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      Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis

      systematic-review

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          Abstract

          Background

          Despite increasing evidence that has shown the association of ultra-processed foods (UPFs) with cancer risk, the results remain inconclusive. We, therefore, conducted the meta-analysis to clarify the association by including recently published studies.

          Methods

          A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies from inception to January 2023. To pool data, fixed-effects or random-effects models were used where appropriate. Subgroup analyses, sensitivity analyses, and publication bias tests were performed.

          Results

          A total of 13 studies (4 cohort studies and 9 case–control studies) were included in the analysis, with a total of 625,738 participants. The highest UPFs consumption was associated with increased risk of colorectal cancer (OR = 1.23, 95% CI: 1.10–1.38), colon cancer (OR = 1.25, 95% CI: 1.14–1.36), and breast cancer (OR = 1.10, 95% CI: 1.00–1.20) but not rectal cancer (OR = 1.18, 95% CI: 0.97–1.43) and prostate cancer (OR = 1.03, 95% CI: 0.93–1.12). In addition, the subgroup analyses showed that a positive association between UPFs consumption and colorectal cancer was observed among men (OR = 1.31, 95% CI: 1.15–1.50), whereas no significant association was observed among women (OR = 1.10, 95% CI: 0.94–1.29).

          Conclusion

          The present meta-analysis suggests that high UPFs consumption is associated with a significantly increased risk of certain site-specific cancers, especially the digestive tract and some hormone-related cancers. However, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.

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          Most cited references47

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.

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              The ever‐increasing importance of cancer as a leading cause of premature death worldwide

              The relative importance of cardiovascular disease (CVD) and cancer as leading causes of premature death are examined in this communication. CVD and cancer are now the leading causes in 127 countries, with CVD leading in 70 countries (including Brazil and India) and cancer leading in 57 countries (including China). Such observations can be seen as part of a late phase of an epidemiologic transition, taking place in the second half of the 20th century and the first half of the present one, in which the dominance of infectious diseases is progressively superseded by noncommunicable diseases. According to present ranks and recent trends, cancer may surpass CVD as the leading cause of premature death in most countries over the course of this century. Clearly, governments must factor in these transitions in developing cancer policies for the local disease profile.
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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                08 June 2023
                2023
                : 10
                : 1175994
                Affiliations
                [1] 1Department of Health Management and Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital , Jinan, China
                [2] 2Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University , Jinan, China
                [3] 3Department of General Surgery, The Fourth People's Hospital of Jinan City , Jinan, China
                [4] 4Department of General Surgery, Shandong Provincial Qianfoshan Hospital and The First Affiliated Hospital of Shandong First Medical University , Jinan, China
                Author notes

                Edited by: Raul Zamora-Ros, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Spain

                Reviewed by: Roberta Zupo, University of Bari Aldo Moro, Italy; Luana Lara Rocha, Federal University of Minas Gerais, Brazil

                *Correspondence: Guang-Yong Zhang guangyongzhang@ 123456hotmail.com

                †These authors have contributed equally to this work

                Article
                10.3389/fnut.2023.1175994
                10285062
                37360305
                d8d261fd-6e8d-423b-9708-87c09c287655
                Copyright © 2023 Lian, Wang, Chen, Chen and Zhang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 February 2023
                : 16 May 2023
                Page count
                Figures: 4, Tables: 2, Equations: 0, References: 51, Pages: 10, Words: 5734
                Funding
                This study was supported by the Shandong Provincial Key Research and Development Program (grant no. 2019GSF108196), the Science and Technology Project of Jinan (grant no. 2019-1-17, 2022-1-25), the Center of China–US Sports Economics and Health Engineering of Shandong (grant no. SDCA20191013), and the Academic Promotion Programme of Shandong First Medical University (grant no. 2019QL013). The funding sources had no role in study design, data analysis and interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication.
                Categories
                Nutrition
                Systematic Review
                Custom metadata
                Nutritional Epidemiology

                ultra-processed foods (upfs),colorectal cancer,breast cancer,systematic review,meta-analysis

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