Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort

Abstract

ObjectiveTo assess the prospective associations between consumption of ultra-processed food and risk of cancer.DesignPopulation based cohort study.Setting and participants104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification.Main outcome measuresAssociations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors.ResultsUltra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis).ConclusionsIn this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations.Study registrationClinicaltrials.gov NCT03335644.

Ultra-processed food and adverse health outcomes

“…The authors designed their studies well, performing various sensitivity and secondary analyses, adjusting for well known sociodemographic and anthropometric risk factors and for established markers of dietary quality. These findings follow a previous study7 and a linked editorial8 reporting an association between consumption of these foods and an increased risk of cancer.…”

Association between watching TV whilst eating and children's consumption of ultraprocessed foods in United Kingdom

“…Cross‐sectional studies have found associations between consumption of ultraprocessed foods and obesity (da Costa Louzada et al, a ), metabolic syndrome (Tavares et al, ), and presence of asthma and wheezing (Melo, Rezende, Machado, Gouveia, & Levy, ). Prospective cohort studies have shown that high consumption of these foods is associated with obesity (Mendonça et al, a ), hypertension (Mendonça et al, b ), and cancer (Fiolet et al, ) in adults and dyslipidemia in children (Rauber et al, ). As the development of long‐standing preferences is built on familiarity (Birch, ), early and frequent exposures to highly palatable ultraprocessed foods raises serious concerns.…”

Ultra-processed foods and cancer

“…In this week’s The BMJ (doi:10.1136/bmj.k322), Fiolet and colleagues report a direct association between intake of ultra-processed food and incidence of total cancer and breast cancer 1. They used data from a population based prospective cohort of 104 980 middle aged French women and men.…”