Public Health Nutr. 2021 Aug 5:1-28. doi: 10.1017/S1368980021003256. Online ahead of print.
ABSTRACT
OBJECTIVE: To determine the association between ultra-processed food intake and all-cause mortality in a representative sample of Spanish population.
DESIGN: Prospective cohort design in which follow-up lasted from baseline (1991) to mortality date or December 31st, 2017, whichever was first. Dietary information was collected using a validated frequency questionnaire and categorized following the NOVA classification according to the extent of food processing. The association between consumption of ultra-processed food and mortality was analysed using Cox models. Isocaloric substitution models were constructed to compare the health effects of the NOVA groups.
SETTING: Cohort from the DRECE study, representative of the Spanish population.
PARTICIPANTS: 4679 subjects between 5 and 59 years old.
RESULTS: Average consumption of ultra-processed food was 370.8 grams/day (24.4% of energy intake). After a median follow-up of 27 years, 450 deaths occurred. Those who consumed the highest amount of ultra-processed foods had higher risk of mortality. For every 10% of the energy intake from ultra-processed foods consumption, an increase of 15% in the hazard of all-cause mortality was observed (HR, 1.15; 95%CI, 1.03-1.27; p-value= 0.012). Substitution of ultra-processed foods with minimally processed foods was significantly associated with a decreased risk of mortality.
CONCLUSIONS: An increase in ultra-processed foods consumption was associated with higher risk of all-cause mortality in a representative sample of the Spanish population. Moreover, the theoretical substitution of ultra-processed food with unprocessed or minimally processed foods leads to a decrease in mortality. These results support the need to promote diets based on unprocessed or minimally processed foods.
PMID:34348832 | DOI:10.1017/S1368980021003256
