A recent study has indicated that cancer survivors who consume higher amounts of ultraprocessed foods may face a significantly increased risk of both all-cause and cancer-specific death. The research, published in Cancer Epidemiology, Biomarkers & Prevention, analyzed data from over 800 cancer survivors in Southern Italy over a median period of 14.6 years.
A study conducted as part of the Moli-sani Study cohort has found an association between higher consumption of ultraprocessed foods and an increased risk of mortality among cancer survivors. The findings suggest that the level and nature of industrial food processing may play an independent role in long-term health outcomes for individuals with a history of cancer.
Study Details
Publication and Authorship
The study was published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR). The lead author was Marialaura Bonaccio, PhD, from the Research Unit of Epidemiology and Prevention at IRCCS Neuromed in Pozzilli, Italy.
Understanding Ultraprocessed Foods
Dr. Bonaccio explained the characteristics of ultraprocessed foods:
Ultraprocessed foods often contain low levels of essential nutrients, such as vitamins, minerals, and fiber. Industrial processing methods typically introduce additives, artificial flavorings, preservatives, emulsifiers, and high levels of added sugars and unhealthy fats. These substances may interfere with metabolic processes, disrupt gut microbiota, and promote inflammation, potentially making ultraprocessed foods more detrimental to health than minimally processed foods with similar caloric or nutritional content.
Methodology
Study Design and Participants
The research was a prospective cohort study that followed 24,325 individuals aged 35 or older in Southern Italy from March 2005 to December 2022. Within this larger group, 802 cancer survivors (476 women and 326 men) at baseline provided comprehensive dietary information.
Data Collection and Analysis
Participants' dietary habits were assessed using the European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire. Foods were categorized by their level of processing using the NOVA classification system. Ultraprocessed food consumption was calculated based on both weight ratio and energy ratio, and participants were divided into three groups based on the weight ratio.
The researchers adjusted their analysis for several factors, including demographic characteristics, smoking status, body mass index, physical activity levels, medical history, cancer type, and overall diet quality, as measured by the Mediterranean Diet Score.
Key Findings
During a median follow-up period of 14.6 years, 281 deaths were recorded among the 802 cancer survivors.
Elevated Mortality Risks
Individuals in the highest third of ultraprocessed food consumption by weight ratio exhibited a 48% higher rate of death from any cause and a 57% higher rate of death from cancer when compared to those in the lowest third. A higher energy ratio of ultraprocessed foods showed similar results for cancer-specific death, but not for all-cause mortality.
Beyond Diet Quality: The Role of Biomarkers
The association between ultraprocessed foods and all-cause death remained evident even after accounting for overall diet quality, suggesting that the level and nature of industrial food processing may contribute independently to long-term health outcomes.
Further analysis of biomarkers indicated that adjusting for inflammatory scores and resting heart rate attenuated the association between ultraprocessed foods and all-cause death by 37.3%. This suggests that increased inflammation and elevated resting heart rate may partially explain the observed link.
While some specific groups of ultraprocessed foods were linked to higher mortality, the researchers noted that individual items are challenging to interpret and are better considered as part of a broader dietary pattern.
Researcher's Observations and Recommendations
Dr. Bonaccio stated that the overall consumption of ultraprocessed foods is more significant than individual items. She provided practical advice for survivors:
Focus on the diet as a whole, reducing ultraprocessed foods, and shifting consumption towards fresh, minimally processed, and home-cooked foods. A practical method for identifying ultraprocessed foods involves checking food labels for more than five ingredients or the presence of any single food additive.
Study Limitations
The researchers noted several limitations to the study:
- Its observational design means that it cannot establish causality.
- Dietary intakes were self-reported, which carries a risk of misreporting.
- Dietary habits may have changed over the extensive follow-up period.
- The study was subject to survival bias, as diet was assessed an average of 8.4 years after cancer diagnosis.
- The relatively small number of deaths limited the statistical power of some analyses.
- Data regarding cancer stage at diagnosis were not available.
Funding
The study received funding from the Fondazione AIRC per la Ricerca sul Cancro ETS. Dr. Bonaccio reported no conflicts of interest.