Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: a large prospective multicenter study

Jian-Yuan Pu; Wei Xu; Qian Zhu; Wei-Ping Sun; Jie-Jun Hu; Dong Cai; Jun-Yong Zhang; Jian-Ping Gong; Bin Xiong; Guo-Chao Zhong

doi:10.3389/fnut.2023.1258242

Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: a large prospective multicenter study

Front Nutr. 2023 Oct 2:10:1258242. doi: 10.3389/fnut.2023.1258242. eCollection 2023.

Authors

Jian-Yuan Pu¹, Wei Xu², Qian Zhu³, Wei-Ping Sun⁴, Jie-Jun Hu¹, Dong Cai¹, Jun-Yong Zhang⁵, Jian-Ping Gong¹, Bin Xiong¹, Guo-Chao Zhong¹

Affiliations

¹ Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Department of Hepatobiliary, Thyroid and Breast Surgery, The People's Hospital of Liangping District, Chongqing, China.
³ Department of Epidemiology and Biostatistics, School of Public Health, Chongqing Medical University, Chongqing, China.
⁴ Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Abstract

Background and aims: Whether ultra-processed food consumption is associated with cancer prognosis remains unknown. We aimed to test whether prediagnosis ultra-processed food consumption is positively associated with all-cause and cancer-specific mortality in patients with colorectal, lung, prostate, or breast cancer.

Methods: This study included 1,100 colorectal cancer patients, 1750 lung cancer patients, 4,336 prostate cancer patients, and 2,443 breast cancer patients. Ultra-processed foods were assessed using the NOVA classification before the diagnosis of the first cancer. Multivariable Cox regression was used to calculate hazard ratio (HR) and 95% confidence interval (CI) for all-cause and cancer-specific mortality.

Results: High ultra-processed food consumption before cancer diagnosis was significantly associated with an increased risk of all-cause mortality in lung (HR_{quartile 4 vs. 1}: 1.18; 95% CI: 0.98, 1.40; P_trend = 0.021) and prostate (HR_{quartile 4 vs. 1}: 1.18; 95% CI: 1.00, 1.39; P_trend = 0.017) cancer patients in a nonlinear dose-response manner (all P_nonlinearity < 0.05), whereas no significant results were found for other associations of interest. Subgroup analyses additionally revealed a significantly positive association with colorectal cancer-specific mortality among colorectal cancer patients in stages I and II but not among those in stages III and IV (P_interaction = 0.006), and with prostate cancer-specific mortality among prostate cancer patients with body mass index <25 but not among those with body mass index ≥25 (P_interaction = 0.001).

Conclusion: Our study suggests that reducing ultra-processed food consumption before cancer diagnosis may improve the overall survival of patients with lung or prostate cancer, and the cancer-specific survival of certain subgroups of patients with colorectal or prostate cancer.

Keywords: cancer patients; cohort study; nutritional epidemiology; prognosis; ultra-processed foods.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from the National Natural Science Foundation of China (Grant No. 82203391), China Postdoctoral Science Foundation (Project number: 2021M700638), and the Special Funding for Postdoctoral Research Project of Chongqing (Grant No. 2021XM2043). The funding supporters had no role in study design, data acquisition and analysis, decision to publish, or the preparation of the manuscript.