CO054 | ULTRA-PROCESSED FOOD CONSUMPTION IS ASSOCIATED WITH AN INCREASED RISK OF UNPROVOKED VENOUS THROMBOEMBOLISM IN THE MOLI-SANI STUDY

M. Bonaccio¹, A. Di Castelnuovo¹, S. Costanzo^1|2, T. Panzera¹, C. Cerletti¹, MB. Donati¹, G. de Gaetano¹, W. Ageno³, L. Iacoviello^1|4 | ¹Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy; ²Dep. of Medicine and Surgery, University of Insubria, Varese, Italy; ³Dep. of Medicine, Università degli Studi di Padova, Padova, Italy; ⁴Dep. of Medicine and Surgery LUM University, Casamassima (BA), Italy

Background and Aims. Ultra-processed foods (UPFs) are industrial formulations typically made from food-derived substances and additives, with little or no intact whole foods. The consumption of UPFs has been increasingly linked to adverse cardiometabolic outcomes, yet its association with unprovoked venous thromboembolism (VTE) remains poorly investigated. This study examined the relationship between UPF intake and the incidence of VTE in the Moli-sani Study cohort, a large population-based prospective study conducted in Southern Italy (enrollment 2005-2010).
Methods. A total of 20,987 men and women free of a personal history of thromboembolic events at baseline were included. Dietary intake was assessed using a validated food frequency questionnaire, and foods were classified according to the Nova system, which groups foods into four categories based on the extent and purpose of processing. UPF consumption was expressed as the proportion of total food intake by weight. Overall diet quality was evaluated using the Mediterranean Diet Score (MDS). Incident VTE events, including deep vein thrombosis and pulmonary embolism, were identified through hospital discharge records, mortality registry data, and clinical records; validated cases were derived from clinical charts (n=107), mortality registry data (n=2), and hospital discharge records (n=6). The association between UPF intake and incident VTE was examined using multivariable Cox proportional hazards models, adjusting for established risk factors.
Results. During a median follow-up of 13.1 years, 115 incident VTE events were documented. Higher UPF consumption was associated with more than a twofold increased risk of incident VTE (HR = 2.33; 95% CI: 1.32–4.12 for Q4 vs. Q1). Further adjustment for the MDS did not substantially alter this association (HR = 2.06; 95% CI: 1.14–3.70). The relationship was consistent across sexes (HR = 3.02; 95% CI: 1.36–6.72 in men, and HR = 2.00; 95% CI: 0.89–4.49 in women; p for difference = 0.23).
Conclusions. Findings from a large population-based cohort suggest that high UPF consumption may represent a modifiable risk factor for unprovoked venous thromboembolism, independent of overall diet quality. This finding raises the possibility that non-nutritional factors (e.g., plastic contaminants, food additives) may play a direct role. Further studies are warranted to confirm these findings and to elucidate the underlying biological mechanisms.