Ultra-processed food intake and risk of type 2 diabetes in a French cohort of middle-aged adults

Abstract Objective The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases. The objective of this study is to assess for the first time the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D). Methods 104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009-2019). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items, categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of T2D were assessed using multi-adjusted Cox proportional hazard models. Results Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (1.06-1.25); P = 0.0009, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses. Conclusions In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of T2D. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption. Key messages The consumption of ultra-processed food is associated with an increased risk of type 2 diabetes. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.

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Ultra-processed food intake and risk of type 2 diabetes in a French cohort of middle-aged adults

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004826 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Léopold K. Fezeu ◽

Emmanuelle Kesse-Guyot ◽

Benjamin Allès ◽

Caroline Méjean ◽

...

Keyword(s):

Type 2 Diabetes ◽

Food Intake ◽

Saturated Fatty Acids ◽

Food Additives ◽

Sensitivity Analyses ◽

Processed Foods ◽

Processed Food ◽

Sugary Drinks ◽

Incident Cases

AbstractIntroduction:The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia. The objective of this study is to assess the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D).Methods:Overall, 104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records (5.7/subject in average), designed to register participants' usual consumption for 3300 different food items. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of type 2 diabetes were assessed using multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history and nutritional factors).Results:Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (95% confidence interval 1.06 to 1.25); P = 0.0009, median follow-up: 6.0y, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.Conclusions:In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of type 2 diabetes. These results need to be confirmed in other populations and settings, and causality remains to be established. Various dimensions of processing such as nutritional composition of the final product, food additives, contact materials, and neoformed contaminants might play a role in these associations and further studies are needed to better understand their relative contribution. Meanwhile, public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.Study Registration: Clinicaltrials.gov NCT03335644.

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Consumption of ultra-processed foods and the risk of overweight, obesity, and weight trajectories

European Journal of Public Health ◽

10.1093/eurpub/ckz185.415 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

B Srour ◽

M Beslay ◽

B Allès ◽

E Chazelas ◽

M Deschasaux ◽

...

Keyword(s):

Repeated Measures ◽

Saturated Fatty Acids ◽

Food Additives ◽

Overweight And Obesity ◽

Sensitivity Analyses ◽

Processed Foods ◽

Sugary Drinks ◽

Increased Risk ◽

Weight Trajectories ◽

Incident Cases

Abstract Previous epidemiological studies found associations between the consumption of ultra-processed foods (UPF) and the risk of obesity-related outcomes. The aim of this study is to investigate the associations between UPF consumption and the risk of overweight and obesity, and weight trajectories, in in the French large scale NutriNet-Santé cohort. Methods Overall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected using repeated 24h dietary records, merged with a food composition database of 3300 different products, categorized according to their degree of processing by the NOVA classification. Associations between UPF intake and risks of overweight and obesity were assessed using Cox proportional hazard models. Associations between UPF intake and weight trajectories were assessed using linear mixed models for repeated measures with random slope and intercept. Results UPF intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (1.08-1.14); P < 0.0001) and obesity (n = 3066 incident cases; HR = 1.09 (1.05-1.13); P < 0.0001). Higher consumers of UPF (4th quartile) were more likely to present an increase in body mass index over time (β = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns) and after a large range of sensitivity analyses. Conclusions In this large observational prospective study, higher consumption of UPF was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting UPF consumption. Key messages The consumption of ultra-processed food is associated with an increased risk of overweight and obesity. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.

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Associations of ultra-processed food and its consumption patterns with incident type 2 diabetes

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.437 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Duan ◽

P C Vinke ◽

G J Navis ◽

E Corpeleijn ◽

L H Dekker

Keyword(s):

Type 2 Diabetes ◽

Diabetes Risk ◽

Consumption Patterns ◽

Processed Foods ◽

Inverse Association ◽

Processed Food ◽

Incident Type ◽

Increased Risk ◽

Incident Type 2 Diabetes

Abstract Background To study the associations of the consumption of ultra-processed food (UPF) and its underlying habitual consumption patterns with incident type 2 diabetes (T2D) in a large population-based cohort. Methods In 70 421 participants (35-70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. Principal component analysis (PCA) was performed to derive UPF consumption patterns. UPF was related to incident diabetes with adjustments for confounders, including overall diet quality. Results During a median follow-up of 41 months, the intake of UPF was associated with higher risk of type 2 diabetes (1128 cases, OR for a 10% increment in UPF intake 1.33 [95% CI 1.26, 1.41]), and remained significant after adjustment for confounders. PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased diabetes risk; a pattern high in traditional Dutch cuisine was not associated with diabetes risk (OR 1.05 [95% CI 0.97, 1.14]); while a pattern high in sweet snacks and pastries was inversely associated with diabetes risk (OR 0.82 [95% CI 0.76, 0.89]). There was a clear inverse association between diabetes risk at baseline and the sweet snacks and pastries pattern (β = -0.104 [95% CI -0.113, -0.094]). Conclusions A higher consumption of UPF was associated with higher risk of type 2 diabetes. For consumption patterns, this association was most pronounced for the patterns that were high in savory snacks. Our findings emphasize that in addition to promoting the consumption of healthy food products, discouraging the consumption of UPF, specifically savory snacks, should be considered as part of future diabetes prevention strategies. Key messages Ultra-processed foods intake was associated with increased risk of type 2 diabetes. Consumption patterns of ultra-processed foods should be the focus for future policies.

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Life-course trajectories of weight and their impact on the incidence of type 2 diabetes

Scientific Reports ◽

10.1038/s41598-021-91910-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Diego Yacamán-Méndez ◽

Ylva Trolle-Lagerros ◽

Minhao Zhou ◽

Antonio Monteiro Ponce de Leon ◽

Hrafnhildur Gudjonsdottir ◽

...

Keyword(s):

Type 2 Diabetes ◽

Life Course ◽

Risk Ratio ◽

Absolute Risk ◽

Early Adulthood ◽

Normal Weight ◽

Overweight And Obesity ◽

Increased Risk ◽

Incident Cases

AbstractAlthough exposure to overweight and obesity at different ages is associated to a higher risk of type 2 diabetes, the effect of different patterns of exposure through life remains unclear. We aimed to characterize life-course trajectories of weight categories and estimate their impact on the incidence of type 2 diabetes. We categorized the weight of 7203 participants as lean, normal or overweight at five time-points from ages 7–55 using retrospective data. Participants were followed for an average of 19 years for the development of type 2 diabetes. We used latent class analysis to describe distinctive trajectories and estimated the risk ratio, absolute risk difference and population attributable fraction (PAF) associated to different trajectories using Poisson regression. We found five distinctive life-course trajectories. Using the stable-normal weight trajectory as reference, the stable overweight, lean increasing weight, overweight from early adulthood and overweight from late adulthood trajectories were associated to higher risk of type 2 diabetes. The estimated risk ratios and absolute risk differences were statistically significant for all trajectories, except for the risk ratio of the lean increasing trajectory group among men. Of the 981 incident cases of type 2 diabetes, 47.4% among women and 42.9% among men were attributable to exposure to any life-course trajectory different from stable normal weight. Most of the risk was attributable to trajectories including overweight or obesity at any point of life (36.8% of the cases among women and 36.7% among men). The overweight from early adulthood trajectory had the highest impact (PAF: 23.2% for woman and 28.5% for men). We described five distinctive life-course trajectories of weight that were associated to increased risk of type 2 diabetes over 19 years of follow-up. The variability of the effect of exposure to overweight and obesity on the risk of developing type 2 diabetes was largely explained by exposure to the different life-course trajectories of weight.

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Consumption of ultra-processed foods and the risk of overweight and obesity, and weight trajectories in the French cohort NutriNet-Santé

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003559 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Marie Beslay ◽

Caroline Méjean ◽

Benjamin Allès ◽

Thibault Fiolet ◽

...

Keyword(s):

Food Intake ◽

Confidence Interval ◽

Prospective Study ◽

Food Consumption ◽

Overweight And Obesity ◽

Processed Foods ◽

Processed Food ◽

Weight Trajectories ◽

Incident Cases

AbstractIntroductionPrevious epidemiological studies have found associations between the consumption of ultra-processed foods and the risk of obesity-related outcomes, such as post-menopausal breast cancer, cardiovascular diseases, hypertension and mortality. However, only one Spanish prospective study has explored the associations between the consumption of ultra-processed foods and the risk of overweight and obesity. The aim of this study is to investigate the associations between ultra-processed food consumption and the risk of overweight and obesity, as well as the associations between ultra-processed food consumption and weight trajectories, in middle-aged adults included in the French large scale NutriNet-Santé cohort.MethodsOverall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records, merged with a food composition database of 3300 different products. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risks of overweight and obesity were assessed using multivariable Cox proportional hazard models. Associations between ultra-processed food intake and weight trajectories were assessed using multivariable linear mixed models for repeated measures with random slope and intercept. Models were adjusted for known risk factors (sociodemographic, lifestyle, and nutritional factors).ResultsUltra-processed food intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (95% confidence interval 1.08 to 1.14); P < 0.0001, median follow-up: 4.1y, 260304 person-years) and obesity (n = 3066 incident cases; HR = 1.09 (95% confidence interval 1.05 to 1.13); P < 0.0001, median follow-up: 8.0y 365344 person-years). Higher consumers of ultra-processed foods (4th quartile) were more likely to present an increase in body mass index over time (change of BMI/time-unit in Q4 vs Q1 = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionIn this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

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Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Diabetologia ◽

10.1007/s00125-019-05001-w ◽

2019 ◽

Vol 62 (12) ◽

pp. 2298-2309 ◽

Cited By ~ 16

Author(s):

Ari V. Ahola-Olli ◽

Linda Mustelin ◽

Maria Kalimeri ◽

Johannes Kettunen ◽

Jari Jokelainen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Fasting Glucose ◽

Diabetes Risk ◽

Increased Risk ◽

Metabolic Biomarkers ◽

Incident Cases ◽

Future Diabetes

Abstract Aims/hypothesis Metabolomics technologies have identified numerous blood biomarkers for type 2 diabetes risk in case−control studies of middle-aged and older individuals. We aimed to validate existing and identify novel metabolic biomarkers predictive of future diabetes in large cohorts of young adults. Methods NMR metabolomics was used to quantify 229 circulating metabolic measures in 11,896 individuals from four Finnish observational cohorts (baseline age 24–45 years). Associations between baseline metabolites and risk of developing diabetes during 8–15 years of follow-up (392 incident cases) were adjusted for sex, age, BMI and fasting glucose. Prospective metabolite associations were also tested with fasting glucose, 2 h glucose and HOMA-IR at follow-up. Results Out of 229 metabolic measures, 113 were associated with incident type 2 diabetes in meta-analysis of the four cohorts (ORs per 1 SD: 0.59–1.50; p< 0.0009). Among the strongest biomarkers of diabetes risk were branched-chain and aromatic amino acids (OR 1.31–1.33) and triacylglycerol within VLDL particles (OR 1.33–1.50), as well as linoleic n-6 fatty acid (OR 0.75) and non-esterified cholesterol in large HDL particles (OR 0.59). The metabolic biomarkers were more strongly associated with deterioration in post-load glucose and insulin resistance than with future fasting hyperglycaemia. A multi-metabolite score comprised of phenylalanine, non-esterified cholesterol in large HDL and the ratio of cholesteryl ester to total lipid in large VLDL was associated with future diabetes risk (OR 10.1 comparing individuals in upper vs lower fifth of the multi-metabolite score) in one of the cohorts (mean age 31 years). Conclusions/interpretation Metabolic biomarkers across multiple molecular pathways are already predictive of the long-term risk of diabetes in young adults. Comprehensive metabolic profiling may help to target preventive interventions for young asymptomatic individuals at increased risk.

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Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé)

BMJ ◽

10.1136/bmj.l1451 ◽

2019 ◽

pp. l1451 ◽

Cited By ~ 107

Author(s):

Bernard Srour ◽

Léopold K Fezeu ◽

Emmanuelle Kesse-Guyot ◽

Benjamin Allès ◽

Caroline Méjean ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Disease Risk ◽

Saturated Fatty Acids ◽

Cerebrovascular Diseases ◽

Incidence Rates ◽

Hazard Ratio ◽

Sensitivity Analyses ◽

Processed Foods ◽

Processed Food

AbstractObjectiveTo assess the prospective associations between consumption of ultra-processed foods and risk of cardiovascular diseases.DesignPopulation based cohort study.SettingNutriNet-Santé cohort, France 2009-18.Participants105 159 participants aged at least 18 years. Dietary intakes were collected using repeated 24 hour dietary records (5.7 for each participant on average), designed to register participants’ usual consumption of 3300 food items. These foods were categorised using the NOVA classification according to degree of processing.Main outcome measuresAssociations between intake of ultra-processed food and overall risk of cardiovascular, coronary heart, and cerebrovascular diseases assessed by multivariable Cox proportional hazard models adjusted for known risk factors.ResultsDuring a median follow-up of 5.2 years, intake of ultra-processed food was associated with a higher risk of overall cardiovascular disease (1409 cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet 1.12 (95% confidence interval 1.05 to 1.20); P<0.001, 518 208 person years, incidence rates in high consumers of ultra-processed foods (fourth quarter) 277 per 100 000 person years, and in low consumers (first quarter) 242 per 100 000 person years), coronary heart disease risk (665 cases; hazard ratio 1.13 (1.02 to 1.24); P=0.02, 520 319 person years, incidence rates 124 and 109 per 100 000 person years, in the high and low consumers, respectively), and cerebrovascular disease risk (829 cases; hazard ratio 1.11 (1.01 to 1.21); P=0.02, 520 023 person years, incidence rates 163 and 144 per 100 000 person years, in high and low consumers, respectively). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (saturated fatty acids, sodium and sugar intakes, dietary fibre, or a healthy dietary pattern derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionsIn this large observational prospective study, higher consumption of ultra-processed foods was associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. These results need to be confirmed in other populations and settings, and causality remains to be established. Various factors in processing, such as nutritional composition of the final product, additives, contact materials, and neoformed contaminants might play a role in these associations, and further studies are needed to understand better the relative contributions. Meanwhile, public health authorities in several countries have recently started to promote unprocessed or minimally processed foods and to recommend limiting the consumption of ultra-processed foods.Study registrationClinicalTrials.gov NCT03335644.

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Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study

Nutrition Journal ◽

10.1186/s12937-020-00642-9 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Results With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0). Conclusions The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

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Mentally tiring work and type 2 diabetes in women: a 22-year follow-up study

Acta Endocrinologica ◽

10.1530/eje-18-0804 ◽

2019 ◽

Vol 180 (4) ◽

pp. 257-263

Author(s):

Guy Fagherazzi ◽

Gaelle Gusto ◽

Douae El Fatouhi ◽

Francesca Romana Mancini ◽

Beverley Balkau ◽

...

Keyword(s):

Type 2 Diabetes ◽

Job Demands ◽

Diabetes Risk ◽

Work Related Stress ◽

Overweight Women ◽

Work Related ◽

Increased Risk ◽

Related Stress ◽

Incident Cases

Hypothesis Previous work suggested no or inconsistent associations between components of work-related stress and type 2 diabetes risk, but suggested sex-specific differences should be further investigated, as women potentially had higher risks. Methods We analyzed data from 73 517 women, mostly teachers, from the E3N cohort study followed for 22 years (1992–2014), to study the association between mentally tiring work, used as a proxy of job demands, and type 2 diabetes risk. Univariate and multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Results A total of 4187 incident cases of type 2 diabetes cases were observed. There was a higher type 2 diabetes risk for women with a ‘Very mentally tiring work’ when compared to women with ‘Little or not mentally tiring work’ (HR = 1.21 (1.09–1.35)). This association was independent of unhealthy lifestyle and traditional metabolic factors. An interaction between mentally tiring work and BMI was detected (P < 0.0001), with a stronger association being observed in non-overweight women, HR = 1.26 (1.08–1.47) vs HR = 1.14 (0.98, 1.32), in overweight women. Conclusions We observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a proxy of job demands. These observational results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment. Increased support for such women should be investigated in intervention studies.

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Ultra-processed food intake and cardiovascular disease risk in the NutriNet-Santé prospective cohort

European Journal of Public Health ◽

10.1093/eurpub/ckz185.059 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

B Srour ◽

L K Fezeu ◽

E Kesse-Guyot ◽

B Allès ◽

E Chazelas ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Diseases ◽

Disease Risk ◽

Saturated Fatty Acids ◽

Cardiovascular Disease Risk ◽

Food Additives ◽

Cerebrovascular Diseases ◽

Sensitivity Analyses ◽

Processed Food ◽

Increased Risk

Abstract Objective To assess the prospective associations between consumption of ultra-processed foods (UPF) and the risk of cardiovascular diseases. Methods 105159 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009-2018) were included. Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items, and categorized according to their degree of processing by the NOVA classification. Associations between UPF intake and risk of cardiovascular, coronary heart, and cerebrovascular diseases assessed by multivariable Cox proportional hazard models, adjusted for known risk factors. Results UPF intake was associated with higher cardiovascular disease risk (n = 1409 cases; HR for an absolute increment of 10 in the percentage of UPF = 1.12(1.05-1.20); P = 0.0008), coronary heart disease risk (n = 665 cases; HR = 1.13(1.02-1.24); P = 0.02), and cerebrovascular disease risk (n = 829 cases; HR = 1.11(1.01-1.22); P = 0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (saturated fatty acids, sodium and sugar intakes, dietary fiber or a Healthy pattern derived by principal component analysis) and after a large range of sensitivity analyses. Conclusions In this large observational prospective study, higher consumption of UPF was associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. These results need to be confirmed in other populations and settings, and causality remains to be established. Key messages The consumption of ultra-processed food is associated with an increased risk of cardiovascular diseases. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.

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