Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study

BMJ. 2019 May 29;365:l1949. doi: 10.1136/bmj.l1949.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Cohort Studies
  • Correlation of Data
  • Eating*
  • Fast Foods* / adverse effects
  • Fast Foods* / analysis
  • Fast Foods* / classification
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mortality*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology

Associated data

  • ClinicalTrials.gov/NCT02669602