UPF consumption and pro-inflammatory cytokines in breast cancer survivors: the LifeBreast trial

Abstract

Background and Objectives: High ultra-processed food (UPF) consumption has been associated with chronic low-grade inflammation, potentially related to the progression and prognosis of breast cancer. We aimed to evaluate the association between UPF consumption and one-year changes in serum levels of pro-inflammatory cytokines (IL-6, IL-18, and TNF-α).

Methods: Analysis included a sub-cohort (n = 176) of the LifeBreast project, a multicenter randomized trial investigating whether a Mediterranean Diet (MedDiet) vs. a low-fat diet (control) affects the prognosis among breast cancer patients. Dietary intake was assessed through a 149-item food frequency questionnaire, with UPF identification based on the NOVA classification. Participants were categorized into tertiles of UPF intake. Cytokine concentrations were measured using the Olink® Target 48 kit. The primary outcome was the change in cytokine levels from baseline to one-year, estimated using multivariable linear regression models.

Results: A significant linear association was found between higher UPF intake and increased TNF-α levels (ptrend=0.032). In stratified analyses, this association was notably stronger within the control group (ptrend=0.001). Although not statistically significant, regression coefficients for both IL-6 (bT3=0.11; 95% CI: -1.49 to 1.71) and IL-18 (bT3=13.32; 95% CI: -43.47 to 70.10) suggested higher levels in the highest UPF tertiles. Notably, these trends were more pronounced among participants allocated to the control group compared to the MedDiet (IL-6: bT3=0.85 vs. −0.57; IL-18: bT3=47.60 vs. −23.81).

Conclusions: Higher UPF intake was associated with a linear increase in TNF-α levels, particularly among participants not following the MedDiet. Non-significant upward trends for IL-6 and IL-18 were most pronounced in the low-fat group, suggesting that adherence to the MedDiet may mitigate UPF-induced pro-inflammatory effects in breast cancer survivors.

Key messages: • UPFs Drive Inflammation: High ultra-processed food intake linearly increases TNF-α levels over time, promoting chronic low-grade inflammation in breast cancer survivors.

• MedDiet as a Buffer: Adherence to a Mediterranean Diet may mitigate the pro-inflammatory effects of UPFs, whereas low-fat diets show a stronger inflammatory response.

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BibTeX RIS

BibTeX

@article{diez2026consumption,
  title = {{UPF consumption and pro-inflammatory cytokines in breast cancer survivors: the LifeBreast trial}},
  author = {MJ Cobo Díez and C Razquin Burillo and JJ Jiménez Moleón and T Dierssen Sotos and R Barrios Rodríguez and I Gómez Acebo and E Toledo Atucha},
  journal = {The European Journal of Public Health},
  year = {2026},
  month = oct,
  doi = {10.1093/eurpub/ckag169.444},
  url = {https://doi.org/10.1093/eurpub/ckag169.444},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - UPF consumption and pro-inflammatory cytokines in breast cancer survivors: the LifeBreast trial
AU  - MJ Cobo Díez
AU  - C Razquin Burillo
AU  - JJ Jiménez Moleón
AU  - T Dierssen Sotos
AU  - R Barrios Rodríguez
AU  - I Gómez Acebo
AU  - E Toledo Atucha
PY  - 2026
DA  - 2026/10/01
JO  - The European Journal of Public Health
DO  - 10.1093/eurpub/ckag169.444
UR  - https://doi.org/10.1093/eurpub/ckag169.444
AB  - Background and Objectives: High ultra-processed food (UPF) consumption has been associated with chronic low-grade inflammation, potentially related to the progression and prognosis of breast cancer. We aimed to evaluate the association between UPF consumption and one-year changes in serum levels of pro-inflammatory cytokines (IL-6, IL-18, and TNF-α).  Methods: Analysis included a sub-cohort (n = 176) of the LifeBreast project, a multicenter randomized trial investigating whether a Mediterranean Diet (MedDiet) vs. a low-fat diet (control) affects the prognosis among breast cancer patients. Dietary intake was assessed through a 149-item food frequency questionnaire, with UPF identification based on the NOVA classification. Participants were categorized into tertiles of UPF intake. Cytokine concentrations were measured using the Olink® Target 48 kit. The primary outcome was the change in cytokine levels from baseline to one-year, estimated using multivariable linear regression models.  Results: A significant linear association was found between higher UPF intake and increased TNF-α levels (ptrend=0.032). In stratified analyses, this association was notably stronger within the control group (ptrend=0.001). Although not statistically significant, regression coefficients for both IL-6 (bT3=0.11; 95% CI: -1.49 to 1.71) and IL-18 (bT3=13.32; 95% CI: -43.47 to 70.10) suggested higher levels in the highest UPF tertiles. Notably, these trends were more pronounced among participants allocated to the control group compared to the MedDiet (IL-6: bT3=0.85 vs. −0.57; IL-18: bT3=47.60 vs. −23.81).  Conclusions: Higher UPF intake was associated with a linear increase in TNF-α levels, particularly among participants not following the MedDiet. Non-significant upward trends for IL-6 and IL-18 were most pronounced in the low-fat group, suggesting that adherence to the MedDiet may mitigate UPF-induced pro-inflammatory effects in breast cancer survivors.  Key messages: • UPFs Drive Inflammation: High ultra-processed food intake linearly increases TNF-α levels over time, promoting chronic low-grade inflammation in breast cancer survivors.  • MedDiet as a Buffer: Adherence to a Mediterranean Diet may mitigate the pro-inflammatory effects of UPFs, whereas low-fat diets show a stronger inflammatory response.
SN  - 1101-1262
SN  - 1464-360X
ER  -

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