Two large studies that followed participants for decades provided additional evidence that the foods we eat – and don’t eat – can have significant health consequences. Research published on August 31 in BMJIt found that people who ate more “ultra-processed” foods were more likely to develop cardiovascular disease, bowel (colorectal) cancer and early death.
What are ultra-processed foods? They include items like hot dogs, luncheon meats, baked goods, salty snacks like chips, and sugary drinks, along with ready-to-eat meals or prepackaged microwave meals, which can contain more unhealthy fats and lots of sodium.
According to the researchers, these findings add further support for policies that limit ultra-processed foods and promote unprocessed or minimally processed foods to improve overall health worldwide.
Researchers have followed participants for more than two decades to assess their cancer risk
In the The first studyResearchers examined the relationship between consumption of ultra-processed foods and the risk of colorectal cancer in US adults using data from 46,341 men and 159,907 women who participated in one of three large studies of American health professionals: the Nurses Health Study (1986-2014), and the Nurses Health Study. The second (1991-2015), the Health Occupational Follow-up Study (1986-2014).
“We’re starting to think that colorectal cancer could be the cancer most affected by diet compared to other cancers,” said the lead author. Lu Wang, Ph.D.a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts University in Boston, VA press release. “Processed meat, most of which falls into the category of ultra-processed foods, is a strong risk factor for colorectal cancer. Ultra-processed foods are also high in added sugars and low in fiber, which contributes to weight gain and obesity, and obesity is a risk factor.” Confirmed to have colon and rectal cancer.
Previous studies have linked ultra-processed foods to a higher risk of obesity, high blood pressure, cholesterol, and some types of cancer, but there isn’t a lot of research examining the relationship between eating ultra-processed foods and the risk of colorectal cancer, according to the authors.
This study followed participants for 24 to 28 years and controlled for many medical and lifestyle factors, giving researchers a unique opportunity to learn about the possible long-term effect of the diet.
“Cancer development takes years or even decades, and from our epidemiological studies, we’ve shown a potential latency effect – it takes years to see an effect of a particular exposure on cancer risk,” said the co-author. Minjiang Song, SCD, Assistant Professor of Clinical Epidemiology and Nutrition at Harvard T.H. Chan School of Public Health, in the press release. “Because of this long process, it is important to have a long-term exposure to the data to better assess cancer risk,” he said.
Ultra-processed foods are often high in sugar and fat, but low in vitamins and fiber
The dietary intake of each person included in the analysis was assessed every four years using detailed food frequency questionnaires. To measure the association between level of processing and cancer risk, researchers assigned foods to one of four groups: unprocessed or minimally processed foods, processed cooking ingredients, processed foods, and ultra-processed foods.
- Unprocessed or minimally processed foods include fresh fruits and vegetables, as well as raw meat and dairy products.
- Processed cooking ingredients include ingredients used in cooking, such as sugars, oils, and starches.
- Processed foods are made by adding sugars, oils, or salt to minimally processed or unprocessed foods, such as canned fruit with added sugar, canned vegetables, and some canned meats and meat products.
- Ultra-processed foods include mass-produced products that require artificial formulations, such as sugar-sweetened beverages, baked goods, packaged snacks, sugary cereals, and ready-to-eat or heat products, which often contain high levels of added sugar, fat, and salt, but not much vitamins and fibres.
Packaged foods and drinks sweetened with sugar have been associated with an increased risk of colorectal cancer in men
The investigators found that compared with those in the lowest quintile of ultra-processed food consumption, men in the highest quintile had a 29 percent higher risk of developing colorectal cancer, which remained significant after controlling for body mass index (BMI) and diet quality.
The strongest association between colorectal cancer and ultra-processed foods among men came from ready-to-eat meat, poultry or fish products, including some processed meats such as sausage, bacon, ham and fish cakes.
“The results are by no means surprising, especially with regard to processed meat,” he says. Otis Brawley, MDprofessor of oncology at Johns Hopkins Medicine in Baltimore and a globally recognized expert in cancer prevention and control who was not involved in the research.
“It is estimated that processed meat actually causes 34,000 deaths annually worldwide,” says Dr. Brawley. An analysis of 10 studies concluded that every 50 grams of processed meat eaten daily Increased risk of colorectal cancer by 18%notice.
Although the latest study provides insight into how self-reported food intake is related to the incidence of colorectal cancer, more research is needed to confirm what is happening and which may contribute to the increased risk, says Amanda Budd, RDN, of the Cleveland Center. Clinic Human Nutrition, who was not involved in the research. Perhaps it is the lack of fruits, vegetables, and whole grains that alters the microbes that lead to inflammation. Or do the additives and preservatives used in processed foods damage the gut? ” Says.
About 1 in 8 adults consume the recommended 1.5 to 2 cups of fruit each day, and only one in 10 eats 2 to 3 cups of vegetables each day, including legumes, according to data from a Centers for Disease Control and Prevention (CDC) report Published January 2022.
Highly processed foods have not been linked to colorectal cancer in Women
Interestingly, no association was observed between total consumption of processed foods and the risk of colorectal cancer among women.
It is possible that the composition of ultra-processed foods consumed by women may be different from that of men, the researchers said. For example, some foods that are considered ultra-processed, such as yogurt, actually reduce the risk of colorectal cancer.
Bode says it’s not clear why the study showed differences in risk and intake between men and women. She says there may be under-reporting of ultra-processed foods, or women may have better choices within the ultra-processed foods group, or there may be female hormones that protect against colorectal cancer.
Which is worse for health, processed foods, or foods low in nutrition?
In the second studyIn the study, the researchers used two different scales to compare “nutrient poor” foods and drinks high in sugar and saturated or trans fats with “ultra-processed” foods and drinks to determine how each category affects the development of chronic disease (particularly heart disease) and early death.
A total of 22,895 Italian adults from Molly Sani Project were included in the study; 52 percent were women, and the average age of the participants was 55 years old.
The researchers looked at the quality and quantity of what was consumed, and mortality was measured over a 14-year period (2005 to 2019), taking into account underlying medical conditions.
The results showed that those who ate the least healthy had a 19 percent higher risk of death from any cause and a 32 percent higher risk of dying from cardiovascular disease than those who followed a healthy diet.
Foods that are significantly lacking in nutrients and processed add the same amount of risk, with processed foods associated with slightly worse outcomes.
The results confirmed that consuming nutrient-deficient foods or ultra-processed foods independently increased the risk of death, particularly from cardiovascular disease, said the first author, Mariala Bonaccio, Ph.D.an epidemiologist in the Department of Epidemiology and Prevention at the IRCCS Mediterranean Neurological Institute in Boselli, Italy, at press release. But when the researchers took into account the overall nutritional composition of the diet and the degree to which it was processed, it turned out that processing was paramount in determining the risk of death, she said.
She noted that more than 80 percent of foods classified as unhealthy are also ultra-processed. “This suggests that the increased risk of death is not directly (or exclusively) due to the poor nutritional quality of some products, but rather to the fact that these foods are often over-processed.”
Brawley says these results are expected. There are a number of factors at work — one of which is that many processed foods are high in calories and contribute to obesity, which is a risk factor for many diseases, he says.
a A study published in October 2020 in European Heart Journal: quality of care and clinical outcomes The researchers concluded that two-thirds of heart disease-related deaths worldwide could be linked to food choices – and the authors estimated that six million deaths could have been avoided through a better diet.
Both the Tufts study and the Italian study were observational and did not establish a cause, and their limitations include the possibility that some disease risk is due to unmeasured factors, according to the authors.
Brawley says that these studies, along with several other well-designed cohort studies, have consistently demonstrated these associations. “The only way forward is to do prospective, long-term randomized trials, which would be impossible to do and potentially unethical. You can’t give a substance that you think is definitely carcinogenic to a group of people in a clinical trial to see if they have cancer, he points out.
Healthy Eating for Life: Expert Tips on Developing a Healthy Eating Pattern
In November 2021, the American Heart Association released Updated nutritional guidelines The first in 15 years. The new guidelines emphasize the importance of a healthy and sustainable eating pattern rather than drastic – and usually short-lived – changes.
Alice H. Liechtenstein, DScD., chair of the American Heart Association Statement Writing Group, chief scientist, and director of the Cardiovascular Nutrition Team at the USDA Human Nutrition Research Center on Aging at Tufts University in Boston, offer the following advice.
Shop around. Find out what different foods are available in your area at the price you are willing to pay.
Find the healthiest foods you eat regularly. Take time to compare the different foods you enjoy. “For example, if you want to eat soup or crackers – check labels to find options lower in sodium, added sugars or unhealthy fats.”
Check the internet for nutritional information on ready meals or ready meals. Many places have nutritional information for different items. As a general rule, even for prepared foods or prepared foods, the less processing, the better.
When faced with choices, consider heart health guidelines. If you’re faced with choices about bread or rice, choose whole grains when possible. When you put a salad together, focus on more vegetables and fewer items such as bacon bits or heavy dressings.
Enjoy your food. People often think that if food is healthy, it won’t taste good, says Dr. Lichtenstein. “Not true. There is a lot of flexibility in healthy choices. You have to be able to find the one you enjoy.”
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