Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study [过度加工食品的食用与全因死亡之间的关系：SUN前瞻性队列研究]

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BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1949 (Published 29 May 2019)
Cite this as: BMJ 2019;365:l1949

Auhtors
Anaïs Rico-Campà, Miguel A Martínez-González, Ismael Alvarez-Alvarez, Raquel de Deus Mendonça, Carmen de la Fuente-Arrillaga, Clara Gómez-Donoso, Maira Bes-Rastrollo

Abstract
Objective To evaluate the association between consumption of ultra-processed foods and all cause mortality.

Design Prospective cohort study.

Setting Seguimiento Universidad de Navarra (SUN) cohort of university graduates, Spain 1999-2018.

Participants 19 899 participants (12 113 women and 7786 men) aged 20-91 years followed-up every two years between December 1999 and February 2014 for food and drink consumption, classified according to the degree of processing by the NOVA classification, and evaluated through a validated 136 item food frequency questionnaire.

Main outcome measure Association between consumption of energy adjusted ultra-processed foods categorised into quarters (low, low-medium, medium-high, and high consumption) and all cause mortality, using multivariable Cox proportional hazard models.

Results 335 deaths occurred during 200 432 persons years of follow-up. Participants in the highest quarter (high consumption) of ultra-processed foods consumption had a higher hazard for all cause mortality compared with those in the lowest quarter (multivariable adjusted hazard ratio 1.62, 95% confidence interval 1.13 to 2.33) with a significant dose-response relation (P for linear trend=0.005). For each additional serving of ultra-processed foods, all cause mortality relatively increased by 18% (adjusted hazard ratio 1.18, 95% confidence interval 1.05 to 1.33).

Conclusions A higher consumption of ultra-processed foods (>4 servings daily) was independently associated with a 62% relatively increased hazard for all cause mortality. For each additional serving of ultra-processed food, all cause mortality increased by 18%.

Study registration ClinicalTrials.gov NCT02669602.