Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study
Fang Z, Rossato SL, Hang D, Khandpur N, Wang K, Lo CH, Willett WC, Giovannucci EL, Song M
BMJ (Clinical research ed.) · 76 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
- Government
- National Institutes of Health
- Government
- Centers for Disease Control and Prevention
- Government
- National Cancer Institute
- Government
- NCI NIH HHS
- Grants
- National Cancer Institute (U01 CA167552); National Cancer Institute (CA-167552); National Cancer Institute (UM1 CA186107); National Cancer Institute (CA-87969); National Cancer Institute (CA-186107); National Cancer Institute (K99 CA283146); National Cancer Institute (U01CA261961); National Cancer Institute ([P01 CA87969); National Institutes of Health (U01-CA167552); National Institutes of Health (P01 CA 87969); National Institutes of Health (U01 CA261961); National Institutes of Health (UM1‐CA‐186107); National Institutes of Health (CA-167552); National Institutes of Health (CA186107); National Institutes of Health (CA 87969); National Institutes of Health (R01CA263776)
Based on 4 listed funder(s).
Publication
- Published
- 2024-05-08 · BMJ · vol. 385 · p. e078476
- Cited
- 94 citations · more than 100% of similar papers · 35.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 53 works
- Access
- Open access (hybrid journal) · CC-BY-NC
- Research areas
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Sodium Intake and Health
- Keywords
- Cohort, Consumption (sociology), Population, Cohort study, Environmental health, Medicine, Computer science, Internal medicine
- MeSH
- humans, neoplasms, cardiovascular diseases, mortality, cause of death, proportional hazards models, risk factors, cohort studies, food handling, adult, aged, middle aged, united states, female, male, food, processed
9 authors
From US, BR, CN, NL
- Zhe FangHarvard University
- Sinara Laurini RossatoHarvard University; Universidade Federal de Uberlândia
- Dong HangHarvard University; Nanjing Medical University
- Neha KhandpurHarvard University; Universidade de São Paulo; Wageningen University & Research
- Kai WangHarvard University
- Chun‐Han LoUniversity of Nevada, Las Vegas
Abstract
Objective
To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality.
Design
Population based cohort study.
Setting
Female registered nurses from 11 US states in the Nurses' Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018).
Participants
74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline.
Main outcome measures
Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes).
Results
30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 years of follow-up, respectively. Compared with those in the lowest quarter of ultra-processed food consumption, participants in the highest quarter had a 4% higher all cause mortality (hazard ratio 1.04, 95% confidence interval 1.01 to 1.07) and 9% higher mortality from causes other than cancer or cardiovascular diseases (1.09, 1.05 to 1.13). The all cause mortality rate among participants in the lowest and highest quarter was 1472 and 1536 per 100 000 person years, respectively. No associations were found for cancer or cardiovascular mortality. Meat/poultry/seafood based ready-to-eat products (for example, processed meat) consistently showed strong associations with mortality outcomes (hazard ratios ranged from 1.06 to 1.43). Sugar sweetened and artificially sweetened beverages (1.09, 1.07 to 1.12), dairy based desserts (1.07, 1.04 to 1.10), and ultra-processed breakfast food (1.04, 1.02 to 1.07) were also associated with higher all cause mortality. No consistent associations between ultra-processed foods and mortality were observed within each quarter of dietary quality assessed by the Alternative Healthy Eating Index-2010 score, whereas better dietary quality showed an inverse association with mortality within each quarter of ultra-processed foods.
Conclusions
This study found that a higher intake of ultra-processed foods was associated with slightly higher all cause mortality, driven by causes other than cancer and cardiovascular diseases. The associations varied across subgroups of ultra-processed foods, with meat/poultry/seafood based ready-to-eat products showing particularly strong associations with mortality.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC).
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