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Ultra-processed Food and Mortality among Long-Term Cancer Survivors from the Moli-sani Study: Prospective Findings
Marialaura Bonaccio1, Augusto Di Castelnuovo1, Simona Costanzo1,2
1Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy.
Background:
Ultra-processed food (UPF) intake may influence outcomes in long-term cancer survivors. This study examined the relationship between postdiagnostic UPF consumption and mortality and assessed whether chronic disease biomarkers explain this association.
Methods:
We longitudinally analyzed 802 men and women with a previous cancer diagnosis (any site) recruited in the Moli-sani Study (2005-2010). Food intake data were collected at baseline and assessed an average of 8.4 years after diagnosis. UPF was defined according to the Nova classification and calculated as a weight ratio. The Mediterranean diet score (MDS) was used to assess overall diet quality. Inflammatory, metabolic, and cardiovascular biomarkers were analyzed as potential explanatory factors on the basis of change-in-estimate.
Results:
During a median follow-up of 14.6 years, a total of 281 deaths occurred. Multivariable (including the MDS)-adjusted HRs of higher UPF consumption for all-cause and cancer mortality were 1.48 [95% confidence interval (CI), 1.07-2.03 for highest vs. lowest third] and 1.57 (95% CI, 1-2.47), respectively. Taken together, inflammation markers and resting heart rate levels attenuated the associations of UPF with all-cause mortality by approximately 40%.
Conclusion:
Higher consumption of UPFs after cancer diagnosis was associated with increased all-cause and cancer mortality rates, irrespective of diet quality. Part of these associations was explained by elevated levels of inflammation markers and resting heart rate.
Impact:
These findings contribute to the growing body of evidence linking UPFs to adverse health outcomes in cancer survivors. Further research is needed to identify specific mechanisms underlying this relationship and explore potential dietary interventions for improving long-term survival.
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