Consumption of higher quantities of ultraprocessed food was associated with increased all-cause and cancer mortality rates in cancer survivors, irrespective of the quality of their diet, according to findings published in Cancer Epidemiology, Biomarkers & Prevention.
“These results suggest that increased inflammation and elevated resting heart rate may partially explain the link between higher consumption of ultraprocessed foods and increased mortality, and help to clarify how food processing itself could contribute to worse outcomes among cancer survivors,” said lead author Marialaura Bonacci, PhD, of the Research Unit of Epidemiology and Prevention at IRCCS Neuromed in Pozzilli, Italy.
Study Methods
Researchers explored the relationship between mortality and post–cancer diagnosis consumption of ultraprocessed food. They also explored whether inflammatory, metabolic, or cardiovascular biomarkers of chronic disease could explain the association between ultraprocessed food and mortality.
“What people eat after a cancer diagnosis may influence survival, but most research in this population has focused only on nutrients, not how processed the food is,” Dr. Bonaccio said. “The substances involved in the industrial processing of foods can interfere with metabolic processes, disrupt gut microbiota, and promote inflammation. As a result, even when an ultraprocessed food has a similar calorie content and nutritional composition on paper compared to a minimally processed or ‘natural’ food, it could still have a more harmful effect on the body.”
They conducted a longitudinal analysis of 802 men and women with a prior cancer diagnosis who were enrolled in the Moli-sani study, a prospective cohort study looking at risk factors for chronic degenerative disease that included 24,325 adult participants from Molise, Italy. In this cohort, the participants provided information on their food intake at baseline.
For the sake of the study, ultraprocessed foods were defined by the Nova classification, and the Mediterranean Diet Score was used for determining the quality of the participants' diets. The investigators explored data across seven groups of ultraprocessed foods to see if nutritional content, or lack thereof, impacted mortality.
Key Findings
In the study period, 281 participants died. Higher ultraprocessed food consumption (vs lowest) was associated with an adjusted hazard ratio (aHR) for all-cause mortality of 1.48 (95% confidence interval [CI] = 1.07–2.03) and the cancer mortality aHR was 1.57 (95% CI = 1.00–2.47).
"The fact that the association between ultraprocessed foods and all-cause death persisted even after adjusting for overall diet quality suggests that the negative health effects are not explained solely by poor nutrient profiles, but that the level and nature of industrial food processing itself play an independent role in influencing long-term health outcomes.” Dr. Bonaccio said.
Inflammation markers plus resting heart rate levels impacted the relationship between ultraprocessed food consumption and all-cause mortality by 37.3%.
“The main message for the public is that overall consumption of ultraprocessed foods matters far more than any individual item,” Dr. Bonaccio said. “Focusing on the diet as a whole and reducing ultraprocessed foods overall and shifting consumption toward fresh, minimally processed, home-cooked foods is the most meaningful and beneficial approach for health. A practical way to do this is by checking labels: foods with more than five ingredients, or even only one food additive, are likely to be ultraprocessed.”
The study authors did note that causality cannot be inferred from these findings due to self reporting of the intake and further research is needed.
DISCLOSURE: The study was funded by the Fondazione AIRC per la Ricerca sul Cancro ETS. Dr. Bonaccio reported no conflicts of interest. For full disclosures of the other study authors, visit aacrjournals.org.
