Ultraprocessed Foods and Cancer Risk

According to the NOVA classification, ultraprocessed foods now contribute to 58% and 57% of mean energy intake for populations in the United States and United Kingdom, respectively.3,4 These food products, therefore, constitute a major part of the overall diets of the people in these areas.

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The only published study that used the NOVA classification system to evaluate the effect of ultraprocessed food consumption on the risk of developing cancer is a prospective, population-based cohort study.5 The study is by the same group of researchers who pioneered the NOVA classification.

The study included 104,980 adults from the French NutriNet-Santé cohort enrolled between 2009 and 2017. The participants did not have cancer at baseline, and the data were adjusted for age, sex, energy intake without alcohol, number of dietary records, smoking status, educational level, physical activity, height, body mass index, alcohol intake, and family history of cancers. For breast cancer cases, additional adjustments were made for menopausal status, and hormonal treatment for menopause and contraception. The researchers further adjusted the model for lipid, sodium, and carbohydrate intakes to reflect a Western dietary pattern.

Ultraprocessed foods consumed by the participants consisted primarily of sugary products (26%), drinks (20%), starchy foods and breakfast cereals (16%), and ultraprocessed fruits and vegetables (15%), as well as dairy and other animal products, salty snacks, and fats.

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The risk for overall cancer was significantly associated with ultraprocessed food consumption with a hazard ratio (HR) of 1.12 (95% CI, 1.06-1.18; P < .001). There was also a significant association for breast cancer (HR, 1.11; 95% CI, 1.02-1.22; P = .02), which was driven by postmenopausal (HR, 1.13; 95% CI, 1.01-1.27; P = .04), but not premenopausal breast cancers (HR, 1.09; 95% CI, 0.95-1.25; P = .2).

When assessing the effect of specific ultraprocessed food products, fats and sauces (P = .002), sugary products (P = .03), and drinks (P = .005) were significantly associated with overall cancer, and sugary products were significantly associated with an increased risk of breast cancer (P = .006).

There was no association found between the consumption of ultraprocessed food and the risk of prostate (HR, 0.98; 95% CI, 0.83-1.16) or colorectal cancers (HR, 1.13; 95% CI, 0.92-1.38), according to the authors.


Consumption of ultraprocessed foods, as defined by the NOVA classification, may be associated with an increased risk of cancer, particularly postmenopausal breast cancer. There was no association between consumption of these foods and the risk of prostate or colorectal cancers, and a link between eating these foods and the risk of developing other specific cancer types was not established by this study. However, there has been some criticism of the NOVA classification, which should be considered when interpreting these data. More research is warranted.


  1. Monteiro CA, Cannon G, Moubarac J-C, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018;21(1):5-17.
  2. Gibney MJ, Forde CG, Mullally D, Gibney ER. Ultra-processed foods in human health: a critical appraisal. Am J Clin Nutr. 2017;106(3):717-724.
  3. Steele EM, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metr. 2017;15(1):6-17.
  4. Rauber F, da Costa Louzada ML, Steele EM, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UK (2008–2014). Nutrients. 2018;10(5):587-600.
  5. Fiolet T, Srour B, Sellem L, et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ. 2018;360:k322.