Association of ultra-processed food consumption with colorectal cancer risk among men and women: results from three prospective US cohort studies
Wang L, Du M, Wang K, Khandpur N, Rossato SL, Drouin-Chartier JP, Steele EM, Giovannucci E, Song M, Zhang FF
BMJ (Clinical research ed.) · 83 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
- Nonprofit
- American Cancer Society
- Government
- National Institutes of Health
- Government
- National Institute on Minority Health and Health Disparities
- Grants
- American Cancer Society (MRSG-17-220-01); American Cancer Society (U01 CA176726); National Institute on Minority Health and Health Disparities (1R01MD011501); American Cancer Society (R00 CA215314); American Cancer Society (CA87969); National Institutes of Health (U01-CA167552); National Institutes of Health (P01 CA 87969); National Institutes of Health (U01-CA176726); National Institutes of Health (CA176726); National Institutes of Health (R00 CA 215314); National Institutes of Health (UM1‐CA‐186107); National Institutes of Health (CA-167552); National Institutes of Health (CA186107); National Institutes of Health (CA 87969)
Based on 3 listed funder(s).
Publication
- Published
- 2022-08-31 · BMJ · vol. 378 · p. e068921
- Cited
- 147 citations · more than 100% of similar papers · 23.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 61 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Culinary Culture and Tourism
- Keywords
- Prospective cohort study, Medicine, Colorectal cancer, Environmental health, Cohort study, Consumption (sociology), Association (psychology), Cohort, Cancer, Oncology, Demography, Internal medicine, Psychology
10 authors
From US, BR, CA
- Lu WangTufts University
- Mengxi DuTufts University
- Kai WangHarvard University
- Neha KhandpurHarvard University; Universidade de São Paulo
- Sinara Laurini RossatoHarvard University; Universidade Federal de Uberlândia
- Jean‐Philippe Drouin‐ChartierUniversité Laval; Institut sur la nutrition et les aliments fonctionnels (INAF); Centre Nutrition, santé et société
Abstract
Objective
To examine the association between consumption of ultra-processed foods and risk of colorectal cancer among men and women from three large prospective cohorts.
Design
Prospective cohort study with dietary intake assessed every four years using food frequency questionnaires.
Setting
Three large US cohorts.
Participants
Men (n= 46 341) from the Health Professionals Follow-up Study (1986-2014) and women (n=159 907) from the Nurses' Health Study (1986-2014; n=67 425) and the Nurses' Health Study II (1991-2015; n=92 482) with valid dietary intake measurement and no cancer diagnosis at baseline.
Main outcome measure
Association between ultra-processed food consumption and risk of colorectal cancer, estimated using time varying Cox proportional hazards regression models adjusted for potential confounding factors.
Results
3216 cases of colorectal cancer (men, n=1294; women, n=1922) were documented during the 24-28 years of follow-up. Compared with those in the lowest fifth of ultra-processed food consumption, men in the highest fifth of consumption had a 29% higher risk of developing colorectal cancer (hazard ratio for highest versus lowest fifth 1.29, 95% confidence interval 1.08 to 1.53; P for trend=0.01), and the positive association was limited to distal colon cancer (72% increased risk; hazard ratio 1.72, 1.24 to 2.37; P for trend<0.001). These associations remained significant after further adjustment for body mass index or indicators of nutritional quality of the diet (that is, western dietary pattern or dietary quality score). No association was observed between overall ultra-processed food consumption and risk of colorectal cancer among women. Among subgroups of ultra-processed foods, higher consumption of meat/poultry/seafood based ready-to-eat products (hazard ratio for highest versus lowest fifth 1.44, 1.20 to 1.73; P for trend<0.001) and sugar sweetened beverages (1.21, 1.01 to 1.44; P for trend=0.013) among men and ready-to-eat/heat mixed dishes among women (1.17, 1.01 to 1.36; P for trend=0.02) was associated with increased risk of colorectal cancer; yogurt and dairy based desserts were negatively associated with the risk of colorectal cancer among women (hazard ratio 0.83, 0.71 to 0.97; P for trend=0.002).
Conclusions
In the three large prospective cohorts, high consumption of total ultra-processed foods in men and certain subgroups of ultra-processed foods in men and women was associated with an increased risk of colorectal cancer. Further studies are needed to better understand the potential attributes of ultra-processed foods that contribute to colorectal carcinogenesis.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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