Presentation description

Background: Ultra-processed foods (UPF) are industrial formulations made from food-derived or synthetic substances that contain little or no whole foods and are typically ready-to-consume, high in fat, salt, or sugar, low in fiber and nutrients, including items such as packaged snacks, sugary beverages, confectionery, and processed meats. UPF has been associated with increased colorectal cancer risk. However, the effect of UPF intake on colorectal cancer survivorship remains under-explored.
Objective: This study aimed to summarize the evidence on associations between UPF intake and colorectal cancer survivorship outcomes while exploring underlying biological mechanisms.
Methods: A systematic literature search identified 3,450 peer-reviewed publications, 57 of which were included in this review. Survivorship outcomes were categorized into mortality (n=17), treatment-related toxicities (n=25), or quality of life (n=15).
Results: Higher UPF intake was consistently associated with increased colorectal cancer-specific mortality. Evidence also indicated associations between higher UPF intake and poorer quality of life, including sleep disturbances, elevated fatigue, and reduced physical and psychosocial functioning. Additionally, several studies reported increased treatment-related toxicities linked to UPF intake, such as gastrointestinal symptoms, adverse side effects, and treatment discontinuation. Proposed biological mechanisms underlying these associations included systemic inflammation, gut microbiota disruption, and metabolic dysregulation.
Conclusion: Our review suggests that higher UPF intake is associated with increased colorectal cancer-specific mortality, poorer quality of life, and greater treatment-related toxicities. Considerable heterogeneity was observed across studies in how UPF intake was assessed. Future research should prioritize prospective, longitudinal designs and integrate objective biomarkers, such as metabolomic profiles, to improve measurement of post-diagnosis dietary exposures and their impact on survivorship.