Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study
Rico-Campà A, Martínez-González MA, Alvarez-Alvarez I, Mendonça RD, de la Fuente-Arrillaga C, Gómez-Donoso C, Bes-Rastrollo M
BMJ (Clinical research ed.) · 330 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2019-05-29 · BMJ · vol. 365 · p. l1949
- Cited
- 544 citations · more than 100% of similar papers · 66.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 51 works
- Access
- Open access (hybrid journal) · CC-BY-NC
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Consumer Packaging Perceptions and Trends
- Keywords
- Hazard ratio, Medicine, Confidence interval, Prospective cohort study, Proportional hazards model, Cohort, Cohort study, Environmental health, Consumption (sociology), Demography, Internal medicine
- MeSH
- humans, incidence, mortality, cause of death, proportional hazards models, risk factors, cohort studies, prospective studies, eating, adult, aged, aged, 80 and over, middle aged, spain, female, male, fast foods, correlation of data
7 authors
From ES, US, BR
- Anaïs Rico-CampàInstituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Universidad de Navarra
- Miguel Ángel Martínez‐GonzálezHarvard University; Instituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
- Ismael Álvarez‐ÁlvarezUniversidad de Navarra
- Raquel de Deus MendonçaUniversidade Federal de Minas Gerais; Universidad de Navarra
- Carmen de la Fuente‐ArrillagaInstituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
- Clara Gómez‐DonosoUniversidad de Navarra
Abstract
Objective
To evaluate the association between consumption of ultra-processed foods and all cause mortality.
Design
Prospective cohort study.
Setting
Seguimiento Universidad de Navarra (SUN) cohort of university graduates, Spain 1999-2018.
Participants
19 899 participants (12 113 women and 7786 men) aged 20-91 years followed-up every two years between December 1999 and February 2014 for food and drink consumption, classified according to the degree of processing by the NOVA classification, and evaluated through a validated 136 item food frequency questionnaire.
Main outcome measure
Association between consumption of energy adjusted ultra-processed foods categorised into quarters (low, low-medium, medium-high, and high consumption) and all cause mortality, using multivariable Cox proportional hazard models.
Results
335 deaths occurred during 200 432 persons years of follow-up. Participants in the highest quarter (high consumption) of ultra-processed foods consumption had a higher hazard for all cause mortality compared with those in the lowest quarter (multivariable adjusted hazard ratio 1.62, 95% confidence interval 1.13 to 2.33) with a significant dose-response relation (P for linear trend=0.005). For each additional serving of ultra-processed foods, all cause mortality relatively increased by 18% (adjusted hazard ratio 1.18, 95% confidence interval 1.05 to 1.33).
Conclusions
A higher consumption of ultra-processed foods (>4 servings daily) was independently associated with a 62% relatively increased hazard for all cause mortality. For each additional serving of ultra-processed food, all cause mortality increased by 18%.
Study registration
ClinicalTrials.gov NCT02669602.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC).
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