Association between midlife intake of ultra-processed foods and later-life subjective cognitive complaints: Evidence from the new York University women's health study

OBJECTIVE: Research into risk factors for subjective cognitive complaints (SCCs) may offer insight into the etiology and prevention of Alzheimer's disease. Ultra-processed foods (UPFs) contain food additives that improve palatability and processed raw materials. Evidence is limited on the role of mid-life UPF intake in the development of late-life SCCs. METHODS: We included 5119 participants who responded to the 2018 or 2020 follow-up of the New York University Women's Health Study, a prospective cohort of 14,274 women recruited in New York City, United States, in 1985-91. Data on diet were collected at baseline using a validated modified Block food frequency questionnaire. Energy-adjusted total intake of UPFs and subgroups of UPFs, defined following the nova guidelines, were estimated using the residual method. RESULTS: The odds ratios (ORs) and 95 % confidence intervals (CIs) for reporting ≥2 SCCs were 1.15 (0.94-1.39), 1.06 (0.87-1.30), 1.20 (0.99-1.46), and 1.24 (1.02-1.51) for women in the 2nd, 3rd, 4th, and 5th quintiles of energy-adjusted UPF intake, respectively, compared to those in the bottom quintile (p-trend = 0.02). The associations were similar in sensitivity analyses using Multiple Imputation and Inverse Probability Weighting to account for potential selection bias. CONCLUSIONS: Higher UPF intakes in midlife were associated with higher odds of late-life SCCs in women.