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February 06, 2022
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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.

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“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.