학술논문
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.
Document Type
Article
Author
Morales-Berstein, Fernanda; Biessy, Carine; Viallon, Vivian; Goncalves-Soares, Ana; Casagrande, Corinne; Hémon, Bertrand; Kliemann, Nathalie; Cairat, Manon; Blanco Lopez, Jessica; Al Nahas, Aline; Chang, Kiara; Vamos, Eszter; Rauber, Fernanda; Bertazzi Levy, Renata; Barbosa Cunha, Diana; Jakszyn, Paula; Ferrari, Pietro; Vineis, Paolo; Masala, Giovanna; Catalano, Alberto
Source
Subject
*ADENOCARCINOMA
*CONFIDENCE intervals
*CONVENIENCE foods
*FOOD consumption
*HEAD & neck cancer
*PACKAGED foods
*RISK assessment
*COMPARATIVE studies
*WAIST-hip ratio
*PHYSICAL activity
*FACTOR analysis
*DESCRIPTIVE statistics
*ALCOHOL drinking
*RESEARCH funding
*BODY mass index
*DATA analysis software
*ADIPOSE tissues
*ESOPHAGEAL tumors
*LONGITUDINAL method
*PROPORTIONAL hazards models
*EDUCATIONAL attainment
*DISEASE risk factors
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Language
ISSN
1436-6207
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). [ABSTRACT FROM AUTHOR]