Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort [深加工食品的消费与癌症风险：NutriNet-Santé 前瞻性队列研究的结果]

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BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k322 (Published 14 February 2018)
Cite this as: BMJ 2018;360:k322

Authors
Thibault Fiolet, Bernard Srour, pharmacist, Laury Sellem, Emmanuelle Kesse-Guyot, Benjamin Allès, Caroline Méjean, Mélanie Deschasaux, Philippine Fassier, Paule Latino-Martel, Marie Beslay, Serge Hercberg, Céline Lavalette, Carlos A Monteiro, Chantal Julia, Mathilde Touvier

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-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 measures Associations 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.

Results Ultra-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).

Conclusions In 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 registration Clinicaltrials.gov NCT03335644.