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Selected Works of Rasha Khatib, Ph.D, MHS
Article
Ultra-processed foods and mortality: Analysis from the prospective urban and rural epidemiology study
The American journal of clinical nutrition
  • Mahshid Dehghan, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: mahshid.dehghan@phri.ca.
  • Andrew Mente, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Sumathy Rangarajan, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Viswanathan Mohan, Dr. Mohan's Diabetes Specialities Centre, Chennai, India.
  • Sumathi Swaminathan, St John's Research Institute, St John's National Academy of Health Sciences, Sarjapur Road, Koramangala, Bangalore, Karnataka, India.
  • Alvaro Avezum, International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Scott A Lear, Faculty of Health Sciences, Simon Fraser University c/o Healthy Heart Program, St. Paul's Hospital, Vancouver, British Columbia, Canada.
  • Annika Rosengren, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, VGR Region, Sweden.
  • Paul Poirier, Heart and Lung Institute, Laval University, Quebec City, QC, Canad.
  • Fernando Lanas, University of La Frontera, Temuco, Chile.
  • Patricio Lopez-Jaramillo, Masira Research Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia.
  • Biju Soman, Health Action by People, Thiruvananthapuram, Kerala, India.
  • Chuangshi Wang, Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Andrés Orlandini, Clinical Studies Latin America, Rosario, Santa Fe, Argentina.
  • Noushin Mohammadifard, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Khalid F AlHabib, Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Jephat Chifamba, University of Zimbabwe, Faculty of Medicine and Health Sciences, Unit of Physiology, Harare, Zimbabwe.
  • Afzal Hussein Yusufali, Hatta Hospital, Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates.
  • Romaina Iqbal, Department of Community Health Sciences and Medicine, Aga Khan University, Pakistan.
  • Rasha Khatib, Advocate Aurora Health
  • Karen Yeates, Department of Medicine, Queen's University, Kingston, Canada.
  • Thandi Puoane, School of Public Health, University of the Western Cape, Bellville, South Africa.
  • Yuksel Altuntas, University of Health Sciences Turkey, Faculty of Medicine, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Endocrinology and Metabolism, Sisli, Istanbul, Turkey.
  • Homer Uy Co, University of the Philippines College of Medicine, Manila, Philippines.
  • Sidong Li, Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Weida Liu, Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Katarzyna Zatońska, Social Medicine Department of Wroclaw Medical University, Poland.
  • Rita Yusuf, Independent University, Dhaka, Bangladesh.
  • Noorhassim Ismail, Department of Community Health, Faculty of Medicine, University Kebangsaan, Kuala Lumpur, Malaysia.
  • Victoria Miller, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Salim Yusuf, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Link
Affiliations
Advocate Aurora Research Institute
Scholarly Activity Date
1-1-2023
Abstract

Background: Higher intake of ultra-processed foods (UPFs) has been associated with increased risk of CVD and mortality in observational studies from Western countries but data from non-Western countries are limited.

Objectives: We aimed to assess the association between consumption of UPFs and risk of mortality and major CVD in a cohort from multiple world regions.

Design: This analysis includes 138,076 participants without a history of CVD between the ages of 35 and 70 y living on 5 continents, with a median follow-up of 10.2 y. We used country-specific validated food-frequency questionnaires to determine individuals' food intake. We classified foods and beverages based on the NOVA classification into UPFs. The primary outcome was total mortality (CV and non-CV mortality) and secondary outcomes were incident major cardiovascular events. We calculated hazard ratios using multivariable Cox frailty models and evaluated the association of UPFs with total mortality, CV mortality, non-CV mortality, and major CVD events.

Results: In this study, 9227 deaths and 7934 major cardiovascular events were recorded during the follow-up period. We found a diet high in UPFs (≥2 servings/d compared with 0 intake) was associated with higher risk of mortality (HR: 1.28; 95% CI: 1.15, 1.42; P-trend < 0.001), CV mortality (HR: 1.17; 95% CI: 0.98, 1.41; P-trend = 0.04), and non-CV mortality (HR: 1.32; 95% CI 1.17, 1.50; P-trend < 0.001). We did not find a significant association between UPF intake and risk of major CVD.

Conclusions: A diet with a high intake of UPFs was associated with a higher risk of mortality in a diverse multinational study. Globally, limiting the consumption of UPFs should be encouraged.

Document Type
Article
PubMed ID
36789944
Citation Information
Dehghan M, Mente A, Rangarajan S, et al. Ultra-processed foods and mortality: analysis from the Prospective Urban and Rural Epidemiology study. Am J Clin Nutr. 2023;117(1):55-63. doi:10.1016/j.ajcnut.2022.10.014