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Topical Area: Diet and Cancer

Diet and Cancer (Poster Session)

(P13-030-23) Ultra-Processed Food Consumption, Adiposity and Upper-Aerodigestive Tract Cancer Risk in the European Prospective Investigation Into Cancer Study: A Mediation Analysis

Sunday, July 23, 2023
12:45 PM – 1:45 PM ET
Location: Poster Board 255
ELPC GSRA
Disclosure(s):
Fernanda Morales Berstein, FMB: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: To investigate the mediating role of body mass index (BMI) and waist-to-hip ratio (WHR) in the associations between the consumption of ultra-processed foods and the risk of head and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer (EPIC) study.

Methods: The EPIC cohort recruited 521,323 adult participants across 10 European countries between 1992 and 1998. Food frequency questionnaires were used to obtain dietary data at baseline and the NOVA classification was used to identify ultra-processed foods in the diet. Our study included 450,111 participants. We used Cox proportional hazards models to investigate the associations between the consumption of ultra-processed foods and the risk of HNC and OAC. Models were stratified by age at recruitment, sex, and centre, and adjusted for education, physical activity, height, smoking status, and alcohol intake. We also performed a mediation analysis to assess the mediating role of BMI and WHR in these associations. The results were scaled to represent a 10% g/d higher proportion of ultra-processed foods in the diet.

Results: During a mean follow-up of 14.13±3.98 years, 850 incident cases of HNC and 215 of OAC were documented. A 10% g/d higher consumption of ultra-processed foods was associated with an increased risk of HNC (HR=1.25, 95%CI 1.15–1.36) and OAC (HR=1.24, 95%CI 1.05–1.47). WHR accounted for 5% (95%CI 2–10%) of the association between the consumption of ultra-processed foods and HNC risk, while BMI and WHR respectively accounted for 13% (95%CI 6–65%) and 15% (95%CI 8–68%) of the association between the consumption of ultra-processed foods and OAC risk.

Conclusions: Our findings suggest that BMI and WHR explain little of the associations between ultra-processed food consumption and the risk of HNC and OAC. Hence, further research is required to investigate whether other mechanisms, such as food additives and contaminants, are at play.

Funding Sources: Wellcome Trust