Consumption of Ultra-Processed Foods and Mortality: A National Prospective Cohort in Spain

被引:164
作者
Blanco-Rojo, Ruth [1 ]
Sandoval-Insausti, Helena [2 ,3 ]
Lopez-Garcia, Esther [1 ,2 ]
Graciani, Auxiliadora [2 ]
Ordovas, Jose M. [1 ,4 ,5 ]
Banegas, Jose R. [2 ]
Rodriguez-Artalejo, Fernando [1 ,2 ]
Guallar-Castillon, Pilar [1 ,2 ,6 ]
机构
[1] Inst Madrileno Estudios Avanzados Super Invest Ci, Madrid, Spain
[2] Univ Autonoma Madrid, IdiPaz, Ctr Invest Biomed Red Epidemiol & Publ Hlth, Sch Med,Dept Prevent Med & Publ Hlth, Madrid, Spain
[3] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA
[4] Ctr Nacl Invest Cardiovasc Carlos III, Madrid, Spain
[5] Tufts Univ, USDA, Human Nutr Res Ctr Aging, Boston, MA 02111 USA
[6] Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA
基金
欧盟地平线“2020”;
关键词
ALL-CAUSE MORTALITY; TOTAL-ENERGY INTAKE; MEDITERRANEAN DIET; CARDIOVASCULAR-DISEASE; FAT INTAKE; RISK; NUTRITION; PRODUCTS; ISSUE; METAANALYSIS;
D O I
10.1016/j.mayocp.2019.03.035
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. Patients and Methods: A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (20082010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. Results: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. Conclusion: A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. (C) 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc.
引用
收藏
页码:2178 / 2188
页数:11
相关论文
共 62 条
[1]   Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12) [J].
Adams, Jean ;
White, Martin .
INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 2015, 12
[2]   Comparison of Dietary Intakes Between a Large Online Cohort Study (Etude NutriNet-Sant,) and a Nationally Representative Cross-Sectional Study (Etude Nationale Nutrition Sant,) in France: Addressing the Issue of Generalizability in E-Epidemiology [J].
Andreeva, Valentina A. ;
Deschamps, Valerie ;
Salanave, Benoit ;
Castetbon, Katia ;
Verdot, Charlotte ;
Kesse-Guyot, Emmanuelle ;
Hercberg, Serge .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2016, 184 (09) :660-669
[3]  
[Anonymous], 2018, BMJ, DOI DOI 10.1136/BMJ.K322
[4]  
[Anonymous], GUID COLL INF FOOD P
[5]  
[Anonymous], 2015, BMJ, DOI DOI 10.1136/BMJ.H3978
[6]   Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study [J].
Baraldi, Larissa Galastri ;
Steele, Euridice Martinez ;
Canella, Daniela Silva ;
Monteiro, Carlos Augusto .
BMJ OPEN, 2018, 8 (03)
[7]   Mortality outcomes associated with intake of fast-food items and sugar-sweetened drinks among older adults in the Vitamins and Lifestyle (VITAL) study [J].
Barrington, Wendy E. ;
White, Emily .
PUBLIC HEALTH NUTRITION, 2016, 19 (18) :3319-3326
[8]   Ultra-Processed Food Products and Obesity in Brazilian Households (2008-2009) [J].
Canella, Daniela Silva ;
Levy, Renata Bertazzi ;
Bortoletto Martins, Ana Paula ;
Claro, Rafael Moreira ;
Moubarac, Jean-Claude ;
Baraldi, Larissa Galastri ;
Cannon, Geoffrey ;
Monteiro, Carlos Augusto .
PLOS ONE, 2014, 9 (03)
[9]   Adding Molecules to Food, Pros and Cons: A Review on Synthetic and Natural Food Additives [J].
Carocho, Marcio ;
Barreiro, Maria Filomena ;
Morales, Patricia ;
Ferreira, Isabel C. F. R. .
COMPREHENSIVE REVIEWS IN FOOD SCIENCE AND FOOD SAFETY, 2014, 13 (04) :377-399
[10]   Ultra-processed foods and added sugars in the Chilean diet (2010) [J].
Cediel, Gustavo ;
Reyes, Marcela ;
da Costa Louzada, Maria Laura ;
Steele, Euridice Martinez ;
Monteiro, Carlos A. ;
Corvalan, Camila ;
Uauy, Ricardo .
PUBLIC HEALTH NUTRITION, 2018, 21 (01) :125-133