Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study
Zhong GC, Gu HT, Peng Y, Wang K, Wu YQ, Hu TY, Jing FC, Hao FB
The international journal of behavioral nutrition and physical activity · 71 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
- Independent funding
- University or hospital
- Chongqing Medical University
- Government
- National Cancer Institute
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2021-02-03 · Int J Behav Nutr Phys Act · vol. 18 · issue 1 · p. 21
- Publisher
- BioMed Central
- Cited
- 95 citations · more than 99% of similar papers · 14.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 61 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Biochemical Analysis and Sensing Techniques
- Keywords
- Medicine, Hazard ratio, Population, Proportional hazards model, Confidence interval, Cohort study, Prospective cohort study, Internal medicine, Demography, Environmental health
- MeSH
- humans, cardiovascular diseases, diet, prospective studies, united states, fast foods
8 authors
From CN
- Guo‐Chao Zhong · correspondingDalian Medical University; Second Affiliated Hospital of Chongqing Medical University; Chongqing Medical University
- Haitao Gu · correspondingDalian Medical University; Second Affiliated Hospital of Chongqing Medical University; Chongqing Medical University
- Yang PengChengdu Fifth People's Hospital
- Kang WangThe Affiliated Yongchuan Hospital of Chongqing Medical University; Chongqing Medical University
- You‐Qi‐Le WuChongqing Public Health Medical Center; Chongqing Medical University
- Tianyang Hu · correspondingDalian Medical University; Second Affiliated Hospital of Chongqing Medical University; Chongqing Medical University
Abstract
Background
Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population.
Methods
A population-based cohort of 91,891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers.
Results
After an average follow-up of 13.5 years (1,236,049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36-1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50-1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76-1.17). A nonlinear dose-response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity interaction < 0.05).
Conclusions
High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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