Association between ultra-processed food intake and risk of colorectal cancer: a systematic review and meta-analysis

Abstract

BackgroundAlthough some epidemiological studies have shown a positive relationship between high intake of ultra-processed food (UPF) and risk of colorectal cancer (CRC), the results remain inconsistent. Therefore, we conducted this systematic review and meta-analysis to clarify the association between UPF intake and CRC risk.MethodsPubMed/MEDLINE, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI) and Wan fang databases were used to search the relevant studies published up to February 2023. The summary relative risks (RRs) with the corresponding 95% confidence intervals (CIs) were estimated by comparing the highest category vs. the lowest category of UPF intake, using the random-effects models (DerSimonian-Laird method). Heterogeneity between studies was explored using the Cochran’s Q test and I-square (I2). Publication bias was assessed by examining the funnel plots, and quantified by Begg’s or Egger’s tests.ResultsA total of seven articles (three cohort and four case-control studies), involving 18,673 CRC cases and 462,292 participants, were included in our study. Combining nine effect sizes from seven articles, an increased risk of CRC was shown in the highest compared with the lowest category of UPF intake (RR = 1.26; 95%CI:1.14–1.38, p < 0.0001). Subgroup analyses showed a positive association between UPF intake and CRC risk in case–control studies (RR = 1.41; 95%CI: 1.22–1.63, p < 0.0001). When we conducted analyses separately by study area, there was a significant association between UPF intake and CRC risk in developed countries (RR = 1.20; 95%CI: 1.11–1.30, p < 0.0001).ConclusionOur results show that high UPF intake is significantly associated with a higher risk of CRC, in the absence, however, of a dose–response association. Further studies in particular of large prospective cohort studies are necessary to confirm these results.

The Influence of Ultra-Processed Food on Colorectal Cancer: A Systematic Review

“…However, despite the general trend in studies indicating a relationship between UPF consumption and CRC, supported by recent meta-analyses by Isaksen and Dankel (2023) and Largo et al ( 2023) [35,[54][55][56], other studies produce contradictory results. This is because there are other relevant factors that can significantly influence the acquisition of healthy habits.…”

Ultra-processed food consumption and chronic kidney disease risk: a systematic review and dose–response meta-analysis

“…According to the NOVA classification system, all foods and beverages were classified into four groups, including unprocessed/minimally processed food, processed culinary ingredients, processed food and UPFs ( 11 ). The UPFs are usually ready-to-eat, hyper-palatable, cheap and characterized by high in energy density, salt, fats, added sugar and low in fiber, vitamins and minerals ( 13 ). Examples of UPF included sugar-sweetened drinks, sweet, crisps, cookies and cakes, and many ready-to-heat products such as pizza, burgers, noodles and desserts.…”

“…Thus far, many epidemiological studies have shown the significant positive associations between high UPF consumption and increased risks of various diet-related chronic non-communicable diseases, such as overweight/obesity, type 2 diabetes, cardiovascular disease (CVD), and certain cancers (14)(15)(16)(17). Moreover, multiple previous systematic reviews and meta-analyses have also confirmed these positive associations (13,18,19). Notwithstanding, only a few epidemiological studies have specially explored the potential relationship between UPF consumption and the risk of CKD (20-27).…”

“…Meanwhile, there has been a global nutrition transition, with food consumption shifting from minimally processed foods to UPFs, a hallmark of Western diet (11). Currently, UPF consumption has drastically increased in some middle-and high-income countries around the world, accounting for 25% ~ 60% of total daily energy intake (12,13). Thus far, many epidemiological studies have shown the significant positive associations between high UPF consumption and increased risks of various diet-related chronic non-communicable diseases, such as overweight/obesity, type 2 diabetes, cardiovascular disease (CVD), and certain cancers (14)(15)(16)(17).…”

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“…Worldwide, the consumption of UPFs has experienced a rapid increase, representing more than half of the daily calories consumed in high-income countries (3,7,8). Similarly, in low-and middleincome countries, a sustained growth in the sale of these products and their contribution to energy intake is observed (4,9).…”