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

Reynalda Cordova, Vivian Viallon, Emma Fontvieille, Laia Peruchet-Noray, Anna Jansana, Karl Heinz Wagner, Cecilie Kyrø, Anne Tjønneland, Verena Katzke, Rashmita Bajracharya, Matthias B. Schulze, Giovanna Masala, Sabina Sieri, Salvatore Panico, Fulvio Ricceri, Rosario Tumino, Jolanda M.A. Boer, W. M.Monique Verschuren, Yvonne T. van der Schouw, Paula JakszynDaniel Redondo-Sánchez, Pilar Amiano, José María Huerta, Marcela Guevara, Yan Borné, Emily Sonestedt, Konstantinos K. Tsilidis, Christopher Millett, Alicia K. Heath, Elom K. Aglago, Dagfinn Aune, Marc J. Gunter, Pietro Ferrari, Inge Huybrechts, Heinz Freisling

Research output: Indexed journal article Articlepeer-review

11 Citations (Scopus)

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.

Original languageEnglish
Article number100771
JournalThe Lancet Regional Health - Europe
Volume35
DOIs
Publication statusPublished - Dec 2023

Keywords

  • Cancer
  • Cardiovascular diseases
  • Diabetes
  • Diet
  • Multimorbidity
  • Ultra-processed foods

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