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Ultra-Processed Foods, MASLD, and Cognitive Aging: A Processing-Centered Gut-Liver-Brain Axis Perspective
Yirui Chen1, Hongxin Gui1, Tieniu Zhao1
1School of Public Health, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Xiqing District, Tianjin 300193, China.
Nutrients
|July 15, 2026
Summary
Ultra-processed foods (UPFs) may accelerate cognitive aging by disrupting gut-liver-brain communication, with metabolic dysfunction-associated steatotic liver disease (MASLD) acting as a key amplifier. This review links UPFs to liver and cognitive decline through various metabolic pathways.
Area of Science:
- Nutrition Science
- Neuroscience
- Hepatology
Background:
- Ultra-processed foods (UPFs) are increasingly linked to adverse health outcomes, including cardiometabolic, hepatic, and neurocognitive effects.
- Current understanding often overlooks how UPFs' processing characteristics, beyond nutritional content, may disrupt gut-liver-brain communication.
Purpose of the Study:
- To examine metabolic dysfunction-associated steatotic liver disease (MASLD) as a potential hepatic amplifier linking UPF consumption to cognitive aging.
- To synthesize evidence on the mechanisms connecting UPFs, MASLD, and cognitive aging.
Main Methods:
- A structured narrative review of studies published from January 2010 to May 2026.
- Searches were conducted across PubMed/MEDLINE, Web of Science, and Scopus, focusing on four key evidence modules.
- Studies were prioritized based on relevance, design, validity, mechanistic specificity, and contribution to knowledge gaps.
Main Results:
- Evidence links higher UPF intake to liver steatosis, MASLD/NAFLD, cognitive decline, stroke, and dementia, though causality requires further establishment.
- Candidate mechanisms involve food matrix disruption, additives, gut barrier dysfunction, metabolic endotoxemia, and inflammation.
- MASLD may amplify gut-derived signals relevant to brain aging, positioning UPFs as an upstream exposure.
Conclusions:
- A gut-liver-brain framework integrating UPFs, MASLD, and cognitive aging offers a new perspective on metabolic-aging phenomena.
- Future research should investigate UPF substitution effects using comprehensive assessments including liver imaging, microbiome analysis, and neurocognitive testing.
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