Evidence map›Paper›PMID 40350408›Full record

ArticleNutrition journal2025

Ten-year trajectories of ultra-processed food intake and prospective associations with cardiovascular diseases and all-cause mortality: findings from the Whitehall II cohort study.

Mengmei E Wang, Clare H LIewellyn, Michail Katsoulis, Tasnime N Akbaraly, Samuel J Dicken, Jiahao Liu, Adrian Brown, Annie Britton

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Article in Nutrition journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Mengmei E WangResearch Department of Epidemiology and Public Health, University College London, London, UK. mengmei.wang.21@ucl.ac.uk.ORCID http://orcid.org/0009-0006-1243-7551
Clare H LIewellynResearch Department of Behavioural Science and Health, University College London, London, UK. c.llewellyn@ucl.ac.uk.
Michail KatsoulisMRC Unit for Lifelong Health and Ageing, University College London, London, UK.
Tasnime N AkbaralyDesbrest Institute of Epidemiology and Public Health, Université de Montpellier, Institut National de Santé et de Recherche Médicale (INSERM), Montpellier, France.
Samuel J DickenResearch Department of Behavioural Science and Health, University College London, London, UK.
Jiahao LiuFaculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Adrian BrownCentre for Obesity Research, Department of Medicine, University College London, London, UK.
Annie BrittonResearch Department of Epidemiology and Public Health, University College London, London, UK. a.britton@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUltra-processed food (UPF) intake has been associated with adverse health outcomes; however, research on UPF intake and cardiovascular disease (CVD) prognosis has largely neglected its longitudinal pattern over time. This study investigated trajectories of UPF intake over a decade and their prospective associations with the risk of fatal and non-fatal CVD, as well as all-cause mortality, using data spanning from 16 to 19 years.

methodsThis study utilized data from the British Whitehall II cohort study, including 7,138 participants (68.3% male; median baseline age 60.4 years), all free of CVD at baseline. Dietary intake was assessed using a validated 127-item food frequency questionnaire at three time points: phase 3 (1991-1994), phase 5 (1997-1999), and phase 7 (2002-2004). UPF intake was estimated using the Nova classification, and group-based trajectory modelling identified different longitudinal consumption patterns. Phase 7 (2002-2004) was the baseline for subsequent monitoring of cardiovascular events and mortality outcomes until 2019/2021. Multivariate Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for socio-demographics, lifestyle, diet quality, energy intake, and clinical factors.

resultsThree distinct UPF trajectory groups were identified: high (26.2% of participants), moderate (52.9%) and low UPF intake (20.9%). All groups showed a slight increase in UPF intake over time. Over the median follow-up of 16 years for incident cases and 19 years for mortality, we observed 1,128 incident CVD events, 859 CHD cases and 1,314 deaths. The highest vs. lowest UPF intake group had a 23% higher risk of CVD (HR 1.23, 95% CI 1.01 to 1.40), and a 32% higher risk of CHD (HR 1.32, 95% CI 1.06 to 1.65). No significant associations were observed between UPF trajectory groups and CVD mortality, CHD mortality, or all-cause mortality.

conclusionsSustained high UPF intake over 10 years was associated with increased risks of non-fatal CVD and CHD but not with CVD-specific, CHD-specific, or all-cause mortality. These findings suggest that sustained high intake of UPF may be a modifiable risk factor for preventing non-fatal cardiovascular risks.

Indexed as

Cardiovascular DiseasesDietFast FoodsAdultAgedCohort StudiesFemaleFood, ProcessedHumansLongitudinal StudiesMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk FactorsUnited KingdomCardiovascular diseasesDietary patternEpidemiologyFood policyFood processingNutritional epidemiologyPublic healthUltra-processed foods

Identifiers

PMID40350408
PMCPMC12067948

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.