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Cited by 465Consumer Attitudes and Food LabelingNutritional Studies and DietDiet, Metabolism, and Disease

Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort

Open access
Srour, Bernard, Fezeu, Léopold K., Kesse-Guyot, Emmanuelle, Allès, Benjamin, Debras, Charlotte, Druesne-Pecollo, Nathalie, Chazelas, Eloi, Deschasaux, Mélanie +5 more·2020·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2019.5942PMC PMC6990737
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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.

Verified 2026-10-10 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

In the French NutriNet-Santé prospective cohort, higher ultraprocessed food (UPF) consumption was associated with increased type 2 diabetes (T2D) risk. The association persisted after adjustment for diet quality, metabolic comorbidities, and weight change.

Key findings

  • Among 104,707 participants, 821 incident T2D cases occurred over 582,252 person-years (median follow-up 6.0 years).
  • Each 10-point increment in the percentage of UPF in the diet was associated with T2D risk: Model 1 HR, 1.15 (95% CI, 1.06-1.25); after further adjustment for metabolic comorbidities, HR, 1.13 (95% CI, 1.03-1.23); after adjustment for weight change, HR, 1.13 (95% CI, 1.01-1.27).
  • Absolute UPF consumption was also associated with T2D risk: HR for a 100 g/d increase, 1.05 (95% CI, 1.02-1.08), even when adjusting for unprocessed/minimally processed food intake.
  • The proportion of unprocessed/minimally processed foods was inversely associated with T2D risk: HR for a 10-point increment, 0.91 (95% CI, 0.84-0.98). Absolute T2D rates were 113 and 166 per 100,000 person-years in the lowest and highest UPF consumers, respectively.

Methods

  • Population-based prospective cohort study using the French NutriNet-Santé cohort (2009-2019); 104,707 adults aged 18 years or older were included (21,800 men [20.8%] and 82,907 women [79.2%]; mean [SD] baseline age, 42.7 [14.5] years).
  • Dietary intake was collected with repeated validated web-based 24-hour dietary records (5.7 per participant on average) covering more than 3500 food items; foods were categorized by degree of processing using the NOVA classification.
  • Cause-specific multivariable Cox proportional hazard models with age as timescale and left truncation assessed UPF proportion and T2D incidence, treating T2D and death as competing events; models adjusted for sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors, with multiple imputation for missing data.

Limitations

  • The paper states that T2D case ascertainment exhaustiveness could not be guaranteed, with about 20% of T2D cases estimated to be underdiagnosed in France, likely reducing statistical power and potentially underestimating associations.
  • The paper states that causation cannot be established from this single observational study and residual confounding cannot be entirely ruled out; NOVA misclassification and the broad, heterogeneous UPF category are also noted as limitations.
  • The paper states that participants were younger, more often women, more educated, and had healthier dietary habits than the general French population, with lower T2D incidence, which may have limited statistical power, especially for stratified analyses such as in men.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1001/jamainternmed.2019.5942

Cites

83 of 84 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 26 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In the NutriNet-Santé prospective cohort, a higher proportion of ultraprocessed food in the diet was associated with a higher risk of type 2 diabetes (multi-adjusted HR for a 10-point increment in UPF percentage, 1.15; 95% CI, 1.06-1.25).

    “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).”
    • Also stated in: § Results · plain
      “Ultraprocessed food intake was associated with an increased T2D risk (Model 1: HR for a 10-point increment in the percentage of UPF in the diet, 1.15; 95% CI, 1.06-1.25;P = .001).”
    • Also stated in: § Discussion · plain
      “In this large cohort, UPF consumption was associated with increased T2D risk.”
    Quote in the paperSubstantial claim
  • Findingown data

    During 582 252 person-years of follow-up (median 6.0 years), 821 incident T2D cases were detected.

    “During follow-up (582 252 person-years; median follow-up time, 6.0 years; interquartile range [IQR], 2.8-8.4 years), 821 incident T2D cases were detected.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The association between UPF consumption and T2D risk remained statistically significant after further adjustment for nutritional quality of the diet, metabolic comorbidities, and weight change (HR, 1.13; 95% CI, 1.03-1.23 and HR, 1.13; 95% CI, 1.01-1.27).

    “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).”
    • Also stated in: § Results · plain
      “The associations remained significant after further adjust- ments for Model 2, 3, 4, and 5 covariates (Table 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    The proportion of unprocessed/minimally processed foods in the diet was inversely associated with T2D risk (HR for a 10-point increment, 0.91; 95% CI, 0.84-0.98).

    “The proportion of unprocessed/minimally processed foods in the diet was inversely associated with T2D risk (HR for a 10-point increment, 0.91; 95% CI, 0.84-0.98;P = .01;[Model 1 covariates]).”
    Quote in the paperSubstantial claim
  • Findingown data

    The absolute amount of UPF consumption (grams per day) was 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).

    “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).”
    • Also stated in: § Results · plain
      “The absolute amount of UPF consumption in grams per day was consistently associated with T2D risk, even when ad- justing for the absolute amount (in g/d) of unprocessed/ minimally processed food intake (HR for a 100 g/d increase in UPF consumption, 1.05; 95% CI, 1.02-1.08; P = .003).”
    Quote in the paperSubstantial claim
  • May combine two claims. 21
  • Classified as probably not a substantial claim. 12

  • May combine two claims.

    Findingown data

    The proportions of UPF in beverages, sugary products, fats/sauces, and dairy products were associated with increased T2D risk.

    “The proportions of UPF in beverages, sugary products, fats/ sauces, and dairy products were more specifically associated with increased T2D risk (eTable 2 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Absolute T2D incidence rates were 132 per 100 000 person-years overall, and age- and sex-corrected rates were 113, 125, 143, and 166 per 100 000 person-years across quartiles of UPF proportion.

    “Absolute incidence rates for T2D in the whole population were 132 per 100 000 personyears; age and sex corrected absolute rates were 113, 125, 143 and 166 per 100 000 person-years in the first quarter (lowest con-sumers), second, third, and fourth quarter (highest consumers) of the proportion of UPF intake in the diet, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The association between UPF intake and T2D risk was significant in women only, with reduced statistical power for men.

    “Although HRs were in the same direction, this association was significant in women only, but statistical power was reduced for men (eTable 1 in the Supple- ment).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Higher UPF consumption was associated with higher FSAm-NPS DI scores and higher intakes of energy, saturated fatty acids, sodium, sugar, sugary drinks, and red/processed meats, and with lower intakes of fiber, alcohol, whole grains, yogurt, nuts, fruits, and vegetables.

    “Higher consumption of UPF was associated with higher FSAm-NPS DI scores (reflecting a poorer nutritional quality of the diet), higher intakes of energy, SFA, sodium and sugar, lower intakes of fiber and alcohol, higher consumptions of sugary drinks and red and processed meats, and lower consumptions of whole grains, yogurt, nuts, and fruits and vegetables (Table 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The mean weight contribution of UPF to the diet was 17.3%.

    “The mean weight contribution of UPF to the diet was 17.3%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The study included 104 707 participants (21 800 men and 82 907 women), with a mean baseline age of 42.7 years.

    “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.”
    • Also stated in: § Results · plain
      “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.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    UPF proportions were higher in younger participants, obese individuals, those with lower physical activity levels, and current smokers.

    “Overall, UPF proportions were higher in younger participants, obese individuals, those with lower physical activity levels, and current smokers (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    T2D incidence was lower in the sample (186 cases per 100 000 person-years after standardization) than in the French population (289 per 100 000), limiting statistical power.

    “Furthermore, T2D incidence was lower (186 cases per 100 000 personyears in our sample after standardization vs 289 per 100 000 in the French population 78 ), thereby limiting statistical power, especially for some stratified analyses (eg, in men).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Only 1304 participants had a null follow-up and were excluded; potential missed cases (<20) likely resulted in nondifferential misclassification and underestimation of the associations.

    “Only 1304 participants had a null follow-up and were excluded.Some of them may have had T2D that was not detected thereafter.However, this should represent a small number of missed cases (<20 cases considering T2D incidence in France 78 ) and, owing to the prospective design, the resulting potential misclassification bias was most likely nondifferential and rather resulted in an underestima-tion”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The NutriNet-Santé web-based self-administered 24-hour dietary records have been tested and validated against an interview by a trained dietitian and against blood and urinary biomarkers.

    “The NutriNet-Santé web-based selfadministered 24-hour dietary records have been tested and validated against an interview by a trained dietitian, 47 and against blood and urinary biomarkers.48,49”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [47] source

      Not checked in the free run.

    • cites [48] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    The accumulation of consistent data leads public health authorities in several countries such as France and Brazil to recommend privileging the consumption of unprocessed/minimally processed foods and limiting the consumption of UPF in the name of the precautionary principle.

    “Even if a causal link between UPF and chronic diseases cannot be established so far, the accumulation of consistent data leads public health authorities in several countries such as France 82 or Brazil 83 to recommend privileging the consumption of unprocessed/minimally processed foods, and limiting the consumption of UPF in the name of the precautionary principle.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [82]

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    • cites [83]

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  • Classified as probably not a substantial claim.

    Study design and conductown data

    T2D cases were ascertained through participant health questionnaires and linkage to medico-administrative databases (SNIIRAM).

    “Participants were asked to declare major health events though the yearly health questionnaire, through a specific health check-up questionnaire every 3 months, or at any time through a specific interface on the study website.They were also asked to declare all currently taken medications and treatments via the check-up and yearly questionnaires.In addition, data are linked to medico-administrative”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The study used a multisource case ascertainment approach, but exhaustiveness could not be guaranteed.

    “Even though we used a multisource case ascertainment approach, exhaustiveness could not be guaranteed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Misclassification bias in the NOVA classification cannot be ruled out, but it would likely be nondifferential and bias toward the null.

    “Third, misclassification bias in the NOVA cannot be ruled out; however, this would have led to a nondifferential measurement error (in cases and noncases), and potentially biasing toward the null hypothesis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Energy balance and overweight are associated with T2D risk.

    “Of note, energy balance and overweight are both associated with T2D risk.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many food groups, mostly ultraprocessed (e.g., processed meat and sugar-sweetened beverages), are recognized T2D risk factors.

    “Many food groups, mostly ultraprocessed (eg, processed meat, and sugary sweetened beverages) are recognized T2D risk factors.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The association between UPF and T2D was assessed using multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).

    “Associations between UPF consumption and risk of T2Dwere assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Multiple imputation for missing data was performed using the multivariate imputation by chained equations (MICE) method.

    “Multiple imputation for missing data was performed using the multivariate imputation by chained equations (MICE) method.53”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    About 20% of T2D cases are estimated to be underdiagnosed in France, probably resulting in a loss of statistical power.

    “About 20% of T2D cases are estimated to be underdiagnosed in France.78 This probably resulted in a loss of statistical power.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Exposure to bisphenol A and high BPA serum concentrations have been associated with increased T2D risk in recent meta-analyses.

    “In particular, the exposure to bisphenol-A (BPA), a hydrophobic substance of very high concern, 66 having endocrine disrupting properties, as well as high BPA serum concentrations, have been associated with increased T2D risk in recent meta-analyses.29,67”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [66] source

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    • cites [29] source

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    • cites [67] source

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  • May combine two claims.

    Premisecitation

    UPF usually have a lower nutritional quality because they are on average richer in sodium, energy, fat, sugar, and poorer in fiber, and often exhibit a higher glycemic index.

    “Overall, UPF usually have a lower nutritional quality 35 because they are on average richer in sodium, energy, fat, sugar, and poorer in fiber [12][13][14][15][16][17][18][19][20]25 and often exhibit a higher glycemic index.61”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [35]

      Not checked in the free run.

    • cites [12][13][14][15][16][17][18][19][20]25

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    • cites [61] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The ultraprocessed category covers diverse products, and the exploratory approach was not designed to focus on a specific food category or to isolate a particular process/additive.

    “Fourth, the ultraprocessed category covers diverse products; this exploratory approach was not designed to focus on a specific food category or to isolate a particular process/additive.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The NutriNet-Santé study was approved by the relevant institutional review boards (Inserm and Cnil), and participants provided electronic informed consent.

    “It was approved by the relevant institutional review boards (Inserm and Cnil).Participants provided electronic informed consent.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    UPF consumption was previously found to be associated with increased risks of cancer, cardiovascular diseases, mortality, depressive symptoms, and metabolic disorders.

    “To our knowledge, although UPF consumption was previously found to be associated with increased risks of cancer, 31 cardiovascular diseases, 35 mortality, 32,36 depressive symptoms, 33,37 and metabolic disorders (obesity, 40 hypertension, 41 and dyslipidemia 39 ), no prior prospective epidemiological study had evaluated their association with T2D risk.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [31] source

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  • Classified as probably not a substantial claim.

    Study design and conductown data

    The Cox model assumptions were verified.

    “The Cox model assumptions were verified (eFigures 2 and 3 in the Supplement).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Causation could not be established from this single observational study, and residual confounding cannot be entirely ruled out.

    “Second, causation could not be established from this single observational study and residual confounding cannot be entirely ruled out.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In a 1-month randomized clinical trial, an ultraprocessed diet versus an unprocessed one led to increased energy intake, which was highly correlated with weight gain.

    “Consistently, in a 1-month randomized clinical trial, 63 an ultraprocessed diet vs an unprocessed one led to an increased energy intake, which was highly correlated with weight gain.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] source

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  • May combine two claims.

    Study design and conductcitation

    Compared with the general French population, participants were younger, more often women, with higher educational levels and healthier dietary habits, which might have underestimated the associations owing to a narrower range of UPF intake.

    “Finally, compared with the general French population, participants to this study were younger, more often women, with higher educational levels 80 and healthier dietary habits.81 This might have underestimated the associations owing to a narrower range of UPF intake.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [80]

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    • cites [81]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Two meta-analyses observed associations between T2D risk and intakes of nonnutritive sweeteners and artificially sweetened beverages.

    “Moreover, 2 meta-analyses observed associations between T2D risk and the intakes of nonnutritive sweeteners and artificially sweetened beverages.28,66”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28]

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29 of 29

  • The paper relies on this without support.

    No prior large-scale prospective study had evaluated the association between UPF consumption and T2D risk before this study.

    “However, no such large-scale prospective study has been conducted regarding T2D.”
    “no prior prospective epidemiological study had evaluated their association with T2D risk.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Ultra-processed food consumption is associated with weight gain, obesity, type-2 diabetes or hypertension risk, and the association remains significant after controlling for nutrient composition and overall diet quality.

    “The level of processing per se as an independent risk factor, comes from a randomised controlled trial finding that an ultra-processed diet relative to an unprocessed one causes excessive calorie intake and weight gain 57 , and three cohort studies showing an association between UPF consumption and weight gain, obesity, type-2 diabetes or hypertension risk, which remains significant after”

    From Ultra‐processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers (2020) · cites this paper as [40]

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Related

Authors
Srour, B., Fezeu, L. K., Kesse-Guyot, E., Allès, B., Debras, C., Druesne-Pecollo, N., Chazelas, E., Deschasaux, M., Hercberg, S., Galan, P., Monteiro, C. A., Julia, C., & Touvier, M.
Affiliations
  • Inserm (FR)
  • Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
  • Universidade de São Paulo (BR)
Corresponding author
Srour, Bernard
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2020-02-01
Volume
180
Issue
2
Pages
283
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2019.5942
PMC
PMC6990737
OpenAlex
W2995681102
Semantic Scholar
c2346ec140c10417145d08b337da652a351745b0
Cited by
465
References
89
Citations by year
2026: 45 · 2025: 69 · 2024: 80 · 2023: 53 · 2022: 85 · 2021: 96 · 2020: 34 · 2019: 1 · 2018: 1
FWCI
49.73
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
ultra-processed foods, type 2 diabetes, NOVA classification, diabetes risk, NutriNet-Santé cohort, diet quality, weight change, metabolic comorbidities, cancer
MeSH terms
Adult, Diabetes Mellitus, Type 2, Diet, Female, Food Handling, France, Humans, Male, Middle Aged, Prospective Studies, Cohort Studies, Proportional Hazards Models

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