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

Cordova, Reynalda ; Viallon, Vivian ; Fontvieille, Emma ; Peruchet-Noray, Laia ; Jansana, Anna ; Wagner, Karl Heinz ; Kyrø, Cecilie ; Tjønneland, Anne ; Katzke, Verena and Bajracharya, Rashmita , et al. (2023) In The Lancet Regional Health - Europe 35.
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... (More)

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.

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type
Contribution to journal
publication status
published
subject
keywords
Cancer, Cardiovascular diseases, Diabetes, Diet, Multimorbidity, Ultra-processed foods
in
The Lancet Regional Health - Europe
volume
35
article number
100771
publisher
Elsevier
external identifiers
  • scopus:85178016598
  • pmid:38115963
ISSN
2666-7762
DOI
10.1016/j.lanepe.2023.100771
language
English
LU publication?
yes
id
d9a86348-7d6b-4d7d-a8fb-259deabce681
date added to LUP
2023-12-18 14:22:47
date last changed
2024-04-17 03:12:36
@article{d9a86348-7d6b-4d7d-a8fb-259deabce681,
  abstract     = {{<p>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.</p>}},
  author       = {{Cordova, Reynalda and Viallon, Vivian and Fontvieille, Emma and Peruchet-Noray, Laia and Jansana, Anna and Wagner, Karl Heinz and Kyrø, Cecilie and Tjønneland, Anne and Katzke, Verena and Bajracharya, Rashmita and Schulze, Matthias B. and Masala, Giovanna and Sieri, Sabina and Panico, Salvatore and Ricceri, Fulvio and Tumino, Rosario and Boer, Jolanda M.A. and Verschuren, W. M.Monique and van der Schouw, Yvonne T. and Jakszyn, Paula and Redondo-Sánchez, Daniel and Amiano, Pilar and Huerta, José María and Guevara, Marcela and Borné, Yan and Sonestedt, Emily and Tsilidis, Konstantinos K. and Millett, Christopher and Heath, Alicia K. and Aglago, Elom K. and Aune, Dagfinn and Gunter, Marc J. and Ferrari, Pietro and Huybrechts, Inge and Freisling, Heinz}},
  issn         = {{2666-7762}},
  keywords     = {{Cancer; Cardiovascular diseases; Diabetes; Diet; Multimorbidity; Ultra-processed foods}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{The Lancet Regional Health - Europe}},
  title        = {{Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases : a multinational cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.lanepe.2023.100771}},
  doi          = {{10.1016/j.lanepe.2023.100771}},
  volume       = {{35}},
  year         = {{2023}},
}