Ultra-processed food consumption and mortality among patients with stages I-III colorectal cancer: a prospective cohort study.

IF 9.6 1区医学 Q1 MEDICINE, GENERAL & INTERNAL EClinicalMedicine Pub Date : 2024-03-28 eCollection Date: 2024-05-01 DOI:10.1016/j.eclinm.2024.102572

Dong Hang, Mengxi Du, Lu Wang, Kai Wang, Zhe Fang, Neha Khandpur, Sinara Laurini Rossato, Eurídice Martínez Steele, Andrew T Chan, Frank B Hu, Jeffrey A Meyerhardt, Dariush Mozaffarian, Shuji Ogino, Qi Sun, John B Wong, Fang Fang Zhang, Mingyang Song

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Abstract

Background: Ultra-processed foods (UPFs) are emerging as a risk factor for colorectal cancer (CRC), yet how post-diagnostic UPF intake may impact CRC prognosis remains unexplored.

Methods: Data collected from food frequency questionnaires were used to estimate intakes of total UPFs and UPF subgroups (serving/d) at least 6 months but less than 4 years post-diagnosis among 2498 patients diagnosed with stages I-III CRC within the Nurses' Health Study and Health Professionals Follow-up Study during 1980-2016. Hazard ratios (HR) and 95% confidence intervals (CIs) of all-cause, CRC- and cardiovascular disease (CVD)-specific mortality in association with UPF consumption were estimated using an inverse probability weighted multivariable Cox proportional hazards regression model, adjusted for confounders.

Findings: The mean (SD) age of patients at diagnosis was 68.5 (9.4) years. A total of 1661 deaths were documented, including 321 from CRC and 335 from CVD. Compared to those in the lowest quintile (median = 3.6 servings/d), patients in the highest quintile (median = 10 servings/d) of post-diagnostic UPF intake had higher CVD mortality (HR = 1.65, 95% CI = 1.13-2.40) but not CRC or all-cause mortality. Among UPF subgroups, higher consumption of fats/condiments/sauces was associated with a higher risk of CVD-specific mortality (highest vs. lowest quintile of intake, HR = 1.96, 95% CI = 1.41-2.73), and higher intake of ice cream/sherbet was associated with an increased risk of CRC-specific mortality (highest vs. lowest quintile, HR = 1.86, 95% CI: 1.33-2.61). No statistically significant association was found between UPF subgroups and overall mortality.

Interpretation: Higher post-diagnostic intake of total UPFs and fats/condiments/sauces in CRC survivors is associated with higher CVD mortality, and higher ice cream/sherbet intake is linked to higher CRC mortality.

Funding: US National Institutes of Health and the American Cancer Society.

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超加工食品摄入量与 I-III 期结直肠癌患者的死亡率：一项前瞻性队列研究。

背景：超加工食品（UPFs）正在成为结直肠癌（CRC）的一个风险因素，但诊断后UPFs摄入量如何影响CRC的预后仍有待研究：方法：在1980-2016年期间的护士健康研究和卫生专业人员随访研究中，对2498名诊断为I-III期CRC的患者进行了调查，通过食物频率调查问卷收集的数据用于估算诊断后至少6个月但少于4年的UPF总摄入量和UPF亚组摄入量（份/天）。采用反概率加权多变量考克斯比例危险回归模型估算了全因、CRC和心血管疾病（CVD）特异性死亡率与UPF摄入量相关的危险比（HR）和95%置信区间（CIs），并对混杂因素进行了调整：患者确诊时的平均（标清）年龄为 68.5 (9.4) 岁。共有 1661 例死亡记录，其中 321 例死于 CRC，335 例死于心血管疾病。与最低五分位数（中位数=3.6份/天）的患者相比，诊断后UPF摄入量最高五分位数（中位数=10份/天）的患者心血管疾病死亡率较高（HR=1.65，95% CI=1.13-2.40），而CRC或全因死亡率则不高。在UPF亚组中，脂肪/调味品/酱汁摄入量越高，心血管疾病特异性死亡风险越高（摄入量最高五分位数与最低五分位数相比，HR = 1.96，95% CI = 1.41-2.73），冰淇淋/雪糕摄入量越高，CRC特异性死亡风险越高（摄入量最高五分位数与最低五分位数相比，HR = 1.86，95% CI：1.33-2.61）。UPF亚组与总死亡率之间没有统计学意义上的关联：解读：CRC幸存者诊断后摄入较高的总UPF和脂肪/调味品/酱汁与较高的心血管疾病死亡率有关，较高的冰淇淋/雪糕摄入量与较高的CRC死亡率有关：美国国立卫生研究院和美国癌症协会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

EClinicalMedicine Medicine-Medicine (all)

CiteScore

18.90

自引率

1.30%

发文量

506

审稿时长

22 days

期刊介绍： eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.