Feinberg Alyssa, Rebholz Casey M, Lemaitre Rozenn N, Fretts Amanda M, Wiggins Kerri, Sotoodehnia Nona, Psaty Bruce M, Kim Hyunju
Department of Epidemiology, University of Washington School of Public Health, Seattle, WA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
Am J Clin Nutr. 2025 Aug;122(2):523-534. doi: 10.1016/j.ajcnut.2025.05.033. Epub 2025 Jun 2.
Ultra-processed food (UPF) consumption is associated with adverse health outcomes. Plant- and animal-sourced UPFs have a unique nutritional composition to improve palatability, which may impact health, but evidence is limited.
The objective of this study was to investigate the association between UPF intake, plant- and animal-sourced UPF, and mortality outcomes in older adults.
We conducted prospective analyses of 2582 participants (median age: 77 y) in the Cardiovascular Health Study who completed a food frequency questionnaire (FFQ) in 1995-1996. We used responses from the FFQ to identify UPF and classify UPF based on their source (plant or animal). Cox proportional hazard regression models were used to study the association between UPF, plant- and animal-sourced UPF, and mortality outcomes (all-cause, cardiovascular disease [CVD] related, non-CVD related, and cancer).
Over a median follow-up of 10 y, there were 2242 deaths. After adjusting for sociodemographic characteristics and health behaviors, per standard deviation (SD) higher intake of UPF was associated with 8%-10% higher risk of all-cause mortality (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.02, 1.14), non-CVD related mortality (HR: 1.10; 95% CI: 1.03, 1.18), and cancer mortality (HR: 1.13; 95% CI: 1.08, 1.46). Similarly, per SD, higher intake of plant- and animal-sourced UPFs was associated with a 4%-17% higher risk of all-cause mortality, non-CVD related mortality, and cancer mortality. However, in a model additionally adjusting for clinical factors, the associations between plant-sourced UPF and mortality attenuated, except for cancer mortality. No significant associations were observed for CVD related mortality.
Higher consumption of UPF and plant- and animal-sourced UPFs was associated with higher risk of all-cause, non-CVD related, and cancer mortality. Our findings emphasize the need to consider the impact of food processing, even in plant-sourced foods, to prevent a shorter lifespan in older adults. Findings on plant-sourced UPF and mortality require replication.
超加工食品（UPF）的摄入与不良健康后果相关。植物源和动物源的超加工食品具有独特的营养成分以提高适口性，这可能会影响健康，但证据有限。
本研究的目的是调查老年人中超加工食品摄入量、植物源和动物源超加工食品与死亡结局之间的关联。
我们对心血管健康研究中2582名参与者（中位年龄：77岁）进行了前瞻性分析，这些参与者在1995 - 1996年完成了食物频率问卷（FFQ）。我们利用FFQ的回答来识别超加工食品，并根据其来源（植物或动物）对超加工食品进行分类。使用Cox比例风险回归模型来研究超加工食品、植物源和动物源超加工食品与死亡结局（全因、心血管疾病[CVD]相关、非CVD相关和癌症）之间的关联。
在中位随访10年期间，有2242人死亡。在调整了社会人口学特征和健康行为后，超加工食品摄入量每增加一个标准差（SD），全因死亡率风险升高8% - 10%（风险比[HR]：1.08；95%置信区间[CI]：1.02，1.14），非CVD相关死亡率（HR：1.10；95% CI：1.03，1.18）和癌症死亡率（HR：1.13；95% CI：1.08，1.46）。同样，每增加一个标准差，植物源和动物源超加工食品摄入量较高与全因死亡率、非CVD相关死亡率和癌症死亡率风险升高4% - 17%相关。然而，在一个额外调整了临床因素的模型中，植物源超加工食品与死亡率之间的关联减弱，但癌症死亡率除外。未观察到与CVD相关死亡率有显著关联。
超加工食品以及植物源和动物源超加工食品的较高消费量与全因、非CVD相关和癌症死亡率的较高风险相关。我们的研究结果强调，即使对于植物源食品，也需要考虑食品加工的影响，以防止老年人寿命缩短。关于植物源超加工食品与死亡率的研究结果需要重复验证。
