Consuming ultra-processed foods, such as instant noodles, frozen pizzas, and more, was associated with an increased risk of premature deaths among Brazilian adults ages 30 to 69, according to a new study published in the American Journal of Preventive Medicine.

Study details and key findings

Ultra-processed foods are those that have little or no whole foods in their ingredients and usually have added salt, sugar, or oil. They are often ready-to-eat foods, such as pre-packaged soups and sauces, frozen pizza, hot dogs, sodas, ice cream, and store-bought baked goods.

For the study, researchers used a model from a previous analysis, which compared the relative mortality risk of those who consumed large amounts of ultra-processed foods and those who did not, and applied it to Brazil's population and level of ultra-processed food consumption to determine a potential association with premature deaths.

Data about food and beverage consumption was collected through the Personal Food Intake module of the POF—National Household Budget Survey for 2017 and 2018. Total mortality data for Brazil in 2019 was taken from the Mortality Information System.

Overall, 541,160 Brazilian adults ages 30 to 69 died prematurely in 2019. Of these deaths, 261,061 were from preventable, noncommunicable diseases.

Consuming ultra-processed foods was linked to roughly 57,000 deaths, or 10% of all preventable premature deaths and 21.8% of all deaths from preventable, noncommunicable diseases.

According to Eduardo Nilson, a nutrition researcher at the University of São Paulo and the study's lead author, "it is very likely that heart disease is among the main factors" contributing to these premature deaths. Other health conditions that could play a role are diabetes, cancer, obesity, and chronic kidney disease, he said.

When analyzing the potential effects of eating less ultra-processed foods, the researchers found that around 5,900 to 29,300 premature deaths could be averted per year in Brazil if its population reduced its consumption of ultra-processed food by 10% to 50%. Although most of the Brazilian population is already below this threshold, 25% of the country's adult population gets up to 50% of their daily calories from ultra-processed foods.

"Even reducing consumption of [ultra-processed foods] to the levels of just a decade ago would reduce associated premature deaths by 21 percent," Nilson said. "Policies that disincentivize the consumption of [the foods] are urgently needed."

Commentary

In the United States, ultra-processed foods make up around 57% of Americans' daily caloric intake, meaning that premature deaths associated with these foods may be even higher among Americans than Brazilians.

Maura Walker, an assistant professor of nutrition at Boston University who was not involved in the study, noted that the study only showed an association between the consumption of ultra-processed foods and premature death and not a direct correlation. However, the connection between the two made sense, she said.

"It's likely that these ultra-processed foods are just one factor that's leading to things like hypertension, poor blood lipids, higher waist circumferences, and that's actually how they're linked to mortality," Walker said.

According to Walker, people could ideally switch out ultra-processed foods for more fresh fruits and vegetables, but there are places in America, such as food deserts, where that is not always possible.

In addition, Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, noted that not all ultra-processed foods are harmful. For example, whole grain bread and breakfast cereals can be considered ultra-processed, but they are healthy sources of dietary fiber, which can help reduce the risk of heart disease and cancer.

Replacing ultra-processed foods with red meat or foods cooked with a lot of butter may not be healthy either, Willett said. Instead, he suggests people avoid certain foods that are significantly associated with a risk of premature death. For example, soda has been linked to around 184,000 adult deaths per year worldwide.

"In general, there's no question that Brazilians and Americans and a lot of other people are eating way too much junk food," Willett said. "Collectively, they add up to a big chunk of preventable mortality." (Melillo, "Changing America," The Hill, 11/7; Bendix, NBC News, 11/6; Nilson et al., American Journal of Preventive Medicine, 11/7)