Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia.
Department of General Medicine, The Alfred Hospital, Alfred Health, Melbourne, VIC, Australia.
Eur J Nutr. 2024 Apr;63(3):713-725. doi: 10.1007/s00394-023-03297-4. Epub 2023 Dec 26.
Ultra-processed food (UPF) intake has increased in recent decades, yet limited knowledge of long-term effects on cardiovascular health persists and sex-specific data is scant. We determined the association of UPF intake with incident cardiovascular disease (CVD) and/or hypertension in a population-based cohort of women.
In the Australian Longitudinal Study on Women's Health, women aged 50-55 years were prospectively followed (2001-2016). UPFs were identified using NOVA classification and contribution of these foods to total dietary intake by weight was estimated. Primary endpoint was incident CVD (self-reported heart disease/stroke). Secondary endpoints were self-reported hypertension, all-cause mortality, type 2 diabetes mellitus, and/or obesity. Logistic regression models assessed associations between UPF intake and incident CVD, adjusting for socio-demographic, medical comorbidities, and dietary variables.
We included 10,006 women (mean age 52.5 ± 1.5; mean UPF intake 26.6 ± 10.2% of total dietary intake), with 1038 (10.8%) incident CVD, 471 (4.7%) deaths, and 4204 (43.8%) hypertension cases over 15 years of follow-up. In multivariable-adjusted models, the highest [mean 42.0% total dietary intake] versus the lowest [mean 14.2% total dietary intake] quintile of UPF intake was associated with higher incident hypertension [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.10-1.74; p = 0.005] with a linear trend (p = 0.02), but not incident CVD [OR 1.22, 95% CI 0.92-1.61; p = 0.16] or all-cause mortality (OR 0.80, 95% CI 0.54-1.20; p = 0.28). Similar results were found after multiple imputations for missing values.
In women, higher UPF intake was associated with increased hypertension, but not incident CVD. These findings may support minimising UPFs within a healthy diet for women.
超加工食品（UPF）的摄入量在近几十年来有所增加，但人们对其对心血管健康的长期影响知之甚少，且相关数据在性别方面十分匮乏。本研究旨在评估人群中 UPF 摄入量与心血管疾病（CVD）和/或高血压的发病风险之间的关系。
在澳大利亚女性健康纵向研究中，对 50-55 岁的女性进行前瞻性随访（2001-2016 年）。使用 NOVA 分类法对 UPF 进行识别，并根据重量估计这些食物在总膳食摄入量中的贡献。主要终点为新发 CVD（自述心脏病/中风）。次要终点包括自述高血压、全因死亡率、2 型糖尿病和/或肥胖。使用逻辑回归模型，在调整了社会人口统计学、合并症和饮食变量后，评估 UPF 摄入量与新发 CVD 之间的关联。
共纳入 10006 名女性（平均年龄 52.5±1.5 岁；平均 UPF 摄入量占总膳食摄入量的 26.6±10.2%）。随访 15 年后，有 1038 名（10.8%）发生 CVD，471 名（4.7%）死亡，4204 名（43.8%）发生高血压。在多变量调整模型中，最高（总膳食摄入量平均 42.0%）与最低（总膳食摄入量平均 14.2%）五分位组的 UPF 摄入量与更高的高血压发病风险相关（比值比 1.39，95%置信区间 1.10-1.74；p=0.005），且呈线性趋势（p=0.02），但与新发 CVD（比值比 1.22，95%置信区间 0.92-1.61；p=0.16）或全因死亡率（比值比 0.80，95%置信区间 0.54-1.20；p=0.28）无关。对于缺失值进行多次插补后也得到了相似的结果。
在女性中，较高的 UPF 摄入量与高血压的发生相关，但与新发 CVD 无关。这些发现可能支持女性在健康饮食中减少 UPF 的摄入。
