Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort
Srour B, Fezeu LK, Kesse-Guyot E, Allès B, Debras C, Druesne-Pecollo N, Chazelas E, Deschasaux M, Hercberg S, Galan P, Monteiro CA, Julia C, Touvier M
JAMA internal medicine · 333 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food diaries or recalls
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2019-12-16 · JAMA Intern Med · vol. 180 · issue 2 · p. 283
- Publisher
- American Medical Association
- Cited
- 476 citations · more than 100% of similar papers · 50.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 88 works
- Access
- Free to read
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Nutritional Studies and Diet
- Keywords
- Medicine, Hazard ratio, Type 2 diabetes, Prospective cohort study, Population, Environmental health, Proportional hazards model, Cohort, Cohort study, Diabetes mellitus, Demography, Internal medicine, Confidence interval, Endocrinology
- MeSH
- humans, diabetes mellitus, type 2, diet, proportional hazards models, cohort studies, prospective studies, food handling, adult, middle aged, france, female, male
13 authors
From FR, BR
- Bernard Srour · correspondingInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
- Léopold FezeuInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
- Emmanuelle Kesse‐GuyotInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
- Benjamin AllèsInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
- Charlotte DebrasInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
- Nathalie Druesne‐PecolloInserm; Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement; Université Sorbonne Paris Nord; Centre de Recherche Épidémiologie et Statistique
Abstract
Importance
Ultraprocessed foods (UPF) are widespread in Western diets. Their consumption has been associated in recent prospective studies with increased risks of all-cause mortality and chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia; however, data regarding diabetes are lacking.
Objective
To assess the associations between consumption of UPF and risk of type 2 diabetes (T2D).
Design, setting, and participants
In this population-based prospective cohort study, 104 707 participants aged 18 years or older from the French NutriNet-Santé cohort (2009-2019) were included. Dietary intake data were collected using repeated 24-hour dietary records (5.7 per participant on average), designed to register participants' usual consumption for more than 3500 different food items. These were categorized according to their degree of processing by the NOVA classification system.
Main outcomes and measures
Associations between UPF consumption and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).
Results
A total of 104 707 participants (21 800 [20.8%] men and 82 907 [79.2%] women) were included. Mean (SD) baseline age of participants was 42.7 (14.5) years. Absolute T2D rates in the lowest and highest UPF consumers were 113 and 166 per 100 000 person-years, respectively. Consumption of UPF was associated with a higher risk of T2D (multi-adjusted hazard ratio [HR] for an absolute increment of 10 in the percentage of UPF in the diet, 1.15; 95% CI, 1.06-1.25; median follow-up, 6.0 years; 582 252 person-years; 821 incident cases). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet, for other metabolic comorbidities (HR, 1.13; 95% CI, 1.03-1.23), and for weight change (HR, 1.13; 95% CI, 1.01-1.27). The absolute amount of UPF consumption (grams per day) was consistently associated with T2D risk, even when adjusting for unprocessed or minimally processed food intake (HR for a 100 g/d increase, 1.05; 95% CI, 1.02-1.08).
Conclusions and relevance
In this large observational prospective study, a higher proportion of UPF in the diet was associated with a higher risk of T2D. Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting UPF consumption.
Trial registration
ClinicalTrials.gov Identifier: NCT03335644.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.