TY - JOUR
T1 - Ultra-processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study
T2 - a mediation analysis
AU - Morales-Berstein, Fernanda
AU - Biessy, Carine
AU - Viallon, Vivian
AU - Goncalves-Soares, Ana
AU - Casagrande, Corinne
AU - Hémon, Bertrand
AU - Kliemann, Nathalie
AU - Cairat, Manon
AU - Blanco Lopez, Jessica
AU - Al Nahas, Aline
AU - Chang, Kiara
AU - Vamos, Eszter
AU - Rauber, Fernanda
AU - Bertazzi Levy, Renata
AU - Barbosa Cunha, Diana
AU - Jakszyn, Paula
AU - Ferrari, Pietro
AU - Vineis, Paolo
AU - Masala, Giovanna
AU - Catalano, Alberto
AU - Sonestedt, Emily
AU - Borné, Yan
AU - Katzke, Verena
AU - Bajracharya, Rashmita
AU - Agnoli, Claudia
AU - Guevara, Marcela
AU - Heath, Alicia
AU - Radoï, Loredana
AU - Mancini, Francesca
AU - Weiderpass, Elisabete
AU - Huerta, José María
AU - Sánchez, María José
AU - Tjønneland, Anne
AU - Kyrø, Cecilie
AU - Schulze, Matthias B.
AU - Skeie, Guri
AU - Lukic, Marko
AU - Braaten, Tonje
AU - Gunter, Marc
AU - Millett, Christopher
AU - Agudo, Antonio
AU - Brennan, Paul
AU - Borges, M. Carolina
AU - Richmond, Rebecca C.
AU - Richardson, Tom G.
AU - Davey Smith, George
AU - Relton, Caroline L.
AU - Huybrechts, Inge
N1 - Funding Information:
FMB was supported by a Wellcome Trust PhD studentship in Molecular, Genetic and Lifecourse Epidemiology (224982/Z/22/Z). RCR was supported by a Cancer Research UK grant (C18281/A29019). AGS is supported by the study of Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases [H2020-SC1-2019-Single-Stage-RTD, project ID 874739]. MCB is supported by a University of Bristol Vice Chancellor’s Fellowship, the British Heart Foundation (AA/18/1/34219) and the UK Medical Research Council (MC_UU_00011/6). GDS works within the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the Medical Research Council (MC_UU_00011/1). CLR was supported by the Medical Research Council (MC_UU_00011/5) and by a Cancer Research UK (C18281/A29019) programme grant (the Integrative Cancer Epidemiology Programme). This work was supported by Cancer Research UK (C33493/A29678), World Cancer Research Fund International (IIG_FULL_2020_033) and the Institut National du Cancer (INCa number 2021–138). The coordination of EPIC is financially supported by the International Agency for Research on Cancer (IARC) and by the 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). The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS)—Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology—ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford). (United Kingdom).
Funding Information:
We acknowledge the use of data from the EPIC cohort and thank the participants and investigators for their contributions to the EPIC resource. We also thank the Asturias Government and the National Institute for Public Health and the Environment (RIVM), Bilthoven in the Netherlands, for their contribution and ongoing support to the EPIC study. We additionally thank Richard Wilkinson for proofreading the manuscript.
Publisher Copyright:
© The Author(s) 2023.
PY - 2024/3
Y1 - 2024/3
N2 - 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).
AB - 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).
KW - Adiposity
KW - Epidemiology
KW - Food processing
KW - Head and neck cancer
KW - Mediation analysis
KW - NOVA classification
KW - Oesophageal cancer
UR - http://www.scopus.com/inward/record.url?scp=85177607194&partnerID=8YFLogxK
U2 - 10.1007/s00394-023-03270-1
DO - 10.1007/s00394-023-03270-1
M3 - Article
C2 - 37989797
AN - SCOPUS:85177607194
SN - 1436-6207
VL - 63
SP - 377
EP - 396
JO - European Journal of Nutrition
JF - European Journal of Nutrition
IS - 2
ER -
