The risk of oesophageal adenocarcinoma (OAC) and head and neck cancer (HNC) due to ultra-processed foods (UPFs) was explored in a recent study published in the European Journal of Nutrition, using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.
The study focused on the association between industrial food processing and disease etiology, particularly UPFs which contain additives like hydrogenated oils and modified starches not typically used in home cooking.
These foods, such as packaged snacks, soft drinks, and frozen dishes, are convenient and inexpensive but are often consumed in large quantities.
Previous research has linked UPF consumption to increased cancer risk, including findings from EPIC suggesting a positive association with HNC and OAC, as well as higher adiposity, a known risk factor for OAC. Additionally, non-smokers with higher body mass index (BMI) have shown increased HNC risk.
The study aimed to further investigate the links between UPF consumption and the risks of HNC and OAC. Researchers analyzed associations not only with HNC but also with its subtypes (hypopharynx, larynx, oral cavity, oropharynx, and others), considering factors such as smoking, alcohol use, and physical activity.
A mediation analysis was conducted to assess the role of BMI in the relationship between UPF consumption and HNC/OAC risk.
The study included 450,111 participants from EPIC, using Cox regression to look for correlations between UPF intake and cancer risks, while considering BMI and waist-to-hip ratio (WHR). Sensitivity analyses included accidental death as a control outcome.
Results indicated that UPF consumption was associated with higher risks of both OAC and HNC, with consistent findings across various HNC subtypes.
Males showed a stronger correlation with HNC compared to females. The mediation analysis suggested that residual confounding might have influenced the results, aligning with existing literature showing that UPFs contribute to central adiposity (WHR) and higher BMI, which are linked to increased cancer risks.
However, the mediated effects via BMI and WHR were found to be modest, suggesting potential involvement of other mechanisms.
The study’s strengths included its large, multi-center cohort with extensive follow-up, and the use of objective measures for BMI and WHR. Different methods of UPF intake assessment enhanced comparability with previous research, while cancer cases were reliably identified through registries.
Limitations included potential measurement errors and residual confounding affecting associations, as well as limited follow-up data for BMI and WHR in some participants, which impacted sensitivity analyses.
Assumptions regarding separate pathways between UPF consumption and OAC risk via BMI and WHR were also considered potentially misleading due to their correlation.
While confirming a link between UPF consumption and higher risks of OAC and HNC, the study highlighted complexities in understanding these associations fully, calling for continued research to elucidate underlying mechanisms and refine preventive strategies.
