Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France
Schnabel L, Kesse-Guyot E, Allès B, Touvier M, Srour B, Hercberg S, Buscail C, Julia C
JAMA internal medicine · 262 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Estudio de cohortes (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- Diarios o recordatorios de alimentación
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2019-02-11 · JAMA Intern Med · vol. 179 · número 4 · pág. 490
- Editorial
- American Medical Association
- Citado
- 399 citas · más que el 100% de estudios similares · 53.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 61 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Nutritional Studies and Diet
- Palabras clave
- Medicine, Environmental health, Nutrition transition, Anthropometry, Hazard ratio, Cohort study, Observational study, Incidence (geometry), Demography, Cohort, Obesity, Pediatrics, Confidence interval, Overweight, Internal medicine
- MeSH
- humans, obesity, exercise, cause of death, survival rate, risk assessment, risk factors, follow-up studies, prospective studies, energy intake, food handling, middle aged, france, female, male, fast foods
8 autores
- Laure Schnabel🇫🇷 · autor de correspondenciaUniversité Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Assistance Publique – Hôpitaux de Paris; Hôpital Avicenne; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Emmanuelle Kesse‐Guyot🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Benjamin Allès🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Mathilde Touvier🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Bernard Srour🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Serge Herçberg🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Assistance Publique – Hôpitaux de Paris; Hôpital Avicenne; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Camille Buscail🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Assistance Publique – Hôpitaux de Paris; Hôpital Avicenne; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
- Chantal Julia🇫🇷Université Paris Cité; Université Sorbonne Paris Nord; Sorbonne Paris Cité; Assistance Publique – Hôpitaux de Paris; Hôpital Avicenne; Equipe de Recherche en Epidémiologie Nutritionnelle; Centre de Recherche Épidémiologie et Statistique
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Growing evidence indicates that higher intake of ultraprocessed foods is associated with higher incidence of noncommunicable diseases. However, to date, the association between ultraprocessed foods consumption and mortality risk has never been investigated.
Objective
To assess the association between ultraprocessed foods consumption and all-cause mortality risk.
Design, setting, and participants
This observational prospective cohort study selected adults, 45 years or older, from the French NutriNet-Santé Study, an ongoing cohort study that launched on May 11, 2009, and performed a follow-up through December 15, 2017 (a median of 7.1 years). Participants were selected if they completed at least 1 set of 3 web-based 24-hour dietary records during their first 2 years of follow-up. Self-reported data were collected at baseline, including sociodemographic, lifestyle, physical activity, weight and height, and anthropometrics.
Exposures
The ultraprocessed foods group (from the NOVA food classification system), characterized as ready-to-eat or -heat formulations made mostly from ingredients usually combined with additives. Proportion (in weight) of ultraprocessed foods in the diet was computed for each participant.
Main outcomes and measures
The association between proportion of ultraprocessed foods and overall mortality was the main outcome. Mean dietary intakes from all of the 24-hour dietary records available during the first 2 years of follow-up were calculated and considered as the baseline usual food-and-drink intakes. Mortality was assessed using CépiDC, the French national registry of specific mortality causes. Hazard ratios (HRs) and 95% CIs were determined for all-cause mortality, using multivariable Cox proportional hazards regression models, with age as the underlying time metric.
Results
A total of 44 551 participants were included, of whom 32 549 (73.1%) were women, with a mean (SD) age at baseline of 56.7 (7.5) years. Ultraprocessed foods accounted for a mean (SD) proportion of 14.4% (7.6%) of the weight of total food consumed, corresponding to a mean (SD) proportion of 29.1% (10.9%) of total energy intake. Ultraprocessed foods consumption was associated with younger age (45-64 years, mean [SE] proportion of food in weight, 14.50% [0.04%]; P < .001), lower income (<€1200/mo, 15.58% [0.11%]; P < .001), lower educational level (no diploma or primary school, 15.50% [0.16%]; P < .001), living alone (15.02% [0.07%]; P < .001), higher body mass index (calculated as weight in kilograms divided by height in meters squared; ≥30, 15.98% [0.11%]; P < .001), and lower physical activity level (15.56% [0.08%]; P < .001). A total of 602 deaths (1.4%) occurred during follow-up. After adjustment for a range of confounding factors, an increase in the proportion of ultraprocessed foods consumed was associated with a higher risk of all-cause mortality (HR per 10% increment, 1.14; 95% CI, 1.04-1.27; P = .008).
Conclusions and relevance
An increase in ultraprocessed foods consumption appears to be associated with an overall higher mortality risk among this adult population; further prospective studies are needed to confirm these findings and to disentangle the various mechanisms by which ultraprocessed foods may affect health.
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