particularly with a lack of an official definition of an addiction — is that a variety of key factors can cause higher consumption of these foods.

People often opt for UPFs due to their convenience and affordability, and they can be less expensive than whole foods, Song told Medscape Medical News.

Song was the senior author on another study on UPFs, which only showed a slightly increased risk for all-cause mortality among those with higher consumption, with the strongest association found in meat, poultry, and seafood packaged meals.

Importantly, the study showed that dietary quality had a stronger inverse association with mortality than UPFs.

“What we found is if someone maintains a relatively healthy diet, even if it contains a certain amount of UPF, the mortality rate is not increased,” Song said.

This study underscores that the mechanisms of the health effects of UPFs are still not well understood, he said.

“We don’t know yet what the specific components of UPFs are that can cause health problems,” he explained.

The study authors and Song had no disclosures to report.