The role of ultra-processed foods in plant-based diets: associations with human health and environmental sustainability

Purpose Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC). Methods Analyses were based on 35,030 participants (20–70 years; 74% females)...

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Published in:	European journal of nutrition Vol. 63; no. 8; pp. 2957 - 2973
Main Authors:	Daas, Merel C., Vellinga, Reina E., Pinho, Maria Gabriela M., Boer, Jolanda M. A., Verschuren, W. M. Monique, van der Schouw, Yvonne T., van’t Veer, Pieter, Biesbroek, Sander
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2024 Springer Nature B.V
Subjects:	Adult Aged Chemistry Chemistry and Materials Science Cohort Studies Diet Diet - methods Diet - statistics & numerical data Diet, Healthy - methods Diet, Healthy - statistics & numerical data Diet, Plant-Based Diet, Vegetarian - methods Diet, Vegetarian - statistics & numerical data Environmental impact Fast Foods - statistics & numerical data Female Food Handling - methods Food processing Food, Processed Greenhouse gases Greenhouse Gases - analysis Humans Male Middle Aged Mortality Nutrition Original Contribution Plant-based foods Regression analysis Young Adult All-cause mortality Ultra-processed foods NOVA classification Environmental impact Cohort study Plant-based diet
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Summary:	Purpose Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC). Methods Analyses were based on 35,030 participants (20–70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption. Results With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and − 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores. Conclusion Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1436-6207 1436-6215 1436-6215
DOI:	10.1007/s00394-024-03477-w