BMJ: Eat less ultra-processed foods, especially men! Data from more than 200,000 people show that men's intake of large amounts of ultra-processed foods is associated with a 72% increased risk of distal coloral cancer

*For medical professionals only

Hamburger cola plus fries, milk tea cake donuts, fairy set to bring everyone a lot of
joy.
These ultra-processed foods will poison our stomach while conquering our stomach
.

Colorectal cancer is the third most common malignancy among men and women in the United States and the second leading cause of cancer death worldwide [1-2
].
Diet has been confirmed to be an important modifiable factor in coloral cancer [3
].
Ultra-processed foods (which contain high sugar, fat, large amounts of starch and food additives, and lack of bioactive compounds such as fiber, calcium, and vitamin D, which typically alter the gut flora and promote inflammation) have been reported to be associated with an increased risk of cancer [4-5].

However, there have been no large cohort studies to explore the association
between ingestion of ultra-processed foods and colorectal overall and anatomical subsite cancers.

Recently, the Fangfang Zhang team of Tufts University in the United States cooperated with researchers from Harvard University and other institutions to publish important research results
in the internationally renowned medical journal "British Medical Journal".
Based on the follow-up data of more than 200,000 people for 24-28 years, they found that the intake of a large number of ultra-processed foods in men was associated with a 72% increase in the risk of distal colorectal cancer, and eating less ready-to-eat meat products and drinking less sugary drinks were associated with a 44% and 21% reduction in coloral cancer risk, respectively.
Drinking more yogurt in women is associated with a 17% lower risk of coloral cancer [6].

Screenshot of the first page of the paper

The study used data
from three large U.
S.
cohorts of more than 200,000 participants.
Dietary intake was assessed every four years through the Food Frequency Questionnaire to investigate the relationship between
ultra-processed food intake and overall risk of colorectal cancer and anatomical subsites.

The researchers provided each participant with a food frequency questionnaire every four years and collected about 130 food consumption frequencies
.

More than 130 food categories are divided into four dietary types: (1) unprocessed or minimally processed foods; (2) contains processed cooking ingredients; (3) processed foods; (4) Ultra-processed food
.
Among them, ultra-processed foods include carbonated drinks, sausages, biscuits, candy, instant soups/noodles, sweetened packaged snacks, sugary milk and fruit drinks
.

Researchers define near-end cancer as a lesion that occurs in the cecum, ascending colon, and transverse colon; Distal colon cancer is defined as descending colon and sigmoid cancer; Rectal cancer is carcinoma at the junction of the rectum and sigmoid colon and rectal cancer
.

Analytical evaluation
was performed using a time-varying Cox proportional risk regression model that adjusted multiple confounding factors.

Figure 1: Percentage
of relative contribution of various food groups to the adjusted portion size of ultra-processed foods.

Over a follow-up period of 24-28 years, the study reported 3216 cases of coloral cancer, of which 1294 were in men; Female 1922 cases
.

One in five people with the highest consumption of ultra-processed foods are more likely to smoke, have a higher body mass index, drink less alcohol and have lower levels of physical activity; Consume less dietary fiber, folic acid, calcium, vitamin D and whole grains, and higher intake of fats, carbohydrate additives, and processed meats; It is also more likely to use aspirin
regularly.

The men with the highest consumption quintiles had a 29% higher risk of coloral cancer compared to the lowest quintile of ultra-processed food consumption (risk ratio [HR]: 1.
29; 95% confidence interval [CI]: 1.
08-1.
53; P trend = 0.
01).

However, the researchers did not find a significant association in women (HR:1.
04; 95% CI: 0.
90-1.
20; P trend = 0.
29) (Figure 2
).

When assessing the risk of anatomy subsites of coloral cancer, high consumption of ultra-processed foods was associated with a 72% increase in distal colon cancer risk in men (HR: 1.
72; 95% CI: 1.
24-2.
37; P trend<0.
001); No significant association
between ultra-processed foods and proximal colon or rectal cancer was found.
The risk of ultra-processed foods and coloral cancer subsites remains not significantly correlated in women (Figure 2
).

Figure 2: Ratio of the risk of coloral cancer in men and women from eating ultra-processed foods

(Red underline is marked as significantly correlated)

After classifying ultra-processed foods by subgroup, higher consumption of meat/poultry/seafood ready-to-eat products and high consumption of sugary beverages (maximum vs minimum quintile) among men were associated with a 44% and 21% higher risk of colorectal cancer (Figure 3).

High intake of ready-to-eat/heated mixed dishes in women (maximum vs minimum one-fifth) was associated with a 17% increased risk of coloral cancer; High intake of yogurt and dairy desserts was associated with a 17% lower risk of colorectal cancer (Figure 3
).

The researchers performed a sensitivity analysis to verify the stability
of the results.
Further adjustments to BMI or dietary nutrient quality measures (Western dietary patterns or dietary quality scores) and subgroup analyses found that these associations remained significant
.
However, an association
between overall ultra-processed food intake and coloral cancer risk has not been observed in women.

Figure 3: Ratio of risk of
ultra-processed foods to colorectal cancer in the male and female subgroups of ultra-processed foods.

(Red underline is marked as significantly correlated)

In summary, based on three large prospective cohorts, the study found that excessive overconsumption of ultra-processed foods in men, particularly meat-ready products (e.
g.
, sausages, bacon, ham, fish), and sugary beverages (sodas, fruit drinks, and sugary milk) were associated
with an increased risk of colorectal cancer.

Excessive consumption of ready-to-eat/heated dishes in women was associated with an increased risk of colorectal cancer, and consumption of more yogurt and dairy desserts was associated
with a reduced risk of coloral cancer.

These sex differences may be due to the effects of obesity and sex hormones
.
Estrogen is mainly produced in adipose tissue, while high estrogen vs.
testosterone may reduce a woman's risk of colorectal cancer, but may increase the risk of coloral cancer in men [7].

In addition, the consumption of "yogurt and dairy desserts" in women is associated with a reduced risk of colorectal cancer, and this protective effect may be due to the harmful effects
of yogurt and dairy desserts containing higher calcium content than higher sugar content.

Although there is no significant association between overall ultra-processed food intake and coloral cancer risk in women, this study suggests that consumption of ready-to-eat/heated dishes is associated
with an increased risk of coloral cancer.

These findings confirm that population health can be improved by restricting certain types of ultra-processed foods
.
Further research is still needed to explore the underlying mechanisms
by which ultra-processed foods lead to colorectal cancer.

In short, autumn is here again, and the annual autumn battle is about to start
.
Maintaining a good body and body is not only to open your legs, but also to control your mouth from the source and stay away from ultra-processed foods
.

References:

[1].
Keum N, Giovannucci E.
Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies.
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1038/s41575-019-0189-8

[2].
Siegel RL, Miller KD, Jemal A.
Cancer statistics, 2018.
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2018; 68(1):7-30.
doi:10.
3322/caac.
21442

[3].
Toledo E, de A Carmona-Torre F, Alonso A, et al.
Hypothesis-oriented food patterns and incidence of hypertension: 6-year follow-up of the SUN (Seguimiento Universidad de Navarra) prospective cohort.
Public Health Nutr.
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doi:10.
1017/S1368980009991066

[4].
Romaguera D, Fernández-Barrés S, Gracia-Lavedán E, et al.
Consumption of ultra-processed foods and drinks and colorectal, breast, and prostate cancer.
Clin Nutr.
2021; 40(4):1537-1545.
doi:10.
1016/j.
clnu.
2021.
02.
033

[5].
Fiolet T, Srour B, Sellem L, et al.
Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort.
BMJ.
2018; 360:k322.
Published 2018 Feb 14.
doi:10.
1136/bmj.
k322

[6].
   Wang L, Du M, Wang K, Khandpur N, Rossato S L, Drouin-Chartier J et al.
 Association of ultra-processed food consumption with colorectal cancer risk among men and women: results from three prospective US cohort studies BMJ 2022; 378 :e068921 doi:10.
1136/bmj-2021-068921

Kim H, Giovannucci EL.
Sex differences in the association of obesity and colorectal cancer risk.
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doi:10.
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Responsible editorEddie Zhang