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Article ; Online: Association between dietary phytochemical index, cardiometabolic risk factors and metabolic syndrome in Switzerland. The CoLaus study.

Gamba, Magda / Roa-Diaz, Zayne M / Raguindin, Peter Francis / Glisic, Marija / Bano, Arjola / Muka, Taulant / Franco, Oscar H / Marques-Vidal, Pedro

Nutrition, metabolism, and cardiovascular diseases : NMCD

2023 Volume 33, Issue 11, Page(s) 2220–2232

Abstract: Background and aims: Plant-based diets are associated with reduced cardiometabolic risk factors (CRFs) and lower risk of metabolic syndrome (MetS), probably via phytochemicals acting synergistically. However, dietary phytochemical content estimation is ... ...

Abstract	Background and aims: Plant-based diets are associated with reduced cardiometabolic risk factors (CRFs) and lower risk of metabolic syndrome (MetS), probably via phytochemicals acting synergistically. However, dietary phytochemical content estimation is challenging; therefore, the dietary phytochemical index (DPI) was proposed as a practical way to assess total dietary phytochemical content from phytochemical-rich foods (PRFs). We evaluated the association between DPI with CRFs and MetS and its components. Methods and results: Cross-sectional analysis of 2009-2012 data of Colaus cohort study (Lausanne, Switzerland), including 3879 participants (mean age 57.6 ± 10.4 years, 53.5% women). Dietary intake was assessed via a validated food frequency questionnaire. DPI was calculated as the total energy intake percentage obtained from PRFs consumption and assessed as quartiles. Associations were determined using multivariable linear and logistic regression for CRFs and MetS, respectively. Median DPI value was 25.5 (interquartile range: 17.7-34.6). After multivariable-adjusted analyses, significant inverse associations were observed between the last two highest DPI quartiles and waist circumference (WC), body mass index (BMI), insulin, leptin, and hs-CRP. No significant associations were observed for MetS or its components except for central obesity, as subjects in the highest DPI quartile had lower odds (OR: 0.78; 95% CI: 0.62, 0.97) than those in lowest quartile. Conclusion: A diet high in PRFs assessed via DPI is associated with lower WC, BMI, insulin, leptin, hs-CRP values, and lower odds of central obesity, indicating a potential protective effect of phytochemical intake on these CRFs and highlighting the importance of high PRFs intake in promoting cardiometabolic health.
Language	English
Publishing date	2023-07-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1067704-5
ISSN	1590-3729 ; 0939-4753
ISSN (online)	1590-3729
ISSN	0939-4753
DOI	10.1016/j.numecd.2023.07.018
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Article ; Online: Association between Total Dietary Phytochemical Intake and Cardiometabolic Health Outcomes-Results from a 10-Year Follow-Up on a Middle-Aged Cohort Population.

Gamba, Magda / Pano, Octavio / Raguindin, Peter Francis / Roa-Diaz, Zayne M / Muka, Taulant / Glisic, Marija / Franco, Oscar H / Marques-Vidal, Pedro

Nutrients

2023 Volume 15, Issue 22

Abstract: Dietary phytochemical intake associations with cardiovascular health and mortality remain unknown. We studied the relations between total dietary phytochemical intake and cardiovascular health outcomes in a middle-aged Swiss population. We analyzed data ... ...

Abstract	Dietary phytochemical intake associations with cardiovascular health and mortality remain unknown. We studied the relations between total dietary phytochemical intake and cardiovascular health outcomes in a middle-aged Swiss population. We analyzed data spanning 2009 to 2021 from a prospective cohort study in Lausanne, Switzerland, including 3721 participants (54.8% women, 57.2 ± 10.3 years) without cardiovascular disease (CVD) history. Dietary intake was assessed using a validated self-reported food frequency questionnaire. The Dietary Phytochemical Index (DPI) and the healthy Dietary Phytochemical Index (hDPI) were calculated as the total energy intake percentage obtained from phytochemical-rich food consumption. The Healthy Plant-Based Diet Index (hPBD) was estimated by scoring healthy plant foods positively and less-healthy plant foods negatively. Indices tertiles and cardiometabolic outcome associations were determined using Cox proportional hazard models. Over 30,217 person-years of follow-up, 262 CVD events, and 178 deaths occurred. Unadjusted analyses found 36%, 33%, and 32% lower CVD risk for the highest hDPI, DPI, and hPBD tertiles, respectively. After adjustment, only the second hDPI tertile showed a 30% lower CVD risk (HR 0.70, 95% CI 0.51-0.95; P for trend 0.362). No other associations emerged. In this middle-aged Swiss cohort, no associations between dietary indices reflecting a phytochemical-rich dietary pattern and incident CVD, all-cause, or CVD mortality were observed.
MeSH term(s)	Middle Aged ; Humans ; Female ; Male ; Prospective Studies ; Follow-Up Studies ; Risk Factors ; Diet ; Eating ; Cardiovascular Diseases/epidemiology ; Phytochemicals ; Outcome Assessment, Health Care
Chemical Substances	Phytochemicals
Language	English
Publishing date	2023-11-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15224793
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Article ; Online: Outcomes of care during the last month of life: a systematic review to inform the development of a core outcome set.

González-Jaramillo, Valentina / Luethi, Nora / Egloff, Martina / Roa-Díaz, Zayne M / González-Jaramillo, Nathalia / Díaz-Ríos, Catalina / Rosero, Andri Christen-Cevallos / Dodd, Susanna / Eychmüller, Steffen / Zambrano, Sofía C

Annals of palliative medicine

2024

Abstract: Background: To date, there is a lack of standardization and consensus on which outcomes are central to assess the care provided to patients in the last month of life. Therefore, we aimed to conduct a systematic review to identify relevant outcomes to ... ...

Abstract	Background: To date, there is a lack of standardization and consensus on which outcomes are central to assess the care provided to patients in the last month of life. Therefore, we aimed to conduct a systematic review to identify relevant outcomes to inform the development of a core outcome set for the best care for the dying person. Methods: We conducted a systematic review of outcomes reported in the scientific literature about the care for the dying person in the last month of life. We searched for peer-reviewed studies published before February 2022 in four electronic databases. To categorise the outcomes, we employed the taxonomy developed by the "Core Outcome Measures in Effectiveness Trials" collaboration. Results: Out of the 2,933 articles retrieved, 619 were included for analyses. The majority of studies (71%) were retrospective and with data extracted from chart reviews (71%) . We extracted 1,951 outcomes in total, from which, after deletion of repeated outcomes, we identified 256 unique ones. The most frequently assessed outcomes were those related to medication or therapeutic interventions and those to hospital/ healthcare use. Outcomes related to psychosocial wellbeing were rarely assessed. The closer to death, the less frequently the outcomes were studied. Conclusions: Most outcomes were related to medical interventions or to hospital use. Only a few studies focused on other components of integrated care such as psychosocial aspects. It remains to be defined which of these outcomes are fundamental to achieve the best care for the dying.
Language	English
Publishing date	2024-03-07
Publishing country	China
Document type	Journal Article
ZDB-ID	2828544-X
ISSN	2224-5839 ; 2224-5839
ISSN (online)	2224-5839
ISSN	2224-5839
DOI	10.21037/apm-23-435
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Article ; Online: Association between Dietary Phytochemical Index, cardiometabolic risk factors and metabolic syndrome in Switzerland. The CoLaus Study

Gamba, Magda / Roa-Diaz, Zayne M. / Raguindin, Peter F. / Glisic, Marija / Bano, Arjola / Muka, Taulant / Franco, Oscar H. / Marques-Vidal, Pedro

Nutrition, Metabolism and Cardiovascular Diseases. 2023 July 17,

2023

Abstract: Plant-based diets are associated with reduced cardiometabolic risk factors (CRFs) and lower risk of metabolic syndrome (MetS), probably via phytochemicals acting synergistically. However, dietary phytochemical content estimation is challenging; therefore, ...

Abstract	Plant-based diets are associated with reduced cardiometabolic risk factors (CRFs) and lower risk of metabolic syndrome (MetS), probably via phytochemicals acting synergistically. However, dietary phytochemical content estimation is challenging; therefore, the dietary phytochemical index (DPI) was proposed as a practical way to assess total dietary phytochemical content from phytochemical-rich foods (PRFs). We evaluated the association between DPI with CRFs and MetS and its components. Cross-sectional analysis of 2009-2012 data of Colaus cohort study (Lausanne, Switzerland), including 3879 participants (mean age 57.6±10.4 years, 53.5% women). Dietary intake was assessed via a validated food frequency questionnaire. DPI was calculated as the total energy intake percentage obtained from PRFs consumption and assessed as quartiles. Associations were determined using multivariable linear and logistic regression for CRFs and MetS, respectively. Median DPI value was 25.5 (interquartile range: 17.7–34.6). After multivariable-adjusted analyses, significant inverse associations were observed between the last two highest DPI quartiles and waist circumference (WC), body mass index (BMI), insulin, leptin, and hs-CRP. No significant associations were observed for MetS or its components except for central obesity, as subjects in the highest DPI quartile had lower odds (OR: 0.78; 95% CI: 0.62, 0.97) than those in lowest quartile. A diet high in PRFs assessed via DPI is associated with lower WC, BMI, insulin, leptin, hs-CRP values, and lower odds of central obesity, indicating a potential protective effect of phytochemical intake on these CRFs and highlighting the importance of high PRFs intake in promoting cardiometabolic health.
Keywords	body mass index ; cohort studies ; cross-sectional studies ; energy intake ; food frequency questionnaires ; food intake ; insulin ; leptin ; metabolic syndrome ; metabolism ; obesity ; phytochemicals ; protective effect ; regression analysis ; risk ; waist circumference ; Switzerland ; Dietary Phytochemical Index ; Phytochemical-rich foods ; Cardiometabolic risk factors
Language	English
Dates of publication	2023-0717
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Pre-press version
ZDB-ID	1067704-5
ISSN	0939-4753
ISSN	0939-4753
DOI	10.1016/j.numecd.2023.07.018
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Menopause and cardiometabolic diseases: What we (don't) know and why it matters.

Roa-Díaz, Zayne M / Raguindin, Peter Francis / Bano, Arjola / Laine, Jessica E / Muka, Taulant / Glisic, Marija

Maturitas

2021 Volume 152, Page(s) 48–56

Abstract: This narrative review discusses the current understanding, knowledge gaps and challenges in expanding our knowledge of the association between menopause and the reproductive aging process and cardiometabolic disease (CMD) in women, with a focus on type 2 ...

Abstract	This narrative review discusses the current understanding, knowledge gaps and challenges in expanding our knowledge of the association between menopause and the reproductive aging process and cardiometabolic disease (CMD) in women, with a focus on type 2 diabetes and cardiovascular disease. The physiological changes that occur at different stages of the reproductive life span, as well as type of menopause and timing, are factors widely associated with CMD risk; however, the underlying mechanisms remain either unclear or insufficiently studied. Decreased ovarian estrogen production and relative androgen excess around menopause onset are the most studied factors linking menopause and cardiometabolic health; nevertheless, the evidence is not persuasive and other hypotheses might explain the changes in CMD risk during menopausal transition. In this context, hormone therapy has been widely adopted in the treatment and prevention of CMD, although uncertainty regarding its cardiometabolic effects has raised the need to optimize therapeutic modalities. Mechanisms such as the "iron overload theory" and new "omics" platforms could provide new insights into potential pathways underlying the association between menopause and cardiometabolic health, such as the DNA damage response. Although it has been widely reported that environmental and lifestyle factors affect both menopause and cardiometabolic health, there is little evidence on the role of these exposures in menopause-associated CMD risk.
MeSH term(s)	Aging ; Cardiovascular Diseases/etiology ; Diabetes Mellitus, Type 2/etiology ; Female ; Humans ; Menopause/physiology ; Reproduction ; Women's Health
Language	English
Publishing date	2021-07-02
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2021.06.013
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Article ; Online: Efficacy of a multimodal nursing intervention strategy in the process of becoming a mother: A randomized controlled trial.

Vargas-Porras, Carolina / Roa-Díaz, Zayne M / Hernández-Hincapié, Hernán G / Ferré-Grau, Carme / de Molina-Fernández, María I

Research in nursing & health

2021 Volume 44, Issue 3, Page(s) 424–437

Abstract: The lack of knowledge and skills for transitioning to motherhood places first-time mothers at greater risk of depression and stress, may lower their perceived self-efficacy and satisfaction with the maternal role, and potentially affects the mother- ... ...

Abstract	The lack of knowledge and skills for transitioning to motherhood places first-time mothers at greater risk of depression and stress, may lower their perceived self-efficacy and satisfaction with the maternal role, and potentially affects the mother-infant bond. The purpose of this study was to test the efficacy of a multimodal nursing intervention (AMACOMPRI), based on Mercer's Becoming a Mother Theory, in supporting the process of becoming a mother in first-time mothers of term infants. This study was a parallel-group, double-blind, randomized, controlled trial with a 4-month postpartum follow-up. The outcome measures were the process of becoming a mother, functional social support, mother-infant bond, and perceived maternal self-efficacy. Sixty-six first-time mothers completed the study: 33 in the intervention group and 33 in the control group. The intervention was effective in supporting the process of becoming a mother, with a large effect size (Cohen's d = 1.50) and higher scores on the Becoming-a-Mother Scale in the intervention group compared with the control group (intergroup difference 13.04 points; 95% confidence interval: 8.72-17.34). Participants in the intervention group demonstrated higher scores in functional social support, perceived maternal self-efficacy, and mother-infant bond. This study provides evidence for the efficacy of an innovative nursing intervention that supports the process of becoming a mother. Further testing of the intervention is required in different settings and first-time mothers of low and high risk newborns.
MeSH term(s)	Adult ; Double-Blind Method ; Female ; Humans ; Infant ; Infant, Newborn ; Mother-Child Relations ; Mothers/psychology ; Self Efficacy ; Social Support ; Young Adult
Language	English
Publishing date	2021-03-08
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	424453-9
ISSN	1098-240X ; 0160-6891
ISSN (online)	1098-240X
ISSN	0160-6891
DOI	10.1002/nur.22123
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Article ; Online: Eating behaviors and health-related quality of life: A scoping review.

Pano, Octavio / Gamba, Magda / Bullón-Vela, Vanessa / Aguilera-Buenosvinos, Inmaculada / Roa-Díaz, Zayne M / Minder, Beatrice / Kopp-Heim, Doris / Laine, Jessica E / Martínez-González, Miguel Ángel / Martinez, Alfredo / Sayón-Orea, Carmen

Maturitas

2022 Volume 165, Page(s) 58–71

Abstract: Discrepancies between total life expectancy and healthy life expectancy are in part due to unhealthy lifestyles, in which diet plays an important role. Despite this knowledge, observational studies and randomized trials have yet to show consistent ... ...

Abstract	Discrepancies between total life expectancy and healthy life expectancy are in part due to unhealthy lifestyles, in which diet plays an important role. Despite this knowledge, observational studies and randomized trials have yet to show consistent improvements in health and well-being, also known as health-related quality of life (HRQoL), given the variety of elements that conform a healthy diet aside from its content. As such, we aimed to describe the evidence and common topics concerning the effects of modifiable eating behaviors and HRQoL in patients with non-communicable diseases (NCD). This scoping review of six electronic databases included 174 reports (69 % were experimental studies, 10 % longitudinal studies, and 21 % cross-sectional studies). Using VOSviewer, a bibliometric tool with text mining functionalities, we identified relevant aspects of dietary assessments and interventions. Commonly observed topics in experimental studies were those related to diet quality (micro- and macronutrients, food items, and dietary patterns). In contrast, less was found regarding eating schedules, eating locations, culturally accepted food items, and the role of food insecurity in HRQoL. Disregarding these aspects of diets may be limiting the full potential of nutrition as a key element of health and well-being in order to ensure lengthy and fulfilling lives.
MeSH term(s)	Cross-Sectional Studies ; Diet ; Eating ; Feeding Behavior ; Humans ; Life Style ; Quality of Life
Language	English
Publishing date	2022-07-22
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2022.07.007
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Article ; Online: Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis.

Mesa-Vieira, Cristina / Haas, Andreas D / Buitrago-Garcia, Diana / Roa-Diaz, Zayne M / Minder, Beatrice / Gamba, Magda / Salvador, Dante / Gomez, Daniel / Lewis, Meghann / Gonzalez-Jaramillo, Wendy C / Pahud de Mortanges, Aurélie / Buttia, Chepkoech / Muka, Taulant / Trujillo, Natalia / Franco, Oscar H

The Lancet. Public health

2022 Volume 7, Issue 5, Page(s) e469–e481

Abstract: Background: Exposure to armed conflict has been associated with negative mental health consequences. We aimed to estimate the prevalence of generalised anxiety disorder, major depressive disorder, and post-traumatic stress disorder among migrants ... ...

Abstract	Background: Exposure to armed conflict has been associated with negative mental health consequences. We aimed to estimate the prevalence of generalised anxiety disorder, major depressive disorder, and post-traumatic stress disorder among migrants exposed to armed conflict. Methods: In this systematic review and meta-analysis, we searched online databases (Cochrane Library, Embase, LILACS, PsycInfo [via Ovid], PubMed, and Web of Science Core Collection) for relevant observational studies published between Jan 1, 1994, and June 28, 2021. We included studies that used standardised psychiatric interviews to assess generalised anxiety disorder, major depressive disorder, or post-traumatic stress disorder among migrants (refugees or internally displaced persons; aged ≥18 years) with pre-migration exposure to armed conflict. We excluded studies in which exposure to armed conflict could not be ascertained, studies that included a clinical population or people with chronic diseases that can trigger the onset of mental disease, and studies published before 1994. We used a random effects model to estimate each mental health disorder's pooled prevalence and random effects meta-regression to assess sources of heterogeneity. Two independent reviewers assessed the risk of bias for each study using the Joanna Briggs Institute Checklist for Prevalence Studies. The protocol was registered with PROSPERO, CRD42020209251. Findings: Of the 13 935 studies identified, 34 met our inclusion criteria; these studies accounted for 15 549 migrants. We estimated a prevalence of current post-traumatic stress disorder of 31% (95% CI 23-40); prevalence of current major depressive disorder of 25% (17-34); and prevalence of generalised anxiety disorder of 14% (5-35). Younger age was associated with a higher prevalence of current post-traumatic stress disorder (odds ratio 0·95 [95% CI 0·90-0·99]), lifetime post-traumatic stress disorder (0·88 [0·83-0·92]), and current generalised anxiety disorder (0·87 [0·78-0·97]). A longer time since displacement was associated with a lower lifetime prevalence of post-traumatic stress disorder (0·88 [0·81-0·95]) and major depressive disorder (0·81 [0·77-0·86]). Migrating to a middle-income (8·09 [3·06-21·40]) or low-income (39·29 [11·96-129·70]) country was associated with increased prevalence of generalised anxiety disorder. Interpretation: Migrants who are exposed to armed conflict are at high risk of mental health disorders. The mental health-care needs of migrants should be assessed soon after resettlement, and adequate care should be provided, with particular attention paid to young adults. Funding: Marie Skłodowska-Curie Actions (Horizon 2020-COFUND), MinCiencias (Colombia), and Swiss National Science Foundation.
MeSH term(s)	Adolescent ; Adult ; Anxiety Disorders/epidemiology ; Armed Conflicts ; Depressive Disorder, Major/epidemiology ; Humans ; Mental Health ; Observational Studies as Topic ; Transients and Migrants ; Young Adult
Language	English
Publishing date	2022-05-24
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(22)00061-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Gene-diet interactions and cardiovascular diseases: a systematic review of observational and clinical trials.

Roa-Díaz, Zayne M / Teuscher, Julian / Gamba, Magda / Bundo, Marvin / Grisotto, Giorgia / Wehrli, Faina / Gamboa, Edna / Rojas, Lyda Z / Gómez-Ochoa, Sergio A / Verhoog, Sanne / Vargas, Manuel Frias / Minder, Beatrice / Franco, Oscar H / Dehghan, Abbas / Pazoki, Raha / Marques-Vidal, Pedro / Muka, Taulant

BMC cardiovascular disorders

2022 Volume 22, Issue 1, Page(s) 377

Abstract: Background: Both genetic background and diet are important determinants of cardiovascular diseases (CVD). Understanding gene-diet interactions could help improve CVD prevention and prognosis. We aimed to summarise the evidence on gene-diet interactions ... ...

Abstract	Background: Both genetic background and diet are important determinants of cardiovascular diseases (CVD). Understanding gene-diet interactions could help improve CVD prevention and prognosis. We aimed to summarise the evidence on gene-diet interactions and CVD outcomes systematically. Methods: We searched MEDLINE Results and discussion: We included 59 articles based on data from 29 studies; six articles involved multiple studies, and seven did not report details of their source population. The median sample size of the articles was 2562 participants. Of the 59 articles, 21 (35.6%) were qualified as high quality, while the rest were intermediate or poor. Eleven (18.6%) articles adjusted for multiple comparisons, four (7.0%) attempted to replicate the findings, 18 (30.5%) were based on Han-Chinese ethnicity, and 29 (49.2%) did not present Minor Allele Frequency. Fifty different dietary exposures and 52 different genetic factors were investigated, with alcohol intake and ADH1C variants being the most examined. Of 266 investigated diet-gene interaction tests, 50 (18.8%) were statistically significant, including CETP-TaqIB and ADH1C variants, which interacted with alcohol intake on CHD risk. However, interactions effects were significant only in some articles and did not agree on the direction of effects. Moreover, most of the studies that reported significant interactions lacked replication. Overall, the evidence on gene-diet interactions on CVD is limited, and lack correction for multiple testing, replication and sample size consideration.
MeSH term(s)	Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/genetics ; Cardiovascular Diseases/prevention & control ; Cross-Sectional Studies ; Diet/adverse effects ; Humans ; Myocardial Infarction/epidemiology ; Prospective Studies
Language	English
Publishing date	2022-08-20
Publishing country	England
Document type	Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-022-02808-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Association Between Ultra-Processed Food Intake and All-Cause Mortality: A Systematic Review and Meta-Analysis.

Taneri, Petek Eylul / Wehrli, Faina / Roa-Díaz, Zayne M / Itodo, Oche Adam / Salvador, Dante / Raeisi-Dehkordi, Hamidreza / Bally, Lia / Minder, Beatrice / Kiefte-de Jong, Jessica C / Laine, Jessica E / Bano, Arjola / Glisic, Marija / Muka, Taulant

American journal of epidemiology

2022 Volume 191, Issue 7, Page(s) 1323–1335

Abstract: Consumption of ultra-processed foods (UPF) has increased worldwide during the last decades because they are hyperpalatable, cheap, and ready-to-consume products. However, uncertainty exists about their impact on health. We conducted a systematic review ... ...

Abstract	Consumption of ultra-processed foods (UPF) has increased worldwide during the last decades because they are hyperpalatable, cheap, and ready-to-consume products. However, uncertainty exists about their impact on health. We conducted a systematic review and meta-analysis evaluating the association of UPF consumption with all-cause mortality risk. Five bibliographic databases were searched for relevant studies. Random effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs). Of 6,951 unique citations, 40 unique prospective cohort studies comprising 5,750,133 individuals were included; publication dates ranged from 1984 to 2021. Compared with low consumption, highest consumption of UPF (RR = 1.29, 95% CI: 1.17, 1.42), sugar-sweetened beverages (RR = 1.11, 95% CI, 1.04, 1.18), artificially sweetened beverages (RR = 1.14, 95% CI, 1.05, 1.22), and processed meat/red meat (RR = 1.15, 95% CI, 1.10, 1.21) were significantly associated with increased risk of mortality. However, breakfast cereals were associated with a lower mortality risk (RR = 0.85, 95% CI, 0.79, 0.92). This meta-analysis suggests that high consumption of UPF, sugar-sweetened beverages, artificially sweetened beverages, processed meat, and processed red meat might increase all-cause mortality, while breakfast cereals might decrease it. Future studies are needed to address lack of standardized methods in UPF categorization.
MeSH term(s)	Eating ; Fast Foods/adverse effects ; Humans ; Meat ; Prospective Studies ; Sweetening Agents/adverse effects
Chemical Substances	Sweetening Agents
Language	English
Publishing date	2022-02-26
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2937-3
ISSN	1476-6256 ; 0002-9262
ISSN (online)	1476-6256
ISSN	0002-9262
DOI	10.1093/aje/kwac039
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