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

Öz

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.

Anahtar Kelimeler

• Ultra-işlenmiş gıdalar
• beslenme Paradoksu
• kronik hastalıklar
• obezite
• halk sağlığı

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

Öz

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.

Anahtar Kelimeler

• Ultra-processed foods
• nutrition paradox
• chronic diseases
• obesity
• public health

Kaynakça

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).