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A major French study released on Monday revealed for the first time a link between ultra-processed food consumption and a higher risk of death, but researchers warned that more work was needed to determine mechanisms at play.
The study, which tracked the diet of tens of thousands of French people between 2009 and 2017, found a modest link between increased consumption of ultra-processed foods – known as ready-to-eat or heated foods – and mortality risk during this period.
The findings were published in JAMA Internal Medicine, published by the American Medical Association.
But "we should not be alarmist, nor say that eating a packaged meal increases by 15% the chances of dying," warned Mathilde Touvier, director of the research team in nutritional epidemiology at the University of Paris 13, who managed the NutriNet-Sante program. study with teams from Inserm, INRA and CNAM.
"It's another step in our understanding of the link between ultra-processed foods and health," she added.
The relationship between diet and disease is complex and the results of the studies are often misinterpreted.
Last year, the same French team published a study on organic foods and its connection to cancer risk.
A higher rate of cancer was found among people consuming less organic food – but the study did not conclude to the existence of a causal link – although This has not prevented many media from highlighting the effects of organic foods on the fight against cancer.
Some 45,000 people over 45, most of them women, participated in the latest study. Every six months, they were asked to complete three online surveys, randomly badigned, over a two-week period, covering everything they ate or drank in a 24-hour period.
After seven years, about 600 people died. The researchers then badyzed the numbers and found that a 10% increase in the proportion of ultra-processed foods in the diet corresponds to a 15% increase in mortality.
But Touvier warned that, rather than focusing on the figure, the important thing is the existence of a statistically significant correlation – and the study is part of the growing body of work in this area.
– Socio-economic inequalities –
Ultra-processed foods belong to group four of the NOVA food clbadification system recognized by health agencies, including the United Nations Food and Agriculture Organization.
They have undergone several processes of transformation, including heating at high temperature and the presence of additives, emulsifiers and texturants. Many ready-to-heat products, high in salt or sugar, low in vitamins and fiber, fall into this category, reports AFP.
Last year, French researchers published the results of the same NutriNet-Sante study, observing more cancers among heavy users of these foods.
Since it is not possible for ethical reasons to conduct a controlled experiment in which one group eats ultra-processed foods and the other no, the observational studies are the only option.
But they are inevitably flawed and depend on an accurate self-declaration. Many other "invisible" factors are also at play, even though the results are adjusted to compensate for the socio-demographic criteria and the overall quality of the diet.
The burning question remains: what is causing negative health effects about these foods?
One prevalent hypothesis is the presence of additives that have been studied in the laboratory on cells and rats, including by the National Institute of Agricultural Research (INRA).
The study is "an important contribution to the literature" on the subject, told AFP Casey Rebholz, professor of epidemiology at the Johns Hopkins School of Public Health, who pointed out that the methodology was robust, despite the limitations inherent to studies of this nature.
Another key message to remember is that these foods are consumed disproportionately by low-income people, said Professor Nita Forouhi of the University of Cambridge's School of Clinical Medicine.
"The consumption of highly processed foods reflects social inequities – they are disproportionately consumed by people with low incomes or with lower education or living alone," she said.
"Such foods are attractive because they tend to be cheaper, they are very appetizing because of their high sugar, salt and saturated fat content, are widely available … There is still a lot to be done to remedy these inequalities. "
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