Are sodas or packaged snacks worse for early death, even after counting diet quality?

"pendent of total sugar intake and total energy intake, whereas pure fruit juice consumption was not associated with all-cause mortality."

"Chronic overconsumption of sugar-sweetened beverages (SSBs) is amongst the dietary factors most consistently found to be associated with obesity, type 2 diabetes (T2D) and cardiovascular disease (CVD) risk in large epidemiological studies."

"Adults in the highest quartile of UPF consumption had higher risk of CVD mortality (HR: 1.58; 95% CI: 1.23, 2.03). Sex, age, energy intake, educational level, housing tenure, smoking, BMI, leisure time physical activity, history of cancer, CVDs, diabetes, hypertension, hyperlipidemia, and residence Mediterranean Diet Score"

"whereas pure fruit juice consumption was not associated with all-cause mortality."

"Although the relationships between SSB overconsumption and obesity, T2D, and CVD are rather consistent in epidemiological studies, it has also been shown that SSB overconsumption is part of an overall poor dietary pattern and is particularly prevalent among subgroups of the population with low socioeconomic status, thereby questioning the major focus on SSBs to target/prevent cardiometabolic disea"

"But after researchers adjusted for participants' BMI at the start of the studies, the trend remained while the apparent dose-response relationship became substantially weaker."

"Participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HR = 1.50; 95% CI: 1.36, 1.64) and heart disease (HR: 1.68; 95% CI: 1.50, 1.87) but not cerebrovascular disease (HR = 0.94; 95% CI: 0.76, 1.17)."

"Public health initiatives aimed specifically at decreasing SSB overconsumption will most likely be successful in influencing SSB consumption per se. However, comprehensive strategies targeting poor dietary patterns and aiming at improving global dietary quality are likely to have much more impact in addressing the unprecedented public health challenges that we are currently facing."

"Our results showed that UPF consumption was related to an enhanced risk of all-cause mortality (HR = 1.21; 95% CI: 1.13, 1.30; I 2 = 21.9%; p < 0.001), CVDs-cause mortality (HR = 1.50; 95% CI: 1.37, 1.63; I 2 = 0.0%; p < 0.001), and heart-cause mortality (HR = 1.66; 95% CI: 1.50, 1.85; I 2 = 0.0%; p = 0.022), but not cancer-cause mortality (HR = 1.00; 95% CI: 0.81, 1.24; I 2 = 0.0%; p = 0.976)"

"subgroup analysis showed that UPF consumption was significantly associated with an enhanced risk of CVDs-cause mortality among adults with a body mass index (BMI) more than 25 (HR = 1.40; 95% CI: 1.02, 1.92; I 2 = 44.8%; p = 0.039)"

"Ultra-processed foods range from sugary drinks and highly refined snacks to fortified products, convenient meals, and foods designed to be shelf-stable, safe, and affordable."

"But every study was observational, dietary intake was assessed subjectively, and the authors acknowledge that broader lifestyle and behavioral factors are difficult to fully account for."

"After adjustment for a range of confounding factors, an increase in the proportion of ultraprocessed foods consumed was associated with a higher risk of all-cause mortality (HR per 10% increment, 1.14; 95% CI, 1.04-1.27; P = .008)."

"We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern."

"Analyses by UPF subgroups revealed positive associations with mortality risk for plant-based UPF (HR = 1.02, 95% CI 1.01–1.03), artificial sweeteners (HR = 1.05, 95% CI 1.03–1.08), and beverages (HR = 1.04, 95% CI 1.03–1.05)."

"En 2019 publicó en el British Medical Journal un estudio que tras evaluar a casi veinte mil participantes, concluía que un mayor consumo de alimentos ultraprocesados provoca mayor riesgo de mortalidad."

"Biological ageing mediated 14.4%, 27.5%, and 8.3% of these associations, respectively."

"While most UPF categories showed harmful effects, breakfast cereals demonstrated protective properties, which may be explained by several biological mechanisms documented in previous studies."

"The adjusted ORs for inadequate CVH were 1.40 (95% CI: 1.23, 1.60), 1.82 (1.45, 2.29), and 2.57 (1.79, 3.70), respectively, comparing quartiles 2, 3, and 4 with quartile 1 of UPF intake."

"A graded inverse association between %kcal from UPFs and CVH was observed."

"The pattern of association was largely consistent across subgroups."