Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases

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 Jakszyn, Daniel 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

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.

Department für Ernährungswissenschaften, Forschungsplattform Active Ageing
Externe Organisation(en)
International Agency for Research on Cancer (IARC-WHO), Danish Cancer Society Research Center, University of Copenhagen, Stiftung Deutsches Krebsforschungszentrum, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DIfE), Universität Potsdam, Istituto per lo studio, la prevenzione e la rete oncologica, Fondazione IRCCS, Instituto Nationale Tumori di Milano, Università degli studi di Napoli Federico II, Università degli Studi di Torino, Hyblean Association for Epidemiological Research, National Institute of Public Health and the Environment, University Medical Centre Utrecht (UMC), Catalan Institute of Oncology (ICO-IDIBELL), Ramon Llull University, Escuela Andaluza de Salud Pública (EASP), Instituto de Investigación Biosanitaria, Consorcio de Investigación Biomédica de Epidemiología y Salud Pública - CIBERESP, Department of Health, Basque Country, Biodonostia Health Research Institute, Murcia Regional Health Council, Instituto de Salud Pública y Laboral de Navarra, Navarra Institute for Health Research (IdiSNA), Lund University, University of Ioannina, Imperial College London, Universidade Nova de Lisboa, Oslo New University College, Cancer Registry of Norway
The Lancet Regional Health - Europe
ÖFOS 2012
303009 Ernährungswissenschaften
ASJC Scopus Sachgebiete
Health policy, Oncology, Internal Medicine
Sustainable Development Goals
SDG 3 – Gesundheit und Wohlergehen
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