Dora Romaguera1, Sílvia Fernández-Barrés2, Esther Gracia-Lavedán3, Eva Vendrell4, Mikel Azpiri5, Emma Ruiz-Moreno6, Vicente Martín7, Inés Gómez-Acebo8, Mireia Obón9, Amaia Molinuevo10, Ujué Fresán11, Ana Molina-Barceló12, Rocío Olmedo-Requena13, Adonina Tardón14, Juan Alguacil15, Marta Solans16, Jose M Huerta17, José Manuel Ruiz-Dominguez18, Nuria Aragonés19, Tania Fernández-Villa20, Trinidad Dierssen-Sotos21, Victor Moreno22, Marcela Guevara23, Mercedes Vanaclocha-Espi24, Macarena Lozano-Lorca25, Guillermo Fernández-Tardón26, Gemma Castaño-Vinyals27, Beatriz Pérez-Gómez28, Antonio J Molina29, Javier Llorca30, Leire Gil31, Jesús Castilla32, Marina Pollán33, Manolis Kogevinas34, Pilar Amiano35. 1. Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain. Electronic address: dora.romaguera@isglobal.org. 2. Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address: silvia.fernandez@isglobal.org. 3. Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address: esthergrala@gmail.com. 4. Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain. Electronic address: evavendrell5@gmail.com. 5. Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain. Electronic address: koor-tolosa@euskadi.eus. 6. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. Electronic address: e.ruiz@externos.isciii.es. 7. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain. Electronic address: vicente.martin@unileon.es. 8. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain. Electronic address: ines.gomez@unican.es. 9. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: mobon@iconcologia.net. 10. Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain. Electronic address: au-molinuevo@euskadi.eus. 11. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain. Electronic address: ujue.fresan.salvo@navarra.es. 12. Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain. Electronic address: molina_anabar@gva.es. 13. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain. Electronic address: rocioolmedo@ugr.es. 14. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain. Electronic address: atardon@uniovi.es. 15. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain. Electronic address: juan.alguacil@dbasp.uhu.es. 16. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Electronic address: martasolans@gmail.com. 17. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Electronic address: jmhuerta.carm@gmail.com. 18. Department of Urology, Hospital Germans Trias i Pujol, Badalona, Spain. Electronic address: jmruizdominguez@gmail.com. 19. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health, Madrid, Spain. Electronic address: nuria.aragones@salud.madrid.org. 20. The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain. Electronic address: tferv@unileon.es. 21. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain. Electronic address: dierssent@unican.es. 22. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain. Electronic address: v.moreno@iconcologia.net. 23. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. Electronic address: mp.guevara.eslava@navarra.es. 24. Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain. Electronic address: vanaclocha_mer@gva.es. 25. Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain. Electronic address: macarenalozano@ugr.es. 26. Department of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain. Electronic address: gfernanta@gmail.com. 27. Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. Electronic address: gemma.castano@isglobal.org. 28. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. Electronic address: bperez@isciii.es. 29. The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain. Electronic address: ajmolt@unileon.es. 30. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain. Electronic address: javier.llorca@unican.es. 31. Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain. Electronic address: l-gil@euskadi.eus. 32. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. Electronic address: jcastilc@navarra.es. 33. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. Electronic address: mpollan@isciii.es. 34. Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. Electronic address: manolis.kogevinas@isglobal.org. 35. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain. Electronic address: epicss-san@euskadi.eus.
Abstract
AIMS: To study whether the consumption of ultra-processed foods and drinks is associated with breast, colorectal, and prostate cancers. METHODS: Multicentric population-based case-control study (MCC-Spain) conducted in 12 Spanish provinces. Participants were men and women between 20 and 85 years of age with diagnoses of colorectal (n = 1852), breast (n = 1486), or prostate cancer (n = 953), and population-based controls (n = 3543) frequency-matched by age, sex, and region. Dietary intake was collected using a validated food frequency questionnaire. Foods and drinks were categorized according to their degree of processing based on the NOVA classification. Unconditional multivariable logistic regression was used to evaluate the association between ultra-processed food and drink consumption and colorectal, breast, and prostate cancer. RESULTS: In multiple adjusted models, consumption of ultra-processed foods and drinks was associated with a higher risk of colorectal cancer (OR for a 10% increase in consumption: 1.11; 95% CI 1.04-1.18). The corresponding odds for breast (OR 1.03; 95% CI 0.96-1.11) and prostate cancer (OR 1.02; 95% CI 0.93-1.12) were indicative of no association. CONCLUSIONS: Results of this large population-based case-control study suggest an association between the consumption of ultra-processed foods and drinks and colorectal cancer. Food policy and public health should include a focus on food processing when formulating dietary guidelines.
AIMS: To study whether the consumption of ultra-processed foods and drinks is associated with breast, colorectal, and prostate cancers. METHODS: Multicentric population-based case-control study (MCC-Spain) conducted in 12 Spanish provinces. Participants were men and women between 20 and 85 years of age with diagnoses of colorectal (n = 1852), breast (n = 1486), or prostate cancer (n = 953), and population-based controls (n = 3543) frequency-matched by age, sex, and region. Dietary intake was collected using a validated food frequency questionnaire. Foods and drinks were categorized according to their degree of processing based on the NOVA classification. Unconditional multivariable logistic regression was used to evaluate the association between ultra-processed food and drink consumption and colorectal, breast, and prostate cancer. RESULTS: In multiple adjusted models, consumption of ultra-processed foods and drinks was associated with a higher risk of colorectal cancer (OR for a 10% increase in consumption: 1.11; 95% CI 1.04-1.18). The corresponding odds for breast (OR 1.03; 95% CI 0.96-1.11) and prostate cancer (OR 1.02; 95% CI 0.93-1.12) were indicative of no association. CONCLUSIONS: Results of this large population-based case-control study suggest an association between the consumption of ultra-processed foods and drinks and colorectal cancer. Food policy and public health should include a focus on food processing when formulating dietary guidelines.
Authors: Marta Solans; Sílvia Fernández-Barrés; Dora Romaguera; Yolanda Benavente; Rafael Marcos-Gragera; Esther Gracia-Lavedan; Laura Costas; Claudia Robles; Eva Gonzalez-Barca; Esmeralda de la Banda; Esther Alonso; Marta Aymerich; Elias Campo; Javier Llorca; Guillermo Fernández-Tardón; Rocío Olmedo-Requena; Eva Gimeno; Gemma Castaño-Vinyals; Nuria Aragonés; Manolis Kogevinas; Marina Pollán; Silvia de Sanjose; Pilar Amiano; Delphine Casabonne Journal: Int J Environ Res Public Health Date: 2021-05-20 Impact factor: 3.390