Summary
BACKGROUND High unprocessed and minimally processed food (UMP) intake has been associated with high-quality diets, while the opposite has been shown for ultra-processed food (UPF). Nevertheless, the association between UMP and UPF consumption and diet-quality over the long-term warrants further examination. OBJECTIVE This study aimed to assess whether UMP and UPF intake are associated with three diet-quality metrics in female and male health professionals from two US cohorts over three decades of follow-up. DESIGN This is a cohort study, including data from the Nurses' Health Study (NHS), from 1986-2010 (n = 51,956) and the Health Professionals Follow-up Study (HPFS) from 1986-2006 (n = 31,307). PARTICIPANTS /setting: Participants were invited in 1976 (NHS) and 1986 (HPFS) to respond to mailed questionnaires every 2-4 years and diet was assessed with a semi-quantitative food frequency questionnaire every 4 years. MAIN EXPOSURE MEASURES UMP and UPF intake were calculated using the NOVA classification. STATISTICAL ANALYSES Generalized estimating equations for marginal means and repeated cross-sectional associations between diet-quality metrics and quintiles of UMP and UPF. Diets were assessed every four years from 1986 to 2010. RESULTS With increasing quintiles of UMP intakes, the AHEI-2010 increased 7.1% (3.80 points [95%CI 3.66; 3.93]) in the NHS and 10.1% (5.75 points [95%CI 5.52; 5.98]) in the HPFS; the aMED increased 11.7% (0.50 points [95%CI 0.47; 0.52]) in the NHS and 14.0% (0.64 points [95%CI 0.60; 0.68]) in the HPFS; and the DASH-diet score increased 7.5% (1.81 points [95%CI 1.76; 1.87]) in the NHS and 10.6% (2.66 points [95%CI 2.57; 2.76]) in the HPFS. In the fifth quintile of UPF intake compared with the first, the AHEI-2010 was -9.3% (-4.60 points [95%CI -4.73; -4.47]) lower in the NHS and -13.7% (-6.89 points [95%CI -7.12; -6.66]) lower in the HPFS; the aMED was -14.7% (-0.55 points [95%CI -0.57; -0.53]) lower in the NHS and -19.0% (-0.74 points [95%CI -0.78; -0.70]) lower in the HPFS; and the DASH-diet score was -8.1% (-1.81 points [95%CI -1.86; -1.76]) lower in the NHS and -12.8% (-2.84 points [95%CI -2.93; -2.74]) lower in the HPFS. CONCLUSION Consumption of UMP was associated with better dietary quality, while consumption of UPF was associated with poorer dietary quality.
Outcomes reported
Referenced by Cambridge UPF young adults as citation 11; likely supports topic area: diet quality / nutrition / dietary guidelines; obesity / chronic disease / public health. Topics: diet quality / nutrition / dietary guidelines; obesity / chronic disease / public health Evidence type: Research article / other Source report: Cambridge UPF young adults Ref#: Cambridge UPF young adults #11 Original: Rossato SL, Khandpur N, Lo C-H, et al. Intakes of unprocessed and minimally processed and ultraprocessed food are associated with diet quality in female and male health professionals in the United States: a prospective analysis. J Acad Nutr Diet. 2023;123:1140-1151.
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