Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study.

Cancer Cardiovascular diseases Diabetes Diet Multimorbidity Ultra-processed foods

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 27 07 2023
revised: 19 10 2023
accepted: 20 10 2023
medline: 20 12 2023
pubmed: 20 12 2023
entrez: 20 12 2023
Statut: epublish

Résumé

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. 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. 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. Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity. Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.

Sections du résumé

Background UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.
Funding UNASSIGNED
Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.

Identifiants

pubmed: 38115963
doi: 10.1016/j.lanepe.2023.100771
pii: S2666-7762(23)00190-4
pmc: PMC10730313
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100771

Informations de copyright

© 2023 Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

None of the authors declared a competing interest.

Auteurs

Reynalda Cordova (R)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Department of Nutritional Sciences, University of Vienna, Vienna, Austria.

Vivian Viallon (V)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Emma Fontvieille (E)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Laia Peruchet-Noray (L)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Anna Jansana (A)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Karl-Heinz Wagner (KH)

Department of Nutritional Sciences, University of Vienna, Vienna, Austria.

Cecilie Kyrø (C)

Danish Cancer Institute Center, Copenhagen, Denmark.

Anne Tjønneland (A)

Danish Cancer Institute Center, Copenhagen, Denmark.
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Verena Katzke (V)

Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Rashmita Bajracharya (R)

Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Matthias B Schulze (MB)

Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.

Giovanna Masala (G)

Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.

Sabina Sieri (S)

Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

Salvatore Panico (S)

Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Fulvio Ricceri (F)

Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Italy.

Rosario Tumino (R)

Hyblean Association for Epidemiological Research, AIRE ONLUS Ragusa, Italy.

Jolanda M A Boer (JMA)

Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

W M Monique Verschuren (WMM)

Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Yvonne T van der Schouw (YT)

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Paula Jakszyn (P)

Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain.

Daniel Redondo-Sánchez (D)

Escuela Andaluza de Salud Pública (EASP), Granada 18011, Spain.
Instituto de Investigación Biosanitaria ibs. Granada, Granada 18012, Spain.
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.

Pilar Amiano (P)

Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain.
Bio Gipuzkoa Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain.

José María Huerta (JM)

Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Department of Epidemiology, Murcia Regional Health Council-IMIB, Murcia, Spain.

Marcela Guevara (M)

Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Instituto de Salud Pública y Laboral de Navarra, Pamplona 31003, Spain.
Navarra Institute for Health Research (IdiSNA), Pamplona 31008, Spain.

Yan Borné (Y)

Nutritional Epidemiology, Department of Clinical Sciences Malmö, The Faculty of Medicine, Lund University, Malmö, Sweden.

Emily Sonestedt (E)

Nutritional Epidemiology, Department of Clinical Sciences Malmö, The Faculty of Medicine, Lund University, Malmö, Sweden.

Konstantinos K Tsilidis (KK)

Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

Christopher Millett (C)

Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom.
NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.

Alicia K Heath (AK)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

Elom K Aglago (EK)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

Dagfinn Aune (D)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Department of Nutrition, Oslo New University College, Oslo, Norway.
Department of Research, The Cancer Registry of Norway, Oslo, Norway.

Marc J Gunter (MJ)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

Pietro Ferrari (P)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Inge Huybrechts (I)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Heinz Freisling (H)

International Agency for Research on Cancer (IARC-WHO), Lyon, France.

Classifications MeSH