Does Processed Food Cause Cancer?

Written by Dr. Steve Chaney on . Posted in Processed Food and Cancer

What Are Processed Foods Doing To Your Health?

Author: Dr. Stephen Chaney

 

does processed food cause cancerDoes processed food cause cancer?

We Americans have a love, hate relationship with processed foods. We love how they taste. We love the convenience. All our friends eat them, so it is the socially acceptable thing to do. But, we also worry about them. We know they aren’t good for us.

We know they increase our risk of becoming obese. We have been warned that they may increase our risk of heart disease, diabetes, and hypertension. But, what if they also increased our risk of cancer? A new study strongly suggests that ultra-processed foods significantly increase our cancer risk.

What Are Ultra-Processed Foods?

udoes processed food cause cancer ultra processed foodsUntil recently it had been very difficult to determine the effect of processed foods on our health because there was no uniform system for classifying the processed food content of our diet. With no consistent classification system, the outcomes varied from one study to the next. That changed around 2016 with the development of the NOVA food classification system. The NOVA system divides foods into four categories:

 

  • Ultra-processed foods.
    • These are foods most Americans would consider junk foods.

 

  • Commercially Processed foods.
    • These are commercially processed foods using natural ingredients like salt, sugar, and fats. For example, frozen peas would be considered a minimally processed food (category 4). Frozen peas with added salt or frozen creamed peas would be considered a commercially process food.

 

  • Restaurant Foods.
    • These are foods processed in a kitchen (either in people’s homes or a restaurant) using salt, sugar, and/or fats to produce a culinary masterpiece (As you might suspect from the emphasis on culinary masterpiece, this is a European classification system).

 

  • Unprocessed or minimally processed foods.
    • These are foods that most Americans would consider whole foods. They are either raw or minimally processed.

 

Intuitively, you have probably already guessed that foods in category 1 are likely to be bad for us and foods in category 4 are likely to be good for us. Categories 2 and 3 start with healthy foods but often end up with foods that are higher in salt, sugar, and/or fat than most experts would consider to be healthy.

With this classification system in mind, the next step was to classify every food in large food databases into one of these four categories. In this case the 3,300 item French NutriNet-Santé food composition database was used.

 

How Was The Study Performed?

does processed food cause cancer studyThis study (T. Fiolet et al, British Medical Journal, 2018;360:k322 doi: 10.1136/bmj.k322) was performed as part of the 8-year NutriNet-Santé web-based program launched in France in 2009 with the objective of studying the associations between nutrition and health. This study enrolled 104,980 participants who were 18 or older. The average age of participants was 42.8 years. There were 82% women and 18% men enrolled in the study.

Dietary intake was assessed using an online 24-hour dietary recall survey administered every 6 months over a two-year period. The survey was administered on random days so that every day of the week was covered in the survey. On average, participants completed 5 diet surveys during the study. The validity of these dietary surveys has been established in other studies that were part of this project.

Over an average 5-year follow-up, cancer incidence was assessed via a check-up questionnaire for health events that was administered every three months.  Participants were also encouraged to self-report health events at any time. Any time a cancer diagnosis was received, a physician from the study team contacted the participant and requested their medical records, which were provided in 80% of the cases. Finally, French death records were also screened to identify any study participants who died from cancer during the study.

In short, this was a very well-done study.

 

Does Processed Food Cause Cancer?

 

does processed food cause cancer junk foodsUsing the NOVA classification system, this question is concerning ultra-processed food.

Here is what the study showed:

  • Every 10% increase in the proportion of ultra-processed foods (junk foods) in the diet was associated with a 12% increase in overall cancer and a 11% increase in breast cancer.
  • No association was seen between commercially processed foods or restaurant foods in the diet and cancer.
  • Every 10% increase in the proportion of unprocessed foods in the diet was associated with a 9% decrease in overall cancer and a 58% decrease in breast cancer.

Just in case you might be tempted to say that a 12% increase in cancer risk is insignificant, remember it is the cancer risk associated with just a 10% increase in ultra-processed foods in the diet. Recent studies have suggested that ultra-processed foods contribute from 25% to 50% of the calories consumed by most Americans.

The authors concluded “[The] rapidly increasing consumption of ultra-processed foods may drive an increased burden of cancer and other non-communicable disease.”

 

What Does This Study Mean For You?

does processed food cause cancer unprocessed foodsBecause the NOVA classification system for identifying the processed food composition of the diet is a recent introduction, this is the first study of its kind. While it is a very good study, it needs to be confirmed by further studies in different population groups.

It would be tempting to ascribe the higher cancer incidence to secondary consequences of ultra-processed food consumption. For example, consumption of ultra-processed food is associated with:

  • Obesity which, in turn, is associated with increased cancer risk.
  • Increased intake of fat, saturated and trans fats, and sugar and decreased intake of fiber and essential nutrients. The effect of these dietary changes is uncertain but could be associated with higher cancer risk.
  • Decreased intake of fruits, vegetables, and whole grains which would result in increased cancer risk.
  • Increased intake of neoformed contaminants (a fancy term for contaminants formed during processing such as acrylamide, heterocyclic amines, and polyaromatic hydrocarbons). These are all carcinogenic compounds. They are usually present in very small amounts, so their effect on cancer risk is uncertain.
  • Increased consumption of food additives of uncertain safety.

While this is an interesting area for future research, it represents a danger and shows that we will try to “have our cake and eat it too.”  Let me explain what I mean by that.

  • does processed food cause cancer restaurant foodWe love our junk foods. Food manufacturers will be only too happy to provide us with “healthier junk foods” by removing salt, sugar, and/or fat and replacing them with a chemical smorgasbord of artificial ingredients. They will reduce calories (again by adding artificial ingredients) so they can claim their junk foods won’t make us fat. They can reduce neoformed contaminants like acrylamide and claim their junk foods are now healthy. But, are they really any healthier? Not necessarily, according to this study.
  • The investigators performed a very sophisticated statistical analysis. The 12% increase in cancer they reported had already been adjusted for differences in age, sex, BMI (a measure of obesity), physical activity, smoking habits, alcohol intake, family history of cancer, and educational level. They also adjusted for fat, salt, and sugar content of the diet.
  • Some supplement companies may tell you that it’s OK to eat junk foods as long as you take the supplements they are trying to sell you. I have head dietitians say it’s OK to eat junk foods as long as you “balance” your diet with lots of fruits and vegetables. The results of this study suggest those approaches won’t be much help either.
  • Further analysis of their data by the investigators showed that the 12% increase in cancer risk was independent of overall fruit and vegetable consumption and supplement use.

The only variables left were increased intake of food additives and neoformed contaminants, and it is unlikely that those would have been sufficient to cause a 12% increase in cancer.

So, does processed food cause cancer?

Once again it appears to be the foods we eat rather than the individual components in those foods that are either good for us or bad for us. The inescapable conclusion from this study is that we are more likely to be healthy if we eat fewer processed foods and more unprocessed foods. Who would have guessed?

 

The Bottom Line:

 

A recent study looked at the effect of ultra-processed foods (otherwise known as junk foods) on cancer  risk. This was a very well-designed study, and it showed.

  • Every 10% increase in the proportion of ultra-processed foods in the diet was associated with a 12% increase in overall cancer and a 11% increase in breast cancer.
  • Every 10% increase in the proportion of unprocessed foods in the diet was associated with a 9% decrease in overall cancer and a 58% decrease in breast cancer.

Just in case you might be tempted to say that a 12% increase in cancer risk is insignificant, remember it is the cancer risk associated with just a 10% increase in ultra-processed foods in the diet. Recent studies have suggested that ultra-processed foods contribute from 25% to 50% of the calories consumed by most Americans.

This is the first study of its kind. While it is a very good study, it needs to be confirmed by further studies in different population groups.

When you look at the details of this study it appears to be the foods we eat rather than the individual components in those foods that are either good for us or bad for us. The inescapable conclusion from this study is that we are more likely to be healthy if we eat fewer processed foods and more unprocessed foods. Who would have guessed?

For more details, read the article above:

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (1)

  • Kathryn Farries

    |

    Dr Chaney,

    Thank you. Again!
    This information is very well explained. And it should be confirmation that what you don’t know can/might kill you.

    Regards,
    Kathryn

    Reply

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Latest Article

Do Omega-3s Lower Blood Pressure in Young, Healthy Adults?

Posted August 14, 2018 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

 

Do omega-3s lower blood pressure in healthy adults?

omega-3s lower blood pressure young adultsThe literature on the potential health benefits of omega-3s is very confusing. That’s because a lot of bad studies have been published. Many of them never determined the omega-3 status of their subjects prior to omega-3 supplementation. Others relied on dietary recalls of fish consumption, which can be inaccurate.

Fortunately, a much more accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes. Using modern technology, it can be determined from a single finger prick blood sample. It is a very accurate reflection of omega-3 intake relative to other fats in the diet over the past few months. More importantly, it is a measure of the omega-3 content of your cell membranes, which is a direct measure of your omega-3 nutritional status.

A recent extension of the Framingham Heart Study reported that participants with an Omega-3 Index >6.8% had a 39% lower risk of cardiovascular disease than those with an Omega-3 Index <4.2% (WS Harris et al, Journal of Clinical Lipidology, 12: 718-724, 2018 ). Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk, while 8% or better is considered indicative of low cardiovascular risk. For reference, the average American has an Omega-3 Index in the 4-5% range. In Japan, where fish consumption is much higher and cardiovascular risk much lower, the Omega-3 Index is in the 9-11% range.

Previous studies have suggested that omega-3 fatty acids lower blood pressure to a modest extent. Thus, it is not surprising that more recent studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, those studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Unfortunately, there were no studies looking at that population. The current study was designed to fill that gap.

 

How Was The Study Done?

omega-3s lower blood pressure young healthy adultsThe current study (M.G. Filipovic et al, Journal of Hypertension, 36: 1548-1554, 2018 ) was based on data collected from 2036 healthy adults, aged 25-41, from Liechtenstein. They were participants in the GAPP (Genetic and Phenotypic Determinants of Blood Pressure) study. Participants were excluded from the study if they had been diagnosed with high blood pressure and were taking medication to lower their blood pressure. They were also excluded if they had heart disease, chronic kidney disease, other severe illnesses, obesity, sleep apnea, or daily use of non-steroidal anti-inflammatory medications.

Blood samples were collected at the time of their enrollment in the study and frozen for subsequent determination of Omega-3 Index. Blood pressure was also measured at their time of enrollment in two different ways. The first was a standard blood pressure measurement in a doctor’s office.

For the second measurement they were given a wearable blood pressure monitor that recorded their blood pressure over 24 hours every 15 minutes during the day and every 30 minutes while they were sleeping. This is considered more accurate than a resting blood pressure measurement in a doctor’s office because it records the variation in blood pressure, while you are sleeping, while you are exercising, and while you go about your everyday activities.

 

Do Omega-3s Lower Blood Pressure In Young, Healthy Adults?

omega-3s lower blood pressure young adults equipmentNone of the participants in the study had significantly elevated blood pressure. The mean systolic and diastolic office blood pressures were 120±13 and 78±9 respectively. The average Omega-3 Index in this population was 4.6%, which is similar to the average Omega-3 Index in the United States.

When they compared the group with the highest Omega-3 Index (average = 5.8%) with the group with the lowest Omega-3 Index (average = 4.6%):

  • The office measurement of systolic and diastolic blood pressure was decreased by 3.3% and 2.6% respectively
  • While those numbers appear small, the differences were highly significant.
  • The 24-hour blood pressure measurements showed a similar decrease.
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index. [In studies of this kind, a linear dose-response is considered an internal validation of the differences observed between the group with the highest Omega-3 Index and the group with the lowest Omega-3 Index.]

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

 

What Does This Mean For You?

omega-3s lower blood pressure young adults questionPerhaps I should first comment on the significance of the relatively small decrease in blood pressure observed in this study.

  • These were young adults, all of whom had normal or near normal blood pressure.
  • The difference in Omega-3 Index was rather small (5.8% to 4.6%). None of the participants in the study were at the 8% or above that is considered optimal.
  • Liechtenstein is a small country located between Switzerland and Spain. Fish consumption is low and omega-3 supplement consumption is rare.

Under these conditions, even a small, but statistically significant, decrease in blood pressure is remarkable.

We should think of this study as the start of the investigation of the relationship between omega-3 status and blood pressure. Its weakness is that it only shows an association between high Omega-3 Index and low blood pressure. It does not prove cause and effect.

Its strength is that it is consistent with many other studies showing omega-3 fatty acids lower blood pressure. Furthermore, it suggests that the effect of omega-3s on blood pressure may also be seen in young, healthy adults who have not yet developed high blood pressure.

Finally, the authors suggested that a diet rich in omega-3s might reduce the incidence of high blood pressure by slowing the age-related increase in blood pressure that most Americans experience. This idea is logical, but speculative at present.

However, the GAPP study is designed to provide the answer to that question. It is a long-term study with follow-up examinations scheduled every 3-5 years. It will be interesting to see whether the author’s prediction holds true, and a higher Omega-3 Index is associated with a slower increase in blood pressure as the participants age.

 

Why Is The Omega-3 Index Important?

 

The authors of this study said: “The Omega-3 Index is very robust to short-term intake of omega-3 fatty acids and reliably reflects an individual’s long-term omega-3 status and tissue omega-3 content. Therefore, the Omega-3 Index has the potential to become a cardiovascular risk factor as much as the HbA1c is for people with diabetes…” That is a bit of an overstatement. HbA1c is a measure of disease progression for diabetes because it is a direct measure of blood sugar control.

In contrast, Omega-3 Index is merely a risk factor for cardiovascular disease. However, if it is further validated by future studies, it is likely to be as important for predicting cardiovascular risk as are cholesterol levels and markers of inflammation.

However, to me the most important role of Omega-3 Index is in the design of future clinical studies. If anyone really wants to determine whether omega-3 supplementation reduces cardiovascular risk, high blood pressure, diabetes or any other health outcome they should:

  • Start with a population group with an Omega-3 Index in the deficient (4-5%) range.
  • Supplement with omega-3 fatty acids in a double blind, placebo-controlled manner.
  • Show that supplementation brought participants up to an optimal Omega-3 Index of 8% or greater.
  • Look at health outcomes such as heart attacks, cardiovascular deaths, hypertension, stroke, or depression.
  • Continue the study long enough for the beneficial effects of omega-3 supplementation to be measurable. For cardiovascular outcomes the American Heart Association has stated that at least two years are required to obtain meaningful results.

These are the kind of experiments that will be required to give definitive, reproducible results and resolve the confusion about the health effects of omega-3 fatty acids.

 

The Bottom Line

 

An accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes.

Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk while 8% or better is considered indicative of low cardiovascular risk.

Previous studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, these studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Until now, there have been no studies looking at that population.

The study described in this article was designed to fill that gap. The participants in this study were ages 25-41, were healthy, and none of them had elevated blood pressure.

When the group with the highest Omega-3 Index (average = 5.8%) was compared with the group with the lowest Omega-3 Index (average = 4.6%):

  • Both systolic and diastolic blood pressure were decreased
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index.

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

Let me translate that last sentence into plain English for you. The authors were saying that optimizing omega-3 intake in young adults may slow the age-related increase in blood pressure and reduce the risk of them developing high blood pressure as they age. This may begin to answer the question “Do omega-3s lower blood pressure in young, healthy adults?”

Or even more simply put: Aging is inevitable. Becoming unhealthy is not.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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