Greater consumption of ultraprocessed food is associated with an increased risk of developing either small cell or non–small cell lung cancer, according to findings published in Thorax.
"Over the past 2 decades, the consumption of ultraprocessed food has significantly increased worldwide, regardless of development or economic status. The rise in ultraprocessed food consumption may have driven global increases in obesity, cardiovascular disease, metabolic disorders, cancer, and mortality, as these foods are confirmed risk factors for such conditions,” wrote study authors.
Study Methods and Rationale
High consumption of ultraprocessed food, which contains many additives and preservatives, has been associated with heightened risk for several health conditions, and researchers wanted to know if this could include lung cancer.
“Industrial processing alters the food matrix, affecting nutrient availability and absorption, while also generating harmful contaminants,” the study authors noted. Among the contaminants of interest, the researchers highlighted acrolein, which is a toxic component of cigarette smoke and is used in many ultraprocessed foods' packaging materials.
The study authors collected data from patients in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trials. The screening trials included 155,000 participants between the ages of 55 and 74 between November 1993 and July 2001.
The study focused on 101,732 participants with completed dietary history questionnaires. Foods were categorized using the NOVA classification by degree of processing: unprocessed or minimally processed, containing processed culinary ingredients, processed, and ultraprocessed. They focused their study on the ultraprocessed category, which included foods such as sour cream, cream cheese, ice cream, frozen yogurt, fried foods, bread, baked goods, salted snacks, breakfast cereals, instant noodles, shop-bought soups and sauces, margarine, confectionery, soft drinks, sweetened fruit drinks, restaurant/shop-bought hamburgers, hot dogs, and pizza.
Key Study Findings
The average energy-adjusted ultraprocessed food consumption was almost 3 servings per day among the participants (range, 0.5–6). The ultraprocessed foods that came up most often were lunch meat, diet or caffeinated soft drinks, and decaffeinated soft drinks.
Among the participants in the analysis, there were 1,706 cases of lung cancer within 12.2 follow-up years, including 1,473 non–small cell lung cancers (NSCLCs) and 233 small cell lung cancers (SCLCs). After multivariable adjustments, individuals who had the highest levels of ultraprocessed food consumption had a higher risk for lung cancer (hazard ratio [HR] = 1.41; 95% confidence interval [CI] = 1.22–1.60) compared with those with the lowest levels of intake. The risk for NSCLC (HR = 1.37; 95% CI = 1.20–1.58) and SCLC (HR = 1.44; 95% CI = 1.03–2.10) specifically were similar.
The results remained statistically significant even after subgroup and sensitivity analyses.
The study authors noted that since this is an observational study, no firm conclusions as to cause and effect can be drawn from these results, and they must be confirmed in other large-scale studies. Yet, limiting consumption of ultraprocessed foods could help to reduce the global burden of lung cancer, they noted.
Disclosure: For full disclosures of the study authors, visit thorax.bmj.com.
