Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
The prevalence of Ultra-Processed food in our diets has many consequences; is type 2 diabetes among them?
Ultra-Processed food (UPF) has become widespread in Western cultures in the last century. Ultra-Processed foods include a vast range of food that contains very distinctive nutrient profiles. Food in this category includes burgers, ice cream, infant formula, cake mixes, sausages, and all sorts of spirits. As difficult as it seems to classify Ultra-Processed food, the number of additives in each food is an even greater challenge to assess. Consumption of these foods has been linked to all-cause mortality and chronic diseases in previous studies. Whether Ultra-Processed foods have a direct correlation to the risk of type 2 diabetes is a very new area of study, which is why the recommendations of diet are very unspecific in the population of people researched. More recent studies suggest that health care providers begin to encourage their patients on the consumption of low to no processed food as much as possible.
The French NutriNet-Sante was a cohort study conducted from 2009 to 2019 on 104,707 French adults aged 18 years or older. The authors of the study intended to assess “the interrelationship between the consumption of Ultra-Processed food and the risk it has on type 2 diabetes.” The researchers did not require the subjects to eat different diets; the participants were given the right to choose what they would like to eat. The researchers recorded what each participant ate and documented cases of type 2 diabetes. The dietary intake of every subject was collected and categorized in consonance with the degree of processing by the NOVA classification system. All of the nutritional intake data were obtained using a 24-hour dietary record. The data record was constructed to note each participants’ usual consumption for more than 3,500 different food articles.
The association between Ultra-Processed food consumption and the risk of type 2 diabetes was determined by using a cause-specific multivariable cox proportional hazard model. Within the hazard models, individual risk factors were adjusted. The risk factors adjusted were lifestyle, sociodemographic, nutrition factors, anthropometric, and medical history factors using that very technique.
Within the study’s 104,707 participants, 21,800 were men, 20.8% of the study population. There were 82,907 women in the study, 79.2% of the community. The standard deviation (mean) baseline age of participants was 42.7 (14.5) years of age. The absolute rates in patients with type 2 diabetes from the lowest to the highest Ultra-Processed food consumers were 113 and 166 per 100 000 person-years. A higher risk of type 2 diabetes correlates to the consumption of Ultra-Processed food. The result indicated a multi-adjusted hazard ratio for an absolute increment of 10 in the percentage of ultra-processed food in the diet as being 1.15. The confidence interval of 95 percent with a mean of 1.06-1.25. The median follow-up is 6.0 years; 58/2 252 person-years with 821 incident cases. These findings remained statistically significant after adjustment for several markers of the nutritional quality of the diet. As for other metabolic comorbidities hazard ratio was 1.13 with a confidence interval of 95 percent between 1.03 to 1.23. The weight change statistics reported a hazard ratio of 13 with a confidence interval of 95 percent between 1.01 to 1.27. Ultra-Processed food consumption was measured in grams per day and had an absolute amount that was consistently linked with type 2 diabetes risk. The unprocessed or minimally processed food intake resulted in a hazard ratio for a 100 g/d increase of 1.05. The study produced a confidence interval of 95 percent ranging between 1.02 to1.08 despite the adjustment.
In conclusion, the prospective observational study suggests that a higher proportion of Ultra-Processed food in a patient’s diet was related to a higher risk of type 2 diabetes.
The research showed a thorough use of statistical methods with the large number of participants it had. As of now, no one can be sure what aspect of Ultra-Processed food is putting people at risk for type 2 diabetes. The cause and effect of the relationship are still unclear. Even though these findings need confirmation in other populations, the study provides healthcare professionals with some evidence to support their recommendation of reducing the consumption of Ultra-Processed foods in patients with or at risk for type 2 diabetes.
Practice Pearls:
- A higher proportion of Ultra-Processed foods in the diet is associated with a higher risk of type 2 diabetes.
- Public health authorities should recommend unprocessed to minimally processed foods
- Making it a priority to limit Ultra-Processed food in diets would greatly benefit type 2 diabetes patients.
Srour B, Fezeu LK, Kesse-Guyot E, et al. Ultra-Processed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. JAMA Intern Med. Published online December 16, 2019. doi:10.1001/jamainternmed.2019.5942
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2757497
Alayna Marteal Wyre, Pharm. D. Candidate, South College School of Pharmacy