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Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort
The BMJ ( IF 105.7 ) Pub Date : 2018-02-14 , DOI: 10.1136/bmj.k322 Thibault Fiolet , Bernard Srour , 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
The BMJ ( IF 105.7 ) Pub Date : 2018-02-14 , DOI: 10.1136/bmj.k322 Thibault Fiolet , Bernard Srour , 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
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.
中文翻译：
食用超加工食品和致癌风险：NutriNet-Santé前瞻性队列研究结果
目的评估食用超加工食品与癌症风险之间的前瞻性关联。
设计基于人群的队列研究。
背景和参与者来自法国NutriNet-Santé队列（2009-17）的年龄至少18岁（中位年龄42.8岁）的104980名参与者。使用重复的24小时饮食记录来收集饮食摄入量，旨在记录参与者3300种不同食品的日常消费量。根据它们的加工程度，通过NOVA分类将它们分类。
主要观察指标通过针对已知风险因素进行调整的多变量Cox比例风险模型评估超加工食品摄入量与总体，乳腺癌，前列腺癌和结肠直肠癌风险之间的关联。
结果摄入超加工食品与更高的总体癌症风险相关（n = 2228例；饮食中超加工食品比例增加10％的危险比1.12（95％置信区间1.06至1.18）； P代表趋势<0.001）和乳腺癌风险（n = 739例；危险比1.11（1.02至1.22）；趋势P = 0.02）。在调整饮食营养质量的几个指标（脂质，钠和碳水化合物的摄入量和/或通过主成分分析得出的Western模式）后，这些结果在统计学上仍然具有统计学意义。
结论在这项大型的前瞻性研究中，饮食中超加工食品的比例增加10％，与罹患整体和乳腺癌的风险显着增加10％以上有关。需要进一步研究以更好地理解这些关联中各种加工维度（营养成分，食品添加剂，接触材料和新形成的污染物）的相对影响。
研究注册Clinicaltrials.gov NCT03335644。
更新日期：2018-02-15
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.
中文翻译：
食用超加工食品和致癌风险：NutriNet-Santé前瞻性队列研究结果
目的评估食用超加工食品与癌症风险之间的前瞻性关联。
设计基于人群的队列研究。
背景和参与者来自法国NutriNet-Santé队列（2009-17）的年龄至少18岁（中位年龄42.8岁）的104980名参与者。使用重复的24小时饮食记录来收集饮食摄入量，旨在记录参与者3300种不同食品的日常消费量。根据它们的加工程度，通过NOVA分类将它们分类。
主要观察指标通过针对已知风险因素进行调整的多变量Cox比例风险模型评估超加工食品摄入量与总体，乳腺癌，前列腺癌和结肠直肠癌风险之间的关联。
结果摄入超加工食品与更高的总体癌症风险相关（n = 2228例；饮食中超加工食品比例增加10％的危险比1.12（95％置信区间1.06至1.18）； P代表趋势<0.001）和乳腺癌风险（n = 739例；危险比1.11（1.02至1.22）；趋势P = 0.02）。在调整饮食营养质量的几个指标（脂质，钠和碳水化合物的摄入量和/或通过主成分分析得出的Western模式）后，这些结果在统计学上仍然具有统计学意义。
结论在这项大型的前瞻性研究中，饮食中超加工食品的比例增加10％，与罹患整体和乳腺癌的风险显着增加10％以上有关。需要进一步研究以更好地理解这些关联中各种加工维度（营养成分，食品添加剂，接触材料和新形成的污染物）的相对影响。
研究注册Clinicaltrials.gov NCT03335644。
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