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

May 2, 2021Clinical nutrition (Edinburgh, Scotland)

Ultra-processed foods and risk of type 2 diabetes in the SUN study

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Abstract

Participants in the highest tertile of ultra-processed food consumption had a 1.65 times higher risk of developing type 2 diabetes compared to those in the lowest tertile.

A total of 175 new-onset type 2 diabetes cases were confirmed during 215,149 person-years of follow-up.
There is a significant dose-response relationship between ultra-processed food consumption and the risk of type 2 diabetes.
The increased risk of type 2 diabetes persists after adjusting for other factors and using repeated dietary measurements.
The findings suggest that higher intake of ultra-processed foods may be independently linked to a greater risk of developing type 2 diabetes.

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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 dose-response relationship (p for linear trend = 0.024). The multivariable adjusted HR using repeated measurements of UPF intake was 1.65 (95% CI 1.14-2.38) 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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Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study

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