2026-07-21T17:02:04Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/89342025-04-25T09:16:30Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605
Repisalud
author
Blanco-Rojo, Ruth
author
Sandoval-Insausti, Helena
author
López-García, Esther
author
Graciani, Auxiliadora
author
Ordovas, Jose M
author
Banegas, José Ramón
author
Rodríguez-Artalejo, Fernando
author
Guallar-Castillón, Pilar
funder
Instituto de Salud Carlos III
funder
Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
funder
Unión Europea
2020-01-29T10:32:30Z
2020-01-29T10:32:30Z
2019-11
Mayo Clin Proc. 2019; 94(11):2178-2188
10.1016/j.mayocp.2019.03.035
1942-5546
0025-6196
Mayo Clinic proceedings
31623843
http://hdl.handle.net/20.500.12105/8934
OBJECTIVE: To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. PATIENTS AND METHODS: A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. RESULTS: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. CONCLUSION: A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01133093.
eng
Consumption of Ultra-Processed Foods and Mortality: A National Prospective Cohort in Spain
journal article
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ConsumptionUltraProcessedFoods_2019.pdf.txt
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