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Ultra-processed food consumption and mortality: three cohort studies in the United States and United Kingdom.

About this Publication
Title
Ultra-processed food consumption and mortality: three cohort studies in the United States and United Kingdom.
Pubmed ID
37690589 (View this publication on the PubMed website)
Digital Object Identifier
Publication
Am J Prev Med. 2023 Sep 8
Authors
Zhao Y, Chen W, Li J, Yi J, Song X, Ni Y, Zhu S, Zhang Z, Xia L, Zhang J, Yang S, Ni J, Lu H, Wang Z, Nie S, Liu L
Affiliations
  • Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P.R. China.
  • Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P.R. China.. Electronic address: liul2012@hust.edu.cn.
Abstract

INTRODUCTION: Given the increase in ultra-processed food (UPF) consumption, their potential health effects have aroused concern. Whether UPF consumption is associated with cancer and cardiovascular disease (CVD) mortality is debatable. This study evaluates the association of UPF consumption with mortality.

METHODS: A total of 108,714 US adults from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial (1993-2001), 208,051 UK adults from UK Biobank (2006-2010), and 41,070 US adults from National Health and Nutrition Examination Survey (NHANES 1999-2018) were included. Dietary data were collected by dietary questionnaire and classified using the NOVA classification. UPF consumption was expressed as the weight proportion of UPFs in total foods consumed. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Mediation analysis was used to evaluate whether multiple metabolic pathways mediated the associations in UK Biobank. Analyses were performed in 2022-2023.

RESULTS: Combined analyses of the three cohorts showed that those with the highest quartile of UPF consumption had higher risks of all-cause mortality (HR, 1.16; 95% CI, 1.11-1.20) and CVD mortality (HR, 1.17; 95% CI, 1.06-1.28) compared to the lowest quartile of UPF consumption. UPF consumption was not associated with cancer mortality risk. Biomarkers of liver function have the greatest mediating effects on all-cause mortality (20.3%), and biomarkers of inflammation have the greatest mediating effects on CVD mortality (29.2%).

CONCLUSIONS: Higher UPF consumption was associated with increased all-cause and CVD mortality risk, with multiple metabolic pathways playing mediating roles.

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