Table 3.
Cox proportional hazard ratios (95% confidence intervals) for all cause mortality of ultra-processed foods consumption categories*
| Variables | Quarters of energy adjusted ultra-processed foods consumption | P for trend | |||
|---|---|---|---|---|---|
| First (<2 servings/day) | Second (2-<3 servings/day) | Third (3-≤4 servings/day) | Fourth (>4 servings/day) | ||
| All cause mortality | |||||
| No of participants | 4975 | 4975 | 4975 | 4974 | |
| Person years | 49 814 | 50 322 | 49 971 | 50 323 | |
| No of deaths | 108 | 74 | 80 | 73 | |
| Unadjusted | 1.00 (reference) | 1.02 (0.75 to 1.37) | 1.38 (1.03 to 1.85) | 1.78 (1.30 to 2.43) | <0.001 |
| Age and sex adjusted | 1.00 (reference) | 1.00 (0.73 to 1.36) | 1.29 (0.94 to 1.77) | 1.72 (1.22 to 2.43) | 0.001 |
| Multivariable adjusted* | 1.00 (reference) | 0.99 (0.72 to 1.37) | 1.24 (0.89 to 1.73) | 1.61 (1.12 to 2.30) | 0.008 |
| Multivariable adjusted† | 1.00 (reference) | 1.06 (0.76 to 1.48) | 1.38 (0.99 to 1.92) | 1.62 (1.13 to 2.33) | 0.005 |
| Adjusted for propensity scores§ | 1.00 (reference) | 1.07 (0.78 to 1.46) | 1.43 (1.01 to 1.98) | 1.89 (1.34 to 2.67) | <0.001 |
| Repeated measurements of diet¶ | 1.00 (reference) | 1.18 (0.85 to 1.63) | 1.39 (1.00 to 1.93) | 1.44 (1.01 to 2.05) | 0.02 |
| Cardiovascular deaths | |||||
| No of participants | 4889 | 4921 | 4909 | 4916 | |
| Person years | 49 245 | 49 941 | 49 474 | 49 893 | |
| No of deaths | 22 | 20 | 14 | 15 | |
| Unadjusted | 1.00 (reference) | 1.37 (0.74 to 2.53) | 1.43 (0.73 to 2.76) | 1.86 (0.90 to 3.83) | 0.09 |
| Age and sex adjusted | 1.00 (reference) | 1.04 (0.54 to 2.00) | 1.33 (0.62 to 2.87) | 2.08 (0.96 to 4.52) | 0.17 |
| Multivariable adjusted* | 1.00 (reference) | 0.87 (0.41 to 1.84) | 1.13 (0.45 to 2.82) | 2.10 (0.94 to 4.69) | 0.10 |
| Multivariable adjusted† | 1.00 (reference) | 0.77 (0.32 to 1.83) | 1.14 (0.46 to 2.82) | 2.16 (0.92 to 5.06) | 0.11 |
| Repeated measurements of diet¶ | 1.00 (reference) | 0.95 (0.41 to 2.22) | 1.40 (0.56 to 3.50) | 1.94 (0.82 to 4.61) | 0.14 |
| Cancer deaths | |||||
| No of participants | 4929 | 4934 | 4935 | 4930 | |
| Person years | 49 518 | 50 019 | 49 689 | 49 987 | |
| No of deaths | 62 | 33 | 40 | 29 | |
| Unadjusted | 1.00 (reference) | 0.78 (0.51 to 1.20) | 1.26 (0.85 to 1.86) | 1.36 (0.85 to 2.18) | 0.14 |
| Age and sex adjusted | 1.00 (reference) | 0.80 (0.52 to 1.23) | 1.03 (0.68 to 1.56) | 1.36 (0.82 to 2.27) | 0.20 |
| Multivariable adjusted* | 1.00 (reference) | 0.79 (0.51 to 1.23) | 1.01 (0.65 to 1.57) | 1.23 (0.71 to 2.11) | 0.50 |
| Multivariable adjusted† | 1.00 (reference) | 0.87 (0.55 to 1.38) | 1.13 (0.73 to 1.73) | 1.22 (0.70 to 2.12) | 0.42 |
| Repeated measurements of diet¶ | 1.00 (reference) | 0.97 (0.60 to 1.57) | 1.43 (0.93 to 2.20) | 1.30 (0.77 to 2.21) | 0.17 |
Adjusted for age (underlying time variable), sex, marital status, physical activity (quarters), smoking status (never, current, former), snacking (dichotomous), special diet at baseline (dichotomous), body mass index (linear and quadratic terms), total energy intake (continuous), alcohol consumption (continuous), and educational level (continuous) stratified by recruitment period, deciles of age, sedentary index (sum of hours each day spent watching television, using a computer, and driving), and television viewing (≥3 h/day).
Adjusted for age (underlying time variable), sex, marital status, physical activity (quarters), smoking status (never, current, former), snacking (dichotomous), special diet at baseline (dichotomous), body mass index (linear and quadratic terms), total energy intake (continuous), alcohol consumption (continuous), family history of cardiovascular disease (CVD, dichotomous), diabetes at baseline (dichotomous), hypertension at baseline (dichotomous), self reported hypercholesterolaemia at baseline (dichotomous), CVD at baseline (dichotomous), cancer at baseline (dichotomous), depression at baseline (dichotomous), education level (continuous) and lifelong smoking (pack-years of smoking, continuous) stratified by recruitment period, deciles of age, sedentary index (sum of hours each day spent watching television, using a computer, and driving), and television viewing (≥3 h/day).
Sum of hours each day spent watching television, using a computer, and driving.
Multivariable adjusted for propensity scores.
Multivariable adjusted model with repeated measures (updated data at 10 years of follow-up).