A recent study from the European Journal of Nutrition examined the risk of oesophageal adenocarcinoma (OAC) and head and neck cancer (HNC) associated with the consumption of ultra-processed foods (UPFs) within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.
Background
The relationship between disease risk and industrial food processing has recently garnered significant attention. Ultra-processed foods (UPFs) are made from ingredients like hydrogenated oils, emulsifiers, and modified starches, not commonly found in home kitchens. These ready-to-eat and cheap products are often consumed in large quantities, with examples including packaged snacks, soft drinks, and prepared dishes.
Past research has shown that consuming UPFs may heighten the risk of cancer. The EPIC cohort revealed a positive association between HNC and OAC and UPF consumption. Additionally, UPFs were linked to greater adiposity, a risk factor for OAC, with one study documenting a positive correlation between body mass index and HNC risk among never-smokers.
About the study
The study aimed to further explore the relationship between UPF consumption and the risk of HNC and OAC. In addition to the association with HNC, the researchers examined subtypes of HNC, including hypopharynx, larynx, oral cavity, oropharynx, and other cancers. They also analyzed additional factors such as smoking, alcohol consumption, and physical activity. A mediation analysis was conducted to study the role of BMI in the association between UPF and HNC, and OAC.
In total, 450,111 EPIC participants were included. Cox regressions were used to explore the correlations between UPF consumption and the risk of HNC and OAC. The effects of BMI and waist-to-hip ratio (WHR) on these correlations were also assessed, along with sensitivity analyses involving accidental death as a negative control outcome.
Key findings
UPF consumption was associated with an elevated risk of OAC and HNC. While there was no evidence of heterogeneity across HNC subtypes, males exhibited a stronger positive correlation between UPF consumption and HNC than females. The mediation analysis suggested that residual confounding could have influenced the results, consistent with existing literature documenting the relationship between UPF consumption and central adiposity (WHR) and excess weight (BMI). These findings highlight the need for replication in other settings to validate these results.
Strengths and limitations
One of the strengths of the study was the large sample size and extended follow-up time, along with the diverse nature of the sample thanks to EPIC’s multi-center design. Actual measurements of BMI and WHR, instead of self-reports, provided robust data. However, the study also had limitations, including potential bias due to measurement error or residual confounding. Further follow-up data and potential confounding factors were only available for a subset of participants, which poses additional limitations.
Conclusions
This study underscores the association between UPF intake and a higher risk of OAC and HNC, independent of BMI and WHR. The findings emphasize the need for cautious interpretation of results due to potential residual confounding, suggesting the importance of replication in other population settings. For more information, please refer to the journal reference provided below.
Journal reference:
- Morales-Berstein, F., Biessy, C., Viallon, V., Goncalves-Soares, A., Casagrande, C., Hémon, B., Kliemann, N., Cairat, M., Blanco Lopez, J., Al Nahas, A., Chang, K., Vamos, E., Rauber, F., Bertazzi Levy, R., Barbosa Cunha, D., Jakszyn, P., Ferrari, P., Vineis, P., Masala, G., Catalano, A., Sonestedt, E., Borné, Y., Katzke, V., Bajracharya, R., Agnoli, C., Guevara, M., Heath, A., Radoï, L., Mancini, F., Weiderpass, E., Huerta, J. M., Sánchez, M.-J., Tjønneland, A., Kyrø, C., Schulze, M. B., Skeie, G., Lukic, M., Braaten, T., Gunter, M., Millett, C., Agudo, A., Brennan, P., Borges, M. C., Richmond, R. C., Richardson, T. G., Davey Smith, G., Relton, C. L. and Huybrechts, I. (2023) European Journal of Nutrition. doi: 10.1007/s00394-023-03270-1. https://link.springer.com/article/10.1007/s00394-023-03270-1
