Increased Stroke Risk and Cognitive Impairment Associated with Ultra-Processed Foods
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The consumption of ultra-processed foods has been linked to negative brain health outcomes, including a higher risk for cognitive impairment and stroke. This association is particularly pronounced among Black patients compared to White patients. These findings, published in the journal Neurology, highlight the detrimental effects of ultra-processed foods on brain health.
Study Overview
Researchers conducted a prospective, observational cohort study to explore the relationship between ultra-processed food intake and the risk of cognitive impairment and stroke. They also compared these associations with other commonly recommended dietary patterns in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) project.
The REGARDS project is a longitudinal study that enrolled Black and White adults aged 45 and older in the United States between 2003 and 2007. Using the NOVA classification system, researchers categorized food items based on their processing levels, from unprocessed or minimally processed (NOVA1) to ultra-processed (NOVA4).
Dietary Patterns and Brain Health Outcomes
Participants' adherence to the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets was also assessed. Brain health outcomes, including incident stroke and cognitive impairment, were evaluated through medical record reviews and memory and fluency assessments.
The study included two cohorts: the cognitive impairment cohort, which comprised 14,175 patients without baseline cognitive impairment, and the stroke cohort, which included 20,243 patients with no history of stroke at baseline.
Key Findings
In fully adjusted models, the researchers found that:
• Higher Risk for Cognitive Impairment: Intake of NOVA4 (ultra-processed foods) was associated with a higher risk for cognitive impairment (hazard ratio [HR], 1.16; 95% CI, 1.09-1.24; P =1.01 x 10^-5).
• Lower Risk for Cognitive Impairment: Intake of NOVA1 (unprocessed or minimally processed foods) was linked to a reduced risk for cognitive impairment (HR, 0.88; 95% CI, 0.83-0.94; P =1.83 x 10^-4).
• Reduced Stroke Risk: The DASH (HR, 0.96; 95% CI, 0.95-0.98; P =5.41 x 10^-5) and MIND (HR, 0.91; 95% CI, 0.87-0.95; P =1.08 x10^-5) diets were associated with a reduced risk for stroke.
• Higher Risk for Stroke: NOVA4 intake was associated with a higher risk for stroke (HR, 1.08; 95% CI, 1.02-1.14, P =1.12 x 10^-2), while NOVA1 intake was associated with a lower risk for stroke (HR, 0.91; 95% CI, 0.86-0.95; P =2.13 x 10^-4).
• Dietary Patterns and Stroke Risk: The Mediterranean (HR, 0.96; 95% CI, 0.93-1.00; P =3.72 x 10^-2), DASH (HR, 0.99; 95% CI, 0.97-1.00; P =4.32 x 10^-2), and MIND (HR, 0.96; 95% CI, 0.93-0.99; P =1.44 x10^-2) diets were linked to reduced stroke risk.
Racial Disparities in Stroke Risk
The effect of NOVA4 intake on stroke risk was more significant among Black patients compared to White patients in the fully adjusted model (HR, 1.15; 95% CI, 1.03-1.29, P =1.50 x 10^-2). This finding underscores the need for targeted dietary interventions to address racial disparities in stroke risk.
Study Limitations
The study has several limitations, including the use of a weight ratio for primary analyses, the NOVA classification system, and self-reported dietary data. Additionally, the observational study design limits the ability to establish causality.
Conclusion
The study supports the hypothesis that the degree of food processing significantly impacts overall brain health. These findings provide complementary information to other recommended dietary patterns, such as the Mediterranean, DASH, and MIND diets. By highlighting the negative effects of ultra-processed foods, this research emphasizes the importance of dietary choices in maintaining brain health and reducing the risk of cognitive impairment and stroke.
References
1. Neurology Journal. "Eating Ultra-Processed Foods Tied to Poor Brain Health Outcomes." Published online June 18, 2024.
2. REGARDS Project. "REasons for Geographic and Racial Differences in Stroke (REGARDS)." Longitudinal study data from 2003-2007.
3. NOVA Classification System. "Classifying Food Based on Processing Levels."
By adopting healthier dietary patterns and reducing the intake of ultra-processed foods, individuals can potentially improve their brain health and lower the risk of cognitive impairment and stroke.
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