Wang, Mengmei E;
LIewellyn, Clare H;
Katsoulis, Michail;
Akbaraly, Tasnime N;
Dicken, Samuel J;
Liu, Jiahao;
Brown, Adrian;
(2025)
Ten-year trajectories of ultra-processed
food intake and prospective associations
with cardiovascular diseases and all-cause
mortality: findings from the Whitehall II cohort
study.
Nutrition Journal
, 24
, Article 79. 10.1186/s12937-025-01144-2.
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Abstract
Background: Ultra-processed food (UPF) intake has been associated with adverse health outcomes; however, research on UPF intake and cardiovascular disease (CVD) prognosis has largely neglected its longitudinal pattern over time. This study investigated trajectories of UPF intake over a decade and their prospective associations with the risk of fatal and non-fatal CVD, as well as all-cause mortality, using data spanning from 16 to 19 years.// Methods: This study utilized data from the British Whitehall II cohort study, including 7,138 participants (68.3% male; median baseline age 60.4 years), all free of CVD at baseline. Dietary intake was assessed using a validated 127-item food frequency questionnaire at three time points: phase 3 (1991–1994), phase 5 (1997–1999), and phase 7 (2002–2004). UPF intake was estimated using the Nova classification, and group-based trajectory modelling identified different longitudinal consumption patterns. Phase 7 (2002–2004) was the baseline for subsequent monitoring of cardiovascular events and mortality outcomes until 2019/2021. Multivariate Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for socio-demographics, lifestyle, diet quality, energy intake, and clinical factors.// Results: Three distinct UPF trajectory groups were identified: high (26.2% of participants), moderate (52.9%) and low UPF intake (20.9%). All groups showed a slight increase in UPF intake over time. Over the median follow-up of 16 years for incident cases and 19 years for mortality, we observed 1,128 incident CVD events, 859 CHD cases and 1,314 deaths. The highest vs. lowest UPF intake group had a 23% higher risk of CVD (HR 1.23, 95% CI 1.01 to 1.40), and a 32% higher risk of CHD (HR 1.32, 95% CI 1.06 to 1.65). No significant associations were observed between UPF trajectory groups and CVD mortality, CHD mortality, or all-cause mortality.// Conclusions: Sustained high UPF intake over 10 years was associated with increased risks of non-fatal CVD and CHD but not with CVD-specific, CHD-specific, or all-cause mortality. These findings suggest that sustained high intake of UPF may be a modifiable risk factor for preventing non-fatal cardiovascular risks.
| Type: | Article |
|---|---|
| Title: | Ten-year trajectories of ultra-processed food intake and prospective associations with cardiovascular diseases and all-cause mortality: findings from the Whitehall II cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12937-025-01144-2 |
| Publisher version: | https://doi.org/10.1186/s12937-025-01144-2 |
| Language: | English |
| Additional information: | © The Author(s), 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Epidemiology, Nutritional epidemiology, Food processing, Cardiovascular diseases, Ultra-processed foods, Public health, Dietary pattern, Food policy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10208352 |
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