Ultra-processed food intake and risk of type 2 diabetes: a pooled analysis of three prospective cohorts of Korean adults and an updated meta-analysis
Kim Y, Cho Y, Koo B, Chen Z, Sun Q, Oh H
European journal of epidemiology · 4 citations
How it was studied
- Design
- Meta-analysis (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
- National Research Foundation of Korea
- Grants
- National Research Foundation of Korea (NRF-2023S1A5C2A03095169); National Research Foundation of Korea (RS-2025-00556008)
Based on 1 listed funder(s).
Publication
- Published
- 2025-09-16 · Eur J Epidemiol · vol. 40 · issue 11 · pp. 1293–1305
- Publisher
- Springer Science+Business Media
- Cited
- 4 citations · more than 93% of similar papers · 3.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 44 works
- Access
- Open access (repository copy) · OTHER-OA
- Research areas
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Obesity, Physical Activity, Diet
- Keywords
- Prospective cohort study, Quartile, Type 2 diabetes, Pooled analysis, Hazard ratio, Proportional hazards model, Confidence interval, Relative risk, Diabetes mellitus
- MeSH
- humans, diabetes mellitus, type 2, diet, proportional hazards models, risk factors, prospective studies, adult, middle aged, female, male, republic of korea, fast foods, food, processed
6 authors
From KR, US, JP, CN, NL, IN
- Yujin KimKorea University
- Yoonkyoung ChoKorea University; University of Michigan
- Bo Kyung KooKorea University; Korea University
- Zhangling ChenCentral South University; Erasmus MC; Second Xiangya Hospital of Central South University
- Qi SunBrigham and Women's Hospital; Harvard University
- Hannah Oh · correspondingKorea University; Department of Public; Korea University
Abstract
Studies suggest a positive association between ultra-processed food (UPF) intake and type 2 diabetes risk. However, studies were primarily conducted in Western populations with diets and disease profiles different from populations living elsewhere. In addition, the dose-response relationship needs to be further elucidated. We conducted an individual-level pooled analysis of three Korean prospective cohorts (n = 72,776). UPF intake (in the percentage of g/d as the main UPF unit) was assessed using validated food frequency questionnaires and categorized according to Nova classification. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We subsequently conducted a meta-analysis of prospective studies, including recent studies from both Western and non-Western populations, to assess the dose-response relationship. In a pooled analysis of Korean cohorts (up to 18 years of follow-up), the highest (vs. lowest) quartile of UPF intake was associated with an increased type 2 diabetes risk (pooled HR [95% CI] = 1.11 [1.02, 1.21] , p-trend = 0.03). The positive association persisted after additional adjustment for BMI, nutritional factors (fiber, sodium, and carbohydrate intakes), or diet quality score. Among individual UPF subgroups, processed meats, ready-to-eat/heat mixed dishes, and ice cream were positively associated with diabetes risk. In a meta-analysis of 17 prospective cohorts, every 10% (of g/d) increment in UPF intake was associated with a 10% (summary RR [95% CI] = 1.10 [1.08, 1.12] ) higher risk in a dose-response fashion. Our meta-evidence supports that higher UPF intake may monotonically increase type 2 diabetes risk.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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