Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort.

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

Journal: BMJ (Clinical research ed.) 2018;360():k322

PMID: 29444771

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Plain Language Summary

Foods that are heavily processed tend to have high levels of total fat, sugar and salt and low levels of fibre and vitamins. They also tend to have high levels of contaminants (caused for example by high heat treatment), food additives and plastic packaging exposure. This large prospective population-based cohort study assessed the association between ultra-processed food consumption and the incidence of cancer. The study found that ultra-processed food intake was associated with a higher overall cancer risk and a higher breast cancer risk. A 10% increase in the consumption of ultra-processed foods was associated with an increase of more than 10% greater risk of overall and breast cancer risk. The authors call for further studies to better understand the different elements of food processing and their association to cancer risk.

Abstract

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.

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Address: Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France.; Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France [email protected].; INRA, UMR 1110 MOISA, 34000 Montpellier, France.; Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France.; Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France.; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.

DOI: 10.1136/bmj.k322