Consumption of ultra-processed foods and mortality: A national prospective cohort in Spain
Entity
UAM. Departamento de Medicina Preventiva y Salud Pública y MicrobiologíaPublisher
ElsevierDate
2019Citation
10.1016/j.mayocp.2019.03.035
Mayo Clinic Proceedings 94.11 (2019): 2178-2188
ISSN
0025-6196 (print); 1942-5546 (online)DOI
10.1016/j.mayocp.2019.03.035Funded by
The following grants funded data collection: FIS PI16/1512; PI16/1460; PI16/609; PI17/1709 (State Secretary of Research and Development Iniciatives and Fondo Europeo de Desarrollo Regional/Fondo Social Europeo), the ATHLOS project (EU H2020-Project ID: 635316), the SALAMANDER project (PCIN-2016-145), and the CIBERESP, Instituto de Salud Carlos III, Madrid, Spain. Researchers were independent of fundersProject
Gobierno de España. PI16/1512; Gobierno de España. PI16/1460; Gobierno de España. PI16/609; Gobierno de España. PI17/1709; info:eu-repo/grantAgreement/EC/H2020/635316/EU//ATHLOS; Gobierno de España. PCIN-2016-145Editor's Version
https://doi.org/10.1016/j.mayocp.2019.03.035Subjects
Ultra-processed foods; Mortality; New nutritional policies; Minimally processed foods; MedicinaEsta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Abstract
Objective: To assess the prospective association between ultra-processed food consumption and allcause
mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution.
Patients and Methods: A population-based cohort of 11,898 individuals (mean age 46.9 years, and
50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized
Spanish population. Dietary information was collected by a validated computer-based
dietary history and categorized according to their degree of processing using NOVA classification.
Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-
2010) to mortality date or December 31th, 2016, whichever was first. The association between
quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted
for the main confounders. Restricted cubic-splines were used to assess dose-response relationships
when using iso-caloric substitutions.
Results: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake).
After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and
95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was
1.44 (95% CI, 1.01-2.07; P trend¼.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend¼.03) in
grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally
processed foods was associated with a significant nonlinear decrease in mortality.
Conclusion: A higher consumption of ultra-processed food was associated with higher mortality in the
general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed
or minimally processed foods would suppose a reduction of the mortality risk. If confirmed,
these findings support the necessity of the development of new nutritional policies and guides at the national and international level.
Files in this item
Google Scholar:Blanco-Rojo, Ruth
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Sandoval-Insausti, Helena
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López García, Esther
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Graciani Pérez-Regadera, Auxiliadora
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Ordovás, José M.
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Banegas Banegas, José Ramón
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Rodríguez Artalejo, Fernando
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Guallar Castillón, María Pilar
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