Two big studies published today in The BMJ indicate correlations between high intake of ultra-processed foods and elevated risks of cardiovascular disease, bowel (colorectal) cancer, and death.

The findings provide more proof in favor of policies that discourage consumption of ultra-processed meals and encourage consumption of unprocessed or less processed foods in order to enhance global public health.

By paying more attention to the degree of processing of foods together with nutrient-based recommendations, they also strengthen the chance to reformulate dietary standards globally.

Packaged baked goods and snacks, carbonated beverages, sugary cereals, and ready-to-eat or heat products are examples of ultra-processed foods. These items typically have high levels of added sugar, fat, and/or salt, but are typically devoid of beneficial fiber and vitamins.

Though previous research has found a correlation between eating ultra-processed foods and an increased risk of obesity, hypertension, high cholesterol, and some malignancies, the results have been inconsistent due to study design and sample size constraints.

In the initial investigation, scientists looked at the relationship between colorectal cancer risk in US people and consumption of highly processed foods.

Their conclusions are based on data from 159,907 women and 46,341 men who participated in three large studies of US health professionals whose dietary consumption was measured every four years using thorough food frequency questionnaires.

Foods were categorized according to their level of processing, and colorectal cancer rates were calculated over a 24- to 28-year period while taking into consideration lifestyle and medical conditions.

The results showed that men in the highest fifth of ultra-processed food consumption had a 29% higher risk of developing colorectal cancer compared to those in the lowest fifth of consumption. This difference was still significant after accounting for factors like body mass index and dietary quality.

Overall consumption of ultra-processed foods was not linked to a higher risk of colorectal cancer in women. However, a higher intake of ready-to-eat foods containing meat, poultry, or fish as well as sugar-sweetened beverages among men and ready-to-eat/heat mixed dishes among women was linked to a higher risk of colorectal cancer.

In the second study, the researchers analyzed the relationship between two food classification systems and mortality: the Food Standards Agency Nutrient Profiling System (FSAm-NPS), from which the color-coded Nutri-Score front-of-pack label is derived, and the NOVA scale, which assesses the degree to which food has been processed.

Their conclusions are based on data from the Moli-Sani Study, which looked at genetic and environmental risk factors for cancer and heart disease in 22,895 Italian individuals (average age, 55; 48% men).

Over a 14-year period (2005 to 2019), deaths were measured and the quantity and quality of food and beverages consumed were evaluated while also accounting for underlying medical conditions.

As opposed to individuals in the lowest quarter (healthiest diet), those in the highest quarter of the FSAm-NPS index (least healthy diet) had a 32% higher risk of dying from cardiovascular disease and a 19% higher chance of dying from any cause.

When the two highest levels of ultra-processed food consumption on the NOVA scale were compared, the risks were comparable (19% and 27% greater for cardiovascular and all-cause mortality, respectively).

Higher levels of food processing explained a big portion of the extra mortality risk seen with poor dietary habits. In contrast, even after accounting for the diet’s poor nutritional content, consumption of ultra-processed foods continued to be linked to death.

The limitations of both studies include the potential that some of the risks may be caused by other unmeasured (confounding) factors since they are observational and therefore unable to determine causality.

However, because both investigations took use of trustworthy dietary quality indicators and took into consideration widely recognized risk factors, the results support earlier studies that have linked highly processed foods to ill health.

So, both research teams say their results show how important it is for the health of the population as a whole to limit certain types of ultra-processed foods. The findings of the Italian study support the possibility of reformulating dietary recommendations globally by paying more attention to the level of processing of foods in addition to nutrient-based advice.

In the linked article, Brazilian researchers say that no sensible person would want to eat foods that make people sick.

They say that the best overall solution is to make fresh, minimally processed foods easy to find, appealing, and affordable. And keeping up national efforts to promote and support freshly made meals made with fresh and minimally processed foods and small amounts of processed culinary ingredients and processed foods.

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