本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-078476

摘要内容如下：

客观

研究超加工食品消费与全因死亡率和特定原因死亡率之间的关系。

设计

基于人群的队列研究。

设置

护士健康研究（1984-2018）中来自美国11个州的女性注册护士和卫生专业人员随访研究（1986-2018）中来自美国所有50个州的男性卫生专业人员。

参与者

基线时无癌症、心血管疾病或糖尿病病史的74563名女性和39501名男性。

主要结果指标

使用多变量Cox比例风险模型来估计每四年通过半定量食物频率问卷测量的超加工食物摄入与癌症、心血管和其他原因（包括呼吸和神经退行性原因）导致的全因死亡率和特定原因死亡率之间的风险比和95%置信区间。

结果

在中位数为34年和31年的随访期间，分别记录了30188例女性死亡和18005例男性死亡。与超加工食品消费量最低的四分之一人群相比，消费量最高的四分之一人群的全因死亡率高4%（风险比为1.04，95%置信区间为1.01至1.07），除癌症或心血管疾病以外的其他原因的死亡率高9%（风险比为1.09，95%置信区间为1.05至1.13）。最低和最高季度参与者的全因死亡率分别为每10万人年1472人和1536人。未发现与癌症或心血管死亡率相关。基于肉类/家禽/海鲜的即食产品（例如，加工肉类）始终显示与死亡率结果有很强的相关性（风险比范围为1.06至1.43）。加糖和人工加糖饮料（1.09，1.07至1.12）、乳制品甜点（1.07，1.04至1.10）和超加工早餐食品（1.04，1.02至1.07）也与较高的全因死亡率相关。根据2010年替代健康饮食指数（Alternative Health Eating Index-2010）评分，在每个季度的膳食质量评估中，超加工食品与死亡率之间没有一致的关联，而较好的膳食质量与超加工食品每个季度的死亡率呈负相关。

结论

这项研究发现，超加工食品摄入量较高与全因死亡率略高有关，这是由癌症和心血管疾病以外的原因造成的。在超加工食品的亚组中，这种关联各不相同，其中以肉类/家禽/海鲜为基础的即食产品与死亡率的关联尤其明显。

英文原文如下：

Abstracts

OBJECTIVE  To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality.

DESIGN  Population based cohort study.

SETTING  Female registered nurses from 11 US states in the Nurses' Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018).

PARTICIPANTS  74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline.

MAIN OUTCOME MEASURES  Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes).

RESULTS  30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 years of follow-up, respectively. Compared with those in the lowest quarter of ultra-processed food consumption, participants in the highest quarter had a 4% higher all cause mortality (hazard ratio 1.04, 95% confidence interval 1.01 to 1.07) and 9% higher mortality from causes other than cancer or cardiovascular diseases (1.09, 1.05 to 1.13). The all cause mortality rate among participants in the lowest and highest quarter was 1472 and 1536 per 100 000 person years, respectively. No associations were found for cancer or cardiovascular mortality. Meat/poultry/seafood based ready-to-eat products (for example, processed meat) consistently showed strong associations with mortality outcomes (hazard ratios ranged from 1.06 to 1.43). Sugar sweetened and artificially sweetened beverages (1.09, 1.07 to 1.12), dairy based desserts (1.07, 1.04 to 1.10), and ultra-processed breakfast food (1.04, 1.02 to 1.07) were also associated with higher all cause mortality. No consistent associations between ultra-processed foods and mortality were observed within each quarter of dietary quality assessed by the Alternative Healthy Eating Index-2010 score, whereas better dietary quality showed an inverse association with mortality within each quarter of ultra-processed foods.

CONCLUSIONS  This study found that a higher intake of ultra-processed foods was associated with slightly higher all cause mortality, driven by causes other than cancer and cardiovascular diseases. The associations varied across subgroups of ultra-processed foods, with meat/poultry/seafood based ready-to-eat products showing particularly strong associations with mortality.

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