Table 3.
Association between the dietary contribution of foods groups that take into account both the plant or animal origin of foods and food processing categories, and fatal and non-fatal cardiovascular events from in the UK biobank cohort (n = 118,397).
| Food groups | Dietary contribution (% of total energy) |
|||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | p for trend | Continuous (10% increase in the contribution) | |
| HR (95% CI) | HR (95% CI) | |||||
| All cardiovascular diseases | ||||||
| n for cases/non-cases = 7806/110,591 | ||||||
| Plant-sourced non-UPF | 1 | 0.89 (0.84–0.95) | 0.85 (0.80–0.91) | 0.80 (0.75–0.86) | <0.001 | 0.93 (0.91–0.95) |
| Plant-sourced UPF | 1 | 1.05 (0.98–1.12) | 1.15 (1.07–1.22) | 1.16 (1.09–1.24) | <0.001 | 1.05 (1.03–1.07) |
| All plant-sourced foods | 1 | 0.99 (0.93–1.05) | 0.95 (0.89–1.01) | 0.97 (0.91–1.04) | 0.229 | 0.99 (0.97–1.02) |
| All UPF | 1 | 1.09 (1.02–1.17) | 1.17 (1.10–1.25) | 1.23 (1.15–1.31) | <0.001 | 1.06 (1.04–1.08) |
| Coronary heart disease | ||||||
| n for cases/non-cases = 6006/112,391 | ||||||
| Plant-sourced non-UPF | 1 | 0.89 (0.83–0.95) | 0.84 (0.78–0.90) | 0.77 (0.71–0.83) | <0.001 | 0.92 (0.90–0.94) |
| Plant-sourced UPF | 1 | 1.09 (1.01–1.17) | 1.20 (1.12–1.29) | 1.21 (1.13–1.31) | <0.001 | 1.06 (1.04–1.09) |
| All plant-sourced foods | 1 | 1.02 (0.95–1.09) | 0.96 (0.89–1.03) | 0.98 (0.91–1.05) | 0.243 | 0.99 (0.97–1.02) |
| All UPF | 1 | 1.18 (1.09–1.27) | 1.24 (1.15–1.34) | 1.31 (1.21–1.41) | <0.001 | 1.07 (1.05–1.09) |
| Cerebrovascular disease | ||||||
| n for cases/non-cases = 2112/116,285 | ||||||
| Plant-sourced non-UPF | 1 | 0.91 (0.81–1.03) | 0.93 (0.83–1.05) | 0.93 (0.82–1.05) | 0.310 | 0.99 (0.95–1.03) |
| Plant-sourced UPF | 1 | 0.94 (0.84–1.06) | 0.96 (0.85–1.09) | 1.03 (0.91–1.16) | 0.602 | 1.01 (0.98–1.05) |
| All plant-sourced foods | 1 | 0.92 (0.82–1.04) | 0.95 (0.84–1.07) | 0.97 (0.86–1.10) | 0.727 | 1.00 (0.96–1.05) |
| All UPF | 1 | 0.89 (0.79–1.01) | 0.98 (0.87–1.10) | 1.00 (0.88–1.13) | 0.697 | 1.01 (0.98–1.04) |
| All cardiovascular diseases mortality | ||||||
| n for cases/non-cases = 529/117,868 | ||||||
| Plant-sourced non-UPF | 1 | 0.90 (0.72–1.13) | 0.78 (0.62–0.99) | 0.61 (0.47–0.79) | <0.001 | 0.87 (0.80–0.94) |
| Plant-sourced UPF | 1 | 1.00 (0.77–1.31) | 1.39 (1.08–1.78) | 1.49 (1.16–1.92) | <0.001 | 1.12 (1.05–1.20) |
| All plant-sourced foods | 1 | 1.05 (0.83–1.33) | 0.89 (0.70–1.13) | 0.89 (0.70–1.14) | 0.195 | 1.00 (0.92–1.09)a |
| All UPF | 1 | 1.30 (1.00–1.68) | 1.35 (1.04–1.74) | 1.42 (1.10–1.84) | 0.010 | 1.09 (1.02–1.16) |
| Coronary heart disease mortality | ||||||
| n for cases/non-cases = 348/118,049 | ||||||
| Plant-sourced non-UPF | 1 | 0.84 (0.64–1.10) | 0.71 (0.53–0.94) | 0.48 (0.34–0.66) | <0.001 | 0.80 (0.73–0.88) |
| Plant-sourced UPF | 1 | 1.32 (0.93–1.87) | 1.75 (1.26–2.44) | 1.90 (1.37–2.65) | <0.001 | 1.18 (1.09–1.28) |
| All plant-sourced foods | 1 | 1.09 (0.81–1.45) | 0.86 (0.64–1.17) | 0.86 (0.63–1.16) | 0.151 | 0.99 (0.89–1.10)a |
| All UPF | 1 | 1.49 (1.07–2.07) | 1.64 (1.18–2.27) | 1.65 (1.19–2.28) | 0.004 | 1.13 (1.05–1.23) |
| Cerebrovascular disease mortality | ||||||
| n for cases/non-cases = 181/118,216 | ||||||
| Plant-sourced non-UPF | 1 | 1.06 (0.71–1.59) | 0.97 (0.64–1.47) | 0.95 (0.62–1.46) | 0.742 | 1.01 (0.89–1.15) |
| Plant-sourced UPF | 1 | 0.67 (0.43–1.04) | 1.00 (0.67–1.49) | 1.05 (0.70–1.57) | 0.472 | 1.00 (0.89–1.13) |
| All plant-sourced foods | 1 | 0.99 (0.66–1.47) | 0.93 (0.62–1.41) | 0.97 (0.64–1.48) | 0.827 | 1.02 (0.88–1.18) |
| All UPF | 1 | 1.06 (0.70–1.60) | 0.97 (0.63–1.48) | 1.13 (0.75–1.72) | 0.670 | 1.01 (0.90–1.12) |
Q, Quartile; UPF, Ultra-processed foods.
Mean follow-up times were 9.1 for overall cardiovascular disease (1,076,104 person-years), 9.2 coronary heart disease (1,083,490 person-years), and 9.3 for cerebrovascular diseases (1,101,715 person-years). Mean follow-up times were 9.2 for mortality for cardiovascular disease (1,091,678 person-years), coronary heart disease (1,091,678 person-years), and cerebrovascular diseases (1,091,678 person-years).
Cut-off for quarters of food contribution ranged from 30.3% of total energy intake (1st quartile) to 65.9% (4th quartile) for UPF; from 56.3% to 82.1% for plant-based foods; from 16.3% to 46.0% for plant-based foods non-UPF; and from 22.9% to 56.4% for plant-based foods UPF, respectively.
Cox proportional hazards models with age as the underlying timescale. Adjusted by sex, ethnic (white, non-white), family history of CVD (no, mother or father, mother and father), BMI (continuous), physical activity (low, moderate, high, missing), smoking status (never, previous, current), index of multiple deprivation (quintile), and region (London, South East, South West, East Midlands, West Midlands, Yorkshire & the Humber, North East, North West, Wales, Scotland). Analysis for risk of CVD were stratified by sex, family history of CVD and smoking status. Analysis for the CVD death were stratified by sex and ethnic.
Non-linear association in restricted cubic spline regression (p = 0.04 and p = 0.03, respectively).