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Meine GC, Picon RV, Espírito Santo PA, Sander GB. Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2024; 119:1056-1065. [PMID: 38832708 DOI: 10.14309/ajg.0000000000002826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 04/14/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model. RESULTS Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer. DISCUSSION The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.
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Affiliation(s)
- Gilmara Coelho Meine
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Gastroenterology, Department of Internal Medicine, Universidade Feevale, Novo Hamburgo, Brazil
| | - Rafael Veiga Picon
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Guilherme Becker Sander
- Program of Graduate Science in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Xiang P, Yan W, Liu D, Ping H. The relationship between ultra-processed foods consumption and urological cancers risk. Clin Nutr 2024; 43:1655-1657. [PMID: 38302381 DOI: 10.1016/j.clnu.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Peng Xiang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Wei Yan
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Dan Liu
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hao Ping
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
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Al Shareef Z, Al-Shahrabi R, Saheb Sharif-Askari F, AlDhmanie A, Alshamsi Y, Zarooni AA, Mahmoud RA, Soliman SSM, Halwani R, Bendardaf R. Incidence and risk factors of prostate cancer among the Northern and Eastern parts of the United Arab Emirates population. Prostate 2024; 84:185-192. [PMID: 37969038 DOI: 10.1002/pros.24637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/22/2023] [Accepted: 09/25/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Prostate cancer (PCa) is a prevalent disease worldwide. However, the incidence and patient-specific risk factors of PCa in the Middle East, specifically in the United Arab Emirates, have not been previously reported. METHODS We conducted a retrospective cohort study on 2377 men diagnosed with either benign prostatic hyperplasia (BPH) or PCa in the Northern and Eastern regions of the United Arab Emirates, excluding the Western part, which includes Abu Dhabi. The study spanned from January 2012 and December 2021. To calculate the PCa incidence rate, we utilized the world age-standardized incidence rates (W-ASIR) categorized by age groups. Patient-specific risk factors of PCa were identified through a multivariate logistic regression analysis of clinical data. RESULTS A total of 247 cases of PCa and 2130 cases of BPH were included in the study. In our cohort, the W-ASIR for PCa was 21.3 per 100,000 men. The incidence of PCa showed an increasing trend with age, with the highest incidence observed among men aged 70 years and older. Accordingly, multivariate analysis revealed that age over 70 was associated with an increased risk of PCa (OR: 2.546, 95% confidence interval [CI]: 1.892-3.425, p < 0.01). On the other hand, preexisting conditions such as hypertension and diabetes mellitus were found to lower the risk of PCa (OR: 0.222, 95% CI: 0.163-0.302, p < 0.001) and (OR: 0.364, 95% CI: 0.205-0.648, p < 0.001), respectively. Additionally, metformin intake was associated with a reduced risk of PCa (OR: 0.385, 95% CI: 0.190-0.782, p = 0.008); while insulin usage increased the risk of PCa (OR: 2.586, 95% CI: 1.539-4.344, p < 0.001). Anti-BPH medications such as phosphodiesterase inhibitors (OR: 0.223, 95% CI: 0.069-0.723, p = 0.012) or 5-α reductase (OR: 0.206, 95% CI: 0.110-0.389, p < 0.000), were found to lower the risk of PCa. CONCLUSION The findings underscore the high incidence of PCa in the United Arab Emirates, with age being a significant factor. Furthermore, the study highlights the influence of certain comorbidities and medications on the risk of developing PCa within the United Arab Emirates population.
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Affiliation(s)
- Zainab Al Shareef
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rula Al-Shahrabi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatemeh Saheb Sharif-Askari
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Amna AlDhmanie
- Data & Statistics Department, Emirates Health Services, Dubai, United Arab Emirates
| | | | | | - Rabah Al Mahmoud
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sameh S M Soliman
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Medicinal Chemistry, College of Pharmacy, Sharjah, United Arab Emirates
| | - Rabih Halwani
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Riyad Bendardaf
- Oncology Unit, University Hospital Sharjah, Sharjah, United Arab Emirates
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Sciacca S, Lo Giudice A, Asmundo MG, Cimino S, Alshatwi AA, Morgia G, Ferro M, Russo GI. Prostate Cancer Severity in Relation to Level of Food Processing. Nutrients 2023; 15:4010. [PMID: 37764793 PMCID: PMC10537278 DOI: 10.3390/nu15184010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The level of food processing has gained interest as a potential determinant of human health. The aim of this study was to assess the relationship between the level of food processing and prostate cancer severity. METHODS A sample of 120 consecutive patients were examined for the following: their dietary habits, assessed through validated food frequency questionnaires; their dietary intake of food groups, categorized according to the NOVA classification; and their severity of prostate cancer, categorized into risk groups according to European Association of Urology (EAU) guidelines. Uni- and multivariate logistic regression analyses were performed to test the association between the variables of interest. RESULTS Individuals reporting a higher consumption of unprocessed/minimally processed foods were less likely to have greater prostate cancer severity than those who consumed less of them in the energy-adjusted model (odds ratio (OR) = 0.38, 95% confidence interval (CI): 1.17-0.84, p = 0.017 and OR = 0.33, 95% CI: 0.12-0.91, p = 0.032 for medium/high vs. low grade and high vs. medium/low grade prostate cancers, respectively); however, after adjusting for potential confounding factors, the association was not significant anymore. A borderline association was also found between a higher consumption of ultra-processed foods and greater prostate cancer severity in the energy-adjusted model (OR = 2.11, 95% CI: 0.998-4.44; p = 0.051), but again the association was not significant anymore after adjusting for the other covariates. CONCLUSIONS The level of food processing seems not to be independently associated with prostate cancer severity, while potentially related to other factors that need further investigation.
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Affiliation(s)
- Salvatore Sciacca
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy; (S.S.); (G.M.)
| | - Arturo Lo Giudice
- Department of Surgery, Urology Section, University of Catania, 95125 Catania, Italy; (A.L.G.); (M.G.A.); (S.C.)
| | - Maria Giovanna Asmundo
- Department of Surgery, Urology Section, University of Catania, 95125 Catania, Italy; (A.L.G.); (M.G.A.); (S.C.)
| | - Sebastiano Cimino
- Department of Surgery, Urology Section, University of Catania, 95125 Catania, Italy; (A.L.G.); (M.G.A.); (S.C.)
| | - Ali A. Alshatwi
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Giuseppe Morgia
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy; (S.S.); (G.M.)
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Giorgio Ivan Russo
- Department of Surgery, Urology Section, University of Catania, 95125 Catania, Italy; (A.L.G.); (M.G.A.); (S.C.)
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Friedrich NA, Freedland SJ, Csizmadi I. Plant-based diets to reduce prostate cancer risk and improve prostate cancer outcomes-ready for prime time? Prostate Cancer Prostatic Dis 2023; 26:445-446. [PMID: 36261588 PMCID: PMC10174216 DOI: 10.1038/s41391-022-00601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Nadine A Friedrich
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, 8631 W 3rd Street, Suite E430, Los Angeles, CA, 90048, USA.
| | - Stephen J Freedland
- Division of Urology, Department of Surgery, Cedars- Sinai Medical Center, Section of Urology, Durham VA Medical Center, 8631 W 3rd Street, Suite E430, Los Angeles, CA, 90048, USA
| | - Ilona Csizmadi
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, 8631 W 3rd Street, Suite E430, Los Angeles, CA, 90048, USA
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Lian Y, Wang GP, Chen GQ, Chen HN, Zhang GY. Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis. Front Nutr 2023; 10:1175994. [PMID: 37360305 PMCID: PMC10285062 DOI: 10.3389/fnut.2023.1175994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Despite increasing evidence that has shown the association of ultra-processed foods (UPFs) with cancer risk, the results remain inconclusive. We, therefore, conducted the meta-analysis to clarify the association by including recently published studies. Methods A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies from inception to January 2023. To pool data, fixed-effects or random-effects models were used where appropriate. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. Results A total of 13 studies (4 cohort studies and 9 case-control studies) were included in the analysis, with a total of 625,738 participants. The highest UPFs consumption was associated with increased risk of colorectal cancer (OR = 1.23, 95% CI: 1.10-1.38), colon cancer (OR = 1.25, 95% CI: 1.14-1.36), and breast cancer (OR = 1.10, 95% CI: 1.00-1.20) but not rectal cancer (OR = 1.18, 95% CI: 0.97-1.43) and prostate cancer (OR = 1.03, 95% CI: 0.93-1.12). In addition, the subgroup analyses showed that a positive association between UPFs consumption and colorectal cancer was observed among men (OR = 1.31, 95% CI: 1.15-1.50), whereas no significant association was observed among women (OR = 1.10, 95% CI: 0.94-1.29). Conclusion The present meta-analysis suggests that high UPFs consumption is associated with a significantly increased risk of certain site-specific cancers, especially the digestive tract and some hormone-related cancers. However, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.
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Affiliation(s)
- Ying Lian
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Gang-Pu Wang
- Department of General Surgery, The Fourth People's Hospital of Jinan City, Jinan, China
| | - Guo-Qiang Chen
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Hua-Nan Chen
- Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Guang-Yong Zhang
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University, Jinan, China
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Isaksen IM, Dankel SN. Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis. Clin Nutr 2023; 42:919-928. [PMID: 37087831 DOI: 10.1016/j.clnu.2023.03.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/06/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Ultra-processed foods (UPF) have become a staple of the diet in many countries, concomitant with increases in non-communicable diseases including cancer. AIM The aim of this systematic literature review was to evaluate associations between the consumption of UPF and cancer risk. METHODS A systematic literature search for observational studies investigating the association between cancer risk and UPF consumption, determined by the NOVA classification system, was performed. Random-effects meta-analyses were conducted. Independent review and risk of bias assessment was performed independently by the authors using the National Institutes of Health's Study Quality Assessment Tools. RESULTS Eleven reports were identified, including eight retrospective case-control studies and three prospective cohorts. The outcome was risk of total cancer and/or one or more of the following cancers: colorectal, breast, prostate, pancreatic, chronic lymphocytic leukemia and central nervous system tumors. Nine studies reported a significant positive association between UPF intake and all the assessed cancers except prostate, after adjustment for confounding factors including obesity and total energy intake. A 10% increment in the diet's proportion of UPF was associated with increased risk of overall cancer (HR = 1.13, 95% CI 1.07 to 1.18) and breast cancer (HR = 1.11, 95% CI 1.01 to 1.21). In addition, a high intake of UPF was associated with increased risk of colorectal cancer (ORT3 vs. T1 = 1.30, 95% CI 1.11 to 1.51) and pancreatic cancer (HRQ4 vs. Q1 = 1.49, 95% CI 1.07 to 2.07). More modest associations were found for chronic lymphocytic leukemia and central nervous system tumors. Common limitations of several of the studies included no prior assessment of diet before known diagnosis (the case-control studies), higher participation rates among cases, and likely misclassification of several foods as UPF or non-UPF. CONCLUSION In conclusion, the available suggestive evidence shows a consistent significant association between intake of UPF and the risk of overall and several cancers, including colorectal-, breast- and pancreatic cancer. These data may inform updated dietary guidelines, policy makers and the public towards improving public health.
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Affiliation(s)
- Irja Minde Isaksen
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway
| | - Simon Nitter Dankel
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway; Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, N-5021 Bergen, Norway.
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Zhong GC, Zhu Q, Cai D, Hu JJ, Dai X, Gong JP, Sun WP. Ultra-processed food consumption and the risk of pancreatic cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Int J Cancer 2023; 152:835-844. [PMID: 36094042 DOI: 10.1002/ijc.34290] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 01/06/2023]
Abstract
Whether ultra-processed food consumption is associated with the risk of pancreatic cancer has not been determined. We performed a prospective study to fill this gap. A population-based cohort of 98 265 American adults was identified from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to estimate hazard ratios (HRs) for pancreatic cancer incidence. Subgroup analysis was performed to identify the potential effect modifiers. During a mean follow-up of 8.86 years, 387 pancreatic cancer cases occurred. High consumption of ultra-processed foods was found to be associated with an increased risk of pancreatic cancer (fully adjusted HRquartile 4 vs 1 :1.49; 95% confidence interval [CI]: 1.07-2.07; Ptrend = .021) in a linear dose-response manner (Pnonlinearity = .075). Subgroup analysis further found that the positive association of ultra-processed food consumption with the risk of pancreatic cancer was more pronounced in subjects aged <65 years (HRquartile 4 vs 1 :2.17; 95% CI: 1.14-4.15) than in those aged ≥65 years (HRquartile 4 vs 1 :1.32; 95% CI: 0.88-1.94), though the interaction test failed to achieve the statistical significance (Pinteraction = .061). These findings suggest that reducing ultra-processed food consumption may be beneficial in decreasing pancreatic cancer incidence.
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Affiliation(s)
- Guo-Chao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Zhu
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Dong Cai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie-Jun Hu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Dai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian-Ping Gong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei-Ping Sun
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kliemann N, Rauber F, Bertazzi Levy R, Viallon V, Vamos EP, Cordova R, Freisling H, Casagrande C, Nicolas G, Aune D, Tsilidis KK, Heath A, Schulze MB, Jannasch F, Srour B, Kaaks R, Rodriguez-Barranco M, Tagliabue G, Agudo A, Panico S, Ardanaz E, Chirlaque MD, Vineis P, Tumino R, Perez-Cornago A, Andersen JLM, Tjønneland A, Skeie G, Weiderpass E, Monteiro CA, Gunter MJ, Millett C, Huybrechts I. Food processing and cancer risk in Europe: results from the prospective EPIC cohort study. Lancet Planet Health 2023; 7:e219-e232. [PMID: 36889863 PMCID: PMC10009757 DOI: 10.1016/s2542-5196(23)00021-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 06/09/2022] [Accepted: 01/25/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Food processing has been hypothesised to play a role in cancer development; however, data from large-scale epidemiological studies are scarce. This study investigated the association between dietary intake according to amount of food processing and risk of cancer at 25 anatomical sites using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS This study used data from the prospective EPIC cohort study, which recruited participants between March 18, 1991, and July 2, 2001, from 23 centres in ten European countries. Participant eligibility within each cohort was based on geographical or administrative boundaries. Participants were excluded if they had a cancer diagnosis before recruitment, had missing information for the NOVA food processing classification, or were within the top and bottom 1% for ratio of energy intake to energy requirement. Validated dietary questionnaires were used to obtain information on food and drink consumption. Participants with cancer were identified using cancer registries or during follow-up from a combination of sources, including cancer and pathology centres, health insurance records, and active follow-up of participants. We performed a substitution analysis to assess the effect of replacing 10% of processed foods and ultra-processed foods with 10% of minimally processed foods on cancer risk at 25 anatomical sites using Cox proportional hazard models. FINDINGS 521 324 participants were recruited into EPIC, and 450 111 were included in this analysis (318 686 [70·8%] participants were female individuals and 131 425 [29·2%] were male individuals). In a multivariate model adjusted for sex, smoking, education, physical activity, height, and diabetes, a substitution of 10% of processed foods with an equal amount of minimally processed foods was associated with reduced risk of overall cancer (hazard ratio 0·96, 95% CI 0·95-0·97), head and neck cancers (0·80, 0·75-0·85), oesophageal squamous cell carcinoma (0·57, 0·51-0·64), colon cancer (0·88, 0·85-0·92), rectal cancer (0·90, 0·85-0·94), hepatocellular carcinoma (0·77, 0·68-0·87), and postmenopausal breast cancer (0·93, 0·90-0·97). The substitution of 10% of ultra-processed foods with 10% of minimally processed foods was associated with a reduced risk of head and neck cancers (0·80, 0·74-0·88), colon cancer (0·93, 0·89-0·97), and hepatocellular carcinoma (0·73, 0·62-0·86). Most of these associations remained significant when models were additionally adjusted for BMI, alcohol and dietary intake, and quality. INTERPRETATION This study suggests that the replacement of processed and ultra-processed foods and drinks with an equal amount of minimally processed foods might reduce the risk of various cancer types. FUNDING Cancer Research UK, l'Institut National du Cancer, and World Cancer Research Fund International.
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Affiliation(s)
- Nathalie Kliemann
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Fernanda Rauber
- Preventive Medicine Department of the Medical School, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Preventive Medicine Department of the Medical School, University of São Paulo, São Paulo, Brazil
| | - Vivian Viallon
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Reynalda Cordova
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Corinne Casagrande
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Genevieve Nicolas
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Department of Nutrition, Oslo New University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Alicia Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Bernard Srour
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Giovanna Tagliabue
- Cancer Registry Unit Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), Nutrition and Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP) Ragusa, Italy
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Copenhagen, Denmark
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Carlos Augusto Monteiro
- Department of Nutrition of the Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marc J Gunter
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, St Mary's Campus, London, UK; NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre (CHRC), NOVA University Lisbon, Lisbon, Portugal
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Heath Organization, Lyon, France.
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10
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Esposito S, Bonaccio M, Ruggiero E, Costanzo S, Di Castelnuovo A, Gialluisi A, Esposito V, Innocenzi G, Paolini S, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Food processing and risk of central nervous system tumours: A preliminary case-control analysis from the MEditerranean DIet in relation to CancEr of brAin (MEDICEA) study. Clin Nutr 2023; 42:93-101. [PMID: 36521255 DOI: 10.1016/j.clnu.2022.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/02/2022] [Accepted: 11/21/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The relationship between diet and central nervous system (CNS) tumours was almost exclusively focused on food composition. We evaluated the relationship of different degrees of food processing with risk of CNS tumours. METHODS The study sample included 44 CNS tumours cases (20 non-malignant and 24 malignant) recruited from the Neurosurgery Department at the IRCCS Neuromed (Italy), and 88 controls matched 1:2 for sex and age± 10 years, identified from the Moli-sani Study. Dietary intake was assessed using a 188-item FFQ. Food items were grouped according to the NOVA classification on the basis of processing as: (1) unprocessed/minimally processed foods; (2) processed culinary ingredients; (3) processed foods; and (4) ultra-processed food (UPF). Conditional logistic regression models were used to estimate odds ratio (OR) and 95% confidence intervals (95%CI) of dietary contributions from each NOVA group (as weight ratio on the total food eaten) and adjusting for potential confounders. RESULTS In a multivariable conditional to match logistic regression analysis also controlled for overall diet quality, 1% increment in UPF intake was associated with higher odds of all CNS tumours (OR = 1.06; 1.01-1.13), particularly of malignant CNS tumours (OR = 1.11; 1.02-1.22), while no association with non-malignant CNS tumours was found (OR = 1.06; 0.99-1.15). In contrast, only processed food was inversely associated with risk of both CNS tumours overall (OR = 0.94; 0.90-0.98) and of malignant CNS tumours (OR = 0.90; 0.83-0.96). CONCLUSION Increasing UPF intake was associated with higher risk of CNS tumours, especially malignant ones, independently of the overall diet quality, while only processed food (but not UPF) was inversely related to the risk of this disease.
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Affiliation(s)
- Simona Esposito
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy.
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy; Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy
| | | | | | - Sergio Paolini
- Department of Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy; Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy
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11
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12
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Kliemann N, Al Nahas A, Vamos EP, Touvier M, Kesse-Guyot E, Gunter MJ, Millett C, Huybrechts I. Ultra-processed foods and cancer risk: from global food systems to individual exposures and mechanisms. Br J Cancer 2022; 127:14-20. [PMID: 35236935 PMCID: PMC9276654 DOI: 10.1038/s41416-022-01749-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 12/21/2022] Open
Abstract
Ultra-processed foods (UPFs) have become increasingly dominant globally, contributing to as much as 60% of total daily energy intake in some settings. Epidemiological evidence suggests this worldwide shift in food processing may partly be responsible for the global obesity epidemic and chronic disease burden. However, prospective studies examining the association between UPF consumption and cancer outcomes are limited. Available evidence suggests that UPFs may increase cancer risk via their obesogenic properties as well as through exposure to potentially carcinogenic compounds such as certain food additives and neoformed processing contaminants. We identify priority areas for future research and policy implications, including improved understanding of the potential dual harms of UPFs on the environment and cancer risk. The prevention of cancers related to the consumption of UPFs could be tackled using different strategies, including behaviour change interventions among consumers as well as bolder public health policies needed to improve food environments.
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Affiliation(s)
- Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Aline Al Nahas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
- National School of Public Health, NOVA University, Lisbon, Portugal
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France.
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13
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Rego RA. Ultra-Processed: The Search of Positioning From the Food Industry Regulatory Authorities. Front Nutr 2022; 9:906561. [PMID: 35734375 PMCID: PMC9207195 DOI: 10.3389/fnut.2022.906561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
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14
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Jardim MZ, Costa BVDL, Pessoa MC, Duarte CK. Ultra-processed foods increase noncommunicable chronic disease risk. Nutr Res 2021; 95:19-34. [PMID: 34798466 DOI: 10.1016/j.nutres.2021.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Several studies have associated the food processing classification - NOVA - and health, but this is not true for all noncommunicable chronic diseases (NCDs). This study aimed to systematically review the association between the intake of NOVA food groups and NCDs. We hypothesized that ultra-processed foods and drinks (UPFD) and processed foods (PF) could increase the risk of NCDs, and that unprocessed (UPF) and minimally processed foods (MPF) may provide protection. We carried out a systematic review of observational studies in January 2021. Searches were performed in SCOPUS, MEDLINE (via PubMed), EMBASE, WEB OF SCIENCE, SCIELO, related articles, hand-searching of reference lists, and direct author contact. In all, 2217 citations were identified and 38 articles met the eligibility criteria for inclusion in this systematic review. Among the analyzed food groups, higher UPFD consumption was positively associated with obesity and associated with the development of all NCDs, mainly hypertension, diabetes and dyslipidemia. However, only a few studies have demonstrated the protective effect of natural foods and MPF consumption on the occurrence of NCDs. In conclusion, UPF may increase the risk of NCDs, and natural foods and MPF may reduce it. Our results reinforce the need for the implementation of policies to mitigate the intake of UPF by the population, as it would improve the quality of the dietary patterns, and directly impact on the incidence of NCDs.
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Affiliation(s)
- Mariana Zogbi Jardim
- Post-Graduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna Vieira de Lima Costa
- Department of Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Kümmel Duarte
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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15
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Meadows AD, Swanson SA, Galligan TM, Naidenko OV, O’Connell N, Perrone-Gray S, Leiba NS. Packaged Foods Labeled as Organic Have a More Healthful Profile Than Their Conventional Counterparts, According to Analysis of Products Sold in the U.S. in 2019-2020. Nutrients 2021; 13:nu13093020. [PMID: 34578899 PMCID: PMC8469099 DOI: 10.3390/nu13093020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
The organic food market’s recent rapid global growth reflects the public’s interest in buying certified organic foods, including packaged products. Our analysis shows that packaged foods containing fewer ingredients associated with negative public health outcomes are more likely to be labeled organic. Previous studies comparing organic and conventional foods focused primarily on nutrient composition. We expanded this research by additionally examining ingredient characteristics, including processing and functional use. Our dataset included nutrition and ingredient data for 8240 organic and 72,205 conventional food products sold in the U.S. from 2019 to 2020. Compared to conventional foods, organic foods in this dataset had lower total sugar, added sugar, saturated fat and sodium content. Using a mixed effects logistic regression, we found that likelihood of classification as organic increased as sodium content, added sugar content and the number of ultra-processed ingredients and cosmetic additives on the product label decreased. Products containing no trans-fat ingredients were more likely to be labeled organic. A product was more likely to be classified “organic” the more potassium it contained. These features of organic foods sold in the U.S. are significant because lower dietary ingestion of ultra-processed foods, added sugar, sodium and trans-fats is associated with improved public health outcomes.
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Affiliation(s)
- Aurora Dawn Meadows
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
- Correspondence: ; Tel.: +1-(202)-667-6982
| | - Sydney A. Swanson
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Thomas M. Galligan
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Olga V. Naidenko
- Environmental Working Group, Washington, DC 20009, USA; (S.A.S.); (T.M.G.); (O.V.N.)
| | - Nathaniel O’Connell
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC 27109, USA;
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17
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Lane MM, Davis JA, Beattie S, Gómez-Donoso C, Loughman A, O'Neil A, Jacka F, Berk M, Page R, Marx W, Rocks T. Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta-analysis of 43 observational studies. Obes Rev 2021; 22:e13146. [PMID: 33167080 DOI: 10.1111/obr.13146] [Citation(s) in RCA: 252] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 12/22/2022]
Abstract
This systematic review and meta-analysis investigated the association between consumption of ultraprocessed food and noncommunicable disease risk, morbidity and mortality. Forty-three observational studies were included (N = 891,723): 21 cross-sectional, 19 prospective, two case-control and one conducted both a prospective and cross-sectional analysis. Meta-analysis demonstrated consumption of ultraprocessed food was associated with increased risk of overweight (odds ratio: 1.36; 95% confidence interval [CI], 1.23-1.51; P < 0.001), obesity (odds ratio: 1.51; 95% CI, 1.34-1.70; P < 0.001), abdominal obesity (odds ratio: 1.49; 95% CI, 1.34-1.66; P < 0.0001), all-cause mortality (hazard ratio: 1.28; 95% CI, 1.11-1.48; P = 0.001), metabolic syndrome (odds ratio: 1.81; 95% CI, 1.12-2.93; P = 0.015) and depression in adults (hazard ratio: 1.22; 95% CI, 1.16-1.28, P < 0.001) as well as wheezing (odds ratio: 1.40; 95% CI, 1.27-1.55; P < 0.001) but not asthma in adolescents (odds ratio: 1.20; 95% CI, 0.99-1.46; P = 0.065). In addition, consumption of ultraprocessed food was associated with cardiometabolic diseases, frailty, irritable bowel syndrome, functional dyspepsia and cancer (breast and overall) in adults while also being associated with metabolic syndrome in adolescents and dyslipidaemia in children. Although links between ultraprocessed food consumption and some intermediate risk factors in adults were also highlighted, further studies are required to more clearly define associations in children and adolescents. STUDY REGISTRATION: Prospero ID: CRD42020176752.
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Affiliation(s)
- Melissa M Lane
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Jessica A Davis
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Sally Beattie
- The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia
| | - Clara Gómez-Donoso
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - Amy Loughman
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Adrienne O'Neil
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Felice Jacka
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Black Dog Institute, Randwick, New South Wales, Australia.,College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard Page
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,The Barwon Centre of Orthopaedic Research and Education (B-CORE), Barwon Health and St John of God Hospital Geelong, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Wolfgang Marx
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Tetyana Rocks
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
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18
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Romaguera D, Fernández-Barrés S, Gracia-Lavedán E, Vendrell E, Azpiri M, Ruiz-Moreno E, Martín V, Gómez-Acebo I, Obón M, Molinuevo A, Fresán U, Molina-Barceló A, Olmedo-Requena R, Tardón A, Alguacil J, Solans M, Huerta JM, Ruiz-Dominguez JM, Aragonés N, Fernández-Villa T, Dierssen-Sotos T, Moreno V, Guevara M, Vanaclocha-Espi M, Lozano-Lorca M, Fernández-Tardón G, Castaño-Vinyals G, Pérez-Gómez B, Molina AJ, Llorca J, Gil L, Castilla J, Pollán M, Kogevinas M, Amiano P. Consumption of ultra-processed foods and drinks and colorectal, breast, and prostate cancer. Clin Nutr 2021; 40:1537-1545. [PMID: 33743289 DOI: 10.1016/j.clnu.2021.02.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 12/11/2022]
Abstract
AIMS To study whether the consumption of ultra-processed foods and drinks is associated with breast, colorectal, and prostate cancers. METHODS Multicentric population-based case-control study (MCC-Spain) conducted in 12 Spanish provinces. Participants were men and women between 20 and 85 years of age with diagnoses of colorectal (n = 1852), breast (n = 1486), or prostate cancer (n = 953), and population-based controls (n = 3543) frequency-matched by age, sex, and region. Dietary intake was collected using a validated food frequency questionnaire. Foods and drinks were categorized according to their degree of processing based on the NOVA classification. Unconditional multivariable logistic regression was used to evaluate the association between ultra-processed food and drink consumption and colorectal, breast, and prostate cancer. RESULTS In multiple adjusted models, consumption of ultra-processed foods and drinks was associated with a higher risk of colorectal cancer (OR for a 10% increase in consumption: 1.11; 95% CI 1.04-1.18). The corresponding odds for breast (OR 1.03; 95% CI 0.96-1.11) and prostate cancer (OR 1.02; 95% CI 0.93-1.12) were indicative of no association. CONCLUSIONS Results of this large population-based case-control study suggest an association between the consumption of ultra-processed foods and drinks and colorectal cancer. Food policy and public health should include a focus on food processing when formulating dietary guidelines.
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Affiliation(s)
- Dora Romaguera
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain.
| | - Sílvia Fernández-Barrés
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Esther Gracia-Lavedán
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Eva Vendrell
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain.
| | - Mikel Azpiri
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Emma Ruiz-Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Mireia Obón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Amaia Molinuevo
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Ujué Fresán
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain.
| | - Ana Molina-Barceló
- Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain.
| | - Rocío Olmedo-Requena
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain.
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain.
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain.
| | - Marta Solans
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.
| | - Jose M Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
| | | | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health, Madrid, Spain.
| | - Tania Fernández-Villa
- The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | | | - Macarena Lozano-Lorca
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain.
| | - Guillermo Fernández-Tardón
- Department of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.
| | - Gemma Castaño-Vinyals
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Antonio J Molina
- The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Leire Gil
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Manolis Kogevinas
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
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Louzada MLDC, Costa CDS, Souza TN, Cruz GLD, Levy RB, Monteiro CA. Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo. CAD SAUDE PUBLICA 2021; 37:e00323020. [DOI: 10.1590/0102-311x00323020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.
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Fliss-Isakov N, Zelber-Sagi S, Ivancovsky-Wajcman D, Shibolet O, Kariv R. Ultra-Processed Food Intake and Smoking Interact in Relation with Colorectal Adenomas. Nutrients 2020; 12:nu12113507. [PMID: 33202603 PMCID: PMC7698317 DOI: 10.3390/nu12113507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022] Open
Abstract
Smoking and ultra-processed foods (UPFs), a substantial part of the western diet, have been suggested to have a potential carcinogenic effect, though epidemiologic data are lacking. We aimed to examine the association between high UPF intake and colorectal adenomas, and to test the interaction with smoking. In a case-control study among consecutive subjects undergoing colonoscopy in a tertiary center during 2010–2015, UPF intake and smoking were compared between cases with colorectal adenomas and controls. Within 652 participants (cases, n = 294 and controls, n = 358), high UPF intake (defined as percent of kcal from UPF above the study sample upper tertile) was positively associated with adenomas (Odds ratio (OR) = 1.75, 95% Confidence interval (CI) 1.14–2.68), advanced and proximal adenomas (OR = 2.17, 1.29–3.65 and OR = 2.38, 1.37–4.11) among the whole study sample; and with adenomas (OR = 3.54, 1.90–6.61), non-advanced adenomas (OR = 2.60, 1.20–5.63), advanced adenomas (OR = 4.76, 2.20–10.30), proximal adenomas (OR = 6.23, 2.67–14.52), and distal adenomas (OR = 2.49, 1.21–5.13) among smokers. Additionally, a dose-dependent association was observed between tertiles of UPF intake and adenomas only among smokers (p for trend < 0.001). A significant interaction between smoking and high UPF intake was detected (p for interaction = 0.004). High intake of UPFs is strongly and independently associated with colorectal adenomas, especially advanced and proximal adenoma, and interacts with smoking. Results highlight smokers as more susceptible to the negative health effects of UPF consumption on colorectal neoplasia.
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Affiliation(s)
- Naomi Fliss-Isakov
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel; (S.Z.-S.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +97-(23)-6947305
| | - Shira Zelber-Sagi
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel; (S.Z.-S.); (O.S.); (R.K.)
- School of Public Health, University of Haifa, Haifa 3498838, Israel;
| | | | - Oren Shibolet
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel; (S.Z.-S.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Revital Kariv
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel; (S.Z.-S.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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The Effects of Ultra-Processed Food Consumption-Is There Any Action Needed? Nutrients 2020; 12:nu12092556. [PMID: 32846915 PMCID: PMC7551378 DOI: 10.3390/nu12092556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 02/04/2023] Open
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Higher ultra-processed food intake is associated with higher DNA damage in healthy adolescents. Br J Nutr 2020; 125:568-576. [DOI: 10.1017/s0007114520001981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractUltra-processed food is one of the main contributors to energy supply and consumption in food systems worldwide, and evidence of their detrimental health outcomes in humans is emerging. This study aimed to assess ultra-processed food intake and its association with urinary levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG), a biomarker of DNA oxidative damage, in 139 healthy adolescents in Karaj City in Iran. Usual dietary intake was measured using a 168-item validated FFQ. The daily intake of ultra-processed food consumption was determined through the classification of NOVA, and general linear models were used to compare the urinary levels of 8-OHdG/creatinine (ng/mg creatinine) within tertiles of ultra-processed food intake. Adolescents in the higher tertile of ultra-processed food consumption had a significantly higher mean level of urinary 8-OHdG/creatinine in comparison with the lower tertiles in the crude model (Pfor trend: 0·003) and after adjustment for confounding variables, including total energy intake, sex, age, BMI for age Z-score, obesity and physical activity (Pfor trend: 0·004). This association was still significant after adjusting for dietary intake of whole grains, nuts, legumes, the ratio of MUFA:SFA (g/d) and Mediterranean dietary score (Pfor trend: 0·002). More studies are needed to explore the determinants of ultra-processed food supply, demand, consumption and health effects; such studies should be applied to develop evidence-informed policies and regulatory mechanisms to improve children’s and adolescents’ food environment policymaking and legislation with special attention to ultra-processed food.
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