- A diet heavy in ultra-processed foods may increase the risk of death among older Americans by up to 10%, according to a new study.
- The study tracked the nutrition and health of more than half a million participants over more than 20 years.
- The highest levels of ultra-processed food consumption in the researcher’s older adult group were seen in young people.
Consuming ultra-processed foods increases the risk of death in older people, an expanded new study suggests.
During the study’s long follow-up period, people who consumed significant amounts of ultra-processed foods were 10 percent more likely to die than those who did not.
The study utilized the following data:
The researchers scored their diets using the NOVA system, which classifies foods according to the degree and type of processing used in their preparation.
They looked not just at the NOVA procedure but also at the Healthy Eating Index (HEI)-2015 scores and noted that people with higher UPF intake tended to have poorer diet quality and higher BMI.
What makes this study particularly noteworthy are the two approaches the researchers used to further validate food frequency questionnaires (FFQs): expert consensus and an alternative and novel food-based approach to define UPF intake (grams/day), which was broken down into food codes, then ingredient codes, and then classified via NOVA.
The researchers also used two 24-hour dietary recalls in a subgroup to calibrate the FFQ risk estimates, which is not standard practice and increases the potential precision of the study’s findings.
The research was presented this week at the American Nutrition Association’s NUTRITION 2024 conference.
According to the NOVA system, natural, processed and ultra-processed foods are defined as follows:
- Unprocessed or natural foods are derived directly from plants or animals, without any modification or processing other than during transportation to where they are sold.
- Minimally processed foods are similar, but have been cleaned and the inedible or unwanted parts removed. They may be portioned, ground, dried, fermented, pasteurized, refrigerated, or frozen to get to the table, but they have no added oils, fats, sugar, salt, or other substances.
- NOVA also includes a category called Processed Culinary Ingredients, which are substances extracted from natural foods. These include oils, fats, salt and sugar, and are ideally used in small amounts to flavor and cook foods without nutritionally compromising the overall quality of the diet.
- Processed foods are foods produced for consumption by adding sugar, salt and fat to natural foods to give them flavor and extend their shelf life. They usually do not contain more than two or three ingredients.
- Ultra-processed foods, or UPF, are industrial creations that are mostly made from fats, oils, sugars, and proteins derived from natural foods, along with substances such as modified starch and hydrogenated oils, added colors, and flavor enhancers. They are inexpensive and convenient for the consumer, and may contain five or more ingredients.
It’s already widely known that a diet full of ultra-processed foods can be detrimental to your health, but the large number of people in this study — 318,889 men and 221,607 women — and the long follow-up period are unusual.
“The very long follow-up period is interesting, but the researchers also noted that it’s not clear what was happening from the time the data was collected to the time of follow-up. Did these people make dietary changes? Did they engage in other activities that were risky for their overall health? We’re not clear on the details,” said Kristin Kirkpatrick, MS, RDN, a registered dietitian who was not involved in the study.
Compared to the lowest amount of processed food consumption, maximum amountIt has been associated with an increased risk of death from heart disease and diabetes, but not from cancer.
“This research shows that greater consumption of ultra-processed foods is associated with an increased risk of death, independent of other factors such as smoking, obesity and diet quality,” said Michelle Routhenstein, MS, RD, CDCES, a preventive cardiology dietitian at EntirelyNourished.com, who was not involved in the study.
“This suggests that the detrimental health effects of ultra-processed foods may persist independent of general lifestyle factors,” Routhenstein said.
“Ultra-processed foods often contain more added sugar, unhealthy fats, and additives, while lacking essential nutrients like fiber and vitamins, which can negatively impact cardiometabolic health. These foods also contain higher levels of advanced glycation end products (AGEs) due to their processing methods, which can increase oxidative stress and inflammation in the body. AGEs can also elevate levels of cystatin C, which is associated with decreased kidney function and an increased risk of cardiovascular disease.”
— Michelle Routhenstein, MSc, PhD, CDCES
Considering the extended follow-up period, participants’ ages ranged from approximately 73 to 94 years at follow-up.
“Research on the impact of ultra-processed foods, particularly in older adults, is limited but growing. The specific long-term impact on mortality in older populations is still an active area of study,” Routhenstein said.
“It’s never too late to make beneficial dietary changes,” Kirkpatrick said. “Previous research has found similar results with lifespan, such as a study evaluating UPF in ages 57 to 91.”
He noted that most of the research he has seen involves young people and focuses on preventing future problems through better nutrition.
The researchers found that younger members of the study group tended to consume more UPF than older members.
“Younger participants, especially middle-aged individuals, may consume more ultra-processed foods due to factors such as convenience, affordability, and advertising. These foods are often widely available, require minimal preparation, and are heavily marketed, making them attractive to their busy lifestyles,” Routhenstein said.
It may also be that “young individuals who are generally healthy and have not had any symptoms or serious illness may not have thought about what will happen in the future with regard to their diet today,” Kirkpatrick said.
The American diet generally includes a significant number of foods that span the spectrum of processing.
“Some of these foods, like breakfast cereals, for example, can even help fill some nutritional gaps through fortification,” Kirkpatrick said.
However, “consuming too many of these foods means not having the opportunity to nourish the body,” she said. [more] “Nutritional dense options.” The result can be high consumption of calorie-dense foods that are low in nutritional value.
Kirkpatrick expressed concern about the over-reliance on the NOVA classification system in assessing the impact of processed foods.
“The NOVA scale is strictly about the degree of processing and has nothing to do with the nutritional value of foods, so it does not take into account things like added sugar, protein or fiber content,” she explained.
“Putting all processed foods in the same box risks oversimplifying nutritional science, so limiting UPF should be accompanied by education for individuals,” Kirkpatrick said.
“There is no one-size-fits-all dietary approach, so each patient may deserve an individualized approach based on their own dietary needs and goals,” he said.