Association Between Ultra-Processed Food Intake and Sinusitis

BackgroundUltra-processed foods (UPF) are industrial formulations derived mostly from substances refined or extracted from foods. UPF intake has been linked to obesity, cardiovascular disease, and adult mortality, with recent studies demonstrating possible associations with asthma and allergy.ObjectiveWe investigate the association of UPF intake with self-reported sinusitis and other sinonasal symptoms.MethodsWe retrospectively reviewed 3 cycles of the National Health and Nutrition Examination Survey (NHANES), ranging from 2005 to 2014, which includes dietary and sinonasal symptom data on a large, representative sample of the US population. Individuals were divided into quartiles based on the percent of daily caloric intake consisting of Nova category 4 UPF. Multivariable logistic regression was performed to assess the association of UPF intake with sinonasal symptoms, adjusting for demographic data and medical comorbidities.ResultsAnd 10,068 individuals (mean age 54.2 years, 52.1% female) were studied. Compared to the lowest quartile of UPF intake, the highest quartile had a higher rate of asthma (16% vs 11%, <i>P</i> = .03), obesity (40% vs 30%, <i>P</i> < .001), smoking (51.6% vs 44.4%, <i>P</i> < .001), emphysema (2.9% vs 1.8%, <i>P</i> = .02), and food insecurity (26% vs 21%, <i>P</i> = .002). On multivariable regression, the highest quartile of UPF intake was associated with self-reported sinusitis (odds ratio [OR] = 1.54, 95% confidence interval [CI] 1.15-2.05, <i>P</i> = .007). UPF intake was also associated with xerostomia-related dysgeusia (OR 1.79, CI 1.15-2.80, <i>P</i> = .02) but not with other sinonasal symptoms, including hyposmia, allergies, hay fever, or nasal congestion from allergies.ConclusionUPF intake is significantly associated with self-reported sinusitis and xerostomia-related dysgeusia, although not with other sinonasal symptoms. Further studies are needed to elucidate the mechanism of this association.