Objective To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality. Design Population based cohort study. Setting Female registered nurses from 11 US states in the Nurses’ Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018). Participants 74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline. Main outcome measures Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes). Results 30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 years of follow-up, respectively. Compared with those in the lowest quarter of ultra-processed food consumption, participants in the highest quarter had a 4% higher all cause mortality (hazard ratio 1.04, 95% confidence interval 1.01 to 1.07) and 9% higher mortality from causes other than cancer or cardiovascular diseases (1.09, 1.05 to 1.13). The all cause mortality rate among participants in the lowest and highest quarter was 1472 and 1536 per 100 000 person years, respectively. No associations were found for cancer or cardiovascular mortality. Meat/poultry/seafood based ready-to-eat products (for example, processed meat) consistently showed strong associations with mortality outcomes (hazard ratios ranged from 1.06 to 1.43). Sugar sweetened and artificially sweetened beverages (1.09, 1.07 to 1.12), dairy based desserts (1.07, 1.04 to 1.10), and ultra-processed breakfast food (1.04, 1.02 to 1.07) were also associated with higher all cause mortality. No consistent associations between ultra-processed foods and mortality were observed within each quarter of dietary quality assessed by the Alternative Healthy Eating Index-2010 score, whereas better dietary quality showed an inverse association with mortality within each quarter of ultra-processed foods. Conclusions This study found that a higher intake of ultra-processed foods was associated with slightly higher all cause mortality, driven by causes other than cancer and cardiovascular diseases. The associations varied across subgroups of ultra-processed foods, with meat/poultry/seafood based ready-to-eat products showing particularly strong associations with mortality. Data can be shared through mechanisms detailed at and .

中文翻译：

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超加工食品消费与全因和特定原因死亡率的关联：基于人群的队列研究


目的 研究超加工食品消费与全因死亡率和特定原因死亡率的关系。设计基于人群的队列研究。在护士健康研究（1984-2018）中设置来自美国 11 个州的女性注册护士，在健康专业人员随访研究（1986-2018）中设置来自美国所有 50 个州的男性健康专业人员。参与者包括 74 563 名女性和 39 501 名男性，基线时没有癌症、心血管疾病或糖尿病史。主要结果测量 使用多变量 Cox 比例风险模型来估计每四年半定量食物频率调查问卷测量的超加工食品摄入量与全因死亡率和癌症、心血管疾病引起的特定死亡率之间的关系的风险比和 95% 置信区间。和其他原因（包括呼吸系统和神经退行性原因）。结果 在平均 34 年和 31 年的随访期间，分别记录了 30 188 名女性死亡和 18 005 名男性死亡。与超加工食品消费最低四分之一的参与者相比，最高四分之一的参与者的全因死亡率高出 4%（风险比 1.04，95% 置信区间 1.01 至 1.07），癌症以外原因导致的死亡率高出 9%或心血管疾病（1.09、1.05 至 1.13）。最低和最高季度参与者的全因死亡率分别为每 10 万人年 1472 人和 1536 人。没有发现与癌症或心血管死亡率之间的关联。以肉类/家禽/海鲜为基础的即食产品（例如加工肉类）始终显示出与死亡率结果密切相关（风险比范围为 1.06 至 1.43）。加糖和人工加糖饮料（1.09、1.07 至 1.12）、乳制品甜点（1.07、1.04 至 1.10）和超加工早餐食品（1.04、1.02 至 1.07）也与较高的全因死亡率相关。在替代健康饮食指数-2010评分评估的每个季度的膳食质量中，没有观察到超加工食品与死亡率之间存在一致的关联，而更好的膳食质量显示出每个季度的超加工食品与死亡率呈负相关。结论 这项研究发现，超加工食品摄入量较高与全因死亡率略高相关，而全因死亡率则由癌症和心血管疾病以外的原因驱动。这些关联在超加工食品的亚组中各不相同，其中以肉类/家禽/海鲜为基础的即食产品与死亡率的关联尤其强烈。数据可以通过详细机制共享和。