A Summary of the article on “Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes”
Background
The article, authored by Bhave V, Oladele C, Ament Z et al (2024), was published in Neurology® on 22 May 2024, appearing in Volume 102, Number 11, on 11 June 2024. This research investigates the link between the consumption of ultra-processed foods (UPFs) and adverse brain health outcomes, specifically incident cognitive impairment and stroke.
The study addresses a crucial gap in understanding whether food processing itself confers neurological risk, independent of general dietary patterns. While UPFs have previously been linked to cardiometabolic diseases, cognitive decline, and stroke, this research sought to clarify the independent effect of food processing. The authors aimed to investigate these associations and compare them with the influence of commonly recommended dietary patterns, such as the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets.
Methods
This prospective, observational cohort study utilised data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, which enrolled Black and White adults in the United States between 2003 and 2007. Dietary data were collected using a baseline food frequency questionnaire, and food items were categorised by their level of processing according to the NOVA system. Participants with incomplete or implausible self-reported dietary data were excluded. Incident cognitive impairment was defined using performance relative to a normative sample on memory and fluency assessments, whilst incident stroke was identified through adjudicated review of medical records. The cognitive impairment cohort comprised 14,175 participants who showed no evidence of impairment at baseline and underwent follow-up testing, and the stroke cohort included 20,243 participants with no history of stroke.
Results
The results, analysed using multivariable Cox proportional hazards models, revealed significant associations. A 10% increase in the relative intake of UPFs was associated with a higher risk of cognitive impairment (hazard ratio [HR] = 1.16, 95% CI 1.09–1.24, p = 1.01 × 10−5). Conversely, greater intake of unprocessed or minimally processed foods was associated with a lower risk of cognitive impairment (HR = 0.88, 95% CI 0.83–0.94, p = 1.83 × 10−4). Similar trends were observed for stroke risk: greater UPF intake was associated with a higher risk (HR = 1.08, 95% CI 1.02–1.14, p = 1.12 × 10−2), and unprocessed or minimally processed foods were linked to a lower risk (HR = 0.91, 95% CI 0.86–0.95, p = 2.13 × 10−4). Notably, the effect of UPFs on stroke risk was more pronounced among Black participants compared to White participants, indicated by a significant UPF-by-race interaction (HR = 1.15, 95% CI 1.03–1.29, p = 1.50 × 10−2). Crucially, the study found that these associations between UPFs and both cognitive impairment and stroke were independent of adherence to the Mediterranean, DASH, and MIND diets.
Conclusions
In conclusion, the study suggests that the degree of food processing may be important to brain health in older adults, independent of known risk factors and adherence to recommended dietary patterns. This highlights the potential significance of food processing as an independent factor influencing neurological outcomes.
The research project received substantial funding through cooperative agreements from the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), both part of the National Institutes of Health. Additional funding was acknowledged from the National Heart, Lung, and Blood Institute (NHLBI) and from NINDS for specific authors. The authors generally reported no relevant financial disclosures, except for some research support for certain authors and personal compensation/stock options for W. Taylor Kimberly from various entities.
References
Bhave, V. M., Oladele, C. R., Ament, Z., Kijpaisalratana, N., Jones, A. C., Couch, C. A., Patki, A., Garcia Guarniz, A.-L., Bennett, A., Crowe, M., Irvin, M. R., & Kimberly, W. T. (2024). Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes. Neurology, 102(11), e209432. https://doi.org/10.1212/WNL.0000000000209432
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