Written by Chrystal Moulton, Staff Writer. Consumption of ultra-processed foods was associated with 52%, 58%, and 26% higher risk of dying from IHD/ cerebrovascular disease, CVD, and all-cause mortality, respectively.
Ultra-processed food (UPF) is defined as foods that are “created mostly or entirely from substances extracted from foods or derived from food constituents with little if any intact food, which often contain flavors, colors and other additives that imitate or intensify the sensory qualities of foods or culinary preparations made from foods” 1. Diets high in ultra-processed food (UPF) are associated with the onset of chronic diseases and obesity 2. Since ultra-processed food (UPF) intake dominates the food supply in developed countries 3, it is important to understand the impact these foods have on the population. In the United states alone, 60% of energy intake comes from UPF 4. In the current study 5, researchers evaluated the association of UPF with specific mortality and all-cause mortality in data from the Moli-sani study cohort and examined the contribution of specific nutrients (like sugar) in mediating the relationship between UPF and mortality risk.
The current study was designed as a longitudinal analysis of data from the Moli-Sani study, a population-based cohort consisting of 24,325 men and women 35 years old or more between 2005 and 2010 from the southern region of Italy. Data from 22,475 participants from the Moli-Sani study was eligible for this longitudinal analysis and these participants were followed up for mortality until December 31, 2015. The average age of participants in this study was 55 years old (mean age: 55± 12 y). Food frequency intake was assessed the year before enrollment. Participants were divided into quartiles based on UPF consumption. Mortality was determined by the Italian mortality registry and validated death certificates.
The analysis showed that high consumers of UPF (>14.6% of total diet) were more likely to be younger women of higher education who reported fewer risk factors and no chronic diseases or health conditions. A median of 10% of dietary intake consisted of UPF with processed meat (19.8%), pizza (16.8%), and cakes (13.4%) the most popular contributor to total UPF consumption. During the follow up, 1216 deaths occurred of which 439 were attributed to cardiovascular disease (CVD), 477 to cancer, 255 to Ischemic heart disease (IHD)/ cerebrovascular disease, and 300 to other causes. In statistical models calculating the association of UPF intake to all-cause and cause-specific mortality risk, researchers found that in the multivariable adjusted Model 1 & 2 hazard ratios for all-cause, cardiovascular disease (CVD), and ischemic heart disease (IHD)/ cerebrovascular mortality where significantly associated with high UPF consumption.
Table 1. Association between highest UPF intake and all-cause/specific cause mortality| Model 1 (hazard ratio) | Model 2 (hazard ratio) | p-value | |
|---|---|---|---|
| All-cause mortality | 1.32 | 1.26 | P = 0.05 |
| CVD | 1.65 | 1.58 | P = 0.05 |
| IHD/cerebrovascular | 1.63 | 1.52 | P = 0.05 |
| Model 1 adjusted for age, energy intake, educational level, sex, housing, smoking, BMI, physical activity, history of chronic disease and residence. Model 2 adjusted additionally for CVD, IHD, UPF, and Mediterranean diet score. |
Based on percentage of exposure effect, sugar content from UPF contributed 23.2% to the association between UPF consumption and mortality risk in all-cause mortality (P < 0.001), 18.0% in CVD death risk (P = 0.003), and 36.3% for IHD/ cerebrovascular death risk (P <0.001). Researchers also found that all CVD risk factors accounted for 22.4% of all-cause mortality risk and 9.4% of CVD mortality risk in relation to UPF consumption. Biomarkers of renal function were also linked to the increased death risk of consuming UPF’s. Individuals with diabetes or a history of CVD had a higher risk associated with UPF intake and all-cause mortality (P= 0.014 and P = 0.019, respectively).
Overall, high consumption of UPF was associated with 52%, 58%, and 26% higher risk of dying from IHD/ cerebrovascular disease, CVD, and all-cause mortality, respectively. Sugar content was found to be a significant contributor in the association between UPF intake and mortality. Additional analysis is needed to support the findings in this study.
Source: Bonaccio, Marialaura, Augusto Di Castelnuovo, Simona Costanzo, Amalia De Curtis, Mariarosaria Persichillo, Francesco Sofi, Chiara Cerletti, Maria Bendetta Donati, Giovanni de Gaetano, and Licia Iacoviello. “Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study.” The American journal of clinical nutrition 113, no. 2 (2021): 446-455.
© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition. All rights reserved.
Click here to read the full text study.
Posted June 7, 2021.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
References:
- Monteiro CA, Cannon G, Levy R, et al. NOVA. The star shines bright. World Nutrition. 2016;7(1-3):28-38.
- Poti JM, Braga B, Qin B. Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content? Curr Obes Rep. 2017;6(4):420-431.
- Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2013;14 Suppl 2:21-28.
- Martínez Steele E, Baraldi LG, Louzada ML, Moubarac JC, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016;6(3):e009892.
- Bonaccio M, Di Castelnuovo A, Costanzo S, et al. Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study. Am J Clin Nutr. 2021;113(2):446-455.
