Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study.

Authors

Li YD, Gong LL, Jiang YB, Qin Q, Ren FQ, Qian SQ, Tan W

Affiliations

• Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
• Department of Proctology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunan, China.
• Department of Urology, The First Affiliated Hospital of Chongqing University of Chinese Medicine, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China.
• Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Abstract

BACKGROUND: Ultra-processed food (UPF) consumption has been linked to adverse health effects, yet findings from prospective cohort studies on mortality remain inconsistent.

METHODS: This study included 82,221 participants from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. At baseline (1993-2001), dietary intake was assessed using the Baseline Questionnaire (BQ) and validated Dietary History Questionnaire (DHQ). UPF intake was defined according to the NOVA classification system. Daily food intake (g/day) was estimated from reported frequency and portion size, and energy and nutrient intakes were computed using the DietCalc analysis program. Mortality outcomes, including all-cause, cancer, circulatory system diseases, nervous system diseases, and other causes, were ascertained. Multivariable Cox models were used to estimate the associations between UPF intake and all-cause and cause-specific mortality.

RESULTS: During a median 17-year follow-up, 24,237 deaths occurred. No association was found between UPF intake and cancer mortality. Despite this, the highest UPF intake quarter, relative to the lowest, was associated with a 10% higher risk of all-cause mortality (HR: 1.10, 95% CI: 1.06-1.14), a 9% higher risk of circulatory system diseases mortality (HR: 1.09, 95% CI: 1.02-1.17), a 20% higher risk of nervous system diseases mortality (HR: 1.20, 95% CI: 1.06-1.37), and a 28% higher risk of mortality from other causes (HR: 1.28, 95% CI: 1.18-1.39). In the joint analysis of UPF intake and diet quality assessed by the Healthy Eating Index-2015 (HEI-2015), no consistent association was observed between UPF intake and mortality within most HEI-2015 quarters. However, among individuals in the highest quarter of UPF intake, those with the highest HEI-2015 scores had a significantly lower mortality risk than those with the lowest HEI-2015 scores, suggesting that higher diet quality may attenuate the adverse effect of high UPF consumption.

CONCLUSION: Our study showed that a higher consumption of UPF was linked to increased mortality in all-cause, as well as in circulatory system diseases, nervous system diseases and other causes diseases.