Ultra-processed foods increase risk for all-cause, CVD mortality in preexisting CVD
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A diet rich in ultra-processed food was found to be associated with increased hazards of all-cause and CVD mortality among patients with preexisting CVD, according to data published in European Heart Journal.
“Although high consumption of ultra-processed food has been reportedly associated with an increased risk of metabolic conditions, such as obesity, diabetes, hyperlipidemia and a decline in renal function, only a few epidemiological studies so far have addressed longitudinally whether such altered conditions possibly mediate the relation between ultra-processed food and adverse health outcomes,” Marialaura Bonaccio, PhD, of the department of epidemiology and prevention at IRCCS Neuromed Mediterranean Neurological Institute in Italy, and colleagues wrote.
“To fill this knowledge gap, we first aimed to disentangle the association of ultra-processed food intake with all-cause and cause-specific mortality among individuals with a history of CVD by analyzing data from a large Italian cohort recruited within the Moli-sani study, taking advantage of a long follow-up period; second, we tested blood biomarkers (eg, markers of renal function) and other known CVD risk factors (eg, blood pressure) as possible parameters on the pathway between ultra-processed food and all-cause and cause-specific mortality.”
Bonaccio and colleagues conducted a longitudinal analysis on 1,171 adults (mean age, 67 years; 32% women) with a history of CVD who were recruited in the Moli-sani study, conducted in Italy from 2005 to 2010. Participants were followed for a median of 10.6 years.
Ultra-processed food was defined as processed foods containing predominantly industrial substances and little to no whole foods. A food frequency questionnaire was used to assess food intake, and ultra-processed food intake was categorized into quartiles dependent on the percentage of ultra-processed food in total food and beverages consumed per day. Researchers evaluated the mediating effects of 18 inflammatory, metabolic, CV and renal biomarkers.
In multivariable-adjusted analyses, researchers found the highest quartile intake of ultra-processed food ( 11.3% of total food), as compared with the lowest quartile intake (< 4.7% of total food), was associated with higher hazards of all-cause (HR = 1.38; 95% CI, 1-1.91) and CVD mortality (HR = 1.65; 95% CI, 1.07-2.55). Researchers also observed a linear dose-response relationship of 1% increment in ultra-processed food intake with all-cause and CVD mortality.
Altered cystatin C levels were attributed to 18.3% and 16.6% of the relation between a 1% increment of ultra-processed food in the diet with all-cause and CVD mortality, respectively.
“Further longitudinal studies with similar designs are warranted to replicate and potentially confirm these findings in different populations with preexisting CVD,” Bonaccio and colleagues wrote.