This study assesses the associations between the consumption of ultra-processed foods (as defined by the NOVA classification system) and the incidence of and mortality from 34 specific types of cancer, as well as overall cancer risk, in a sample of nearly 200,000 British adults. After correcting for a wide range of confounding factors such as smoking status and physical activity levels, greater UPF intake was found to have a statistically significant association with overall cancer incidence and mortality, as well as with some (but not most) of the specific cancers assessed.
Participants with the highest quartile of UPF consumption compared to the lowest had 7% higher overall cancer incidence, 45% higher ovarian cancer incidence, 25% higher lung cancer incidence, 52% higher brain cancer incidence, 63% higher diffuse large B-cell lymphoma incidence and 41% lower head and neck cancer incidence.
For cancer mortality, participants with the highest quartile of UPF intake compared to the lowest quartile had 17% higher overall cancer mortality risk, 38% higher risk of lung cancer mortality, and 91% higher risk of ovarian cancer mortality.
In both cases, the findings were broadly similar after sensitivity analyses, including further adjusting the models to account for nutritional factors such as intake of sodium, total fat, carbohydrate, red meat, processed meat, fibre, and calcium.
Associations, both positive and negative, with UPF consumption and other cancers included in the study were not statistically significant.
The study could not determine causality, since it is based on observational data. Food consumption patterns were determined through 24-hour recall questionnaires (up to five per participant, but 40% of the study cohort had completed only one 24-hour recall). The authors note that other confounding factors, beyond those already corrected for in the study, may have affected the results.
In the quartile of study participants consuming the highest amount of UPFs (as a percentage of daily weight of food intake), the five greatest contributors to UPF consumption were carbonated drinks, fruit-based drinks, ready-to-eat/heat food, industrially processed breads, and dairy-based drinks.
Abstract
Background
Global dietary patterns are increasingly dominated by relatively cheap, highly palatable, and ready-to-eat ultra-processed foods (UPFs). However, prospective evidence is limited on cancer development and mortality in relation to UPF consumption. This study examines associations between UPF consumption and risk of cancer and associated mortality for 34 site-specific cancers in a large cohort of British adults.
Methods
This study included a prospective cohort of UK Biobank participants (aged 40–69 years) who completed 24-h dietary recalls between 2009 and 2012 (N = 197426, 54.6% women) and were followed up until Jan 31, 2021. Food items consumed were categorised according to their degree of food processing using the NOVA food classification system. Individuals’ UPF consumption was expressed as a percentage of total food intake (g/day). Prospective associations were assessed using multivariable Cox proportional hazards models adjusted for baseline socio-demographic characteristics, smoking status, physical activity, body mass index, alcohol and total energy intake.
Findings
The mean UPF consumption was 22.9% (SD 13.3%) in the total diet. During a median follow-up time of 9.8 years, 15,921 individuals developed cancer and 4009 cancer-related deaths occurred. Every 10 percentage points increment in UPF consumption was associated with an increased incidence of overall (hazard ratio, 1.02; 95% CI, 1.01–1.04) and specifically ovarian (1.19; 1.08–1.30) cancer. Furthermore, every 10 percentage points increment in UPF consumption was associated with an increased risk of overall (1.06; 1.03–1.09), ovarian (1.30; 1.13–1.50), and breast (1.16; 1.02–1.32) cancer-related mortality.
Interpretation
Our UK-based cohort study suggests that higher UPF consumption may be linked to an increased burden and mortality for overall and certain site-specific cancers especially ovarian cancer in women.
Funding
The Cancer Research UK and World Cancer Research Fund.
Reference
Chang, K., Gunter, M.J., Rauber, F., Levy, R.B., Huybrechts, I., Kliemann, N., Millett, C. and Vamos, E.P., 2023. Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank. eClinicalMedicine, Online First, 101840.
Read the full paper here. See also the TABLE explainer What is ultra-processed food? And why do people disagree about its utility as a concept?
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