Ultra-processed Foods and Gastrointestinal Cancer: Epidemiologic Evidence, Mechanistic Pathways, and Clinical...

Area of Science:

• Nutrition Science
• Gastroenterology
• Oncology

Background:

• Ultra-processed foods (UPFs) constitute a significant portion of diets in high-income nations.
• Growing evidence links UPF consumption to gastrointestinal (GI) malignancies, independent of nutritional content.
• The NOVA classification defines UPFs as industrial formulations rich in refined ingredients and additives.

Purpose of the Study:

• To review the association between UPF intake and major GI cancers: colorectal, gastric, esophageal, and pancreatic.
• To explore potential biological mechanisms linking UPFs to carcinogenesis.
• To assess the potential of UPF reduction as a GI cancer prevention strategy.

Main Methods:

• Systematic review of epidemiologic studies on UPF consumption and GI cancer incidence.
• Integration of mechanistic data supporting biological plausibility.
• Analysis of dose-response relationships and consistency of findings.

Main Results:

• A consistent association between high UPF intake and increased colorectal cancer risk (10-30%).
• Emerging evidence suggests links to non-cardia gastric cancer and esophageal adenocarcinoma, though data are limited.
• Inconclusive findings for pancreatic cancer; mechanistic data point to pathways like altered gut microbiome, inflammation, and effects of specific additives.

Conclusions:

• UPF consumption is associated with increased risk of several GI cancers, most notably colorectal cancer.
• Mechanisms include disruption of food matrix, altered gut microbiome, impaired barrier function, and chronic inflammation.
• Reducing UPF intake may offer a promising approach for GI cancer prevention.