Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study.

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-06-02 DOI:10.1016/j.ajcnut.2025.05.033

Alyssa Feinberg, Casey M Rebholz, Rozenn N Lemaitre, Amanda M Fretts, Kerri Wiggins, Nona Sotoodehnia, Bruce M Psaty, Hyunju Kim

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引用次数: 0

Abstract

Background: Ultra-processed food (UPF) consumption is associated with adverse health outcomes. Plant- and animal-sourced UPFs have a unique nutritional composition to improve palatability, which may impact health, but evidence is limited.

Objectives: The objective of this study was to investigate the association between UPF intake, plant- and animal-sourced UPF, and mortality outcomes in older adults.

Methods: We conducted prospective analyses of 2582 participants (median age: 77 y) in the Cardiovascular Health Study who completed a food frequency questionnaire (FFQ) in 1995-1996. We used responses from the FFQ to identify UPF and classify UPF based on their source (plant or animal). Cox proportional hazard regression models were used to study the association between UPF, plant- and animal-sourced UPF, and mortality outcomes (all-cause, cardiovascular disease [CVD] related, non-CVD related, and cancer).

Results: Over a median follow-up of 10 y, there were 2242 deaths. After adjusting for sociodemographic characteristics and health behaviors, per standard deviation (SD) higher intake of UPF was associated with 8%-10% higher risk of all-cause mortality (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.02, 1.14), non-CVD related mortality (HR: 1.10; 95% CI: 1.03, 1.18), and cancer mortality (HR: 1.13; 95% CI: 1.08, 1.46). Similarly, per SD, higher intake of plant- and animal-sourced UPFs was associated with a 4%-17% higher risk of all-cause mortality, non-CVD related mortality, and cancer mortality. However, in a model additionally adjusting for clinical factors, the associations between plant-sourced UPF and mortality attenuated, except for cancer mortality. No significant associations were observed for CVD related mortality.

Conclusion: Higher consumption of UPF and plant- and animal-sourced UPFs was associated with higher risk of all-cause, non-CVD related, and cancer mortality. Our findings emphasize the need to consider the impact of food processing, even in plant-sourced foods, to prevent a shorter lifespan in older adults. Findings on plant-sourced UPF and mortality require replication.

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美国老年人的超加工食品、植物和动物来源、全因、心血管和癌症死亡率：来自心血管健康研究的结果

背景：超加工食品（UPF）消费与不良健康结果相关。植物和动物源UPF具有独特的营养成分，可改善可影响健康的适口性，但证据有限。目的：本研究的目的是调查UPF摄入量、植物源和动物源UPF与老年人死亡率结果之间的关系。方法：我们对心血管健康研究的2582名参与者（中位年龄：77岁）进行了前瞻性分析，这些参与者在1995-1996年间完成了食物频率问卷（FFQ）。我们使用FFQ的响应来识别UPF，并根据UPF的来源（植物或动物）对其进行分类。使用Cox比例风险回归模型研究UPF、植物源和动物源UPF与死亡率结局[全因、心血管（CVD）相关、非CVD相关和癌症]之间的关系。结果：在中位随访10年期间，有2242人死亡。在对社会人口学特征和健康行为进行调整后，每标准差（SD）较高的UPF摄入量与全因死亡率（HR: 1.08, 95% CI: 1.02, 1.14）、非心血管疾病相关死亡率（HR: 1.10, 95% CI: 1.03, 1.18）和癌症死亡率（HR: 1.13, 95% CI: 1.08, 1.46）升高8-10%相关。同样，每SD植物源UPF和动物源UPF的高摄入量与4-17%的全因死亡率、非心血管疾病相关死亡率和癌症死亡率相关。然而，在一个额外调整临床因素的模型中，除癌症死亡率外，植物源UPF与死亡率之间的关联减弱。未观察到心血管疾病相关死亡率的显著相关性。结论：UPF、植物源和动物源UPF的较高消费与全因、非心血管疾病相关和癌症死亡率的较高风险相关。我们的研究结果强调，有必要考虑食品加工的影响，即使是植物来源的食品，以防止老年人寿命缩短。关于植物源UPF和死亡率的研究结果需要复制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.