Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study
Llavero-Valero M, Escalada-San Martín J, Martínez-González MA, Basterra-Gortari FJ, de la Fuente-Arrillaga C, Bes-Rastrollo M
Clinical nutrition (Edinburgh, Scotland) · 82 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 frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- Instituto de Salud Carlos III
Based on 1 listed funder(s).
Publication
- Published
- 2021-04-05 · Clin Nutr · vol. 40 · issue 5 · pp. 2817–2824
- Publisher
- Elsevier BV
- Cited
- 123 citations · more than 100% of similar papers · 17.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 41 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Dietary Effects on Health
- Keywords
- Medicine, Type 2 diabetes, Prospective cohort study, Cohort study, Environmental health, Diabetes mellitus, Internal medicine, Endocrinology
- MeSH
- humans, diabetes mellitus, type 2, diet, risk factors, cohort studies, food handling, adult, middle aged, female, male, fast foods
6 authors
From ES, US
- María Llavero-ValeroUniversidad de Navarra
- Javier Escalada-San MartínInstituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
- Miguel Ángel Martínez‐GonzálezHarvard University; Instituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
- Francisco Javier Basterra-GortariComplejo Hospitalario de Navarra; Navarre Institute of Health Research; Universidad de Navarra
- Carmen de la Fuente‐ArrillagaInstituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
- Maira Bes‐Rastrollo · correspondingInstituto de Salud Carlos III; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition; Navarre Institute of Health Research; Universidad de Navarra
Abstract
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.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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