Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
Cordova R, Viallon V, Fontvieille E, Peruchet-Noray L, Jansana A, Wagner KH, Kyrø C, Tjønneland A, Katzke V, Bajracharya R, Schulze MB, Masala G, Sieri S, Panico S, Ricceri F, Tumino R, Boer JMA, Verschuren WMM, van der Schouw YT, Jakszyn P, Redondo-Sánchez D, Amiano P, Huerta JM, Guevara M, Borné Y, Sonestedt E, Tsilidis KK, Millett C, Heath AK, Aglago EK, Aune D, Gunter MJ, Ferrari P, Huybrechts I, Freisling H
The Lancet regional health. Europe · 164 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 (classified by our AI screen)
- 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
- Government
- World Health Organization
- Nonprofit
- Kræftens Bekæmpelse
- University or hospital
- Deutsches Krebsforschungszentrum
- University or hospital
- Centre International de Recherche sur le Cancer
- Nonprofit
- Health Research Foundation
- Government
- National Research Council
- Nonprofit
- World Cancer Research Fund International
- Nonprofit
- Cancer Research UK
- Government
- National Institute for Health and Care Research
- University or hospital
- Imperial College London
- Government
- Institut National de la Santé et de la Recherche Médicale
- University or hospital
- Österreichischen Akademie der Wissenschaften
- Government
- Bundesministerium für Bildung und Forschung
- Nonprofit
- Cancerfonden
- Government
- Ministerie van Volksgezondheid, Welzijn en Sport
- Nonprofit
- Ligue Contre le Cancer
- Government
- Vetenskapsrådet
- Nonprofit
- Fondation de France
- Nonprofit
- Associazione Italiana per la Ricerca sul Cancro
- Nonprofit
- Deutsche Krebshilfe
- Government
- Institut National Du Cancer
- University or hospital
- Institut Gustave-Roussy
- Nonprofit
- Mutuelle Générale de l'Education Nationale
- Government
- Consejería de Salud y Familias, Junta de Andalucía
- University or hospital
- University of Maryland School of Public Health
- Government
- Medical Research Council
- Nonprofit
- World Cancer Research Fund
- Government
- Instituto de Salud Carlos III
- Government
- Rijksinstituut voor Volksgezondheid en Milieu
- University or hospital
- NIHR Imperial Biomedical Research Centre
- University or hospital
- School of Public Health, Imperial College London
- University or hospital
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Nonprofit
- Mutuelle Générale de l'Education Nationale
- Grants
- Vetenskapsrådet (14136); Medical Research Council (M012190/1); Mutuelle Générale de l'Education Nationale (MR/M012190/1); Deutsche Krebshilfe (14136); Fondation de France (00081166); Fondation de France (MR/M012190/1); World Cancer Research Fund (14136); Ligue Contre le Cancer (MR/M012190/1); Bundesministerium für Bildung und Forschung (1000143); Mutuelle Générale de l'Education Nationale (14136); World Cancer Research Fund (MR/M012190/1); Bundesministerium für Bildung und Forschung (14136); Fondation de France (14136); Institut Gustave-Roussy (MR/M012190/1); Deutsche Krebshilfe (MR/M012190/1); Institut National Du Cancer (2021–138); Institut National Du Cancer (2021\u2013138); Ligue Contre le Cancer (14136); Medical Research Council (14136); Cancerfonden (14136); Medical Research Council (MR/M012190); Cancer Research UK (29678); Cancer Research UK (C8221 / A29017); Institut Gustave-Roussy (14136); Institut Gustave-Roussy (1000143); World Cancer Research Fund (1000143); Bundesministerium für Bildung und Forschung (MR/M012190/1); Associazione Italiana per la Ricerca sul Cancro (1000143); Medical Research Council (1000143); Institut National de la Santé et de la Recherche Médicale (MR/M012190/1); Medical Research Council (MR/M012190/1); Institut National de la Santé et de la Recherche Médicale (1000143); Cancer Research UK (C33493/A29678); Cancer Research UK (A29017); Associazione Italiana per la Ricerca sul Cancro (MR/M012190/1); Mutuelle Générale de l'Education Nationale (1000143); Associazione Italiana per la Ricerca sul Cancro (14136); Rijksinstituut voor Volksgezondheid en Milieu (00081166); Institut National de la Santé et de la Recherche Médicale (14136); World Cancer Research Fund (IIG_FULL_2020_033); Cancer Research UK (14136); Cancer Research UK (1000143); Cancer Research UK (MR/M012190/1); National Institute for Health and Care Research (1000143); Ligue Contre le Cancer (1000143); Deutsches Krebsforschungszentrum (14136); Institut National Du Cancer (1000143); Deutsche Krebshilfe (1000143); Fondation de France (1000143); Vetenskapsrådet (1000143); Deutsches Krebsforschungszentrum (MR/M012190/1); Institut National Du Cancer (MR/M012190/1); Institut National Du Cancer (14136); National Institute for Health and Care Research (MR/M012190/1); World Cancer Research Fund International (IIG_FULL_2020_033); Vetenskapsrådet (MR/M012190/1); Deutsches Krebsforschungszentrum (1000143); National Institute for Health and Care Research (14136)
Based on 33 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2023-11-14 · Lancet Reg Health Eur · vol. 35 · p. 100771
- Publisher
- Elsevier BV
- Cited
- 232 citations · more than 100% of similar papers · 53.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 51 works
- Access
- Open access (journal) · CC-BY-NC-ND
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Biochemical Analysis and Sensing Techniques
- Keywords
- Multinational corporation, Environmental health, Multimorbidity, Medicine, Cohort, Cancer, Cohort study, Consumption (sociology), Internal medicine, Business, Population, Sociology
35 authors
From AT, FR, DK, DE, IT, NL, ES, SE, GR, GB, PT, NO
- Reynalda CórdovaUniversity of Vienna; Centre international de recherche sur le cancer
- Vivian ViallonCentre international de recherche sur le cancer
- Emma FontvieilleCentre international de recherche sur le cancer
- Laia Peruchet‐NorayCentre international de recherche sur le cancer
- Anna JansanaCentre international de recherche sur le cancer
- Karl‐Heinz WagnerUniversity of Vienna
Abstract
Background
It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes.
Methods
This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases.
Findings
After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.
Interpretation
Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.
Funding
Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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