Evidence map›Paper›PMID 40466910›Full record

ArticleThe American journal of clinical nutrition2025

Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study.

Alyssa Feinberg, Casey M Rebholz, Rozenn N Lemaitre, Amanda M Fretts, Kerri Wiggins, Nona Sotoodehnia, Bruce M Psaty, Hyunju Kim

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of clinical nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alyssa FeinbergDepartment of Epidemiology, University of Washington School of Public Health, Seattle, WA.
Casey M RebholzDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
Rozenn N LemaitreCardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA; Department of Medicine, University of Washington, Seattle, Washington, WA, United States.
Amanda M FrettsDepartment of Epidemiology, University of Washington School of Public Health, Seattle, WA; Cardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA.
Kerri WigginsCardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA.
Nona SotoodehniaCardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA; Department of Medicine, University of Washington, Seattle, Washington, WA, United States.
Bruce M PsatyDepartment of Epidemiology, University of Washington School of Public Health, Seattle, WA; Cardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA; Department of Medicine, University of Washington, Seattle, Washington, WA, United States.
Hyunju KimDepartment of Epidemiology, University of Washington School of Public Health, Seattle, WA; Cardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, WA. Electronic address: hyunjuk1@uw.edu.

Funding

Exceptional aging: 12 year trajectories to functionR01AG023629 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2004 to 2005
$2.6M
Infrastructure for mentored access to CHS data and specimensR01HL172803 · UNIVERSITY OF WASHINGTON · 2025 to 2025
$1.4M
CHS Events Follow-up StudyU01HL080295 · UNIVERSITY OF WASHINGTON · 2005 to 2005
$1.1M
Proteomic and epigenetic alterations associated with plant-based diets and CVDK01HL168232 · UNIVERSITY OF WASHINGTON · 2025 to 2025
$219k
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · JOHNS HOPKINS UNIVERSITY · 1988 to 2000
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CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085083 · UNIVERSITY OF CALIFORNIA DAVIS · 1988 to 1999
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CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · WAKE FOREST UNIVERSITY · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · UNIVERSITY OF WASHINGTON · 1988 to 2005
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CHS-Transition Phase -268055222N01HC055222 · University of Washington · 2005 to 2005
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NHLBI NIH HHS 75N92021D00006NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS K01 HL168232NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS R01 HL153178NHLBI NIH HHS R01 HL172803NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIA NIH HHS R01 AG023629
6 · The paper itself

Abstract

backgroundUltra-processed food (UPF) consumption is associated with adverse health outcomes. Plant- and animal-sourced UPFs have a unique nutritional composition to improve palatability, which may impact health, but evidence is limited.

objectivesThe objective of this study was to investigate the association between UPF intake, plant- and animal-sourced UPF, and mortality outcomes in older adults.

methodsWe conducted prospective analyses of 2582 participants (median age: 77 y) in the Cardiovascular Health Study who completed a food frequency questionnaire (FFQ) in 1995-1996. We used responses from the FFQ to identify UPF and classify UPF based on their source (plant or animal). Cox proportional hazard regression models were used to study the association between UPF, plant- and animal-sourced UPF, and mortality outcomes (all-cause, cardiovascular disease [CVD] related, non-CVD related, and cancer).

resultsOver a median follow-up of 10 y, there were 2242 deaths. After adjusting for sociodemographic characteristics and health behaviors, per standard deviation (SD) higher intake of UPF was associated with 8%-10% higher risk of all-cause mortality (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.02, 1.14), non-CVD related mortality (HR: 1.10; 95% CI: 1.03, 1.18), and cancer mortality (HR: 1.13; 95% CI: 1.08, 1.46). Similarly, per SD, higher intake of plant- and animal-sourced UPFs was associated with a 4%-17% higher risk of all-cause mortality, non-CVD related mortality, and cancer mortality. However, in a model additionally adjusting for clinical factors, the associations between plant-sourced UPF and mortality attenuated, except for cancer mortality. No significant associations were observed for CVD related mortality.

conclusionHigher consumption of UPF and plant- and animal-sourced UPFs was associated with higher risk of all-cause, non-CVD related, and cancer mortality. Our findings emphasize the need to consider the impact of food processing, even in plant-sourced foods, to prevent a shorter lifespan in older adults. Findings on plant-sourced UPF and mortality require replication.

Indexed as

Cardiovascular DiseasesDietFast FoodsMeatNeoplasmsAgedAged, 80 and overAnimalsFemaleFood, ProcessedHumansMaleProportional Hazards ModelsProspective StudiesUnited Statesanimal productsfood processingmortalityolder adultsplant-based foodsultra-processed foods

Identifiers

PMID40466910
PMCPMC12378140

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.