Abstract
BackgroundUltra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease. We aimed to assess whether consumption of UPF is directly associated with subclinical coronary atherosclerosis in middle-aged men.MethodsA computed tomography scan was performed on 1876 men from the Aragon Workers’ Health Study, recruited from January 2011 to December 2014, to assess coronary calcium. All participants were free of coronary heart disease. Dietary intake was collected by a validated 136-item semi-quantitative food frequency questionnaire. UPF was defined according to the NOVA classification. Associations between consumption of total energy-adjusted UPF and Coronary Calcium Agatston Score (CACS)—categorized into CACS of 0, > 0 and < 100, and ≥ 100—were cross-sectionally assessed by generalized ordered logistic regression adjusted for main confounders.ResultsNo coronary calcium was detected in 60.2% of the participants, whereas 10.2% had a CACS ≥ 100. A significant dose-response association was observed between energy-adjusted UPF consumption and the risk of having a CACS ≥ 100, when compared with those in the lowest CACS categories (CACS of 0 together with CACS > 0 and < 100). The fully adjusted ORs (95% CI) of having a CACS ≥ 100 across quartiles of energy-adjusted UPF consumption (approximately 100 g/day in the lowest quartile (ref.) and 500 g/day in the highest) were 1.00 (ref.), 1.50 (0.93, 2.42), 1.56 (0.96, 2.52), and 2.00 (1.26, 3.16), p trend .005.ConclusionIn this middle-aged worker’s sample, approximately 500 g/day of UPF consumption was associated with a 2-fold greater prevalence of subclinical coronary atherosclerosis than consuming only 100 g/day, independently of total energy intake and other well-established cardiovascular risk factors.
Highlights
Ultra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease
We provide two estimators to describe the association between UPF consumption and Calcium Agatston Score (CACS)
A significant dose-response association was observed between daily consumption of UPF and the risk of progress from the two lowest categories (CACS of 0 together with CACS > 0 and < 100) to the highest category (CACS ≥ 100)
Summary
Ultra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease. UPF consumption in Spain is low to moderate [2], but it is increasing rapidly. While in 1990, UPF consumption represented 11% of daily energy intake in Spain, it has almost tripled in 10 years [3]. In 2000, the mean contribution of UPF in total energy intake was about 35% in Spain and Italy, but it reached up to 60% in the Netherlands, Sweden, Norway, Denmark, and the UK general population [4]. UPF consumption replaces the intake of other unprocessed or minimally processed food and freshly prepared meals that have beneficial nutritional attributes, affecting health in an indirect way
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