High consumption of ultra-processed food may double the risk of subclinical coronary atherosclerosis: the Aragon Workers’ Health Study (AWHS)

Table 2 Progression to higher coronary artery calcium score (CACS) categories according to quartiles of ultra-processed food (UPF) consumption, using generalized ordered logistic models, the AWHS cohort study (N = 1876)

CACS categories	Quartiles of energy-adjusted UPF consumption (g/day)*, odds ratio (95% confidence intervals)
CACS categories	Q1	Q2	Q3	Q4	p trend
From the lowest category to the two highest^†
Model 1, OR (95% CI)	1 (ref.)	1.10 (0.84, 1.44)	1.18 (0.90, 1.55)	1.15 (0.88, 1.51)	.315
Model 2, OR (95% CI)	1 (ref.)	1.09 (0.83, 1.44)	1.19 (0.90, 1.57)	1.14 (0.86, 1.51)	.382
Model 3, OR (95% CI)	1 (ref.)	1.09 (0.83, 1.45)	1.17 (0.88, 1.56)	1.13 (0.85, 1.50)	.425
From the two lowest categories to the highest^γ
Model 1, OR (95% CI)	1 (ref.)	1.39 (0.88, 2.18)	1.47 (0.93, 2.31)	1.86 (1.20, 2.87)	.006
Model 2, OR (95% CI)	1 (ref.)	1.37 (0.86, 2.19)	1.54 (0.96, 2.47)	1.96 (1.24, 3.07)	.003
Model 3, OR (95% CI)	1 (ref.)	1.50 (0.93, 2.42)	1.56 (0.96, 2.52)	2.00 (1.26, 3.16)	.005

The generalized ordered logistic model (gologit/partial proportional odds model) allows for the no equality of slopes among categories, being less restrictive and more flexible than the ordinal ordered logistic model (parallel-lines model). OR odds ratio, CI confidence interval
Model 1: logistic regression model adjusted for age
Model 2: as in model 1 and additionally adjusted for marital status, education, smoking, physical activity, sleep duration during weekdays and during the weekend, alcohol consumption, total fiber intake, cholesterol intake, and total energy intake
Model 3: as in model 2 and additionally adjusted for cardiovascular risk factors: total serum cholesterol, HDL serum cholesterol, systolic and diastolic blood pressure, body mass index, and diabetes
*Energy adjusted by the residual method
^†Lowest category: CACS of 0; the two highest categories: CACS > 0 and < 100 together with CACS ≥ 100
^γTwo lowest categories: CACS of 0 together with CACS > 0 and < 100; highest category: CACS ≥ 100

ISSN: 1741-7015