Higher Ultra-Processed Food Consumption Is Associated with Increased Risk of Incident Coronary Artery Disease in the Atherosclerosis Risk in Communities Study
Higher Ultra-Processed Food Consumption Is Associated with Increased Risk of Incident Coronary Artery Disease in the Atherosclerosis Risk in Communities Study
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DOI：
10.1093/jn/nxab285
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发表时间：
2021-12-03
影响因子：
4.2
通讯作者：
Rebholz, Casey M.
中科院分区：
文献类型：
--
作者：
Du, Shutong;Kim, Hyunju;Rebholz, Casey M.
研究背景：超加工食品摄入量增加与多种心脏代谢和心血管疾病有关。然而，来自美国人群的前瞻性证据仍然很少。目的验证超加工食品摄入量与冠状动脉疾病风险相关的假设。方法分析样本包括来自社区动脉粥样硬化风险研究的13，548名年龄在45-65岁的成年人。膳食摄入数据通过66项FFQ收集。使用NOVA分类定义超加工食品，并计算每位参与者的摄入量（份/天）并分为四分位数。我们使用考克斯比例风险模型和限制性三次样条来评估超加工食品摄入量的四分位数与冠状动脉疾病之间的关联。结果在中位随访27年的时间里，记录了2006例冠心病事件。超加工食品摄入量最高四分位数（70.8/10，000人-y; 95% CI：65.1，77.1）的发病率高于最低四分位数（59.3/10，000人-y; 95% CI：54.1，65.0）。在调整社会人口因素和健康行为后，超加工食品摄入量最高的参与者与最低的四分位数相比，患冠状动脉疾病的风险高19%（HR：1.19; 95%CI：1.05，1.35）。超加工食品摄入量与冠状动脉疾病风险之间存在近似线性关系。结论：在美国中年成年人中，超加工食品摄入量增加与冠状动脉疾病风险增加相关。需要进一步的前瞻性研究来证实这些发现，并调查超加工食品可能影响健康的机制。
Background Higher ultra-processed food intake has been linked with several cardiometabolic and cardiovascular diseases. However, prospective evidence from US populations remains scarce. Objectives To test the hypothesis that higher intake of ultra-processed foods is associated with higher risk of coronary artery disease. Methods A total of 13,548 adults aged 45-65 y from the Atherosclerosis Risk in Communities study were included in the analytic sample. Dietary intake data were collected through a 66-item FFQ. Ultra-processed foods were defined using the NOVA classification, and the level of intake (servings/d) was calculated for each participant and divided into quartiles. We used Cox proportional hazards models and restricted cubic splines to assess the association between quartiles of ultra-processed food intake and incident coronary artery disease. Results There were 2006 incident coronary artery disease cases documented over a median follow-up of 27 y. Incidence rates were higher in the highest quartile of ultra-processed food intake (70.8 per 10,000 person-y; 95% CI: 65.1, 77.1) compared with the lowest quartile (59.3 per 10,000 person-y; 95% CI: 54.1, 65.0). Participants in the highest compared with lowest quartile of ultra-processed food intake had a 19% higher risk of coronary artery disease (HR: 1.19; 95% CI: 1.05, 1.35) after adjusting for sociodemographic factors and health behaviors. An approximately linear relation was observed between ultra-processed food intake and risk of coronary artery disease. Conclusions Higher ultra-processed food intake was associated with a higher risk of coronary artery disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed foods may affect health.