@misc{10481/91366,
year = {2023},
month = {11},
url = {https://hdl.handle.net/10481/91366},
abstract = {Purpose To investigate the role of adiposity in the associations between ultra-processed food (UPF) consumption and head
and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer and
Nutrition (EPIC) cohort.
Methods Our study included 450,111 EPIC participants. We used Cox regressions to investigate the associations between
the consumption of UPFs and HNC and OAC risk. A mediation analysis was performed to assess the role of body mass
index (BMI) and waist-to-hip ratio (WHR) in these associations. In sensitivity analyses, we investigated accidental death as
a negative control outcome.
Results During a mean follow-up of 14.13 ± 3.98 years, 910 and 215 participants developed HNC and OAC, respectively.
A 10% g/d higher consumption of UPFs was associated with an increased risk of HNC (hazard ratio [HR] = 1.23, 95%
confidence interval [CI] 1.14–1.34) and OAC (HR = 1.24, 95% CI 1.05–1.47). WHR mediated 5% (95% CI 3–10%) of the
association between the consumption of UPFs and HNC risk, while BMI and WHR, respectively, mediated 13% (95% CI
6–53%) and 15% (95% CI 8–72%) of the association between the consumption of UPFs and OAC risk. UPF consumption
was positively associated with accidental death in the negative control analysis.
Conclusions We reaffirmed that higher UPF consumption is associated with greater risk of HNC and OAC in EPIC. The
proportion mediated via adiposity was small. Further research is required to investigate other mechanisms that may be at
play (if there is indeed any causal effect of UPF consumption on these cancers).},
organization = {Cancer Research UK (C33493/A29678)},
organization = {World Cancer
Research Fund International (IIG_FULL_2020_033)},
organization = {Institut
National du Cancer (INCa number 2021–138)},
organization = {International Agency for Research
on Cancer (IARC)},
organization = {Department of Epidemiology and Biostatistics,
School of Public Health, Imperial College London which
has additional infrastructure support provided by the NIHR Imperial
Biomedical Research Centre (BRC)},
organization = {Regional Governments
of Andalucía, Asturias, Basque Country, Murcia and Navarra},
organization = {Catalan Institute of Oncology—ICO},
publisher = {Springer Nature},
keywords = {Epidemiology},
keywords = {Food processing},
keywords = {NOVA classification},
title = {Ultra‑processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study: a mediation analysis},
doi = {10.1007/s00394-023-03270-1},
author = {Morales Berstein, Fernanda and Sánchez Pérez, María José and EPIC Network},
}