A multinational cohort study published in The Lancet Regional Health – Europe investigated the association between consumption of ultra processed foods (UPF) and the risk of developing multiple chronic diseases, such as cancer and cardiometabolic diseases.
Ultra processed foods contain ingredients “never or rarely used in kitchens, or classes of additives whose function is to make the final product palatable or more appealing,” according to the Food and Agriculture Organization of the United Nations.
The list of additives includes
preservatives to resist mold and bacteria;
emulsifiers to keep incompatible ingredients from separating;
artificial colorings and dyes;
anti-foaming, bulking, bleaching, gelling and glazing agents; and
added or altered sugar, salt and fats designed to make food more appealing.
The study included 266,666 participants from seven European countries who were free of these diseases at baseline and followed up for an average of 14.5 years.
The researchers found that higher consumption of ultra processed foods (UPF) was associated with increased risk of
cancer,
cardiovascular disease,
type 2 diabetes, and
subsequent cancer-cardiometabolic multimorbidity (having both cancer and a cardiometabolic disease).
These associations were independent of other factors such as
energy intake,
alcohol intake,
physical activity,
education level, and
adherence to the Mediterranean diet.
The study suggests that reducing ultra processed foods (UPF) consumption could have important health benefits and prevent the development of multiple chronic diseases.
“What is particularly significant in this large study is that eating more ultra processed foods, in particular animal products and sweetened beverages, was linked to an increased risk of developing cancer along with another disease such as a stroke or diabetes,” said Helen Croker, assistant director of research and policy at World Cancer Research Fund International, which funded the study, in a statement.
"While the study cannot conclusively prove that ultra processed foods are the direct cause of the multiple diseases, a good deal of other research has shown a connection between certain ultra processed foods (UPF) and health harms," said nutrition researcher Ian Johnson, emeritus fellow at Quadram Institute Bioscience in Norwich, United Kingdom.
The study’s findings are concerning because in Europe ultra processed foods make up “more than half of our daily food intake,” said coauthor Heinz Freisling, a nutrition and metabolism scientist at the International Agency for Research on Cancer, in a statement.
In the United States, a 2019 study estimated some 71% of the food supply may be ultra processed.
Added value of this study
the first to examine in a multinational cohort with long-term follow-up the relationship between ultra processed food consumption and the incidence of multimorbidity of cancer and cardiometabolic diseases.
contributes to the evidence base suggesting a potential role of a higher consumption of ultra processed foods in the accumulation of chronic morbidity and multimorbidity.
provides evidence of a differential relationship of subgroups of ultra processed foods and multimorbidity of cancer and cardiometabolic diseases.
provides important evidence that can inform risk reduction of multimorbidity of cancer and cardiometabolic diseases through dietary recommendations, public health policies, and interventions.
Implications of the study
Findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.
Artificially and sugar-sweetened beverages, animal-based products and sauces, spreads and condiments, but not other subgroups, were associated with increased risk, suggesting that more nuanced subgroup analyses of ultra processed foods are warranted.
Multimorbidity is a growing health challenge not only in Europe, but in many regions of the world.
Lowering consumption of certain ultra processed foods by replacing them with similar but less processed foods may be beneficial for the prevention of cancer and cardiometabolic multimorbidity.
Resources
Cordova, Reynalda, et al. “Consumption of Ultra-Processed Foods and Risk of Multimorbidity of Cancer and Cardiometabolic Diseases: A Multinational Cohort Study.” The Lancet Regional Health - Europe, Nov. 2023, p. 100771. DOI.org (Crossref), https://doi.org/10.1016/j.lanepe.2023.100771.
Baldridge, A.S.; Huffman, M.D.; Taylor, F.; Xavier, D.; Bright, B.; Van Horn, L.V.; Neal, B.; Dunford, E. The Healthfulness of the US Packaged Food and Beverage Supply: A Cross-Sectional Study. Nutrients2019, 11, 1704. https://doi.org/10.3390/nu11081704
Monteiro, C.A., Cannon, G., Lawrence, M., Costa Louzada, M.L. and Pereira Machado, P. 2019. Ultra-processed foods, diet quality, and health using the NOVA classification system. Rome, FAO.
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