TOPLINE:

Higher consumption of ultraprocessed foods (UPFs) was associated with a 45% increased risk for early-onset colorectal conventional adenomas in women younger than 50 years, on the basis of a prospective cohort study of 29,105 female nurses.

METHODOLOGY:

• Global incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50 years, has increased over recent decades, particularly in high-income countries like the US. UPF consumption has increased by approximately 10% of total daily calories in recent decades.
• Researchers analyzed data of 29,105 female participants from the Nurses’ Health Study II, an ongoing US prospective cohort of registered nurses established in 1989, with a follow-up from June 1, 1991, through June 1, 2015.
• Participants completed the baseline 1991 food frequency questionnaire, underwent at least one lower endoscopy before age 50 years and had no history of cancer or colorectal polyps.
• Analysis focused on incidence of EOCRC precursors, including conventional adenomas and serrated lesions, confirmed via medical records and pathology reports.
• UPF intake was assessed using validated food frequency questionnaires administered every 4 years and classified using the Nova system, modeled as quintiles of energy-adjusted servings per day.

TAKEAWAY:

• Participants with higher UPF intake showed an increased risk for early-onset conventional adenomas (adjusted odds ratio [AOR], 1.45; 95% CI, 1.19-1.77; P < .001) but not serrated lesions (AOR, 1.04; 95% CI, 0.89-1.22; P for trend = .48).
• UPFs provided 34.8% of total daily calories with a median of 5.7 (interquartile range, 4.5-7.4) servings per day.
• Among the 29,105 participants over 24 years of follow-up, researchers documented 1189 cases of early-onset conventional adenomas and 1598 serrated lesions.
• The findings remained consistent after adjusting for BMI, T2D, dietary factors (fiber, folate, calcium, and vitamin D), and Alternative Healthy Eating Index-2010 score.

IN PRACTICE:

“These data highlight the important role of UPFs in early-onset colorectal tumorigenesis and support improving dietary quality as a strategy to mitigate the increasing burden of EOCRC,” wrote the authors of the study.

Gunter Kuhnle, professor of nutrition and food science, University of Reading, Reading, England, criticized the study design in a statement from the Science Media Centre Roundups.

“In order to investigate the effects of ultraprocessed food intake on health, it is important to be able to measure how much ultraprocessed food people consume. This is very difficult — even with very detailed dietary information — because the definition is ambiguous and most methods don’t collect enough information,” he said.

Kuhnle continued, “This study relies on food frequency questionnaires to estimate ultraprocessed food intake: By their very nature, they need to combine different foods and collect less information. Many foods that are listed as options have ultraprocessed and non-ultraprocessed options (eg, tomato sauce, bread, or breakfast cereals), and it is impossible for the scientist to know what has actually been consumed.”

SOURCE:

The study was led by Andrew T. Chan, MD, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston. It was published online on November 13 in JAMA Oncology.

LIMITATIONS:

According to the authors, the study was unable to evaluate the risk for EOCRC directly due to insufficient statistical power from limited incident cases. Additionally, the cohort consisted predominantly of well-educated female nurses, which may limit generalizability to broader populations. The food frequency questionnaires used did not routinely capture preparation methods, brand information, or disaggregation of composite items, potentially leading to nondifferential misclassification of food items that may have attenuated the results.

DISCLOSURES:

This work was supported by grants from Cancer Research UK, the National Cancer Institute, the Bowelbabe Fund for Cancer Research UK, and Institut National Du Cancer. Mengxi Du, PhD, reported grants from the National Institutes of Health or National Cancer Institute during the conduct of the study. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.