Association of fried food consumption with all cause, cardiovascular, and cancer mortality: prospective cohort study
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k5420 (Published 23 January 2019) Cite this as: BMJ 2019;364:k5420
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
The prospective cohort study by Yangbo Sun, Buyun Liu and colleagues on the “Association of fried food consumption with all cause, cardiovascular, and cancer mortality” is a timely published research article [1].
This research study was carried out in older US women (gender based study), but the results of the cohort study are applicable and beneficial to all. The type of oil used for frying is much more important, and accordingly frying itself may not be bad [2].
This cohort study gives a very clear message to health care professionals (HCPs) and people that a non-vegetarian diet is not good to consume. It is better to adopt a vegetarian diet, and the inclusion of dietary fiber & whole grains is beneficial to health.
A study showed that the intake of dietary fiber lowers all cause and cardiovascular mortality in patients who have survived MI [3].
It is a well known fact that long use of whole grains reduces lipid levels, reduces blood pressure, redistributes fat and maintains weight, regulates blood sugar, provides essential minerals, vitamin B & C, may reduce asthma and reduces cancer risk [4]. Studies revealed that whole grains, fruit & milk dietary pattern is associated with improved bone mineral density (BMD) in Korean healthy adults [5] and that whole grain consumption for breakfast is linked with higher test scores in elementary school students [6].
Fast food fever, the modern "Western diet", is addictive, reduces body immunity, and is not good for health [7].
The type of food and its quality (what we eat), the quantity of food (how much we eat) and the right method of taking food (how we eat) are very important [8].
It has become the responsibility of HCPs to encourage people to adopt a vegetarian diet & avoid consuming fast food.
Regards,
References:
1. https://www.bmj.com/content/364/bmj.k5420
2. https://www.bmj.com/content/344/bmj.d8274
3. https://www.bmj.com/content/348/bmj.g2659
4. http://www.huffingtonpost.com/entry/whole-grains-health-benefits_n_56550...
5. European Journal of Clinical Nutrition (2015) 69, 442–448.
6. J Am Coll Nutr. 2016 May-Jun;35(4):326-33.
7. https://www.foodnavigator.com/Article/2015/08/05/Fast-food-fever-Modern-...
8. https://www.nhp.gov.in/spirituality-and-health_mty
Competing interests: No competing interests
The glaring absence in this study that there was no inclusion of the Defoamer or Antifoaming chemicals adding to frying oils in the US and other region states.
This explains the difference in results with the Mediterranean Regions where these chemicals are typically not added.
The reuse of frying oils would not be possible without the addition of these harmful and indigestible chemicals.
Competing interests: No competing interests
Re: Association of fried food consumption with all cause, cardiovascular, and cancer mortality: prospective cohort study
Sun and colleagues1 presented a comprehensive description of the association between frequent consumption of fried foods with risk of a higher risk of all cause and cardiovascular mortality in women in the US. However, in this study, impact of some risk factors on all-cause and cardiovascular diseases mortality was not fully characterized.
First, the National Health and Nutrition Examination Survey (NHANES) 2003 to 2006 data indicate that the prevalence of diabetes is approximately 12% with 27% of cases remain undiagnosed, and 35% of US adults aged>20 years have prediabetes. Similar to diagnosed diabetes, prediabetes was also associated with a higher risk of future stroke, one of the most important cardiovascular diseases.2 Therefore, we suggest that undiagnosed diabetes or prediabetes should be considered in subgroup analyzes as well. Second, Perak AM et al.3 concluded that familial hypercholesterolemia was likely to increase the long-term cardiovascular diseases burden in the general US population. In fact, familial hypercholesterolemia affects up to 1.5 million individuals in the US, and the prevalence is about 1 in 250 to 1 in 200. Consequently, FH deserves more attention in this study.
In sum, we concerned that assessing the association of total and individual fried food consumption with incident cardiovascular diseases and all-cause mortality in women without a detailed analysis of undiagnosed diabetes or prediabetes, familial hypercholesterolemia represents a big confounding issue. In our view, due to this shortcoming, the conclusion of this study should be treated with caution although this is an important finding at the population level.
Reference
1. Sun Y, Liu B, Snetselaar LG, et al. Association of fried food consumption with all cause, cardiovascular, and cancer mortality: prospective cohort study. BMJ. 2019;364:k5420.
2. Lee M, Saver JL, Hong KS, Song S, Chang KH, Ovbiagele B. Effect of pre-diabetes on future risk of stroke: meta-analysis. BMJ. 2012;344:e3564.
3. Perak AM, Ning H, de Ferranti SD, Gooding HC, Wilkins JT, Lloyd-Jones DM. Long-Term Risk of Atherosclerotic Cardiovascular Disease in US Adults With the Familial Hypercholesterolemia Phenotype. Circulation. 2016;134(1):9-19.
Competing interests: No competing interests