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

Fernanda Morales-Berstein, Carine Biessy, Vivian Viallon, Ana Goncalves-Soares, Corinne Casagrande, Bertrand Hémon, Nathalie Kliemann, Manon Cairat, Jessica Blanco Lopez, Aline Al Nahas, Kiara Chang, Eszter Vamos, Fernanda Rauber, Renata Bertazzi Levy, Diana Barbosa Cunha, Paula Jakszyn, Pietro Ferrari, Paolo Vineis, Giovanna Masala, Alberto CatalanoEmily Sonestedt, Yan Borné, Verena Katzke, Rashmita Bajracharya, Claudia Agnoli, Marcela Guevara, Alicia Heath, Loredana Radoï, Francesca Mancini, Elisabete Weiderpass, José María Huerta, María José Sánchez, Anne Tjønneland, Cecilie Kyrø, Matthias B. Schulze, Guri Skeie, Marko Lukic, Tonje Braaten, Marc Gunter, Christopher Millett, Antonio Agudo, Paul Brennan, M. Carolina Borges, Rebecca C. Richmond, Tom G. Richardson, George Davey Smith, Caroline L. Relton, Inge Huybrechts

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

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).

Original languageEnglish
Pages (from-to)377-396
Number of pages20
JournalEuropean Journal of Nutrition
Volume63
Issue number2
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Adiposity
  • Epidemiology
  • Food processing
  • Head and neck cancer
  • Mediation analysis
  • NOVA classification
  • Oesophageal cancer

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