Yet other studies have linked consumption of ultraprocessed foods, or “junk” foods, with poor health outcomes.
In a longitudinal analysis of more than 22,000 men and women from southern Italy, those consuming the most ultraprocessed foods (UPF) had the highest risk for cardiovascular disease (CVD) and all causes of death, likely mediated through a high-sugar diet, the researchers said.
High UPF consumption in this Mediterranean cohort was associated with a 58% increased risk for CVD mortality and a 52% higher risk of death. ischemic heart disease (IHD) and cerebrovascular causes, regardless of known risk factors for CVD, even among individuals following a Mediterranean diet.
The findings “should serve as an incentive to limit UPF consumption and encourage natural or minimally processed foods, as recommended by several national nutrition policies,” Marialaura Bonaccio, PhD, Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy, and colleagues. writing. The result published online December 18 at American Journal of Clinical Nutrition.
Earlier this year, as reported by Medscape Medical News, the researchers found a lot of evidence that obesity epidemics and an increased incidence of chronic conditions are associated with increased intake of UPF.
A study conducted in a European cohort found that adults whose diets included more UPF and beverages, such as ice cream, soda, and hamburgers, were more likely to develop CVD or die sooner than other people who had a healthier diet.
As previously reported by theheart.org | Medscape Cardiology, among French adults who had a 10% higher intake of UPF and drink, rates of CVD, coronary heart disease, and cerebrovascular disease were 11% to 13% higher over a period of about 5 years.
Likewise, university graduates in Spain who consumed more than four servings of UPF and drinks every day were 62% more likely to die from any cause for about a decade than those who consumed less than two servings per day.
Where’s the food?
The actual food at UPF is minimal. The NOVA classification provides 4 main classes of food and beverage, the last one being represented by the ultra processed food group (UPF). It consists of products (e.g. snacks, drinks, and ready-to-eat food, ‘made mostly or entirely from substances extracted from food or derived from food constituents with little, if any whole food, which often contain flavors, colors, and other additives. that mimic or enhance the sensory qualities of food or culinary preparations made from food, ‘”wrote Bonaccio and colleagues.
Such food is very convenient, tasty, inexpensive and has a long shelf life. They are highly competitive with foods that are naturally ready to eat and freshly prepared dishes and meals, add the authors.
Researchers performed a longitudinal analysis of 22,475 men and women (mean age, 55 years; range, 43-67 years) recruited from the Moli-sani Study, a population-based cohort of men and women aged 35 years and over in the Molise region of Italy. south, between 2005 and 2010. Participants were followed for 8.2 years.
Food intake was assessed by the Food Frequency Questionnaire; The UPF is defined using the NOVA classification according to the level of processing.
The UPF intake is categorized as a quartile of the ratio of the UPF to total food consumed.
Overall, study participants reported a median of 10% (interquartile range, 6.6% – 14.6%) of food intake as UPF and a total of 181.5 g / day of UPF intake.
The food that gave the biggest contribution to the total UPF consumed was processed meat, which was 19.8% of the UPF intake; pizza (16.8%); and cakes and pies (13.4%).
High UPF consumers, defined as those with a UPF of more than 14.6% of their total diet, are more likely to be female, younger, and have a higher level of education. They also reported fewer risk factors and fewer chronic diseases and underlying health conditions than people who took UPF less frequently.
In addition, high UPF consumption was associated with lower adherence to the Mediterranean diet; higher intake of fat, sugar, dietary cholesterol, and sodium; but lower fiber intake.
During a median follow-up of 8.2 years, 1,216 all-cause deaths occurred. Of these, 439 were associated with CVD, 255 IHD / cerebrovascular diseases, 477 cancers, and 300 other causes.
The more UPF, the higher the risk of CVD, death
The investigators found a direct linear dose-response relationship between a 5% increase in the proportion of UPF in the diet and the risk for all-cause and mortality of CVD.
Individuals reporting highest UPF intake (fourth quartile [Q4], 14.6% of the total diet) compared to the lowest (Q1, UPF <6.6%) had an increased risk of CVD death (hazard ratio [HR]: 1.58; 95% CI, 1.23 - 2.03), death from IHD / cerebrovascular disease (HR, 1.52, 95% CI, 1.10 - 2.09), and all causes of death (HR, 1.26; 95% CI, 1.09 - 1.46).
High sugar levels accounted for 36.3% of the UPF association with IHD / cerebrovascular mortality. Other nutritional factors, such as saturated fat, may not have played a role, the researchers wrote.
Renal function biomarkers accounted for 20.1% of the UPF association with all-cause mortality and 12.0% for UPF with CVD mortality.
Subgroup analyzes showed that the magnitude of the association between UPF and all-cause risk of death was greater among high-risk individuals, such as those with a history of CVD or diabetes. UPF may also be more closely related to CVD mortality among these high-risk groups.
The interesting finding that the association between UPF mortality and CVD was greater among individuals with good adherence to the Mediterranean diet, which is known to have health benefits, can be explained by the fact that people who might benefit from a Mediterranean diet are more prone to lose health benefits when they also included “adverse dietary behavior,” whereas those who ate a poor quality diet were less likely to be harmed by additional unhealthy behaviors such as eating UPF regularly, Bonaccio and colleagues wrote.
“This is an exciting study confirming that consumption of processed foods such as pizza, processed meats, and soda is associated with a greater risk of cardiovascular disease,” Walter Willett, MD, professor of epidemiology and nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, was told theheart.org | Medscape Cardiology.
“This higher risk appears to be mediated in part by a high intake of saturated fat and sugar, but a lower intake of the health-enhancing aspects of the diet also most likely contributed to these findings,” Willett said.
“Some food processing can be useful for the preservation and control of infectious agents, but in general, a diet that emphasizes minimally processed fruits and vegetables, whole grains, legumes, legumes, and vegetable fat sources would be best. for long-term health to be, “he said.
This study was partially supported by the Italian Ministry of Health and the Italian Association for Cancer Research HYPERCAN Study. Bonaccio and Willett report no relevant financial relationship.
Am J Clin Nutr. Published online 18 December 2020. Abstract