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Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé)

Published on May 29, 2019in BMJ27.60
· DOI :10.1136/bmj.l1451
Bernard Srour4
Estimated H-index: 4
(University of Paris),
Leopold Fezeu30
Estimated H-index: 30
(University of Paris)
+ 10 AuthorsMathilde Touvier44
Estimated H-index: 44
(University of Paris)
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Abstract
Abstract Objective To assess the prospective associations between consumption of ultra-processed foods and risk of cardiovascular diseases. Design Population based cohort study. Setting NutriNet-Sante cohort, France 2009-18. Participants 105 159 participants aged at least 18 years. Dietary intakes were collected using repeated 24 hour dietary records (5.7 for each participant on average), designed to register participants’ usual consumption of 3300 food items. These foods were categorised using the NOVA classification according to degree of processing. Main outcome measures Associations between intake of ultra-processed food and overall risk of cardiovascular, coronary heart, and cerebrovascular diseases assessed by multivariable Cox proportional hazard models adjusted for known risk factors. Results During a median follow-up of 5.2 years, intake of ultra-processed food was associated with a higher risk of overall cardiovascular disease (1409 cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet 1.12 (95% confidence interval 1.05 to 1.20); P Conclusions In this large observational prospective study, higher consumption of ultra-processed foods was associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. These results need to be confirmed in other populations and settings, and causality remains to be established. Various factors in processing, such as nutritional composition of the final product, additives, contact materials, and neoformed contaminants might play a role in these associations, and further studies are needed to understand better the relative contributions. Meanwhile, public health authorities in several countries have recently started to promote unprocessed or minimally processed foods and to recommend limiting the consumption of ultra-processed foods. Study registration ClinicalTrials.gov NCT03335644.
  • References (71)
  • Citations (6)
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References71
Newest
Published on Aug 1, 2018in The American Journal of Gastroenterology10.24
Laure Schnabel2
Estimated H-index: 2
(University of Paris),
Camille Buscail5
Estimated H-index: 5
(University of Paris)
+ 8 AuthorsRobert Benamouzig36
Estimated H-index: 36
Ultra-processed foods (UPF) consumption has increased over the last decades and is raising concerns about potential adverse health effects. Our objective was to assess the association between UPF consumption and four functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FDh), and functional dyspepsia (FDy), in a large sample of French adults. We analyzed dietary data of 33,343 participants from the web-based NutriNet-San...
Published on Aug 1, 2018in Environment International7.94
Yu Zhang24
Estimated H-index: 24
(ZJU: Zhejiang University),
Mengmeng Huang4
Estimated H-index: 4
(ZJU: Zhejiang University)
+ 4 AuthorsYongning Wu2
Estimated H-index: 2
(Chinese Ministry of Health)
Abstract Background Long-term exposure to acrylamide (AA) from diet sources may induce oxidative stress and chronic inflammation. However, the association between AA exposure and the prevalence of cardiovascular diseases (CVD) remains unclear. Objectives We aimed to examine the association between blood exposure levels of AA biomarkers and the prevalence of main types of CVD in a general population of US adults. Methods We analyzed the associations between AA hemoglobin biomarkers [hemoglobin ad...
Published on Jul 14, 2018in British Journal of Nutrition3.32
Filippa Juul2
Estimated H-index: 2
(NYU: New York University),
Euridice Martinez-Steele1
Estimated H-index: 1
(USP: University of São Paulo)
+ 2 AuthorsVirginia W. Chang23
Estimated H-index: 23
(NYU: New York University)
Ultra-processed foods provide 58 % of energy intake and 89 % of added sugars in the American diet. Nevertheless, the association between ultra-processed foods and excess weight has not been investigated in a US sample. The present investigation therefore aims to examine the association between ultra-processed foods and excess weight in a nationally representative sample of US adults. We performed a cross-sectional analysis of anthropometric and dietary data from 15 977 adults (20–64 years) parti...
Published on May 9, 2018in Nutrients4.17
Fernanda Rauber11
Estimated H-index: 11
,
Maria Laura da Costa Louzada14
Estimated H-index: 14
+ 3 AuthorsRenata Bertazzi Levy29
Estimated H-index: 29
We described the contribution of ultra-processed foods in the U.K. diet and its association with the overall dietary content of nutrients known to affect the risk of chronic non-communicable diseases (NCDs). Cross-sectional data from the U.K. National Diet and Nutrition Survey (2008–2014) were analysed. Food items collected using a four-day food diary were classified according to the NOVA system. The average energy intake was 1764 kcal/day, with 30.1% of calories coming from unprocessed or minim...
Published on Apr 1, 2018in Lancet Oncology35.39
Elizabeth Gourd2
Estimated H-index: 2
Published on Apr 1, 2018in JAMA Cardiology
Sadiya Sana Khan18
Estimated H-index: 18
(NU: Northwestern University),
Hongyan Ning27
Estimated H-index: 27
(NU: Northwestern University)
+ 5 AuthorsDonald M. Lloyd-Jones83
Estimated H-index: 83
(NU: Northwestern University)
Importance Prior studies have demonstrated lower all-cause mortality in individuals who are overweight compared with those with normal body mass index (BMI), but whether this may come at the cost of greater burden of cardiovascular disease (CVD) is unknown. Objective To calculate lifetime risk estimates of incident CVD and subtypes of CVD and to estimate years lived with and without CVD by weight status. Design, Setting, and Participants In this population-based study, we used pooled individual-...
Published on Mar 17, 2018in Nutrients4.17
Marit K. Zinöcker1
Estimated H-index: 1
,
Inge A. Lindseth1
Estimated H-index: 1
The dietary pattern that characterizes the Western diet is strongly associated with obesity and related metabolic diseases, but biological mechanisms supporting these associations remain largely unknown. We argue that the Western diet promotes inflammation that arises from both structural and behavioral changes in the resident microbiome. The environment created in the gut by ultra-processed foods, a hallmark of the Western diet, is an evolutionarily unique selection ground for microbes that can...
Published on Mar 1, 2018in BMJ Open2.38
Larissa Galastri Baraldi12
Estimated H-index: 12
(USP: University of São Paulo),
Eurídice Martínez Steele8
Estimated H-index: 8
(USP: University of São Paulo)
+ 1 AuthorsCarlos Augusto Monteiro52
Estimated H-index: 52
(USP: University of São Paulo)
Objectives To compare ultra-processed food consumption across sociodemographic groups and over time (2007–2008, 2009–2010, 2011–2012) in the USA. Design Cross-sectional study. Setting National Health and Nutrition Examination Survey (NHANES) 2007–2012. Participants All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847). Main outcome measures Average dietary contribution of ultra-processed foods (expressed as a percentage of the total caloric value of the ...
Published on Feb 14, 2018in BMJ27.60
Thibault Fiolet3
Estimated H-index: 3
(Sorbonne),
Bernard Srour4
Estimated H-index: 4
(Sorbonne)
+ 12 AuthorsMarie Beslay1
Estimated H-index: 1
(Sorbonne)
Abstract Objective To assess the prospective associations between consumption of ultra-processed food and risk of cancer. Design Population based cohort study. Setting and participants 104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Sante 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 d...
Published on Jan 1, 2018in Public Health Nutrition2.53
Carlos Augusto Monteiro52
Estimated H-index: 52
(USP: University of São Paulo),
Carlos Augusto Monteiro37
Estimated H-index: 37
(USP: University of São Paulo)
+ 3 AuthorsPatricia Constante Jaime23
Estimated H-index: 23
(USP: University of São Paulo)
Given evident multiple threats to food systems and supplies, food security, human health and welfare, the living and physical world and the biosphere, the years 2016–2025 are now designated by the UN as the Decade of Nutrition, in support of the UN Sustainable Development Goals. For these initiatives to succeed, it is necessary to know which foods contribute to health and well-being, and which are unhealthy. The present commentary outlines the NOVA system of food classification based on the natu...
Cited By6
Newest
Published on Nov 1, 2019in Trends in Food Science and Technology8.52
Anthony Fardet19
Estimated H-index: 19
(INRA: Institut national de la recherche agronomique),
Edmond Rock43
Estimated H-index: 43
(INRA: Institut national de la recherche agronomique)
Abstract Background The concept of ultra-processed foods (UPFs) is new, and it was proposed for the first time in 2009 as group 4 of the NOVA classification to address the degree of food processing. UPFs include not only “junk foods” but also foods marketed as healthy, such as light, vegan, organic, or gluten-free products. UPFs are characterized by the presence of highly-processed/purified “cosmetic” ingredients and/or additives to restore and/or exacerbate organoleptic properties, i.e., taste,...
Published on 2019in Nutrients4.17
A Western diet characterised by high intake of energy-dense and processed food is a risk factor for many chronic diseases including diabetes, obesity and cardiovascular diseases [...]
Published on 2019in Nutrients4.17
Amelia A. Martí del Moral39
Estimated H-index: 39
Poor eating habits, such as the increasing consumption of highly processed products, have deleterious effects on health status and represent a serious challenge for public health systems [...]
Published on Jul 1, 2019in Cell Metabolism22.41
Kevin D. Hall37
Estimated H-index: 37
(NIH: National Institutes of Health)
Published on Aug 1, 2019in BMJ Open2.38
Priscila Pereira Machado5
Estimated H-index: 5
,
Eurídice Martínez Steele8
Estimated H-index: 8
(USP: University of São Paulo)
+ 6 AuthorsCarlos Augusto Monteiro52
Estimated H-index: 52
Objective This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs). Design Cross-sectional study. Setting National Nutrition and Physical Activity Survey (2011-2012). Participants 12,153 participants aged 2+ years. Main outcome measures Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. Data anal...
Published on 2019in Pediatric Obesity3.71
Daniela Neri (USP: University of São Paulo), Euridice Martinez-Steele1
Estimated H-index: 1
(USP: University of São Paulo)
+ 1 AuthorsRenata Bertazzi Levy29
Estimated H-index: 29
(USP: University of São Paulo)
Published on Jul 24, 2019in Nutrients4.17
Abigail S. Baldridge8
Estimated H-index: 8
,
Mark Daniel Huffman30
Estimated H-index: 30
+ 5 AuthorsElizabeth Dunford20
Estimated H-index: 20
The US food supply is dominated by highly-processed packaged food and beverage products that are high in energy, saturated fat, sugar, and salt. We report results of a cross-sectional assessment of the 2018 US packaged food and beverage supply by nutritional composition and indicators of healthfulness and level of processing. Data were obtained through Label Insight’s Open Data database, which represents >80% of all food and beverage products sold in the US over the past three years. Healthfulne...
Published on Jul 17, 2019in Nutrients4.17
Vanessa Mello Rodrigues4
Estimated H-index: 4
,
Jeffery Bray4
Estimated H-index: 4
+ 6 AuthorsRossana Pacheco da Costa Proença14
Estimated H-index: 14
Vegetable consumption is a predictor for improved health outcomes, such as reduced obesity and likelihood of food-related noncommunicable diseases. Young adults are a key population, being in a transitional stage-of-life: Habits gained here are taken through the lifespan. This review establishes insight into the consumption of vegetables among young adults during their college/university years, and factors associated with increased consumption. Seventy-one papers were extracted, published betwee...
Published on Jul 2, 2019in Journal of the American Heart Association4.66
Kristina S. Petersen9
Estimated H-index: 9
(PSU: Pennsylvania State University)
View next paperOverall diet quality and risk of stroke: A prospective cohort study in women