Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study

Levy, Renata Bertazzi; Rauber, Fernanda; Chang, Kiara; Louzada, Maria Laura da Costa; Monteiro, Carlos Augusto; Millett, Christopher; Vámos, Eszter

doi:10.1016/j.clnu.2020.12.018

Cited by 131 publications

(121 citation statements)

References 28 publications

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“…Our results are also in line with the results of the UK Biobank published meanwhile our paper was under review by Renata B.Levy et al [23], which showed a gradient of elevated risk of T2D associated with increasing quartiles of UPF intake after a mean followup of 5.4 years. Once again, the SUN cohort supports these results after a longer follow-up and using repeated measurements of UPF intake.…”

Section: Discussionsupporting

confidence: 92%

Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study

et al. 2021

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Background & aim: The association between ultra-processed foods (UPF) consumption and the risk of type 2 diabetes (T2D) has not been much explored. We aimed to evaluate the association between consumption of UPF and the incidence of T2D. Methods: We assessed 20,060 participants (61.5% women) from the SUN project (Seguimiento Universidad de Navarra) followed-up every two years (median follow-up 12 years). Food and drink consumption were evaluated through a validated 136-item food frequency questionnaire and grouped according to their degree of processing by the NOVA classification. Participants were categorized into tertiles of UPF consumption adjusted for total energy intake. We fitted Cox proportional hazard models with repeated dietary measurements at baseline and updating information on food consumption after 10 years of follow-up to minimise the potential effect of diet variation. Results: During 215,149 person-years of follow-up, 175 new-onset T2D cases were confirmed. Participants in the highest baseline tertile (high consumption) of UPF consumption had a higher risk of T2D as compared to those in the lowest tertile (multivariable adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI]: 1.06 to 2.22) with a significant doseeresponse relationship (p for linear trend ¼ 0.024). The multivariable adjusted HR using repeated measurements of UPF intake was 1.65 (95% CI 1.14e2.38) when comparing extreme tertiles. Conclusions: In a highly-educated Mediterranean cohort with a low absolute risk, a higher intake of UPF was independently associated with a higher risk for T2D. These results provide more evidence to encourage the limitation of UPF consumption to reduce the population burden of T2D.

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Section: Discussionsupporting

confidence: 92%

Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study

et al. 2021

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“…11,12 The growing consumption worldwide, including in low-and middle-income countries, has mirrored a parallel rise in the prevalence of childhood and adult obesity globally, 9,10,13 suggesting that UPF consumption may be a key underlying driver of the obesity epidemic and diet-related noncommunicable diseases. 9,10,14,15 A recent clinical trial found that UPF consumption leads to excess calorie intake and weight gain in adults, 1 and cohort studies have reported associations between higher consumption and elevated risks of obesity, 2,3 type 2 diabetes, 4,5 cardiovascular disease, 6 cancer, 7 and mortality in adults. 8 Associations of UPF consumption with adiposity in children and adolescents remain scarce, with only few previous smallscale studies available.…”

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confidence: 99%

Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort

et al. 2021

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IMPORTANCE Reports of associations between higher consumption of ultraprocessed foods (UPF) and elevated risks of obesity, noncommunicable diseases, and mortality in adults are increasing. However, associations of UPF consumption with long-term adiposity trajectories have never been investigated in children.OBJECTIVE To assess longitudinal associations between UPF consumption and adiposity trajectories from childhood to early adulthood. DESIGN, SETTING, AND PARTICIPANTSThis prospective birth cohort study included children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC) in Avon County, southwest England. Children were followed up from 7 to 24 years of age during the study period from

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“…However, due to the limited amount of evidence and the high heterogeneity among the studies, it is still difficult to draw definitive conclusions [ 8 , 9 ]. UPF are a hallmark of Western dietary patterns, and their consumption has been associated with all-cause mortality [ 10 ] and many negative health outcomes, such as overweight and obesity [ 14 ], hypertension [ 42 ], cardiovascular events [ 43 ], diabetes [ 15 , 16 , 17 ], and cancer [ 44 ]. Recently, a cross-sectional study showed that women with a higher proportion of UPF in total energy intake had a greater risk of excess body weight, but not of GDM, compared with women with lower UPF consumption [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…From a nutritional point of view, UPF are high in fat, sugar, and salt and low in fiber, and, for this reason, may be an important driver of the increasing prevalence of obesity and diabetes. High UPF consumption has been found to be linked to the risk of obesity and diabetes in several prospective cohorts [ 14 , 15 , 16 , 17 ]. Recent clinical trials have also shown that UPF consumption causes excessive energy intake and weight gain [ 18 ] and a greater accumulation of visceral fat [ 19 ], a known risk factor for insulin resistance [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Pre-Gestational Consumption of Ultra-Processed Foods and Risk of Gestational Diabetes in a Mediterranean Cohort. The SUN Project

et al. 2021

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We aimed to investigate the relationship between the pre-gestational consumption of ultra-processed foods (UPF) and the risk of gestational diabetes (GDM). We carried out a prospective study among 3730 Spanish women of the SUN cohort who reported at least one pregnancy after baseline recruitment. Cases of GDM were identified among women with a confirmed diagnosis of GDM. UPF consumption was assessed through a validated, semi-quantitative food frequency questionnaire and the frequency of UPF consumption was categorized in tertiles. We identified 186 cases of GDM. In the pooled sample, we did not observe a significant association of UPF with the risk of GDM. When we stratified by age, the multivariate OR for the third tertile of UPF consumption compared with the lowest one was 2.05 (95% CI 1.03, 4.07) in women aged ≥30 years at baseline (Ptrend = 0.041). The association remained significant in a sensitivity analysis after changing many of our assumptions and adjusting for additional confounders. No association between a higher UPF consumption and GDM risk was observed in women aged 18–29 years. The pre-gestational UPF consumption may be a risk factor for GDM, especially in women aged 30 years or more. Confirmatory studies are needed to validate these findings.

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Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study

Cited by 131 publications

References 28 publications

Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study

Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study

Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort

Pre-Gestational Consumption of Ultra-Processed Foods and Risk of Gestational Diabetes in a Mediterranean Cohort. The SUN Project

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