Effects of Ultra-Processed Foods and Food Additives on Disease Activity in Adults with Inflammatory Bowel Disease: A Scoping Review

Abstract

Background/Objectives: This scoping review aims to identify and map out the current state of research on the relationship between ultra-processed foods (UPF) intake and disease activity and symptoms in adults with inflammatory bowel disease (IBD). Methods: A search strategy was developed using key terms, and the search was conducted through the PubMed, Medline, Embase, CINAHL, Web of Science, The Cochrane Library, Google Scholar, and ProQuest Theses and Dissertations databases to identify relevant studies. Data were comprehensively extracted, analyzed, and synthesized. Results: A total of 18 studies were included in the review: 7 on UPF and 11 on food additives. Most prospective cohort and cross-sectional studies suggested a positive association between UPF intake and IBD activity, measured using disease activity indexes and fecal calprotectin (FC) as an inflammatory marker. Trials excluding food additives from the diet provided inconclusive evidence regarding their effectiveness in reducing IBD symptoms or disease activity. Conclusions: Current evidence suggests potential links between UPF and food additive intake and IBD outcomes. Yet, heterogeneity in UPF definitions, variability in additive formulations, and the lack of standardized dietary assessment methods limit definitive conclusions. Future studies should integrate standardized exposure assessment methods with validated outcome measures to better clarify the role of UPF and food additives on IBD trajectory.