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Association of ultra-processed food consumption with incident myeloid neoplasms: population-based cohort study
Xinghao Yu1, Zhihua Liu1, Yi Jin2
1National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, Jiangsu, China.
Background:
Higher ultra-processed food (UPF) consumption has been linked to chronic disease, but prospective evidence for incident myeloid neoplasms remains limited.
Objective:
To examine ultra-processed food consumption, quantified as UPF energy percentage, in relation to incident myeloid neoplasms.
Methods:
We analyzed 204,494 UK Biobank participants without prevalent hospital-recorded myeloid neoplasms. UPF energy percentage was averaged across valid Oxford WebQ dietary assessments, and follow-up began at each participant's final valid assessment. The primary outcome was ascertained from hospital inpatient records. Cause-specific Cox models adjusted for demographic, behavioral, socioeconomic, dietary, physical-activity, and anthropometric factors. Secondary analyses examined myeloid-neoplasm subtypes, alternative UPF metrics, baseline CHIP status, and circulating molecular signatures.
Results:
During a median 10.5 years of follow-up, 848 participants developed an incident hospital-recorded myeloid neoplasm. Each 1-SD higher UPF energy percentage was associated with a higher hazard of myeloid neoplasms (HR, 1.12; 95% CI (1.05, 1.21); P = 0.001). MPN showed the clearest subtype association (HR, 1.15; 95% CI (1.04, 1.27); P = 0.006; FDR-adjusted P = 0.019). The association was also observed using UPF weight percentage. Among participants without detectable CHIP at baseline, the corresponding HR was 1.10 (95% CI (1.01, 1.20); P = 0.032), with no evidence of interaction by baseline CHIP status (P for interaction = 0.528). Exploratory molecular analyses identified lipid-related, inflammatory, hematologic, and immune/myeloid correlates, with several UPF-molecular associations showing cross-cohort consistency in external datasets.
Conclusions:
Higher UPF consumption was prospectively associated with a higher hazard of hospital-recorded incident myeloid neoplasms, with MPN showing the clearest major subtype association. The association was also observed among participants without detectable CHIP at baseline. Molecular and cross-cohort findings provide complementary biological context but do not establish a causal pathway.