Higher consumption of most ultra-processed foods is linked to a slightly higher risk of death, with ready-to-eat meat, poultry, and seafood based products, sugary drinks, dairy based desserts, and highly processed breakfast foods showing the strongest associations, finds a 30-year US study in The BMJ today.
The researchers say not all ultra-processed food products should be universally restricted, but that their findings “provide support for limiting consumption of certain types of ultra-processed food for long term health.”
Ultra-processed foods include packaged baked goods and snacks, fizzy drinks, sugary cereals, and ready-to-eat or heat products. They often contain colours, emulsifiers, flavours, and other additives and are typically high in energy, added sugar, saturated fat, and salt, but lack vitamins and fibre.
Mounting evidence links ultra-processed foods to higher risks of obesity, heart disease, diabetes and bowel cancer, but few long term studies have examined links to all cause and cause specific deaths, especially due to cancer.
To address this knowledge gap, researchers tracked the long-term health of 74,563 female registered nurses from 11 US states in the Nurses’ Health Study (1984-2018) and 39,501 male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018) with no history of cancer, cardiovascular diseases, or diabetes at study enrolment.
Every two years participants provided information on their health and lifestyle habits, and every four years they completed a detailed food questionnaire. Overall dietary quality was also assessed using the Alternative Healthy Eating Index-2010 (AHEI) score.
During an average 34-year follow-up period, the researchers identified 48,193 deaths, including 13,557 deaths due to cancer, 11,416 deaths due to cardiovascular diseases, 3926 deaths due to respiratory diseases, and 6343 deaths due to neurodegenerative diseases.
Compared with participants in the lowest quarter of ultra-processed food intake (average 3 servings per day), those in the highest quarter (average 7 servings per day) had a 4% higher risk of total deaths and a 9% higher risk of other deaths, including an 8% higher risk of neurodegenerative deaths.
No associations were found for deaths due to cardiovascular diseases, cancer, or respiratory diseases.
In absolute numbers, the rate of death from any cause among participants in the lowest and highest quarter of ultra-processed food intake was 1472 and 1536 per 100,000 person years, respectively.
The association between ultra-processed food intake and death varied across specific food groups, with meat, poultry, and seafood based ready-to-eat products showing the strongest and most consistent associations, followed by sugar sweetened and artificially sweetened beverages, dairy based desserts, and ultra-processed breakfast food.
And the association was less pronounced after overall dietary quality was taken into account, suggesting that dietary quality has a stronger influence on long term health than ultra-processed food consumption, note the authors.
This is an observational study, so no firm conclusions can be drawn about cause and effect, and the authors point out that the ultra-processed food classification system does not capture the full complexity of food processing, leading to potential misclassification. In addition, participants were health professionals and predominantly white, limiting the generalizability of the findings.
https://dx.doi.org/10.1136/bmj-2023-078476
