Ultraprocessed Food Intake and SLE Incidence Among Women

According to a study published in Arthritis Care & Research, higher than cumulative average of daily ultraprocessed food (UPF) intake was associated with a greater than 50% increase in systemic lupus erythematosus (SLE) risk, and a doubled risk for antidouble stranded DNA antibody (dsDNA) with SLE.

Researchers aimed to assess the relationship between UPF intake and the incidence of SLE within the prospective Nurses’ Health Study (NHS) cohorts. The study followed 204,175 women from 2 cohorts, NHS (1984-2016) and NHSII (1991-2017), with semiquantitative food frequency questionnaires completed every 2-4 years to determine UPF intake as per the Nova classification. New doctor-diagnosed SLE cases were self-reported by nurses and confirmed through medical records.

Time-varying Cox regressions were used to estimate hazard ratios (HR) for incident SLE and SLE characterized by anti-dsDNA, based on cumulatively updated daily UPF servings, total intake (grams and milliliters), and percentage of total intake. The analyses were adjusted for factors including age, race, cohort, caloric and alcohol intakes, household income, smoking, BMI, physical activity, menarche age, and oral contraceptive use. Interaction with BMI and specific UPF categories were also examined.

The baseline mean age was approximately 50 years for NHS and 36 years for NHSII, with 93% of participants self-reporting as White. A total of 212 incident SLE cases were identified. The risk of SLE was higher in the highest tertile of UPF intake compared to the lowest (HR 1.56, 95% CI 1.04-2.32; p trend 0.03), with a stronger association for dsDNA-positive SLE (HR 2.05, 95% CI 1.15-3.65; p trend 0.01). The associations were more pronounced for absolute UPF intake than for the percentage of total intake. Specifically, sugar/artificially sweetened beverages were linked to an increased SLE risk (HR 1.45, 95% CI 1.01-2.09). No interactions with BMI were observed.

“Higher cumulative-average daily UPF intake was associated with >50% increased SLE risk, and with doubled risk for anti-dsDNA+ SLE. Many deleterious effects on systemic inflammation and immunity are postulated,” the authors concluded.

Reference
Rossato S, Oakes EG, Barbhaiya M, et al. Ultra-processed food intake and risk of systemic lupus erythematosus among women followed in the nurses' health study cohorts. Arthritis Care Res (Hoboken). Published online June 27, 2024. doi:10.1002/acr.25395