Energy restriction with ultra-processed food restriction yields greater weight loss than generic energy restriction in obesityLow-Processed Food Diet May Help People With Obesity Lose More Weight

Nutrition, metabolism, and cardiovascular diseases : NMCD Published May 1, 2026 Study authors: Macena Mateus L, Pereira Micnéias R, Silva Dafiny R, Silva-Júnior André E, Oliveira Ana Debora S, Sa… PubMed ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Note that ER-UPF showed statistically significant but non-clinically significant greater weight loss versus ER-G.

This randomized clinical trial evaluated 148 individuals with obesity over a 12.0-month follow-up period. Participants were randomized to either energy restriction associated with ultra-processed food restriction (ER-UPF) or generic energy restriction (ER-G). The study aimed to assess weight loss and metabolic effects while monitoring ultra-processed food intake and body composition.

The primary outcome measured was weight loss. At 12 months, the ER-UPF group lost 82.9 kg of bodyweight, whereas the ER-G group lost 86.3 kg. The difference in weight loss between the groups was statistically significant with a p-value of 0.01. Regarding ultra-processed food intake, the ER-UPF group decreased from 21.16% to 13.86%, while the ER-G group decreased from 23.70% to 20.02%. This difference in UPF intake was not statistically significant with a p-value of 0.08.

The NOVA-UPF Score decreased in the ER-UPF group from 2.74 to 1.86, compared to a decrease from 2.62 to 2.47 in the ER-G group. This reduction in the NOVA-UPF Score was statistically significant with a p-value of 0.03. Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported in the study. A key limitation was that individuals in the trial had low ultra-processed food intake at baseline.

While the ER-UPF intervention showed statistical advantages in weight loss and ultra-processed food score reduction, the authors caution that the greater weight loss was statistically, but non-clinically significant. Consequently, the practice relevance of these specific findings remains uncertain given the baseline characteristics and the nature of the observed differences.

This randomized clinical trial compared two diets for individuals with obesity. One group followed a plan with energy restriction and limits on ultra-processed foods. The other group followed a plan with energy restriction but no specific limits on ultra-processed foods. Both groups were followed for 12 months.

The group limiting ultra-processed foods lost more weight than the group with only calorie limits. They also reduced their intake of ultra-processed foods and improved their overall food quality score. The difference in weight loss was statistically significant but described as non-clinically significant.

No serious adverse events were reported, and no participants discontinued the study due to safety issues. However, the study had a limitation because participants started with low intake of ultra-processed foods. Readers should understand that while the results are promising, this is an early trial with a small group of 148 people.

What this means for you:

Limiting ultra-processed foods with calorie limits may help people with obesity lose slightly more weight in a trial.

Study Details

Study typeRct

EvidenceLevel 2

Follow-up12.0 mo

PublishedMay 2026

PMID41381310

View Original Abstract ↓

BACKGROUND AND AIMS: To evaluate the effectiveness and metabolic effects of restricting UPF consumption in individuals with obesity undergoing energy restriction. METHODS AND RESULTS: Randomized, parallel clinical trial, lasting 12 months. Participants were randomly allocated into two groups: (a) generic energy restriction (ER-G) and (b) energy restriction associated with UPF restriction (ER-UPF). Energy requirements were determined using calorimetry and accelerometry data. Anthropometric, dietary, body composition, metabolic, and biochemical data were collected. 148 individuals were included. The baseline intake of UPF was 21.16 [18.42; 23.90]% in the ER-UPF group and 23.70 [20.92; 26.48]% in the ER-G group, and, at 12 months, decreased to 13.86 % in the ER-UPF and to 20.02 % in the ER-G (p = 0.08). The ER-UPF group reduced the NOVA-UPF Score (from 2.74 [2.28; 3.20] to 1.86 [1.18; 2.53] at 12 months) compared to the ER-G (from 2.62 [2.15; 3.09] to 2.47 [1.76; 3.17]; p = 0.03). The monthly bodyweight data analysis showed that the ER-UPF group lost more weight compared to the ER-G group (final values: 82.9 [79.6; 86.2] kg vs. 86.3 [83.0; 89.7] kg; p = 0.01). Despite these findings, no changes were observed in the other outcomes. CONCLUSION: The proposed intervention resulted in significantly smaller decreases in UPF intake than expected and induced only a statistically, but non-clinically significant, greater weight loss compared to the ER-G. These findings may be partially explained by the fact that individuals had low UPF intake in the baseline. Future studies should focus on populations with higher basal UPF intake.

Energy restriction with ultra-processed food restriction yields greater weight loss than generic energy restriction in obesityLow-Processed Food Diet May Help People With Obesity Lose More Weight

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