Ultra-processed food consumption and exposure to acrylamide in a nationally representative sample of the US population aged 6 years and older

Ultra-processed food (UPF) consumption has been associated with cardiovascular disease and cancer. Acrylamide is a probable human carcinogen commonly found in foods that are processed at high temperatures. The aim of this study was to examine the association between dietary energy contribution of UPF and acrylamide exposure, in the US. Among the 4418 participants from cross-sectional 2013-2016 National Health and Nutrition Examination Survey, aged 6+ years, with hemoglobin biomarkers of acrylamide exposure, 3959 that completed the first 24-h dietary recall and had information on all covariates were included in the study. UPF were identified based on the Nova classification system, a four-group food classification based on the extent and purpose of industrial food processing. Linear regression was used to compare average acrylamide and glycidamide hemoglobin (HbAA+HbGA) concentrations across quintiles of daily energy contribution of UPF. Adjusted geometric means of acrylamide and glycidamide hemoglobin concentrations increased monotonically from the lowest to the highest quintile of UPF consumption in the overall population. Compared to the lowest quintile, the highest quintile had 9.1% higher levels of HbAA+HbGA (94.1 vs. 86.3 pmol/g Hb). These positive associations were statistically significant among males and in the young adult population and were largely driven by UPF which are known potential sources of acrylamide. The main effects remained unchanged when excluding current smokers. As both acrylamides and UPF have been previously associated with cardiovascular disease and cancer, our results suggest that acrylamides in UPF may partially explain previously observed links between UPF consumption and these health outcomes.