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Session: Ultra-Processed Food Consumption and Health Outcomes (Poster Theater Flash Session 3)

(PTFS03-01-23) Association of Ultra-Processed Food Intake With All-Cause and Cause-Specific Mortality

Sunday, July 23, 2023

8:05 AM – 8:09 AM ET

Location: Fairfax

Presenting Author(s)

Zhe Fang, MBBS, MS (she/her/hers)

PhD candidate
Harvard T.H. Chan School of Public Health
Cambridge, Massachusetts, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

SR

Sinara Rossato

Universidade Federal de Uberlândia
DH

Dong Hang

School of Public Health, Gusu School, Nanjing Medical University, Nanjing, China
NK

Neha Khandpur

School of Public Health, University of São Paulo, São Paulo, Brazil
KW

Kai Wang, MD, PhD

Postdoctoral Fellow
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
CL

Chun-Han Lo

Kirk Kerkorian School of Medicine at University of Nevada
WW

Walter c. Willett, DrPH, MPH, MD

Professor
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
Edward L. Giovannucci, PhD

Professor of Nutrition and Epidemiology
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
MS

Mingyang Song

Harvard T.H. Chan School of Public Health

Disclosure(s):

Zhe Fang, MBBS, MS: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To examine the association of ultra-processed foods (UPF) with mortality.

Methods: Dietary intake was measured by food frequency questionnaires every four years among men (n=39 505) from the Health Professionals Follow-up Study (1986-2018) and women (n=74 564) from the Nurses’ Health Study (1984-2018) who had no previous diagnosis of cancer, cardiovascular diseases, or diabetes. Associations between energy-adjusted UPF categorized into deciles and all-cause mortality and mortality of cancer, cardiovascular disease, and other causes (including respiratory and neurodegenerative diseases), were examined by Cox proportional hazard models. To assess the individual and combined effects of food processing components and diet quality, we conducted a joint analysis between UPF and the Alternative Healthy Eating Index-2010.

Results: We documented 48181 deaths over 30 years of follow-up. Compared with those in the lowest decile of UPF intake, participants in the highest decile had an 8% higher risk of total deaths (multivariable-adjusted HR 1.08, 95%CI 1.04-1.13; P for trend=0.002) and 14% higher risk of other deaths (1.14, 1.08-1.21; P for trend < 0.0001). No associations were found for cancer or cardiovascular mortality. Among UPF subgroups, meat/poultry/seafood-based products showed the strongest association with higher all-cause mortality (HR comparing extreme deciles 1.19, 95%CI 1.14-1.24) and mortality of individual causes (HR ranged from 1.06-1.60). Higher intake of artificially- and sugar-sweetened beverages (1.13, 1.08-1.18), yogurt/dairy desserts (1.09, 1.04-1.13), and ultra-processed breakfast food (excluding whole grain bread) (1.08, 1.04-1.12) were also associated with all-cause mortality. There were significant interactions between the Alternative Healthy Eating Index and UPF for total mortality and mortality of cardiovascular and neurodegenerative diseases, with positive associations observed to be stronger in the high dietary quality group.

Conclusions: A higher intake of total UPF was associated with a modest increase in all-cause mortality. The associations varied across UPF subgroups, with meat/poultry/seafood-based products consistently associated with higher all-cause or cause-specific mortality.

Funding Sources: This study is supported by NIH grants U01 CA167552, UM1 CA186107 and P01 CA87969.