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<h1><center><strong>Is the consumption of ultra-processed foods linked to a cancer risk?</strong></center></h1>
<h1><center><strong></strong></center></h1>
Following their recent scientific publication suggesting an association between the consumption of ultra-processed foods and an over-risk of developing cancer , Mathilde Touvier , Bernard Srour and Serge Hercberg (Unit 1153 Inserm / Inra / Cnam / University Paris 13 - Sorbonne Paris Cité, research team in nutritional epidemiology, Center for Research in Epidemiology and Statistics) decipher their work in a forum published by The Conversation .
During the last decades, eating habits have changed in France as in many countries in the world: there has been an increase in the consumption of ultra-processed foods, which today contribute to more than half of the caloric intake in numerous countries. Formulated to be tasty, and microbiologically sound, they are often characterized by lower nutritional quality: they are, in general, richer in salt, sugar and saturated fattyfattyCatégorie de lipides assurant un rôle fondamental dans la structure des cellules et le stockage de l’énergie. acids, and lower in fiber and vitamins. In addition, these foods often contain food additives, as well as substances from packaging and other food contact materials, and are likely to carry certain newly formed compounds created during processing.
The concept of food processing is complex, as the possible processes (industrial or not) and the authorized additives are multiple. A first classification of levels of food processing, the NOVA , developed by researchers from the University of São Paulo, allowed to initiate the reflection on the relationship between the degree of food processing and health. Foods are categorized into 4 groups, depending on the degree of processing (low or no processed foods, cooking ingredients, processed foods, ultra-processed foods).
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<h1><strong>Sodas, nuggets, dehydrated soups</strong></h1>
The ultra-processed food group includes, for example, pre-packaged industrial breads and buns, instant vegetable powder soups, chocolate bars, snack cookies, soft drinks and flavored sweet drinks, and poultry and fish nuggets. . Transformation processes include, for example, high temperature heating, hydrogenation, and frying pretreatment. Colorants, emulsifiers, texturizers, sweeteners and other additives are often added to these products.
While salted meats are considered "processed foods", smoked meats and / or with added nitrite and preservatives, such as sausages and ham, are classified as "ultra-processed foods". Similarly, salted vegetable preserves are considered "processed foods" while cooked or fried industrial vegetables, marinated in sauces and / or with added flavorings or texturizers (such as vegetable vegetable frying) are considered "ultra-processed foods".
Some epidemiological studies have found associations between the consumption of ultra-transformed foods according to the NOVA classification and an increased risk of developing metabolic disorders such as dyslipidemias, overweight, obesity, and high blood pressure. However, no studies have been conducted to date on the risk of cancer. Our team has therefore studied the associations between the consumption of ultra-processed foods and the risk of cancer in a large population of French adults.
The study involved 104,980 subjects over the age of 18, participating in the NutriNet-Santé cohort, followed between 2009 and 2017. Food data were collected using 24-hour repeated Internet recordings. designed to assess the usual consumption of participants. The 3,300 different foods consumed were classified according to their degree of NOVA transformation.
In this study , which we published on February 15 in the British Medical Journal , we observed that a 10% increase in the proportion of ultra-processed foods in the diet was associated with an increase of about 10% risks of developing cancer at all sites (2,228 cases) and breast cancer more specifically (739 cases). These results remain significant after taking into account a large number of socio-demographic factors (age, level of education, etc.), anthropometric, lifestyle (physical activity, alcohol, tobacco, etc.), but also indicators of the nutritional quality of the diet (intake of salt, sugars, fats, etc.).
<h1><strong>Carcinogenic compounds?</strong></h1>
Among the different hypotheses that could explain these results, the poorer overall nutritional quality of ultra-processed foods can be advanced, but would not be the only one involved. The presence of other compounds (additives, substances formed during processing processes, materials in contact with food, etc.) could also play a role. Indeed, although the evidence in humans remains limited to date, experimental studies in animals have suggested carcinogenic properties for several of these compounds (examples: additives such as titanium dioxide or nitrites, compounds newly formed during cooking of certain foods such as acrylamide or bisphenol A in some plastic packaging).
As we pointed out in the scientific publication, this work must be considered as a first line of investigation in this field. We are aware that the "observational" approach of this study does not allow us to conclude on the existence of a causal link. For example, a randomized intervention trial comparing two groups of people (one to whom ultra-processed foods had been consumed for several years and the other not consuming them) would be convincing. a causal link ... But this type of study, as is often the case in the field of nutrition research, can not be envisaged, for practical and logistical reasons obvious but also ethical, since an effect deleterious is suspected.
It is necessary to confirm these results by new epidemiological studies carried out on various populations and in other countries. We must also go further in understanding the transformation processes, factors and mechanisms potentially involved, through new epidemiological and experimental approaches, on animal or cellular models.
The category of "ultra-processed foods" is broad and diverse and needs to be refined to better understand its relationship to health. It is therefore essential to develop new research in order to obtain precise answers to all the questions asked, which will take several years. In the meantime, it is important not to alarm consumers, but to inform them with as much objectivity and scientific pedagogy as possible about the progress of research. The High Council of Public Health in France has introduced since 2017 in its official recommendations the fact to focus on raw products (not or little processed), in the name of the precautionary principle. Several manufacturers have already committed to improving the quality of their agri-food products.
<h1><strong>Research on food additives</strong></h1>
To continue this work, we are launching a new research program on food additives, whose main objective will be to evaluate the usual exposures to these substances and to study their potential effects on health and the occurrence of chronic diseases. This will be made possible through a precise and repeated assessment of dietary exposure in the NutriNet-Santé cohort still ongoing, including the brands and trade names of the industrial foods consumed.
This last point is fundamental to accurately estimate additive exposure at the individual level given the large variability of compositions between brands. The recruitment of new volunteers to participate in the NutriNet-Santé study is continuing. Simply register online and complete questionnaires, which will allow researchers to advance knowledge about the relationship between nutrition and health, and thereby improve the prevention of chronic diseases through our diet.
Mathilde Touvier , Researcher - Nutritional Epidemiology Research Team (EREN U1153 Inserm / Inra / Cnam / Sorbonne Paris Cité UP13), Sorbonne Paris Cité University (USPC) ; Bernard Srour , Epidemiologist - Research Team in Nutritional Epidemiology EREN (INSERM U1153 / INRA U1125 / Cnam / USPC) - Center for Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), National Institute of Health and Medical Research (Inserm ) , and Serge Hercberg , Director of the research team in Nutritional Epidemiology, Professor of Nutrition, Inserm, University Paris 13 - USPC
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