Ultraprocessed food consumption may promote early-onset colorectal adenoma

Consumption of ultraprocessed foods in high amounts appears to put women at risk of early-onset colorectal conventional adenomas, according to a study.

The study included 29,105 female participants (mean age 45.2 years) of the Nurses’ Health Study II. UPF intake was assessed using food-frequency questionnaires administered every 4 years. Intake was categorized as quintiles of energy-adjusted servings per day.

All participants had completed the baseline 1991 food-frequency questionnaire, undergone at least one lower endoscopy before age 50 years after baseline, had no history of cancer (except for nonmelanoma skin cancer) before endoscopy, and no colorectal polyp or inflammatory bowel disease.

Study outcomes included early-onset colorectal cancer (CRC) precursors such as conventional adenomas and serrated lesions, which were ascertained via medical records and pathology reports.

Over 24 years of follow-up, 1,189 cases of early-onset conventional adenomas and 1,598 cases of serrated lesions were documented. UPFs accounted for 34.8 percent of total daily calories (median, 5.7 servings per day).

Multivariable logistic regression analysis showed that participants with the highest vs lowest UPF intake had an elevated risk of early-onset conventional adenomas (adjusted odds ratio [AOR], 1.45, 95 percent confidence interval [CI], 1.19–1.77; p<0.001) but not serrated lesions (AOR, 1.04, 95 percent CI, 0.89–1.22; p=0.48).

Results were similar despite further adjustment for BMI, type 2 diabetes status, dietary factors (fibre, folate, calcium, and vitamin D), and Alternative Healthy Eating Index–2010 score.

These data underscore the important role of UPFs in early-onset colorectal tumorigenesis and support dietary quality improvement as a strategy to mitigate the increasing burden of early-onset CRC.