Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australian Health and Medical Research Institute, Level 7, SAHMRI North Terrace, Adelaide, SA, 5000, Australia.
School of Public Health, College of Medicine and Health Science, Wollo University, 1145, Dessie, Ethiopia.
Eur J Nutr. 2024 Jun;63(4):1357-1372. doi: 10.1007/s00394-024-03356-4. Epub 2024 Feb 28.
The purpose of the study was to determine the relationships between ultra-processed food (UPF) consumption and risk of mortality due to chronic respiratory diseases (CRDs) overall, chronic obstructive pulmonary disease (COPD), and lung cancer.
A total of 96,607 participants aged 55 years and over were included from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer trial. Dietary intake was measured using food frequency questionnaire. Cox regression was fitted to estimate the risk of all-cause mortality and mortality due to CRDs overall, COPD and lung cancer associated with UPF intake. Competing risk regression was used to account for deaths from other causes and censoring.
During the follow-up of 1,379,655.5 person-years (median 16.8 years), 28,700 all-cause, 4092 CRDs, 2015 lung cancer and 1,536 COPD mortality occurred. A higher intake of UPF increased the risk of mortality from CRDs overall by 10% (HR 1.10; 95% CI 1.01, 1.22) and COPD by 26% (HR 1.26; 95% CI 1.06, 1.49) but not associated with lung cancer mortality risk (HR 0.97; 95% CI 0.84, 1.12). However, the risk of lung cancer increased by 16% (HR 1.16; 95% CI 1.01, 1.34) in the highest UPF intake after multiple imputation. Dose-response relationships existed for CRDs and COPD mortality but not lung cancer.
UPF consumption was associated with an increased risk of CRD mortality. The association between UPF consumption and lung cancer mortality is inconclusive and only significant when multiple imputation was applied.
本研究旨在确定超加工食品（UPF）的摄入与慢性呼吸道疾病（CRD）总死亡率、慢性阻塞性肺疾病（COPD）和肺癌死亡率之间的关系。
共纳入来自前列腺癌、肺癌、结直肠癌和卵巢癌（PLCO）癌症试验的 96607 名年龄在 55 岁及以上的参与者。饮食摄入量通过食物频率问卷进行测量。采用 Cox 回归估计 UPF 摄入与全因死亡率以及与 CRD 总死亡率、COPD 和肺癌相关的死亡率之间的风险。竞争风险回归用于考虑其他原因导致的死亡和删失。
在 1379655.5 人年（中位数 16.8 年）的随访期间，发生了 28700 例全因死亡、4092 例 CRD 死亡、2015 例肺癌死亡和 1536 例 COPD 死亡。较高的 UPF 摄入使 CRD 总死亡率增加 10%（HR 1.10；95%CI 1.01，1.22）和 COPD 死亡率增加 26%（HR 1.26；95%CI 1.06，1.49），但与肺癌死亡率无关（HR 0.97；95%CI 0.84，1.12）。然而，在多次插补后，最高 UPF 摄入量与肺癌死亡风险增加 16%（HR 1.16；95%CI 1.01，1.34）相关。CRD 和 COPD 死亡率与剂量反应关系存在，但肺癌无此关系。
UPF 摄入与 CRD 死亡率增加有关。UPF 摄入与肺癌死亡率之间的关联尚无定论，仅在应用多次插补时才具有统计学意义。
