Women with high ultraprocessed food intake have 56% greater lupus risk
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Key takeaways:
- Women in the highest tertile of ultraprocessed food consumption had a 56% greater chance of SLE vs. the lowest.
- Sugar- or artificially sweetened beverages were most strongly associated with SLE.
Women who consume the greatest daily amount of ultraprocessed foods on average demonstrate a 56% higher risk for systemic lupus erythematosus, according to data published in Arthritis Care & Research.
The researchers additionally concluded that those women also had more than double the risk for anti-dsDNA antibodies, potentially leading to more severe disease.
“We have also investigated other factors, such as obesity and body mass index, and found that high body mass index was associated with increased risk for lupus, especially in more recent years, and we started thinking about what has changed in terms of dietary intake over the past decades,” Karen H. Costenbader, MD, MPH, professor of medicine at Harvard Medical School, told Healio. “Intake of factory-made, ultraprocessed food has really taken off over that time and just continues to increase in the American diet.”
To assess the links between ultraprocessed food intake and SLE, Costenbader and colleagues analyzed data from two prospective cohorts of women in the Nurses’ Health Study (n = 98,614) and the Nurses’ Health Study II (n = 105,561). The two studies cover overlapping time spans ranging from 1984 to 2017.
Every 2 to 4 years, participants reported food intake over the previous year using the semiquantitative food frequency questionnaire. Ultraprocessed foods included ready-to-eat products, packaged sweets and desserts, sugar-sweetened and artificially sweetened beverages, and packaged savory snacks. The researchers grouped the participants into tertiles based on their cumulative average intake of ultraprocessed foods, and used time-varying Cox regressions to estimate their risks for incident SLE.
In all, 212 participants demonstrated incident SLE during the study period.
In the pooled cohort, participants in the highest intake tertile had a 56% higher chance of developing SLE (HR = 1.56; 95% CI, 1.04-2.32), following multivariable adjustment, according to the researchers. There was an even stronger association with anti-dsDNA antibodies, which were more than twice as likely (HR = 2.05; 95% CI, 1.15-3.65) in the highest tertile.
The category of ultraprocessed food most strongly associated with increased SLE risk was sugar-sweetened or artificially sweetened beverages (multivariable HR = 1.45; 95% CI, 1.01-2.09), the researchers added.
“We have found the same in the past for rheumatoid arthritis risk,” Costenbader said. “I think this is very interesting and points to an underlying biological effect.”
According to Costenbader, it is critical for clinicians to assess patient diets and have “frank conversations” about the outcomes associated with ultraprocessed food, including obesity, diabetes and cancer.
“Now lupus is added to that list,” she said. “Anything that can be done to reduce the risk for developing lupus, in my opinion, should be done. This is really most applicable for young women with a family member with lupus, as they are at highest risk.”
Costenbader called for further study of ultraprocessed food intake and the development of autoimmunity — concurrent with efforts to reduce intake at the population level.
“It would be great to prove that changes in diet, and reducing ultraprocessed food consumption in particular, can lead to prevention of cases of lupus and other autoimmune diseases in a high risk population,” she said.
For more information:
Karen H. Costenbader, MD, MPH, can be reached at kcostenbader@bwh.harvard.edu; X (Twitter): @karen_kc123.
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