Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 30742202 · doi:10.1001/jamainternmed.2018.7289
What was done
This prospective observational cohort study evaluated 44,551 French adults aged 45 years or older from the NutriNet-Santé study followed for a median of 7.1 years (2009–2017). Baseline dietary intake was assessed using at least one set of three web-based 24-hour dietary records over the first two years of follow-up. Foods were categorized using the NOVA classification system to determine the proportion (by weight) of ultraprocessed foods in the diet. All-cause mortality was tracked via the French national mortality registry (CépiDC), and multivariable Cox proportional hazards regression models adjusted for sociodemographic, anthropometric, and lifestyle factors.
What was found
Ultraprocessed foods accounted for a mean (SD) of 14.4% (7.6%) of food weight and 29.1% (10.9%) of total energy intake. Higher consumption was significantly associated with younger age (45–64 years: 14.50% vs older; P < .001), lower income (<€1200/month: 15.58%; P < .001), lower educational level (no diploma/primary: 15.50%; P < .001), living alone (15.02%; P < .001), BMI ≥30 (15.98%; P < .001), and lower physical activity (15.56%; P < .001). Over follow-up, 602 deaths (1.4%) occurred. After multivariable adjustment, each 10% increment in the proportion of ultraprocessed food consumption was associated with a 14% increase in all-cause mortality risk (HR 1.14; 95% CI, 1.04–1.27; P = .008).
Why it matters
This study provides early prospective epidemiological evidence linking higher consumption of ultraprocessed foods directly to increased all-cause mortality risk in middle-aged adults, supporting dietary guidelines that recommend limiting industrial food processing.
Limits
Dietary intake relied on self-reported web-based records, introducing potential measurement error. The cohort predominantly comprised women (73.1%) and health-conscious volunteers, limiting generalizability. The total number of deaths was relatively small (602 events, 1.4% mortality rate), and residual confounding from unmeasured socioeconomic or lifestyle variables cannot be ruled out.
Cited by
- supports A JAMA study published around 2019 demonstrated that consumption of ultra-processed foods was associated with a 14% increased risk of all-cause mortality.