鉴于超加工食品（UPF）的消耗增加，其潜在的健康影响引起了关注。UPF消耗与癌症和心血管疾病（CVD）死亡的关联性是值得讨论的。本研究评估了UPF消耗与死亡的关联性。研究包括来自前列腺、肺、结直肠和卵巢（PLCO）癌症筛查试验（1993-2001）的108,714名美国成年人，来自英国生物库（2006-2010）的208,051名英国成年人，以及来自美国国家健康与营养调查（NHANES 1999-2018）的41,070名美国成年人。饮食数据通过膳食问卷收集，并使用NOVA分类进行分类。UPF消耗以UPF在总食物中的重量比例表示。使用Cox比例风险模型计算风险比（HR）和95%置信区间（CI）。中介分析用于评估英国生物库中多种代谢途径是否介导这些关联。分析于2022-2023年进行。三个队列的综合分析显示，UPF消耗最高四分位组与最低四分位组相比，所有原因的死亡风险更高（HR为1.16，95% CI为1.11-1.20），CVD死亡风险更高（HR为1.17，95% CI为1.06-1.28）。UPF消耗与癌症死亡风险无关。肝功能的生物标志物对全因死亡的调节作用最大（20.3％），而炎症的生物标志物对CVD死亡的调节作用最大（29.2%）。较高的UPF消耗与增加的全因和CVD死亡风险相关，多种代谢途径发挥中介作用。版权所有©2023。Elsevier Inc.发表。

Given the increase in ultra-processed food (UPF) consumption, their potential health effects have aroused concern. Whether UPF consumption is associated with cancer and cardiovascular disease (CVD) mortality is debatable. This study evaluates the association of UPF consumption with mortality.A total of 108,714 US adults from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial (1993-2001), 208,051 UK adults from UK Biobank (2006-2010), and 41,070 US adults from National Health and Nutrition Examination Survey (NHANES 1999-2018) were included. Dietary data were collected by dietary questionnaire and classified using the NOVA classification. UPF consumption was expressed as the weight proportion of UPFs in total foods consumed. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Mediation analysis was used to evaluate whether multiple metabolic pathways mediated the associations in UK Biobank. Analyses were performed in 2022-2023.Combined analyses of the three cohorts showed that those with the highest quartile of UPF consumption had higher risks of all-cause mortality (HR, 1.16; 95% CI, 1.11-1.20) and CVD mortality (HR, 1.17; 95% CI, 1.06-1.28) compared to the lowest quartile of UPF consumption. UPF consumption was not associated with cancer mortality risk. Biomarkers of liver function have the greatest mediating effects on all-cause mortality (20.3%), and biomarkers of inflammation have the greatest mediating effects on CVD mortality (29.2%).Higher UPF consumption was associated with increased all-cause and CVD mortality risk, with multiple metabolic pathways playing mediating roles.Copyright © 2023. Published by Elsevier Inc.