Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study

Abstract Background Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed and outcomes are scarce US population. We aimed to examine association of a Methods A population-based cohort 91,891 participants was identified from Prostate, Lung, Colorectal, Ovarian Cancer Screening Trial. Dietary were collected through validated 137-item frequency questionnaire. defined by NOVA classification. Cox regression used calculate hazard ratios (HRs) 95% confidence intervals (CIs) for mortality. Restricted cubic spline test nonlinearity. Subgroup analyses conducted identify potential effect modifiers. Results After an average follow-up 13.5 years (1,236,049.2 person-years), 5490 deaths documented, including 3985 heart disease 1126 cerebrovascular deaths. In fully adjusted model, highest vs. lowest quintiles had higher risks death (HR quintile 5 1 , 1.50; CI, 1.36–1.64) 1.68; 1.50–1.87) but not 0.94; 0.76–1.17). nonlinear dose–response pattern observed overall (all P nonlinearity < 0.05), threshold at 2.4 servings/day 2.3 servings/day, respectively; below thresholds, no significant associations these two outcomes. showed that increased significantly women than men interaction 0.05). Conclusions High These harmful may be more pronounced women. Our findings need confirmed other populations settings.