Wang Peilu, Chen Xiao, Na Muzi, Flores-Torres Mario H, Bjornevik Kjetil, Zhang Xuehong, Chen Xiqun, Khandpur Neha, Rossato Sinara Laurini, Zhang Fang Fang, Ascherio Alberto, Gao Xiang
Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, State College.
Neurology. 2025 Jun 10;104(11):e213562. doi: 10.1212/WNL.0000000000213562. Epub 2025 May 7.
Consumption of ultraprocessed foods (UPFs) has been associated with a higher risk of various chronic diseases, but its relation to prodromal Parkinson disease (PD) remains unclear. We aimed to assess the association between long-term UPF consumption and nonmotor features suggestive of prodromal PD.
This longitudinal analysis included participants without a history of PD from the Nurses' Health Study and Health Professionals Follow-Up Study. UPF consumption was assessed using repeated food frequency questionnaires (1984-2006) and grouped based on Nova classification. Participants provided data on probable REM sleep behavior disorder (pRBD) and constipation in 2012. Between 2014 and 2015, a subset of participants provided data on 5 additional nonmotor features, including hyposmia, impaired color vision, excessive daytime sleepiness, body pain, and depressive symptoms. The primary outcome was the combination of all 7 prodromal features and further categorized as 0 (reference), 1, 2, and ≥3 features. The secondary outcomes were all features except constipation, a combination of 3 commonly recognized features (constipation, pRBD, and hyposmia), and individual features. Multinomial logistic regression was used to estimate the association of UPF consumption with the combination of prodromal features. The association between UPF consumption and each individual feature was further examined using logistic regression.
The study analyzed 42,853 participants (25,095 women [58.6%]; mean [SD] age, 47.8 [5.2] years). Comparing extreme quintiles of UPF consumption, the multivariable-adjusted odds ratio (OR) for having ≥3 vs 0 prodromal features was 2.47 (95% CI 1.89-3.23, < 0.0001) for cumulative average intake and 1.50 (95% CI 1.18-1.89, = 0.0009) for baseline intake. Similar results were observed for combinations of all features except constipation (OR 2.00, 95% CI 1.29-3.11, < 0.0001) and combinations of 3 features (OR 2.47, 95% CI 1.41-4.34, = 0.008). In addition, higher UPF consumption was associated with increased odds of individual prodromal features, including pRBD, constipation, body pain, and depressive symptoms.
Long-term UPF consumption was positively associated with nonmotor prodromal PD features. More studies are warranted to confirm whether lowering UPF consumption may prevent the occurrence of nonmotor symptoms that often precede PD diagnosis.
超加工食品（UPF）的消费与多种慢性疾病的较高风险相关，但其与前驱帕金森病（PD）的关系仍不明确。我们旨在评估长期UPF消费与提示前驱PD的非运动特征之间的关联。
这项纵向分析纳入了护士健康研究和卫生专业人员随访研究中无PD病史的参与者。使用重复食物频率问卷（1984 - 2006年）评估UPF消费情况，并根据诺瓦分类法进行分组。参与者在2012年提供了关于可能的快速眼动睡眠行为障碍（pRBD）和便秘的数据。在2014年至2015年期间，一部分参与者提供了另外5种非运动特征的数据，包括嗅觉减退、色觉受损、日间过度嗜睡、身体疼痛和抑郁症状。主要结局是所有7种前驱特征的组合，并进一步分类为0（参照）、1、2和≥3种特征。次要结局是除便秘外的所有特征、3种常见特征（便秘、pRBD和嗅觉减退）的组合以及各个特征。使用多项逻辑回归来估计UPF消费与前驱特征组合之间的关联。使用逻辑回归进一步检验UPF消费与每个个体特征之间的关联。
该研究分析了42,853名参与者（2,5095名女性[58.6%]；平均[标准差]年龄为47.8[5.2]岁）。比较UPF消费的极端五分位数，累积平均摄入量时，具有≥3种与0种前驱特征的多变量调整优势比（OR）为2.47（95%CI 1.89 - 3.23，P < 0.0001），基线摄入量时为1.50（95%CI 1.18 - 1.89，P = 0.0009）。除便秘外的所有特征组合（OR 2.00，95%CI 1.29 - 3.11，P < 0.0001）和3种特征组合（OR 2.47，95%CI 1.41 - 4.34，P = 0.008）也观察到类似结果。此外，较高的UPF消费与个体前驱特征的几率增加相关，包括pRBD、便秘、身体疼痛和抑郁症状。
长期UPF消费与前驱PD的非运动特征呈正相关。需要更多研究来证实降低UPF消费是否可以预防PD诊断前经常出现的非运动症状的发生。
