Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality worldwide. While obesity and metabolic dysfunction are established risk factors, the contribution of processed-food–dominant dietary patterns to incident VTE risk remains incompletely understood. Methods: We performed a systematic review and meta-analysis of PubMed and Web of Science through November 2025. Eligible studies for quantitative synthesis included prospective cohort studies evaluating processed-food-dominant dietary patterns and incident VTE. Mendelian randomization (MR) studies and prior systematic reviews were synthesized narratively. Processed-food exposures, including Western dietary pattern scores, ultra-processed food intake, processed meats, and refined-grain dominant dietary patterns, were harmonized into a broader processed food dominant dietary construct. A random-effects meta-analysis using the DerSimonian-Laird estimator was conducted. Hazard ratios (HRs), relative risks (RRs), and odds ratios (ORs) were pooled as approximations of RR because of the low absolute incidence of VTE. Results: Fifteen studies met the inclusion criteria for qualitative synthesis, including 10 prospective cohort studies, 3 Mendelian randomization analyses, and 2 systematic reviews/meta-analyses. Six prospective cohort studies evaluating incident VTE were included in the quantitative meta-analysis. High processed-food consumption was associated with increased incident VTE risk (pooled RR 1.52; 95% CI 1.28 - 1.80; I2 = 57%). Processed meats and refined-grain dominant dietary patterns demonstrated the strongest associations. Mendelian randomization studies supported adiposity- and adipokine-mediated pathways linking metabolic dysfunction with increased VTE susceptibility. Conclusions: Processed food dominant dietary patterns are associated with increased risk of incident VTE. Observational and genetic evidence suggest that inflammation, visceral adiposity, endothelial dysfunction, and adipokine imbalance may mediate this relationship. Future prospective and interventional studies using standardized processed-food classifications are needed to clarify causality and inform dietary prevention strategies.
References
[1]
Yi, S.Y., Steffen, L.M., Lutsey, P.L., Cushman, M. and Folsom, A.R. (2021) Contrasting Associations of Prudent and Western Dietary Patterns with Risk of Developing Venous Thromboembolism. TheAmericanJournalofMedicine, 134, 763-768.E3. https://doi.org/10.1016/j.amjmed.2021.01.016
[2]
Varraso, R., Kabrhel, C., Goldhaber, S.Z., Rimm, E.B. and Camargo, C.A. (2011) Prospective Study of Diet and Venous Thromboembolism in US Women and Men. American Journal of Epidemiology, 175, 114-126. https://doi.org/10.1093/aje/kwr377
[3]
Lutsey, P.L., Steffen, L.M., Virnig, B.A. and Folsom, A.R. (2009) Diet and Incident Venous Thromboembolism: The Iowa Women’s Health Study. American Heart Journal, 157, 1081-1087. https://doi.org/10.1016/j.ahj.2009.04.003
[4]
Lippi, G., Cervellin, G. and Mattiuzzi, C. (2015) Red Meat, Processed Meat and the Risk of Venous Thromboembolism: Friend or Foe? Thrombosis Research, 136, 208-211. https://doi.org/10.1016/j.thromres.2015.04.027
[5]
Steffen, L.M., Folsom, A.R., Cushman, M., Jacobs, D.R. and Rosamond, W.D. (2007) Greater Fish, Fruit, and Vegetable Intakes Are Related to Lower Incidence of Venous Thromboembolism. Circulation, 115, 188-195. https://doi.org/10.1161/circulationaha.106.641688
[6]
Yuan, S., Chen, J., Fu, T., Li, X., Bruzelius, M., ？kesson, A., et al. (2023) Ultra-Processed Food Intake and Incident Venous Thromboembolism Risk: Prospective Cohort Study. Clinical Nutrition, 42, 1268-1275. https://doi.org/10.1016/j.clnu.2023.06.016
[7]
Zhang, Y., Ding, J., Guo, H., Liang, J. and Li, Y. (2020) Associations of Fish and Omega-3 Fatty Acids Consumption with the Risk of Venous Thromboembolism. A Meta-Analysis of Prospective Cohort Studies. Frontiers in Nutrition, 7, Article ID: 614784. https://doi.org/10.3389/fnut.2020.614784
[8]
Ageno, W., Becattini, C., Brighton, T., et al. (2008) Cardiovascular Risk Factors and Venous Thromboembolism: A Meta-Analysis. Circulation, 117, 93-102. https://pubmed.ncbi.nlm.nih.gov/18086925/
[9]
Isaksen, T., Evensen, L.H., Br？kkan, S.K. and Hansen, J.-B. (2019) Dietary Intake of Marine Polyunsaturated N-3 Fatty Acids and Risk of Recurrent Venous Thromboembolism. Thrombosis and Haemostasis, 119, 2053-2063. https://doi.org/10.1055/s-0039-1697663
[10]
Rosito, G.A., D’Agostino, R.B., Massaro, J., et al. (2004) Association between Obesity and a Prothrombotic State: The Framingham Offspring Study. Thrombosis and Haemostasis, 91, 683-689. https://pubmed.ncbi.nlm.nih.gov/15045128/
[11]
He, F.J., Marrero, N.M. and MacGregor, G.A. (2008) Salt and Blood Pressure in Children and Adolescents. Journal of Human Hypertension, 22, 4-11. https://doi.org/10.1038/sj.jhh.1002268
[12]
Miller, G.J. (1998) Effects of Diet Composition on Coagulation Pathways. The American Journal of Clinical Nutrition, 67, 542S-545S. https://doi.org/10.1093/ajcn/67.3.542s
[13]
Fonte, M.L., Fiechner, L., Manuelli, M. and Cena, H. (2016) Nutritional Management of a Patient with Obesity and Pulmonary Embolism: A Case Report. Nutrition Journal, 15, Article No. 90. https://nutritionj.biomedcentral.com/articles/10.1186/s12937-016-0202-9
[14]
Cundiff, D.K., Agutter, P.S., Malone, P.C. and Pezzullo, J.C. (2010) Diet as Prophylaxis and Treatment for Venous Thromboembolism? Theoretical Biology and Medical Modelling, 7, Article No. 31. https://doi.org/10.1186/1742-4682-7-31
[15]
Sun, Y., Wang, X., Liu, T., Zhu, X. and Pan, X. (2022) The Multifaceted Role of the SASP in Atherosclerosis: From Mechanisms to Therapeutic Opportunities. Cell & Bioscience, 12, Article No. 74. https://doi.org/10.1186/s13578-022-00815-5
[16]
Goldhaber, S.Z. (2010) Risk Factors for Venous Thromboembolism. Journal of the American College of Cardiology, 56, 1-7. https://doi.org/10.1016/j.jacc.2010.01.057
[17]
Nestel, P.J. and Mori, T.A. (2022) Dietary Patterns, Dietary Nutrients and Cardiovascular Disease. Reviews in Cardiovascular Medicine, 23, Article No. 17. https://doi.org/10.31083/j.rcm2301017
[18]
Violi, F., Pastori, D., Pignatelli, P. and Carnevale, R. (2020) Nutrition, Thrombosis, and Cardiovascular Disease. Circulation Research, 126, 1415-1442. https://doi.org/10.1161/circresaha.120.315892
[19]
Phang, M., Lazarus, S., Wood, L. and Garg, M. (2011) Diet and Thrombosis Risk: Nutrients for Prevention of Thrombotic Disease. Seminars in Thrombosis and Hemostasis, 37, 199-208. https://doi.org/10.1055/s-0031-1273084
[20]
Branchford, B.R. and Carpenter, S.L. (2018) The Role of Inflammation in Venous Thromboembolism. Frontiers in Pediatrics, 6, Article No. 142. https://doi.org/10.3389/fped.2018.00142
[21]
Emdin, C.A., Khera, A.V. and Kathiresan, S. (2017) Mendelian Randomization. JAMA, 318, 1925-1926. https://doi.org/10.1001/jama.2017.17219
[22]
Estruch, R., Ros, E., Salas-Salvadó, J., et al. (2013) Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine, 368, 1279-1290. https://doi.org/10.1056/NEJMoa1200303
[23]
Yuan, S., Bruzelius, M., Damrauer, S.M., H？kansson, N., Wolk, A., ？kesson, A., et al. (2021) Anti-inflammatory Diet and Venous Thromboembolism: Two Prospective Cohort Studies. Nutrition, Metabolism and Cardiovascular Diseases, 31, 2831-2838. https://doi.org/10.1016/j.numecd.2021.06.021
[24]
Heit, J.A., Spencer, F.A. and White, R.H. (2016) The Epidemiology of Venous Thromboembolism. Journal of Thrombosis and Thrombolysis, 41, 3-14. https://doi.org/10.1007/s11239-015-1311-6
[25]
Guo, J., He, Y., Suo, X., Liu, Y., Xiao, L., Zhou, Y., et al. (2024) Healthy Plant-Based Diet, Genetic Predisposition, and the Risk of incident venous Thromboembolism. JACC: Advances, 3, 101318. https://doi.org/10.1016/j.jacadv.2024.101318
[26]
Berti, A., Matteson, E.L., Crowson, C.S., Specks, U. and Cornec, D. (2018) Risk of Cardiovascular Disease and Venous Thromboembolism among Patients with Incident Anca-Associated Vasculitis: A 20-Year Population-Based Cohort Study. Mayo Clinic Proceedings, 93, 597-606. https://doi.org/10.1016/j.mayocp.2018.02.010
[27]
Juul, F., Vaidean, G. and Parekh, N. (2021) Ultra-Processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action. Advances in Nutrition, 12, 1673-1680. https://doi.org/10.1093/advances/nmab049
[28]
Benincasa, G., Costa, D., Infante, T., Lucchese, R., Donatelli, F. and Napoli, C. (2019) Interplay between Genetics and Epigenetics in Modulating the Risk of Venous Thromboembolism: A New Challenge for Personalized Therapy. Thrombosis Research, 177, 145-153. https://doi.org/10.1016/j.thromres.2019.03.008
[29]
Jin, B., Li, Y., Li, D., Jing, C. and Sheng, Q. (2025) Causal Associations between Epigenetic Age and Thromboembolism: A Bi-Directional Two-Sample Mendelian Randomization Study. Clinical Epigenetics, 17, Article No. 75. https://doi.org/10.1186/s13148-025-01875-3
[30]
Monteiro, C.A., Cannon, G., Levy, R.B., et al. (2019) Ultra-Processed Foods: What They Are and How to Identify Them. Public Health Nutrition, 22, 936-941. https://doi.org/10.1017/S1368980018003762
[31]
Zhang, D., Fu, W., Zhu, S., Pan, Y. and Li, R. (2024) RNA Methylation Patterns, Immune Characteristics, and Autophagy-Related Mechanisms Mediated by N6-Methyladenosine (m6a) Regulatory Factors in Venous Thromboembolism. BMC Genomics, 25, [page]. https://doi.org/10.1186/s12864-024-10294-2
[32]
Srour, B., Fezeu, L.K., Kesse-Guyot, E., Allès, B., Méjean, C., Andrianasolo, R.M., et al. (2019) Ultra-Processed Food Intake and Risk of Cardiovascular Disease: Prospective Cohort Study (Nutrinet-Santé). BMJ, 365, l1451. https://doi.org/10.1136/bmj.l1451
[33]
Lippi, G., Mattiuzzi, C. and Franchini, M. (2016) Vegetables Intake and Venous Thromboembolism. Blood Coagulation & Fibrinolysis, 27, 242-245. https://doi.org/10.1097/mbc.0000000000000427
[34]
Lowe, G.D.O. (2008) Common Risk Factors for Both Arterial and Venous Thrombosis. British Journal of Haematology, 140, 488-495. https://doi.org/10.1111/j.1365-2141.2007.06973.x
[35]
Wang, X., Memon, A.A., Palmér, K., Svensson, P.J., Sundquist, J. and Sundquist, K. (2020) The Association between Blood-Based Global DNA Methylation and Venous Thromboembolism. Seminars in Thrombosis and Hemostasis, 47, 662-668. https://doi.org/10.1055/s-0040-1722271
[36]
Chanchal, S., Sharma, S., Mohd, S., Sultan, A., Mishra, A. and Ashraf, M.Z. (2023) Unraveling Epigenetic Interplay between Inflammation, Thrombosis, and Immune-Related Disorders through a Network Meta-analysis. TH Open, 08, e81-e92. https://doi.org/10.1055/a-2222-9126
[37]
Yuan, S., Li, X., Morange, P., Bruzelius, M. and Larsson, S.C. (2022) Plasma Phospholipid Fatty Acids and Risk of Venous Thromboembolism: Mendelian Randomization Investigation. Nutrients, 14, Article 3354. https://doi.org/10.3390/nu14163354
[38]
Johansson, M., Br？kkan, S.K., Giske？deg？rd, G.F., Wade, K.H., Hindberg, K.D., Timpson, N., et al. (2025) High Concentrations of Polyunsaturated N-3 Fatty Acids in Serum Are Inversely Associated with Risk of Future Incident Venous Thromboembolism—The HUNT Cohort Study. The American Journal of Clinical Nutrition, 122, 1195-1203. https://doi.org/10.1016/j.ajcnut.2025.08.008
[39]
Li, Z., Liu, Y., Ding, W., Liu, Y., Li, W., Guan, S., et al. (2025) Food and Medicine Homology: A Potential Nutritional Intervention Strategy for Post-Acute COVID-19 Syndrome. Frontiers in Pharmacology, 16, Article ID: 1588037. https://doi.org/10.3389/fphar.2025.1588037
[40]
Li, S., Jiang, M., Guan, Y., Cao, X., Shao, Z., Deng, J., et al. (2025) Association between Genetic Risk and Adherence to the Dietary Approaches to Stop Hypertension Diet for Developing Venous Thromboembolism. Research and Practice in Thrombosis and Haemostasis, 9, Article 102731. https://doi.org/10.1016/j.rpth.2025.102731
[41]
Chen, X., Zhang, Z., Yang, H., Qiu, P., Wang, H., Wang, F., et al. (2020) Consumption of Ultra-Processed Foods and Health Outcomes: A Systematic Review of Epidemiological Studies. Nutrition Journal, 19, Article No. 86. https://doi.org/10.1186/s12937-020-00604-1
[42]
Zhao, K. (2026) Pathological, Diagnostic, and Therapeutic Implications of Non-Coding RNAs in Deep Vein Thrombosis: A Comprehensive Review. Journal of Thrombosis and Thrombolysis, 59, 1011-1030. https://doi.org/10.1007/s11239-025-03202-2
[43]
Schulman, S., Makatsariya, A., Khizroeva, J., Bitsadze, V. and Kapanadze, D. (2024) The Basic Principles of Pathophysiology of Venous Thrombosis. International Journal of Molecular Sciences, 25, Article 11447. https://doi.org/10.3390/ijms252111447
[44]
Marschang, P., Gerotziafas, G., Kozak, M., Cosmi, B., Catalano, M. and Stanek, A. (2025) Epidemiology of Venous Thromboembolism: Implications for Clinical Practice. Polish Archives of Internal Medicine, 135, Article 17105. https://doi.org/10.20452/pamw.17105
[45]
Nicolaides, A.N., Fareed, J., Spyropoulos, A.C., Caprini, J. and Prandoni, P. (2024) Venous Thromboembolism Risk and Its Assessment in Hospitalized Patients. Vascular Investigation and Therapy, 7, 47-53. https://doi.org/10.4103/vit.vit_27_24
[46]
Pastori, D., Cormaci, V.M., Marucci, S., Franchino, G., Del Sole, F., Capozza, A., et al. (2023) A Comprehensive Review of Risk Factors for Venous Thromboembolism: From Epidemiology to Pathophysiology. International Journal of Molecular Sciences, 24, Article 3169. https://doi.org/10.3390/ijms24043169
[47]
Yuan, S., Bruzelius, M., H？kansson, N., ？kesson, A. and Larsson, S.C. (2021) Lifestyle Factors and Venous Thromboembolism in Two Cohort Studies. Thrombosis Research, 202, 119-124. https://doi.org/10.1016/j.thromres.2021.03.024
[48]
Wendelboe, A. and Weitz, J.I. (2024) Global Health Burden of Venous Thromboembolism. Arteriosclerosis, Thrombosis, and Vascular Biology, 44, 1007-1011. https://doi.org/10.1161/atvbaha.124.320151
[49]
Shu, L., Zhang, X., Zhou, J., Zhu, Q. and Si, C. (2023) Ultra-Processed Food Consumption and Increased Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies. Frontiers in Nutrition, 10, Article ID: 1211797. https://doi.org/10.3389/fnut.2023.1211797
[50]
Detopoulou, P., Dedes, V., Syka, D., Tzirogiannis, K. and Panoutsopoulos, G.I. (2023) Relation of Minimally Processed Foods and Ultra-Processed Foods with the Mediterranean Diet Score, Time-Related Meal Patterns and Waist Circumference: Results from a Cross-Sectional Study in University Students. International Journal of Environmental Research and Public Health, 20, Article 2806. https://doi.org/10.3390/ijerph20042806
[51]
Rodrigues, A.E., Fernandes, A.E., Carrasco, A.G.M., Pellenz, F.M., da Rosa, P.W.L., de Moura, A.M.D.S.H., et al. (2025) High Consumption of Ultra-Processed Foods Is Associated with Genome-Wide DNA Methylation Differences in Women: A Pilot Study. Nutrients, 17, Article 3465. https://doi.org/10.3390/nu17213465
[52]
Llauradó-Pont, J., Stratakis, N., Fiorito, G., Handakas, E., Neumann, A., Barros, H., et al. (2025) A Meta-Analysis of Epigenome-Wide Association Studies of Ultra-Processed Food Consumption with DNA Methylation in European Children. Clinical Epigenetics, 17, Article No. 3. https://doi.org/10.1186/s13148-024-01782-z
[53]
Mendoza, K., Smith-Warner, S.A., Rossato, S.L., Khandpur, N., Manson, J.E., Qi, L., et al. (2024) Ultra-Processed Foods and Cardiovascular Disease: Analysis of Three Large US Prospective Cohorts and a Systematic Review and Meta-Analysis of Prospective Cohort Studies. The Lancet Regional Health-Americas, 37, Article 100859. https://doi.org/10.1016/j.lana.2024.100859
[54]
Martínez-González, M.A., Gea, A. and Ruiz-Canela, M. (2019) The Mediterranean Diet and Cardiovascular Health. Circulation Research, 124, 779-798. https://doi.org/10.1161/circresaha.118.313348
[55]
Bonaccio, M., Costanzo, S., Di Castelnuovo, A., Gialluisi, A., Ruggiero, E., De Curtis, A., et al. (2023) Increased Adherence to a Mediterranean Diet Is Associated with Reduced Low-Grade Inflammation after a 12.7-Year Period: Results from the Moli-Sani Study. Journal of the Academy of Nutrition and Dietetics, 123, 783-795.E7. https://doi.org/10.1016/j.jand.2022.12.005
[56]
Lippi, G. and Favaloro, E.J. (2018) Nutritional and Metabolic Aspects of Venous Thromboembolism. Semin Thromb Hemostasis, 44, 423431. https://doi.org/10.1055/s-0038-1653950
[57]
Favaloro, E. and Lippi, G. (2018) Editorial Compilation V. Seminars in Thrombosis and Hemostasis, 44, 193-196. https://doi.org/10.1055/s-0038-1637741
[58]
Tang, W.H.W., Wang, Z., Levison, B.S., Koeth, R.A., Britt, E.B., Fu, X., et al. (2013) Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk. New England Journal of Medicine, 368, 1575-1584. https://doi.org/10.1056/nejmoa1109400
[59]
Sanz, Y., Cryan, J.F., Deschasaux-Tanguy, M., Elinav, E., Lambrecht, R. and Veiga, P. (2025) The Gut Microbiome Connects Nutrition and Human Health. Nature Reviews Gastroenterology & Hepatology, 22, 534-555. https://doi.org/10.1038/s41575-025-01077-5
[60]
Monteiro, C.A., Cannon, G., Lawrence, M., et al. (2024) Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System. FAO, 48.
