Cordova Reynalda, Viallon Vivian, Fontvieille Emma, Peruchet-Noray Laia, Jansana Anna, Wagner Karl-Heinz, Kyrø Cecilie, Tjønneland Anne, Katzke Verena, Bajracharya Rashmita, Schulze Matthias B, Masala Giovanna, Sieri Sabina, Panico Salvatore, Ricceri Fulvio, Tumino Rosario, Boer Jolanda M A, Verschuren W M Monique, van der Schouw Yvonne T, Jakszyn Paula, Redondo-Sánchez Daniel, Amiano Pilar, Huerta José María, Guevara Marcela, Borné Yan, Sonestedt Emily, Tsilidis Konstantinos K, Millett Christopher, Heath Alicia K, Aglago Elom K, Aune Dagfinn, Gunter Marc J, Ferrari Pietro, Huybrechts Inge, Freisling Heinz
International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
Lancet Reg Health Eur. 2023 Nov 14;35:100771. doi: 10.1016/j.lanepe.2023.100771. eCollection 2023 Dec.
It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes.
This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases.
After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.
Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.
Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
目前尚不清楚食用超加工食品（UPF）是否与更高的多病共患发生率相关。我们研究了UPF的总消费量和亚组消费量与多病共患风险之间的关系，多病共患定义为个体中至少两种慢性病同时存在，包括任何部位的原发性癌症、心血管疾病和2型糖尿病。
这是一项前瞻性队列研究，纳入了欧洲癌症与营养前瞻性调查（EPIC）研究中来自七个欧洲国家的266,666名参与者（60%为女性），这些参与者在招募时无癌症、心血管疾病和2型糖尿病。通过食物频率问卷在基线时评估过去12个月内食用的食物和饮料，并根据诺瓦分类法根据其加工程度进行分类。我们使用基于Cox回归的多状态模型来估计UPF的总量和亚组与癌症和心脏代谢疾病多病共患风险之间关联的病因特异性风险比（HR）及其95%置信区间（CI）。
经过中位11.2年的随访，4461名参与者（39%为女性）出现了癌症和心脏代谢疾病的多病共患情况。较高的UPF消费量（每增加1个标准差，不包括酒精饮料时约为260克/天）与癌症和心脏代谢疾病多病共患风险增加相关（HR：1.09，95%CI：1.05，1.12）。在UPF亚组中，基于动物的产品（HR：1.09，95%CI：1.05，1.12）以及人工加糖饮料（HR：1.09，95%CI：1.06，1.12）的关联最为显著。其他亚组，如超加工面包和谷物（HR：0.97，95%CI：0.94，1.00）或植物性替代品（HR：0.97，95%CI：0.91，1.02）与风险无关。
我们的研究结果表明，较高的UPF消费量会增加癌症和心脏代谢多病共患的风险。
奥地利科学院、法国基金会、英国癌症研究中心、国际世界癌症研究基金以及法国国家癌症研究所。
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