Higher intake of ultra-processed food associated with increased prostate cancer risk

Higher consumption of ultra-processed foods (UPFs) was associated with an increased risk of prostate cancer among US men, according to results from a nationally representative analysis of National Health and Nutrition Examination Survey (NHANES) data.¹

The findings, published in The American Journal of Medicine, contribute to a growing body of evidence linking higher UPF consumption with adverse health outcomes.

“Among adult men in this nationally representative US population, those who consumed higher amounts of UPFs had significantly higher risks of the subsequent development of prostate cancer,” said senior author Charles H. Hennekens, MD, FACPM, FACC, professor of medicine and preventive medicine at Florida Atlantic University (FAU), in a news release on the findings.² “These findings add to emerging evidence that UPFs have major adverse health effects and underscore the need for large-scale observational studies and randomized trials to adequately test the hypothesis.”

Study examines UPF consumption and prostate cancer

The analysis included 17,024 male adults aged 18 years or older who participated in NHANES between 2003 and 2023. Investigators estimated UPF intake using data from two 24-hour dietary recalls and used the NOVA classification system to categorize participants into quartiles based on percentage of total energy intake. The lowest category included participants consuming less than approximately 20% of total energy from UPFs, whereas the highest category included those consuming more than approximately 44%.

Prostate cancer was determined by self-report. The investigators used logistic regression to estimate relative risks and adjusted the multivariable models for age, smoking status, race and ethnicity, and poverty status.

Compared with men in the lowest UPF-consumption quartile, those in the combined second, third, and fourth quartiles had a significant 29% higher risk of prostate cancer (RR, 1.29; 90% CI, 1.03 to 1.62; P = .031), and men in the combined third and fourth quartiles had a significant 30% higher risk (RR, 1.30; 90% CI, 1.03 to 1.65; P = .035). The fourth quartile alone demonstrated a 31% higher risk, but this association did not reach statistical significance (RR, 1.31; 90% CI, 0.96 to 1.78; P = .079).

After adjustment for the prespecified covariates, the corresponding relative increases were 27% (P = .045), 31% (P = .037), and 34% (P = .072), respectively.

According to the authors, while the observed effect sizes are small, they could have major impacts if true given the high burden of prostate cancer in the US and globally.

Findings support preventive counseling

The authors acknowledged several limitations of the current analysis, including the study’s observational, cross-sectional design, the reliance on self-report for dietary data, and the potential for confounding due to unmeasured variables such as family history, prostate-specific antigen screening, and physical inactivity. The authors called for large-scale observational studies and randomized trials to further evaluate the link between UPF consumption and prostate cancer risk.

However, they also emphasized that these findings support dietary counseling as part of broader preventive care, while also acknowledging the challenges of reducing UPF consumption.

“All health care professionals should encourage patients to adopt healthy lifestyle practices and evidence-based therapies, while also helping them reduce their consumption of ultra-processed foods,” Hennekens added in the news release.² “Patients and their health care providers should consider this finding as part of broader efforts to promote healthier dietary choices.”

That said, the authors also acknowledged the challenges of reducing UPF consumption, particularly given their widespread availability and accessibility.

“Reducing consumption of UPFs is a complex public health challenge, particularly given how prevalent and accessible these products are,” said study author Timothy De Ver Dye, PhD, professor and chair of FAU's Department of Population Health, in the press release.² “Health care providers should recognize that many patients face barriers to accessing and affording healthier food options.”

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