Liens malbouffe et longévité?

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Novel Dietary and Lifestyle Inflammation Scores Directly Associated with All-Cause, All-Cancer, and All-Cardiovascular Disease Mortality Risks Among Women
Zhuoyun Li, The Journal of Nutrition, 09 March 2021

Background
Exogenous exposures collectively may contribute to chronic, low-grade inflammation and increase risks for major chronic diseases and mortality. We previously developed, validated, and reported a novel, FFQ-based and lifestyle questionnaire–based, inflammation biomarker panel–weighted, predominantly whole foods–based 19-component dietary inflammation score (DIS) and 4-component lifestyle inflammation score (LIS; comprising physical activity, alcohol intake, BMI, and current smoking status). Both scores were more strongly associated with circulating biomarkers of inflammation in 3 populations than were previously reported dietary inflammation indices. Associations of the DIS and LIS with mortality risk have not been reported.

Objectives
To investigate separate and joint associations of the DIS and LIS with all-cause, all-cancer, and cardiovascular disease (CVD) mortality risks in the prospective Iowa Women's Health Study (1986–2012; n = 33,155 women, ages 55–69 years, of whom 17,431 died during follow-up, including 4379 from cancer and 6574 from CVD).

Methods
We summed each study participant's scores’ components, weighted by their published weights, to yield the participant's inflammation score; a higher score was considered more pro-inflammatory. We assessed DIS and LIS mortality associations using multivariable Cox proportional hazards regression.

Results
Among participants in the highest relative to the lowest DIS and LIS quintiles, the adjusted HRs for all-cause mortality were 1.11 (95% CI: 1.05–1.16) and 1.60 (95% CI: 1.53–1.68), respectively; for all-cancer mortality were 1.07 (95% CI: 0.97–1.17) and 1.51 (95% CI: 1.38–1.66), respectively; and for CVD mortality were 1.12 (95% CI: 1.03–1.21) and 1.79 (95% CI: 1.66–1.94), respectively (all Ptrend values < 0.01). Among those in the highest relative to the lowest joint LIS/DIS quintiles, the HRs for all-cause, all-cancer, and all-CVD mortality were 1.88 (95% CI: 1.71–2.08), 1.82 (95% CI: 1.50–2.20), and 1.92 (95% CI: 1.64–2.24), respectively.

Conclusions
More pro-inflammatory diets and lifestyles, separately but especially jointly, may be associated with higher all-cause, all-cancer, and all-CVD mortality risks among women.

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Traduction de l'étude

Nouveaux scores d'inflammation dans le régime alimentaire et le mode de vie directement associés aux risques de mortalité toutes causes, tous cancers et toutes maladies cardiovasculaires chez les femmes
Zhuoyun Li, The Journal of Nutrition, 9 mars 2021

Fond
Les expositions exogènes collectivement peuvent contribuer à une inflammation chronique de bas grade et augmenter les risques de maladies chroniques majeures et de mortalité. Nous avons précédemment développé, validé et rapporté un nouveau score d'inflammation alimentaire (DIS) à 19 composants et un score d'inflammation au mode de vie à 4 composants (LIS; comprenant l'activité physique, la consommation d'alcool, l'IMC et le statut tabagique actuel). Les deux scores étaient plus fortement associés aux biomarqueurs circulants de l'inflammation dans 3 populations que les indices d'inflammation alimentaires précédemment rapportés. Aucune association du DIS et du LIS avec le risque de mortalité n'a été signalée.

Objectifs
Étudier les associations séparées et conjointes du DIS et du LIS avec les risques de mortalité toutes causes, tous cancers et maladies cardiovasculaires (MCV) dans l'étude prospective Iowa Women's Health Study (1986-2012; n = 33 155 femmes, âgées de 55 à 69 ans) , dont 17 431 sont décédés au cours du suivi, dont 4379 d'un cancer et 6574 d'une maladie cardiovasculaire).

Méthodes
Nous avons additionné les composants des scores de chaque participant à l'étude, pondérés par leurs poids publiés, pour obtenir le score d'inflammation du participant; un score plus élevé était considéré comme plus pro-inflammatoire. Nous avons évalué les associations de mortalité DIS et LIS à l'aide de la régression à risques proportionnels multivariés de Cox.

Résultats
Parmi les participants des quintiles DIS et LIS les plus élevés par rapport aux quintiles les plus bas, les HR ajustés pour la mortalité toutes causes étaient respectivement de 1,11 (IC à 95%: 1,05-1,16) et 1,60 (IC à 95%: 1,53-1,68); pour tous les cancers, la mortalité était de 1,07 (IC à 95%: 0,97–1,17) et 1,51 (IC à 95%: 1,38–1,66), respectivement; et pour la mortalité par MCV étaient respectivement de 1,12 (IC à 95%: 1,03–1,21) et 1,79 (IC à 95%: 1,66–1,94) (toutes les valeurs de Ptrend <0,01). Parmi les personnes appartenant aux quintiles LIS / DIS articulaires les plus élevés par rapport aux plus faibles, les RR pour la mortalité toutes causes, tous cancers et toutes maladies cardiovasculaires étaient de 1,88 (IC à 95%: 1,71–2,08), 1,82 (IC à 95%: 1,50 –2,20) et 1,92 (IC à 95%: 1,64–2,24), respectivement.

Conclusions
Des régimes alimentaires et des modes de vie plus pro-inflammatoires, séparément mais surtout conjointement, peuvent être associés à des risques plus élevés de mortalité toutes causes, tous cancers et toutes maladies cardiovasculaires chez les femmes

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Ultra-Processed Foods and Incident Cardiovascular Disease in the Framingham Offspring Study
Filippa Juul, J Am Coll Cardiol. 2021 Mar, 77 (12) 1520–1531

Background
Ultra-processed foods provide 58% of total energy in the U.S. diet, yet their association with cardiovascular disease (CVD) remains understudied.
Objectives
The authors investigated the associations between ultra-processed foods and CVD incidence and mortality in the prospective Framingham Offspring Cohort.
Methods
The analytical sample included 3,003 adults free from CVD with valid dietary data at baseline. Data on diet, measured by food frequency questionnaire, anthropometric measures, and sociodemographic and lifestyle factors were collected quadrennially from 1991 to 2008. Data regarding CVD incidence and mortality were available until 2014 and 2017, respectively. Ultra-processed foods were defined according to the NOVA framework. The authors used Cox proportional hazards models to determine the multivariable association between ultra-processed food intake (energy-adjusted servings per day) and incident hard CVD, hard coronary heart disease (CHD), overall CVD, and CVD mortality. Multivariable models were adjusted for age, sex, education, alcohol consumption, smoking, and physical activity.
Results
During follow-up (1991 to 2014/2017), the authors identified 251, 163, and 648 cases of incident hard CVD, hard CHD, and overall CVD, respectively. On average, participants consumed 7.5 servings per day of ultra-processed foods at baseline. Each additional daily serving of ultra-processed foods was associated with a 7% (95% confidence interval [CI]: 1.03 to 1.12), 9% (95% CI: 1.04 to 1.15), 5% (95% CI: 1.02 to 1.08), and 9% (95% CI: 1.02 to 1.16) increase in the risk of hard CVD, hard CHD, overall CVD, and CVD mortality, respectively.
Conclusions
The current findings support that higher consumption of ultra-processed foods is associated with increased risk of CVD incidence and mortality. Although additional research in ethnically diverse populations is warranted, these findings suggest cardiovascular benefits of limiting ultra-processed foods.

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Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study
Jennifer Griffin BMJ Nutr 2021

Abstract
Objective To examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort.

Design Cross-sectional.

Setting Occupational cohort.

Participants 53 163 British police force employees enrolled (2004–2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study.

Main outcome measures A CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake.

Results In this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=−0.32, p<0.001), fibre (r=−0.20, p<0.001) and protein (r = −0.40, p<0.001) and positively correlated with fat (r=0.18, p<0.001), saturated fat (r=0.14, p<0.001) and nmes (r=0.10, p<0.001) intake . Multivariable analysis suggests a positive association between ultraprocessed food (NOVA 4) consumption and CMR. However, this main effect was no longer observed after adjustment for diet quality (p=0.209). Findings from mediation analysis indicate that the effect of ultraprocessed food (NOVA 4) intake on CMR is mediated by diet quality (p<0.001).

Conclusions Ultraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.

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What this paper adds
WHO has recently highlighted that the processing of foods is often coupled with a decline in the nutritional profile of the diet.

Classification systems have been created to aid categorisation of foods according to the grade at which they are processed. The most popular system is the NOVA Classification of Foods.

Studies have shown that foods categorised as ultra-processed are often high in fat and low in fibre.

High intakes of ultra-processed foods have been linked to increased risk of non-communicable diseases, including cardiovascular disease and some cancers.

This study demonstrates a deterioration in diet quality and cardiometabolic health with increasing intakes of ultra-processed food.

The association between ultra-processed food intake and poor health is mediated by diet quality.

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Traduction de l'étude

Ce que cet article ajoute
L'OMS a récemment souligné que la transformation des aliments est souvent associée à une baisse du profil nutritionnel de l'alimentation.

Des systèmes de classification ont été créés pour faciliter la catégorisation des aliments en fonction de la qualité à laquelle ils sont transformés. Le système le plus populaire est la classification NOVA des aliments.

Des études ont montré que les aliments classés comme ultra-transformés sont souvent riches en matières grasses et pauvres en fibres.

Des apports élevés d'aliments ultra-transformés ont été associés à un risque accru de maladies non transmissibles, y compris les maladies cardiovasculaires et certains cancers.

Cette étude démontre une détérioration de la qualité de l'alimentation et de la santé cardiométabolique avec des apports croissants d'aliments ultra-transformés.

L'association entre la consommation d'aliments ultra-transformés et une mauvaise santé est médiée par la qualité de l'alimentation.

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Association between consumption of ultra-processed foods and hyperuricemia: TCLSIH prospective cohort study
Tingjing Zhang Nutrition, Metabolism and Cardiovascular Diseases Articles in Press E-mail Alert - May 7, 2021

Highlights
• Ultra-processed foods dominate the food supplies in countries, and they present an unbalanced nutritional composition, lack micronutrients and phytochemicals, contain low levels of fiber and protein and are rich in free sugars, total fats, saturated and trans fats and sodium.
• Hyperuricemia is the precursor of gout and closely related to hypertension, cardiovascular disease, renal disease and the metabolic syndrome and has doubled worldwide during the last few decades.
• The present study is the first to demonstrated that ultra-processed foods consumption was positively associated with the incidence of hyperuricemia in a large-scale population.

Background and Aims
Emerging evidence suggests that consumption of ultra-processed foods (UPF) plays a role in the development of chronic diseases, but evidence of their influence on hyperuricemia is limited. We therefore designed a cohort study to examine whether UPF consumption increase the risk of hyperuricemia in adults.
Methods and Results
This was a prospective study (n = 18,444) performed in Tianjin, China from 2013-2019. Participants that were aged 18 years and over and with no history of hyperuricemia, were followed up for 1 to 6 years (median follow-up duration=4.2 years). UPF consumption was assessed by a validated semi-quantitative food frequency questionnaire. Hyperuricemia was defined as serum uric acid levels ≥ 7.0 mg/dL in males and ≥ 6mg/dL in females. Multivariable Cox proportional hazards regression models were used to assess the association between UPF consumption and the risk of hyperuricemia. Restricted cubic spline regression was used to estimate the dose-response association between UPF consumption and risk of hyperuricemia. During follow-up period, the incidence of hyperuricemia was 20.3% in general population (27.7% in males and 13.2% in females). In the final multivariate models, the hazard ratios (95% confidence interval) for hyperuricemia across energy adjusted UPF consumption quartiles were 1.00 (reference), 1.04 (0.94, 1.14), 1.11 (1.01, 1.23), 1.16 (1.05, 1.28) (p for trend =0.02) in general population.
Conclusions
This population-based prospective cohort study suggests that increased consumption of UPF is independently associated the risk of hyperuricemia.

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Traduction de l'étude

Association entre consommation d'aliments ultra-transformés et hyperuricémie: étude de cohorte prospective TCLSIH
Tingjing Zhang Nutrition, métabolisme et maladies cardiovasculaires Articles dans la presse Alerte par courrier électronique - 7 mai 2021

Points forts
• Les aliments ultra-transformés dominent les approvisionnements alimentaires dans les pays, et ils présentent une composition nutritionnelle déséquilibrée, manquent de micronutriments et de composés phytochimiques, contiennent de faibles niveaux de fibres et de protéines et sont riches en sucres libres, en graisses totales, en graisses saturées et trans et en sodium.
• L'hyperuricémie est le précurseur de la goutte et étroitement liée à l'hypertension, aux maladies cardiovasculaires, aux maladies rénales et au syndrome métabolique et a doublé dans le monde au cours des dernières décennies.
• La présente étude est la première à démontrer que la consommation d'aliments ultra-transformés était positivement associée à l'incidence de l'hyperuricémie dans une population à grande échelle.

Contexte et objectifs
De nouvelles preuves suggèrent que la consommation d'aliments ultra-transformés (UPF) joue un rôle dans le développement des maladies chroniques, mais les preuves de leur influence sur l'hyperuricémie sont limitées. Nous avons donc conçu une étude de cohorte pour examiner si la consommation de FUP augmente le risque d'hyperuricémie chez l'adulte.

Méthodes et résultats
Il s'agissait d'une étude prospective (n = 18 444) réalisée à Tianjin, en Chine, de 2013 à 2019. Les participants âgés de 18 ans et plus et sans antécédent d'hyperuricémie ont été suivis pendant 1 à 6 ans (durée médiane du suivi = 4,2 ans). La consommation d'UPF a été évaluée par un questionnaire de fréquence alimentaire semi-quantitatif validé. L'hyperuricémie était définie comme un taux d'acide urique sérique ≥ 7,0 mg / dL chez les hommes et ≥ 6 mg / dL chez les femmes. Des modèles de régression à risques proportionnels multivariables de Cox ont été utilisés pour évaluer l'association entre la consommation de FUP et le risque d'hyperuricémie. Une régression spline cubique restreinte a été utilisée pour estimer l'association dose-réponse entre la consommation de FUP et le risque d'hyperuricémie. Au cours de la période de suivi, l'incidence de l'hyperuricémie était de 20,3% dans la population générale (27,7% chez les hommes et 13,2% chez les femmes). Dans les modèles multivariés finaux, les rapports de risque (intervalle de confiance à 95%) pour l'hyperuricémie dans les quartiles de consommation UPF ajustés en énergie étaient de 1,00 (référence), 1,04 (0,94, 1,14), 1,11 (1,01, 1,23), 1,16 (1,05, 1,28) ( p pour tendance = 0,02) dans la population générale.
Conclusions
Cette étude de cohorte prospective basée sur la population suggère qu'une consommation accrue d'UPF est indépendamment associée au risque d'hyperuricémie.