Higher Ultra-Processed Food Intake Linked to Early-Onset Colorectal Adenomas: JAMA
A new study published in the Journal of the American Medical Association revealed that greater consumption of ultra-processed foods (UPFs) is associated with an increased risk of early-onset colorectal conventional adenomas (EOCRC). The findings suggest that poor dietary quality contributes to early colorectal tumor development and highlight improving diet as a key strategy to reduce the rising burden of early-onset colorectal cancer.
The research explored the connection between UPF intake and precancerous colorectal lesions diagnosed before age 50. EOCRC continues to draw concern as cases in younger adults climb globally in parallel with increased accessibility and consumption of heavily processed packaged products.
The study followed 29,105 female registered nurses from 1991 through 2015, all of who underwent at least one lower endoscopy before age 50 and had no cancer or inflammatory bowel disease at baseline. Using food-frequency questionnaires administered every 4 years, this research measured UPF intake based on servings per day using the Nova classification system.
Over 24 years of follow-up, this study documented 1,189 cases of early-onset conventional adenomas and 1,598 serrated lesions, both types of colorectal precursors. On average, UPFs comprised nearly 35% of total daily caloric intake among participants, with a median of 5.7 servings consumed daily.
The core findings highlight a significant association between high UPF consumption and increased risk of conventional adenomas which are more likely to progress into colorectal cancer. The participants in the highest consumption quintile showed a 45% higher likelihood of developing adenomas when compared to those in the lowest intake group, reflected by an adjusted odds ratio (AOR) of 1.45 with a 95% confidence interval of 1.19-1.77.
Also, no meaningful association was found between UPF intake and serrated lesions (AOR, 1.04; 95% CI, 0.89-1.22; P = .48), a different class of polyps with varied malignant potential. This study emphasized that findings remained robust even after accounting for potential confounding factors including body mass index, type 2 diabetes, fiber intake, folate, calcium, vitamin D levels, and overall dietary quality.
The participants with the lowest UPF intake served as the reference group, while higher quintiles of intake demonstrated a gradient increase in adenoma risk. Overall, this study suggests that industrial food processing may influence cancer development mechanisms and highlights dietary modification as an actionable strategy to counter the escalation of EOCRC.
Source:
Wang, C., Du, M., Kim, H., Nguyen, L. H., Wang, Q.-L., Drew, D. A., Leeming, E. R., Khandpur, N., Sun, Q., Zong, X., Gweon, T.-G., Ogino, S., Ng, K., Berry, S., Giovannucci, E. L., Song, M., Cao, Y., & Chan, A. T. (2025). Ultraprocessed food consumption and risk of early-onset colorectal cancer precursors among women. JAMA Oncology. https://doi.org/10.1001/jamaoncol.2025.4777
