Ultra-processed food consumption and mortality among patients with stages I–III colorectal cancer : a prospective cohort study

Background: Ultra-processed foods (UPFs) are emerging as a risk factor for colorectal cancer (CRC), yet how post-diagnostic UPF intake may impact CRC prognosis remains unexplored. Methods: Data collected from food frequency questionnaires were used to estimate intakes of total UPFs and UPF subgroups (serving/d) at least 6 months but less than 4 years post-diagnosis among 2498 patients diagnosed with stages I–III CRC within the Nurses’ Health Study and Health Professionals Follow-up Study during 1980–2016. Hazard ratios (HR) and 95% confidence intervals (CIs) of all-cause, CRC- and cardiovascular disease (CVD)-specific mortality in association with UPF consumption were estimated using an inverse probability weighted multivariable Cox proportional hazards regression model, adjusted for confounders. Findings: The mean (SD) age of patients at diagnosis was 68.5 (9.4) years. A total of 1661 deaths were documented, including 321 from CRC and 335 from CVD. Compared to those in the lowest quintile (median = 3.6 servings/d), patients in the highest quintile (median = 10 servings/d) of post-diagnostic UPF intake had higher CVD mortality (HR = 1.65, 95% CI = 1.13–2.40) but not CRC or all-cause mortality. Among UPF subgroups, higher consumption of fats/condiments/sauces was associated with a higher risk of CVD-specific mortality (highest vs. lowest quintile of intake, HR = 1.96, 95% CI = 1.41–2.73), and higher intake of ice cream/sherbet was associated with an increased risk of CRC-specific mortality (highest vs. lowest quintile, HR = 1.86, 95% CI: 1.33–2.61). No statistically significant association was found between UPF subgroups and overall mortality. Interpretation: Higher post-diagnostic intake of total UPFs and fats/condiments/sauces in CRC survivors is associated with higher CVD mortality, and higher ice cream/sherbet intake is linked to higher CRC mortality. Funding: US National Institutes of Health and the American Cancer Society.

Bibliographic Details

Main Authors:	Hang, Dong, Du, Mengxi, Wang, Lu, Wang, Kai, Fang, Zhe, Khandpur, Neha, Rossato, Sinara Laurini, Steele, Eurídice Martínez, Chan, Andrew T., Hu, Frank B., Meyerhardt, Jeffrey A., Mozaffarian, Dariush, Ogino, Shuji, Sun, Qi, Wong, John B., Zhang, Fang Fang, Song, Mingyang
Format:	Article/Letter to editor biblioteca
Language:	English
Subjects:	Colorectal cancer survivorship, Longitudinal analysis, Patient care, Post-diagnostic dietary intake,
Online Access:	https://research.wur.nl/en/publications/ultra-processed-food-consumption-and-mortality-among-patients-wit
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