Different Levels of Ultraprocessed Food and Beverage Consumption and Associations with Environmental Sustainability and All-cause Mortality in EPIC-NL
Vellinga RE, van den Boomgaard I, M A Boer J, van der Schouw YT, Harbers MC, Verschuren WMM, van 't Veer P, H M Temme E, Biesbroek S
The American journal of clinical nutrition · 19 citations
Review labels
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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
- 2023-05-17 · Am J Clin Nutr · vol. 118 · issue 1 · pp. 103–113
- Publisher
- Elsevier BV
- Cited
- 27 citations · more than 97% of similar papers · 6.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 34 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Agriculture Sustainability and Environmental Impact
- Keywords
- Quartile, Medicine, Hazard ratio, Proportional hazards model, Environmental health, Consumption (sociology), Cohort, EPIC, Demography, Confidence interval, Internal medicine
- MeSH
- humans, diet, risk, prospective studies, food handling, beverages, food, adult, fast foods
9 authors
From NL
- Reina E. Vellinga · correspondingNational Institute for Public Health and the Environment; Wageningen University & Research
- Iris van den BoomgaardWageningen University & Research
- Jolanda M.A. BoerNational Institute for Public Health and the Environment
- Yvonne T. van der SchouwUtrecht University; University Medical Center Utrecht
- Marjolein C. HarbersUtrecht University; University Medical Center Utrecht
- W. M. Monique VerschurenUtrecht University; University Medical Center Utrecht; National Institute for Public Health and the Environment
Abstract
Background
The adverse health effects of high ultraprocessed food and drink (UPFD) consumption are well documented. However, the environmental impact remains unclear, and the separate effects of ultraprocessed foods (UPFs) and drinks (UPDs) on all-cause mortality have not been studied previously.
Objectives
To assess the association between levels of UPFD, UPF, and UPD consumption and diet-related environmental impacts and all-cause mortality in Dutch adults.
Methods
Habitual diets were assessed by a Food Frequency Questionnaire (FFQ) from 1993-1997 in 38,261 participants of the Dutch European Prospective Investigation into Cancer and Nutrition cohort. The mean follow-up time was 18.2 y (SD = 4.1); 4,697 deaths occurred. FFQ items were categorized according to the NOVA classification. Associations between quartiles of UPFD, UPF, and UPD consumption and environmental impact indicators were analyzed using general linear models and all-cause mortality by Cox proportional hazard models. The lowest UPFD, UPF, and UPD consumption quartiles were used as comparator.
Results
The average UPFD consumption was 181 (SD = 88) g/1000 kcal. High UPF consumption was statistically significantly inversely associated with all environmental impact indicators (Q4vsQ1: -13.6% to -3.0%), whereas high UPD consumption was, except for land use, statistically significant positively associated with all environmental impact indicators (Q4vsQ1: 1.2% to 5.9%). High UPFD consumption was heterogeneously associated with environmental impacts (Q4vsQ1: -4.0% to 2.6%). After multivariable adjustment, the highest quartiles of UPFD and UPD consumption were significantly associated with all-cause mortality (HRQ4vsQ1: 1.17, 95%CI: 1.08, 1.28 and HRQ4vsQ1: 1.16, 95%CI: 1.07, 1.26, respectively). UPF consumption of Q2 and Q3 were associated with a borderline significant lower risk of all-cause mortality (HRQ2vsQ1: 0.93, 95% CI: 0.85, 1.00; HRQ3vsQ1: 0.91, 95% CI: 0.84, 0.99) whereas Q4 was not statistically significant (HRQ4vsQ1: 1.06, 95% CI: 0.97, 1.15).
Conclusions
Reducing UPD consumption may lower environmental impact and all-cause mortality risk; however, this is not shown for UPFs. When categorizing food consumption by their degree of processing, trade-offs are observed for human and planetary health aspects.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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