Background/Objectives: The consumption of ultra-processed foods (UPF) has been associated with poorer cardiometabolic health in omnivorous populations. However, evidence on the impact of UPF consumption on cardiometabolic health among vegans remains limited. This study aimed to evaluate the association between UPF intake and body mass index (BMI), waist circumference, waist-to-height ratio, waist-to-hip ratio, blood pressure and heart rate among vegans from five European countries.

Methods: The VEGANScreener study is a cross-sectional and multicenter study conducted in Europe. Adults aged 18 to 65 were included, excluding those with metabolic diseases, BMI≥ 30kg/m², digestive disorders, pregnant or breastfeeding. UPF consumption was defined by the Nova food classification and assessed through 4-day dietary records. The percentage of grams/day from UPF was calculated. Participants were categorized into quartiles according to their UPF consumption. Age- and multivariable-adjusted linear regression models, adjusted for potential confounding factors, were used to calculate beta estimates and their corresponding 95% confidence intervals (CIs).

Results: A total of 344 vegans from Germany, Spain, Belgium, Czech Republic and Switzerland were included in the final analysis. In multivariable-adjusted analyses, compared with vegans with lower UPF consumption, those with higher consumption exhibited higher BMI [β = 1.04; 95%CI: 0.14 to 1.95; p for trend = 0.018], waist circumference [β = 3.32; 95%CI: 0.77 to 5.87; p for trend = 0.018], and waist-to-height ratio [β = 0.018; 95%CI: 0.004 to 0.030; p for trend = 0.016], showing a dose-response relationship. However, UPF intake was not associated with systolic blood pressure [β = 1.98; 95%CI: -2.44 to 6.40; p for trend = 0.291], diastolic blood pressure [β = 0.50; 95%CI: -2.48 to 3.50; p for trend = 0.607], waist-to-hip ratio [β = 0.010; 95%CI: -0.011 to 0.032; p for trend = 0.354], or heart rate [β = 1.14; 95%CI: -2.42 to 4.70; p for trend = 0.171] after adjustment for multiple confounders.

Conclusions/Recommendations: In this European study, vegans with higher UPF consumption showed higher BMI, greater waist circumference and waist to height ratio compared with those with lower UPF intake.