TY - JOUR
T1 - Associations between degree of food processing and all-cause and cause-specific mortality
T2 - a multicentre prospective cohort analysis in 9 European countries
AU - González-Gil, Esther M.
AU - Matta, Michèle
AU - Morales Berstein, Fernanda
AU - Cairat, Manon
AU - Nicolas, Geneviève
AU - Blanco, Jessica
AU - Kliemann, Nathalie
AU - Bertazzi Levy, Renata
AU - Rauber, Fernanda
AU - Jacobs, Inarie
AU - Al Nahas, Aline
AU - Cakmak, Emine Koc
AU - Vamos, Eszter P.
AU - Chang, Kiara
AU - Yammine, Sahar G.
AU - Millett, Christopher
AU - Touvier, Mathilde
AU - Matias Pinho, Maria Gabriela
AU - Tsilidis, Konstantinos K.
AU - Heath, Alicia K.
AU - Lill, Christina M.
AU - Pala, Valeria
AU - Moreno-Iribas, Conchi
AU - De Magistris, Maria Santucci
AU - Dahm, Christina C.
AU - Bock, Niels
AU - Olsen, Anja
AU - Tjønneland, Anne
AU - van der Schouw, Yvonne T.
AU - Amiano, Pilar
AU - Jannasch, Franziska
AU - Schulze, Matthias B.
AU - Romana Mancini, Francesca
AU - Marques, Chloé
AU - Cadeau, Claire
AU - Bonet, Catalina
AU - Redondo-Sánchez, Daniel
AU - Borch, Kristin Benjaminsen
AU - Brustad, Magritt
AU - Skeie, Guri
AU - Humberto-Gómez, Jesús
AU - Macciotta, Alessandra
AU - Ferrari, Pietro
AU - Dossus, Laure
AU - Gunter, Marc J.
AU - Huybrechts, Inge
N1 - Publisher Copyright:
© 2024
PY - 2025/3
Y1 - 2025/3
N2 - Background: Ultra-processed food (UPF) consumption has been linked with higher risk of mortality. This multi-centre study investigated associations between food intake by degree of processing, using the Nova classification, and all-cause and cause-specific mortality. Methods: This study analyzed data from the European Prospective Investigation into Cancer and Nutrition. All-cause mortality and cause-specific mortality due to cancer, circulatory diseases, digestive diseases, Parkinson's disease, and Alzheimer's disease served as endpoints. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models. Substitution analyses were also performed. Findings: Overall, 428,728 (71.7% female) participants were included in the analysis and 40,016 deaths were documented after 15.9 years of follow-up. UPFs (in percentage grams per day [g/d]) were positively associated with all-cause mortality (HRs per 1-SD: 1.04; 95% CI: 1.02,1.05), as well as mortality from circulatory diseases (1.09; 95% CI: 1.07,1.12), cerebrovascular disease (1.11; 95% CI: 1.05,1.17), ischemic heart disease (1.10; 95% CI: 1.06,1.15), digestive diseases (1.12; 95% CI: 1.05,1.20), and Parkinson's disease (1.23; 95% CI: 1.06,1.42). No associations were found between UPFs and mortality from cancer or Alzheimer's disease. Replacing processed and UPFs with unprocessed/minimally processed foods was associated with lower mortality risk. Interpretation: In this pan-European analysis, higher UPF consumption was associated with greater mortality from circulatory diseases, digestive diseases, and Parkinson's disease. The results support growing evidence that higher consumption of UPFs and lower consumption of unprocessed foods may have a negative impact on health. Funding:l'Institut National du Cancer, and World Cancer Research Fund International.
AB - Background: Ultra-processed food (UPF) consumption has been linked with higher risk of mortality. This multi-centre study investigated associations between food intake by degree of processing, using the Nova classification, and all-cause and cause-specific mortality. Methods: This study analyzed data from the European Prospective Investigation into Cancer and Nutrition. All-cause mortality and cause-specific mortality due to cancer, circulatory diseases, digestive diseases, Parkinson's disease, and Alzheimer's disease served as endpoints. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models. Substitution analyses were also performed. Findings: Overall, 428,728 (71.7% female) participants were included in the analysis and 40,016 deaths were documented after 15.9 years of follow-up. UPFs (in percentage grams per day [g/d]) were positively associated with all-cause mortality (HRs per 1-SD: 1.04; 95% CI: 1.02,1.05), as well as mortality from circulatory diseases (1.09; 95% CI: 1.07,1.12), cerebrovascular disease (1.11; 95% CI: 1.05,1.17), ischemic heart disease (1.10; 95% CI: 1.06,1.15), digestive diseases (1.12; 95% CI: 1.05,1.20), and Parkinson's disease (1.23; 95% CI: 1.06,1.42). No associations were found between UPFs and mortality from cancer or Alzheimer's disease. Replacing processed and UPFs with unprocessed/minimally processed foods was associated with lower mortality risk. Interpretation: In this pan-European analysis, higher UPF consumption was associated with greater mortality from circulatory diseases, digestive diseases, and Parkinson's disease. The results support growing evidence that higher consumption of UPFs and lower consumption of unprocessed foods may have a negative impact on health. Funding:l'Institut National du Cancer, and World Cancer Research Fund International.
KW - EPIC study
KW - Mortality
KW - Nova classification
KW - Ultra-processed foods
KW - Unprocessed/minimally processed foods
UR - http://www.scopus.com/inward/record.url?scp=85214285906&partnerID=8YFLogxK
U2 - 10.1016/j.lanepe.2024.101208
DO - 10.1016/j.lanepe.2024.101208
M3 - Article
AN - SCOPUS:85214285906
SN - 2666-7762
VL - 50
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
M1 - 101208
ER -