Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort...

Ultra-processed food (UPF) consumption has been linked to adverse health effects, yet findings from prospective cohort studies on mortality remain inconsistent.

This study included 82,221 participants from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. At baseline (1993-2001), dietary intake was assessed using the Baseline Questionnaire (BQ) and validated Dietary History Questionnaire (DHQ). UPF intake was defined according to the NOVA classification system. Daily food intake (g/day) was estimated from reported frequency and portion size, and energy and nutrient intakes were computed using the DietCalc analysis program. Mortality outcomes, including all-cause, cancer, circulatory system diseases, nervous system diseases, and other causes, were ascertained. Multivariable Cox models were used to estimate the associations between UPF intake and all-cause and cause-specific mortality.

During a median 17-year follow-up, 24,237 deaths occurred. No association was found between UPF intake and cancer mortality. Despite this, the highest UPF intake quarter, relative to the lowest, was associated with a 10% higher risk of all-cause mortality (HR: 1.10, 95% CI: 1.06-1.14), a 9% higher risk of circulatory system diseases mortality (HR: 1.09, 95% CI: 1.02-1.17), a 20% higher risk of nervous system diseases mortality (HR: 1.20, 95% CI: 1.06-1.37), and a 28% higher risk of mortality from other causes (HR: 1.28, 95% CI: 1.18-1.39). In the joint analysis of UPF intake and diet quality assessed by the Healthy Eating Index-2015 (HEI-2015), no consistent association was observed between UPF intake and mortality within most HEI-2015 quarters. However, among individuals in the highest quarter of UPF intake, those with the highest HEI-2015 scores had a significantly lower mortality risk than those with the lowest HEI-2015 scores, suggesting that higher diet quality may attenuate the adverse effect of high UPF consumption.

Our study showed that a higher consumption of UPF was linked to increased mortality in all-cause, as well as in circulatory system diseases, nervous system diseases and other causes diseases.