Association Between Ultra-Processed Food Intake and Self-Reported Arthritis

Abstract

Introduction: Ultra-processed foods are typically high in fat, salt, sugar, and food additives, which may contribute to the development of arthritis. This study examined the association between ultra-processed food intake and the presence of self-reported arthritis. Methods: The 2001–2018 U.S. National Health and Nutrition Examination Survey data was used to analyze the association between ultra-processed food intake and arthritis in 2025. Ultra-processed foods were identified by applying Nova classifications to 24-hour dietary recall data and expressed as a percentage of daily total energy intake. The outcomes were self-reported physician's diagnosis of arthritis, osteoarthritis, and rheumatoid arthritis. Survey-weighted logistic regressions were conducted to analyze associations between ultra-processed food intake and outcomes, controlling for age, gender, race/ethnicity, smoking status, health insurance status, and poverty-to-income ratio. Results: UPFs contributed 55.2% of the daily total energy intake in the U.S. population. After adjusting for covariates, a positive association was found between daily total energy intake from ultra-processed foods and self-reported arthritis (AOR associated with each 10-percentage point increase in intake: 1.04; 95% CI=1.02, 1.06). For the second, third, and fourth quartiles of ultra-processed food intake, the AOR of arthritis was 1.14 (95% CI=1.04, 1.25), 1.22 (95% CI=1.10, 1.35), and 1.27 (95% CI=1.14, 1.41), respectively (p for linear trend <0.001). A positive association was also observed between ultra-processed food intake and rheumatoid arthritis (AOR=1.05; 95% CI=1.02, 1.09) but not for osteoarthritis. Conclusions: In this nationally representative sample of U.S. adults, higher consumption of ultra-processed foods was associated with overall arthritis and rheumatoid arthritis.