Ultra processed foods or brain damage! A 10-year study of 70,000 people by a team at Tianjin Medical University found for the first time that higher intakes of ultra-processed foods were associated with an increased risk of dementia

*For medical professionals only

As the saying goes, if you want to conquer his heart, you must first conquer his stomach! It has to be said that if ultra-processed foods (UPFs) are called second in this regard, no other food dares to say first! All kinds of carbonated drinks, ice cream, bread cakes, milk teas, hamburger fries and other foods that have swept the world have already captured our stomachs

However, UPF generally has the disadvantages of high calorie, high sugar, high oil and high salt, high additives, low fiber and micronutrients, and it is also known as "junk food"

Recently, a research team led by Professor Wang Yaogang of the School of Public Health of Tianjin Medical University published important research results in the journal Neurology [1]: Higher UPF intake was significantly associated with a higher risk of dementia, while unprocessed or microprocessed foods were closely related to

The study is also the first cohort study to link UPF to dementia risk, and UPF has added a new label – "brain injury"!

Screenshot of the first page of the article

According to the World Health Organization (WHO), about 50 million people worldwide have dementia, and this number is expected to triple by 2050 [2-3].

At present, dementia is still an incurable disease, and there are no effective drugs [4].

Consuming too much UPF can cause many health problems, including diabetes[5], cardiovascular disease[6], and cancer[7

To do this, the researchers analysed data from the UK Biobank, a large UK population cohort, to investigate the association

UK Biobank is a large population cohort
of over 500,000 people.

After screening, the study ultimately included 72,083 participants, of whom 33,940 (47.
1%)
were men.

The average age of the participants was 61.
6 years, and more than 40% of the participants had a university or college degree and none of them had dementia at the beginning of the survey (Figure 1
).

The participants joined the study in 2009-2012 and were followed up until 2021, with a median follow-up of 10 years
.

The researchers used the Oxford Web questionnaire to survey participants' 24-hour diets
.

The researchers assessed the participants' diets and calculated upF intake
by the NOVA classification.

The researchers averaged at least two 24-hour dietary records from participants and treated them as baseline data
.

The NOVA taxonomy divides foods into four categories: 1) unprocessed or microprocessed foods such as fresh fruits, vegetables, legumes, and milk; 2) Processed cooking ingredients such as table salt and sugar; 3) Processed foods such as fresh bread, pickled nuts and canned food; 4) UPF, such as all kinds of soft drinks, sauces, chocolates and various snacks
.

There are too many kinds of food in this world, and Tuli is only a drop in the ocean

The researchers found that participants' intake of UPFs consisted mainly of a variety of beverages (34 percent), sugary products (21 percent), ultra-processed dairy products (17 percent) and salty snacks (11 percent
).

Based on the proportion of UPF in the diet, the researchers divided the participants into four groups of Q1-Q4, with Q1 being the lowest quartile
of UPF intake.

During the follow-up period, participants had a total of 518 dementia events, of which 287 were Alzheimer's disease and 119 were vascular dementia
.

The researchers found that compared with Q1, people with higher UPF consumption tended to be younger, mostly white, who did not smoke or drink
alcohol.

In addition, they had higher BMI and caloric intake, but lower poverty index (TDI), physical activity (PA), education level, and healthy eating scores
.

In order to explore the association between UPF intake in diet and the risk of dementia, the researchers used COX regression analysis to establish a total of three models, of which Model 3 (Mode3) is a complete adjustment model, adjusting a variety of factors affecting the risk of dementia
.

Factors adjusted for included gender, age, smoking and drinking habits, PA, BMI, sleep duration, cardiovascular disease history (CVD), family history of dementia, caloric intake, and healthy eating scores
.

In Mode3, the population with the highest intake of UPF (Q4) compared to Q1 was significantly associated with a 51% increased risk of developing all-cause dementia (risk ratio (HR): 1.
51, p<0.
001
).

In addition, the Q4 population was more than 1-fold associated with an increased risk of vascular dementia (HR: 2.
19, p<0.
01), but not with
the risk of Alzheimer's disease.

At the same time, a 10% increase in dietary UPF intake was significantly associated with a 25% increased risk of all-cause dementia (HR: 1.
25, p<0.
001) and a 28% increased risk of vascular dementia (HR: 1.
28, p<0.
01), but not significantly associated with Alzheimer's disease (HR: 1.
14, p=0.
06).

Association between UPF intake and risk of developing dementia

Is there a linear relationship between UPF intake and the risk of developing dementia? To this end, the researchers constructed a restrictive cubic spline model for evaluation
.

As shown in the figure below, the p-values representing nonlinear associations are all greater than 0.
05 and are not statistically significant
.

Therefore, there is a linear relationship
between upf intake ratio and the risk of developing all-cause dementia, Alzheimer's disease, and vascular dementia.

A curve of risk of developing dementia with the proportion of UPF in the diet

Since ingestion of UPF is associated with developing dementia, does replacing UPF with unprocessed or microprocessed foods reduce the risk? As expected, when an equal proportion of unprocessed or microprocessed foods were substituted for 10% UPF weight in the diet, this behavior was significantly associated
with a 19% lower risk of all-cause dementia (HR: 0.
81; p<0.
001) and a 22% risk of vascular dementia (HR: 0.
78; p<0.
01) of participants.

When the proportion reached 20%, this behavior was significantly associated with a 34% lower risk of all-cause dementia (HR: 0.
66; p<0.
001) and a 39% risk of vascular dementia (HR: 0.
61; p<0.
01).


In contrast, replacing UPFs with unprocessed or microprocessed foods is not associated
with the risk of Developing Alzheimer's disease.

Association between replacing UPF with raw or microprocessed foods and the risk of developing dementia

A variety of factors affect the risk of developing dementia, so the researchers also conducted a stratified analysis, classified by factors such as sex, BMI, smoking and drinking, PA and education level, and the results were basically consistent
with the above.

The researchers also analyzed the effects of different types of ultra-processed foods: beverages were significantly associated
with a high risk of all-cause dementia (HR: 1.
17; p<0.
001) and vascular dementia (HR<0.
001).

Sugary products were significantly associated with a higher risk of dementia (HR: 1.
14; p<0.
01
).

Hyperprocessed meat, fish, and eggs were significantly associated with a higher risk of Alzheimer's disease (HR: 1.
24; p<0.
001
).

This shows that the effects of different kinds of UPF are different and deserve further study
in the future.

Overall, this prospective cohort study suggests that high intake of UPF is strongly associated
with a higher risk of dementia, Alzheimer's disease, and vascular dementia.

UPF can adversely affect
our brain health.

The study also has several limitations
.

First of all, cases of dementia may have errors
.

The cases in the study were all confirmed through medical institutions and mild cases may be missed; Second, the participants included in the study tended to be white, female, less poor, and more educated, a typical health-focused volunteer study that caused sample bias
.

As a result, the prevalence of the findings may be affected
.

As an observational study, the study also cannot establish causality, and more research is needed in the future to validate the relevant findings
.

It is worth mentioning that substitution analysis shows that simply replacing a portion of UPF intake with unprocessed or microprocessed foods can bring health benefits
.

For example, adding just 50 grams of unprocessed or microprocessed foods per day (equivalent to half an apple) and reducing your UPF intake by 50 grams (equivalent to a piece of chocolate or a piece of bacon) can be significantly associated
with a reduced risk of dementia.

So, start changing your own recipes today, and a small change can bring health benefits
.

Friends who have purchased courses,

Directly enter the mini program to listen to the addition of food Oh ~

References:

[1] Li H, Li S, Yang H, et al.
Association of Ultraprocessed Food Consumption With Risk of Dementia: A Prospective Cohort [published online ahead of print, 2022 Jul 27].
Neurology.
2022; 10.
1212/WNL.
0000000000200871.
doi:10.
1212/WNL.
0000000000200871

[2] International AsD.
World Alzheimer Report 2015: The Global Impact of Dementia.
2015.

[3] WHO.
Global Health Estimates 2016: Disease burden by Cause, Age, Sex,by Country and by Region, 2000-2016.
Geneva: World Health Organization.
2018

[4] Szeto JY, Lewis SJ.
Current Treatment Options for Alzheimer's Disease and Parkinson's Disease Dementia.
Curr Neuropharmacol.
2016; 14(4):326-338.
doi:10.
2174/

1570159x14666151208112754

[5] Srour B, Fezeu LK, Kesse-Guyot E, et al.
Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort.
JAMA Intern Med.
2020; 180(2):283-291.
doi:10.
1001/jamainternmed.
2019.
5942

[6] Srour B, Fezeu LK, Kesse-Guyot E, et al.
Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé).
BMJ.
2019; 365:l1451.
Published 2019 May 29.
doi:10.
1136/bmj.
l1451

[7] 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

Responsible Editor Tan Shuo