A growing body of evidence suggests that consuming too many highly processed foods — items like hot dogs, chips, soda and ice cream — can have consequences beyond obesity and high cholesterol.
A study published Monday in the American Journal of Preventive Medicine estimated that in 2019, the deaths of about 57,000 Brazilians between the ages of 30 and 69 were attributable to the consumption of ultra-processed foods. This represents more than 10% of annual premature deaths in Brazil in this age group.
The authors say their study is the first to estimate the impact of ultra-processed foods on the risk of premature death.
The study used calculations from a previous analysis, which compared the relative mortality risk of people who ate large amounts of processed foods to those who ate relatively little. The authors applied this model to the Brazilian population and the level of consumption of ultra-processed foods. From this, they estimated the number of premature deaths that could have been avoided if people aged 30 to 69 had consumed less of this type of food. The researchers focused on this age group because the World Health Organization considers death from non-communicable diseases to be premature at this age.
Eduardo Nilson, a nutrition researcher at the University of São Paulo and lead author of the study, said he thought “heart disease is very likely to be among the main factors” contributing to these premature deaths. Diabetes, cancer, obesity and chronic kidney disease may also play a role, he said.
“Ultra-processed” foods contain more artificial ingredients than those that have just added salt, sugar or oil. They usually contain very few whole ingredients and contain flavorings, colorings or other additives. Instant noodles, frozen pizzas, and store-bought cookies generally fall into this category.
In Brazil, Nilson said, the ultra-processed foods that contribute the most to daily calorie intake are mass-produced breads, cakes and pies; margarine; salty crackers; cookies; meat products such as ham, hot dogs and hamburgers; pizza; and sugary drinks.
Nilson and his collaborators estimated that if all adults in Brazil ensured that ultra-processed foods made up less than 23% of their daily calories, the country could see about 20,000 fewer premature deaths per year. Most Brazilians are already below that threshold, but a quarter of the country’s adult population gets up to 50% of their daily calories from ultra-processed foods, Nilson said.
In the United States, ultra-processed foods make up about 57% of daily calories on average. Based on this, Nilson thinks the United States could expect even more premature deaths associated with this type of food.
Many previous studies have linked ultra-processed foods to other negative health outcomes, including a higher risk of diabetes, cognitive decline, heart disease and cancer. An August study found that people in Italy who ate ultra-processed foods in large amounts had a higher overall risk of death.
Maura Walker, an assistant professor of nutrition at Boston University who was not involved in the new research, warned that this study did not show that eating ultra-processed foods directly caused premature death – only that there was an association. But the connection makes sense, she says.
“It’s likely that these ultra-processed foods are just one of the factors that lead to things like high blood pressure, bad blood lipids, an increased waist circumference, and that’s actually how they are. related to mortality,” Walker said.
She added that ideally people could swap ultra-processed foods for more fresh fruits and vegetables, but that’s not always possible in food deserts where people rely on a supermarket or dollar store for the grocery store.
Ultra-processed foods can often be identified by their long list of ingredients, many of which you wouldn’t normally find in your own kitchen.
But not everything in this category is harmful, according to Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard TH Chan School of Public Health. For example, whole-grain bread and whole-grain breakfast cereals are sometimes considered ultra-processed, but they are also sources of dietary fiber, which may reduce the risk of heart disease or cancer.
Willett also said there may be little benefit to replacing ultra-processed foods with certain items, such as more red meat or foods cooked in lots of butter. Eating too much red meat in particular can increase the risk of diabetes, heart disease and certain cancers.
For this reason, Willett said, it’s important to focus on avoiding particular foods that are significantly associated with risk of premature death. Soda, for example, is linked to an estimated 184,000 adult deaths per year worldwide.
“In general, there’s no question that Brazilians and Americans and a lot of other people eat way too much junk food,” Willett said. “Collectively, they account for a large portion of preventable mortality.
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