The DOI matches its Crossref record; 83 of the 89 references it cites were found in a registry or an index, and 1 are not checked yet; none of the 26 sources its claims cite is checked for support yet.
Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort
Open accessAbstract
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.
Checked 2026-10-10 · 1 reference not checked yet
Overview
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
Cites
Statistics
Verification
Claims the paper makes
32 Own result · 14 Not checked yet · 7 Own method · 4 Own interpretation
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Abstract
plaincorrelationaln = 821 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plainn = 821- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Abstract
plaincorrelationaln = 821- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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]).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These results suggest an association between UPF consumption and T2D risk.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Sodium intake, mg/1000 kcal/d | 1479.10 (369.21) | 6.97 (1.20) | <.001 |”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Alcohol intake, g/1000 kcal/d | 3.91 (5.53) | -0.50 (0.02) | <.001 |”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Whole grains, g/1000 kcal/d | 18.96 (24.36) | -3.14 (0.08) | <.001 |”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Fiber, g/1000 kcal/d | 10.72 (3.57) | -0.78 (0.01) | <.001 |”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 21
- Probably not a substantial claim. 12
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plainn = 821- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plaincorrelationaln = 707- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean weight contribution of UPF to the diet was 17.3%.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plainn = 707- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Abstract
plainn = 707- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, UPF proportions were higher in younger participants, obese individuals, those with lower physical activity levels, and current smokers (Table 1).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Results
plaincorrelationaln = 707- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
What the sources say
- Not checked yetcites [78]
plainn = 186- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
What the sources say
- Not checked yetcites [78]
hedgedn = 20- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Dietary Data and Food Processing Categorization
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Conclusions
What the sources say
- Not checked yetcites [82]
- Not checked yetcites [83]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Case Ascertainment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Even though we used a multisource case ascertainment approach, exhaustiveness could not be guaranteed.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Of note, energy balance and overweight are both associated with T2D risk.3”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
- Not checked yetcites [3] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Many food groups, mostly ultraprocessed (eg, processed meat, and sugary sweetened beverages) are recognized T2D risk factors.3”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
- Not checked yetcites [3] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Multiple imputation for missing data was performed using the multivariate imputation by chained equations (MICE) method.53”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Statistical Analyses
What the sources say
- Not checked yetcites [53] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“About 20% of T2D cases are estimated to be underdiagnosed in France.78 This probably resulted in a loss of statistical power.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
What the sources say
- Not checked yetcites [78]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
- Not checked yetcites [35]
- Not checked yetcites [12][13][14][15][16][17][18][19][20]25
- Not checked yetcites [61] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It was approved by the relevant institutional review boards (Inserm and Cnil).Participants provided electronic informed consent.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Study Population and Data Collection
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The Cox model assumptions were verified (eFigures 2 and 3 in the Supplement).”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Statistical Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, causation could not be established from this single observational study and residual confounding cannot be entirely ruled out.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
- Not checked yetcites [63] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Limitations
What the sources say
- Not checked yetcites [80]
- Not checked yetcites [81]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, 2 meta-analyses observed associations between T2D risk and the intakes of nonnutritive sweeteners and artificially sweetened beverages.28,66”
§ Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort > Discussion
What the sources say
- Not checked yetcites [28]
- Not checked yetcites [66] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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.”
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?
In the citing paper
“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]
Citations
Cites
International physical activity questionnaire: 12-country reliability and validity
CRAIG, C. L., MARSHALL, A. L., SJ??STR??M, M., BAUMAN, A. E., BOOTH, M. L., AINSWORTH, B. E., PRATT, M., EKELUND, U., YNGVE, A., SALLIS, J. F., et al. (2003) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000078924.61453.fb · Cited by 21,619
Multiple Imputation for Nonresponse in Surveys
Rubin, D. B. (1987) · Wiley Series in Probability and Statistics · doi:10.1002/9780470316696 · Cited by 20,701
A Proportional Hazards Model for the Subdistribution of a Competing Risk
Fine, J. P., & Gray, R. J. (1999) · Journal of the American Statistical Association · doi:10.1080/01621459.1999.10474144 · Cited by 14,290
International Diabetes Federation 2017
Carracher, A. M., Marathe, P. H., & Close, K. L. (2018) · Journal of Diabetes · doi:10.1111/1753-0407.12644 · Cited by 13,379
RUBIN, D. B. (1976) · Biometrika · doi:10.1093/biomet/63.3.581 · Cited by 9,925
Ultra-processed foods: What they are and how to identify them
Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J.-C., Louzada, M. L., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E., et al. (2019) · Public Health Nutrition · doi:10.1017/s1368980018003762 · Cited by 2,964
Self-citationMultiple imputation of discrete and continuous data by fully conditional specification
van Buuren, S. (2007) · Statistical Methods in Medical Research · doi:10.1177/0962280206074463 · Cited by 2,827
The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing
Monteiro, C. A., Cannon, G., Moubarac, J.-C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2018) · Public Health Nutrition · doi:10.1017/s1368980017000234 · Cited by 2,333
Self-citationHall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., et al. (2019) · Cell Metabolism · doi:10.1016/j.cmet.2019.05.008 · Cited by 1,971
Ultra‐processed products are becoming dominant in the global food system
Monteiro, C. A., Moubarac, J. ‐., Cannon, G., Ng, S. W., & Popkin, B. (2013) · Obesity Reviews · doi:10.1111/obr.12107 · Cited by 1,827
Self-citation
Cited by
Sorted by citations
Items 101–200 of 458
Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes
Bhave, V. M., Oladele, C., Ament, Z., Kijpaisalratana, N., Jones, A. C., Couch, C. A., Patki, A., Guarniz, A. G., Bennett, A., Crowe, M. G., et al. (2024) · Neurology · doi:10.1212/wnl.0000000000209432 · Cited by 58
How and why ultra-processed foods harm human health
Levy, R. B., Barata, M. F., Leite, M. A., & Andrade, G. C. (2023) · Proceedings of The Nutrition Society · doi:10.1017/s0029665123003567 · Cited by 61
O’Connor, L. E., Higgins, K., Smiljanec, K., Bergia, R. E., Brown, A. W., Baer, D. J., Davis, C. D., Ferruzzi, M. G., Miller, K., Rowe, S. B., et al. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.09.005 · Cited by 49
Rebouillat, P., Vidal, R., Cravedi, J., Taupier‐Letage, B., Debrauwer, L., Gamet‐Payrastre, L., Touvier, M., Deschasaux, M., Latino‐Martel, P., Herçberg, S., et al. (2021) · International Journal of Epidemiology · doi:10.1093/ije/dyab015 · Cited by 45
Self-citationKonieczna, J., Fiol, M., Colom, A., Martínez‐González, M. Á., Salas‐Salvadó, J., Corella, D., Soria-Florido, M. T., Martínez, J. A., Alonso‐Gómez, Á. M., Wärnberǵ, J., et al. (2022) · Nutrients · doi:10.3390/nu14194142 · Cited by 47
“Other prospective studies with adult cohorts found associations between UPF consumption and higher risks of obesity [13–15], CVD [16], type 2 diabetes [17,18], renal dysfunction [19], cancer [20], biological aging [21], and all-cause mortality [22].”
BackgroundPopkin, B. M., Miles, D. R., Taillie, L. S., & Dunford, E. (2024) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2024.100713 · Cited by 54
Zhao, L., Clay‐Gilmour, A., Zhang, J., Zhang, X., & Steck, S. E. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.10.014 · Cited by 45
Health impacts of exposure to synthetic chemicals in food
Muncke, J., Touvier, M., Trasande, L., & Scheringer, M. (2025) · Nature Medicine · doi:10.1038/s41591-025-03697-5 · Cited by 50
“…the NutriNet-Santé cohort in France (2009 and ongoing), which includes 180,000 people >15 years of age, was the first epidemiological study to show associations between UPF exposure and hard endpoints such as a higher incidence of cancer 115 , cardiovascular diseases 116 and type 2 diabetes 117 .”
Self-citationDeschasaux, M., Srour, B., Bourhis, L., Arnault, N., Druesne‐Pecollo, N., Esseddik, Y., de Edelenyi, F. S., Allègre, J., Allès, B., Andreeva, V. A., et al. (2021) · BMC Medicine · doi:10.1186/s12916-021-02168-1 · Cited by 42
“A large range of nutritional exposures were considered to reflect the diversity of dietary intakes: from intakes of energy, macronutrients, dietary fiber, vitamins, and minerals to intakes of main food groups and indicators of the overall diet quality: the proportion of ultra-processed foods in the diet (% of food wei…”
Self-citationMeine, G. C., Picon, R. V., Santo, P. A. D. E., & Sander, G. B. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002826 · Cited by 47
Robert, M., Shankland, R., Bellicha, A., Kesse‐Guyot, E., Deschasaux, M., Andreeva, V. A., Srour, B., Herçberg, S., Touvier, M., Leys, C., et al. (2022) · Journal of Nutrition · doi:10.1093/jn/nxac124 · Cited by 42
Self-citationArtificial sweeteners and their implications in diabetes: a review
Angelin, M., Kumar, J., Vajravelu, L. K., Satheesan, A., Chaithanya, V., & Murugesan, R. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1411560 · Cited by 48
González‐Palacios, S., Oncina-Cánovas, A., de la Hera, M. G., Martínez‐González, M. Á., Salas‐Salvadó, J., Corella, D., Schröder, H., Martínez, J. A., Alonso‐Gómez, Á. M., Wärnberǵ, J., et al. (2023) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2023.05.022 · Cited by 56
Lim, S. Y., Lee, K. W., Seow, W.-L., Mohamed, N. A., Devaraj, N. K., & Nordin, S. A. (2021) · Foods · doi:10.3390/foods10081861 · Cited by 44
Evaluation of the toxic effects of food additives, alone or in mixture, in four human cell models
Recoules, C., Touvier, M., Pierre, F. H. F., & Audebert, M. (2024) · Food and Chemical Toxicology · doi:10.1016/j.fct.2024.115198 · Cited by 48
Self-citationMazzolani, B. C., Smaira, F. I., Esteves, G. P., André, H. C. S., Amarante, M. C., Castanho, D., Campos, K., Benatti, F. B., Pinto, A. J., Roschel, H., et al. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.672372 · Cited by 39
Saleem, S. M., Bhattacharya, S., & Deshpande, N. (2022) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2022.102422 · Cited by 40
Canhada, S., Vigo, Á., Levy, R. B., Luft, V. C., da Fonseca, M. D. J. M., Giatti, L., Molina, M. D. C. B., Duncan, B. B., & Schmidt, M. I. (2023) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-023-01162-2 · Cited by 39
“In addition, six prospective studies in European and North American countries [9–13] have found that higher consumption of UPFs predicted an increased risk of type 2 diabetes.”
BackgroundResultUltra-processed Food Intake and Risk of Type 2 Diabetes in Korean Adults
Cho, Y., Ryu, S., Kim, R., Shin, M., & Oh, H. (2023) · Journal of Nutrition · doi:10.1016/j.tjnut.2023.11.021 · Cited by 42
Ultraprocessed beverages and processed meats increase the incidence of hypertension in Mexican women
Monge, A., Canella, D. S., López‐Olmedo, N., Lajous, M., Cortés-Valencia, A., & Stern, D. (2020) · British Journal Of Nutrition · doi:10.1017/s0007114520004432 · Cited by 42
Sansone, N. M. S., Boschiero, M. N., Ortega, M. M., Ribeiro, I. A., Peixoto, A. O., Mendes, R. T., & Marson, F. A. L. (2022) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2021.100177 · Cited by 38
Meyer, A., Dong, C., Casagrande, C., Chan, S. S. M., Huybrechts, I., Nicolas, G., Rauber, F., Levy, R. B., Millett, C. J., Oldenburg, B., et al. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.09.031 · Cited by 40
Koppe, L., & Soulage, C. O. (2022) · Kidney International · doi:10.1016/j.kint.2022.06.025 · Cited by 38
Du, S., Sullivan, V. K., Fang, M., Appel, L. J., Selvin, E., & Rebholz, C. M. (2024) · Diabetologia · doi:10.1007/s00125-024-06221-5 · Cited by 45
Leone, A., Martínez‐González, M. Á., Craig, W. J., Fresán, U., Gómez‐Donoso, C., & Bes‐Rastrollo, M. (2021) · Nutrients · doi:10.3390/nu13072202 · Cited by 44
Zhong, G., Zhu, Q., Cai, D., Hu, J., Dai, X., Gong, J., & Sun, W. (2022) · International Journal of Cancer · doi:10.1002/ijc.34290 · Cited by 39
Lv, J.-L., Wei, Y., Sun, J., Shi, Y., Liu, F.-H., Sun, M.-H., Chang, Q., Wu, Q., & Zhao, Y. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1306310 · Cited by 46
Gupta, S., Rose, C. M., Buszkiewicz, J., Ko, L. K., Mou, J., Cook, A. J., Aggarwal, A., & Drewnowski, A. (2020) · British Journal Of Nutrition · doi:10.1017/s0007114520004705 · Cited by 40
Srour, B., & Touvier, M. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100747 · Cited by 38
“These studies * Corresponding author at: Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre University of Paris (CRESS), Bobigny, France.”
MethodInfluentialSelf-citationWood, B., Williams, O. D., Baker, P., Nagarajan, V., & Sacks, G. (2021) · Globalization and Health · doi:10.1186/s12992-021-00688-2 · Cited by 41
Steele, E. M., Batis, C., Cediel, G., Louzada, M. L. D. C., Khandpur, N., Machado, P. P., Moubarac, J., Rauber, F., Jedlicki, M. R., Levy, R. B., et al. (2021) · Journal of Nutritional Science · doi:10.1017/jns.2021.30 · Cited by 36
“The relationship found between UPF consumption and excessive saturated fatty acid intake indicates that these intakes may be one of the mechanisms for the prospective association between UPF consumption and both cardiovascular diseases((2,32)) and several major risk factors for these diseases, including overweight and…”
BackgroundSelf-citationWatanabe, J. A., Nieto, J. A., Suarez-Diéguez, T., & Silva, M. (2024) · Nutrition · doi:10.1016/j.nut.2024.112354 · Cited by 35
Liu, Z., Huang, H., Zeng, Y., Chen, Y., & Xu, C. (2023) · British Journal Of Nutrition · doi:10.1017/s0007114522003956 · Cited by 32
“There are also several cohort studies that reported a positive association of UPF intake with the risk of developing type 2 diabetes mellitus (13) , hypertension (14) , CVD (15) and all-cause mortality (16,17) .”
Avesani, C. M., Cardozo, L., Wang, A. Y.-M., Shiels, P. G., Lambert, K., Lindholm, B., Stenvinkel, P., & Mafra, D. (2022) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2022.09.003 · Cited by 36
Lee, S., & Choi, M.-J. (2023) · Nutrients · doi:10.3390/nu15092169 · Cited by 35
“has been associated with mortality [12], obesity [13,14], hypertension [15], diabetes [16], cardiovascular disease [17,18], and dementia [19].”
BackgroundCheng, Y., Lu, Z., Mao, T., et al. (2024) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.3c09634 · Cited by 32
Gbadamosi, M. A., & Tlou, B. (2020) · BMC Public Health · doi:10.1186/s12889-020-08816-0 · Cited by 38
“Like the present study, evidence elsewhere has shown a positive relationship between the consumption of salty processed food and T2DM [32] and hypertension [33].”
ResultGriffin, J., AlBaloul, A. H., Kopytek, A., Elliott, P., & Frost, G. S. (2021) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2020-000225 · Cited by 39
Tang, S., Fang, C., Liu, Y., Tang, L., & Xu, Y. (2022) · Journal of Oleo Science · doi:10.5650/jos.ess21258 · Cited by 33
Li, M., & Shi, Z. (2022) · Nutrients · doi:10.3390/nu14204241 · Cited by 35
Decoding the Foodome: Molecular Networks Connecting Diet and Health
Menichetti, G., Barabási, A.-L., & Loscalzo, J. (2024) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-062322-030557 · Cited by 32
“Overall, an increased proportion of HPFs in an individual’s diet is associated with greater risk for numerous diseases, including CVD, CHD, and cerebrovascular disease (138); overweight and obesity (18); type 2 diabetes mellitus (137); cancer (49); and depression (1).”
BackgroundPan, F., Wang, Z., Wang, H., Zhang, J., Su, C., Jia, X., Du, W., Jiang, H., Li, W., Wang, L., et al. (2023) · Nutrients · doi:10.3390/nu15030752 · Cited by 37
“Of note, substances present in food packaging materials such as bisphenol-A (BPA) have been found to have endocrine-disrupting properties and a positive association with increased T2D in previous meta-analyses [55].”
BackgroundInfluentialSteele, E. M., Khandpur, N., Sun, Q., & Monteiro, C. A. (2020) · Preventive Medicine · doi:10.1016/j.ypmed.2020.106261 · Cited by 35
Self-citationZhang, Z., Jackson, S. L., Steele, E. M., Gillespie, C., & Yang, Q. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.09.031 · Cited by 35
Ultra-Processed Food Intake and Risk of Colorectal Cancer: A Matched Case-Control Study
Jafari, F., Yarmand, S., Nouri, M., Nejad, E. T., Ramezani, A., Sohrabi, Z., & Rashidkhani, B. (2022) · Nutrition and Cancer · doi:10.1080/01635581.2022.2125990 · Cited by 33
“Several studies indicated that displacement of UPFs is correlated with increasing and higher incidence of various adverse health outcomes such as obesity (27, 28), metabolic syndrome (29), diabetes (30), cardiovascular diseases (31), dyslipidemia (32), hypertension (33), cancer (34) and all-cause mortality (35, 36).”
BackgroundA review of the impact of social disruptions on food security and food choice
Munialo, C. D., & Mellor, D. D. (2023) · Food Science & Nutrition · doi:10.1002/fsn3.3752 · Cited by 41
Prescott, S. L. (2020) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2020.05.025 · Cited by 26
Costa, C. D. S., Steele, E. M., de Faria, F. R., & Monteiro, C. A. (2022) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00119421 · Cited by 60
Self-citationWang, L., Pan, X., Munro, H. M., Shrubsole, M. J., & Yu, D. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.08.012 · Cited by 32
Gövez, N. E., Köksal, E., Martinez-Perez, C., & Daimiel, L. (2024) · Nutrients · doi:10.3390/nu16152552 · Cited by 31
Rebouillat, P., Vidal, R., Cravedi, J., Taupier‐Letage, B., Debrauwer, L., Gamet‐Payrastre, L., Guillou, H., Touvier, M., Fezeu, L., Herçberg, S., et al. (2022) · Environmental Health · doi:10.1186/s12940-022-00862-y · Cited by 28
“In a previous study on T2D conducted in the NutriNet-Santé cohort, T2D incidence was found lower: 186 cases per 100 000 person-years in the sample after standardization vs 289 per 100,000 in the French population [72, 73].”
ResultSelf-citationKatidi, A., Vlassopoulos, A., Noutsos, S., & Kapsokefalou, M. (2023) · Foods · doi:10.3390/foods12071520 · Cited by 29
Ultra-processed foods and health: are we correctly interpreting the available evidence?
Visioli, F., Rio, D. D., Fogliano, V., Marangoni, F., Ricci, C., & Poli, A. (2024) · European Journal of Clinical Nutrition · doi:10.1038/s41430-024-01515-8 · Cited by 28
Examining Nutrition and Food Waste Trade-offs Using an Obesity Prevention Context
Ellison, B., & Prescott, M. P. (2021) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2020.11.005 · Cited by 28
U.S. food policy to address diet-related chronic disease
Matthews, E. D., & Kurnat‐Thoma, E. L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1339859 · Cited by 32
Fardet, A., Aubrun, K., & Rock, E. (2021) · Public Health Nutrition · doi:10.1017/s1368980021003311 · Cited by 28
Lane, K. E., Davies, I. G., Darabi, Z., Ghayour‐Mobarhan, M., Khayyatzadeh, S. S., & Mazidi, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106338 · Cited by 32
“Whilst the NOVA classification system is widely used in the literature [1,2,4,5], its use may also represent a limitation.”
BackgroundMethodMa, H., Wang, M., Chu, Q., Shi, Y., Mandizadza, O. O., Ni, H., & Ji, C. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1570321 · Cited by 31
de Pinho, M. G. M., Lakerveld, J., Harbers, M. C., Sluijs, I., Vermeulen, R. C. H., Huss, A., Boer, J. M. A., Verschuren, W. M. M., Brug, J., Beulens, J. W. J., et al. (2020) · European Journal of Nutrition · doi:10.1007/s00394-020-02436-5 · Cited by 27
Nestares, T., Martín-Masot, R., Flor-Alemany, M., Bonavita, A., Maldonado, J., & Aparicio, V. A. (2021) · Nutrients · doi:10.3390/nu13010156 · Cited by 24
Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations
Zelber‐Sagi, S. (2021) · Seminars in Liver Disease · doi:10.1055/s-0041-1729971 · Cited by 23
Marković, J., Karan, J., Ivelja, I., Matavulj, M., & Stošić, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23116112 · Cited by 24
“Similarly, a large French prospective cohort study proposed a strong link between ultra-processed food intake and the risk of type 2 diabetes occurrence [54].”
BackgroundRosenfeld, R. M., Grega, M. L., Karlsen, M. C., Dabrh, A. M. A., Aurora, R. N., Bonnet, J. P., Donnell, L., Fitzpatrick, S. L., Frates, E. P., Joy, E. A., et al. (2025) · American Journal of Lifestyle Medicine · doi:10.1177/15598276251325488 · Cited by 31
Jin, D., Zhang, Y., Zhang, Y., Duan, L., Zhou, R., Duan, Y., Sun, Y., Lian, F., & Tong, X. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.734151 · Cited by 23
“Another study reported that poor diets (such as ultra-processed foods, soft drinks, poultry or fish nuggets and salty snacks are associated with an increased risk of diabetes and its complications (Srour et al., 2020).”
BackgroundBonaccio, M., Castelnuovo, A. F. D., Costanzo, S., Ruggiero, E., Esposito, S., Persichillo, M., Cerletti, C., Donati, M. B., de Gaetano, G., & Iacoviello, L. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.07.004 · Cited by 29
Um, C. Y., Hodge, R. A., Tran, H. Q., Campbell, P. T., Gewirtz, A. T., & McCullough, M. L. (2021) · Nutrition and Cancer · doi:10.1080/01635581.2021.1957947 · Cited by 22
“Consumption of these foods is also associated with weight gain and obesity, and increased risk of chronic diseases, including postmenopausal breast and colorectal cancer (19), cardiovascular disease (17), and type 2 diabetes (18) as reported in analyses of the French NutriNet-Santé cohort, which collected dietary info…”
BackgroundMethodStratakis, N., Siskos, A., Papadopoulou, E., Nguyen, A. N., Zhao, Y., Margetaki, K., Lau, C. E., Coen, M., Maître, L., Fernández‐Barrés, S., et al. (2022) · eLife · doi:10.7554/elife.71332 · Cited by 24
“compound and characteristics, and high consumption of UPF has been proposed to 340 lead to metabolic dysregulation.(50) 341”
BackgroundHallinan, S., Rose, C. M., Buszkiewicz, J., & Drewnowski, A. (2021) · Nutrients · doi:10.3390/nu13113838 · Cited by 23
“Accounting for >60% of energy in the American diet [2,3], ultra-processed foods have been linked to a variety of adverse health outcomes, including obesity [4], diabetes [5], hypertension [6], depression [7], cancer [8], and all-cause mortality [9].”
BackgroundMadrid, M. C. C., Guzmán, N. C., Bergeron, G., Mesa, S. L. R., & Cediel, G. (2023) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.15054 · Cited by 26
Ultra-processed foods – a scoping review for Nordic Nutrition Recommendations 2023
Juul, F., & Bere, E. T. (2024) · Food & Nutrition Research · doi:10.29219/fnr.v68.10616 · Cited by 24
“…type 2 diabetes was investigated in four prospective cohort studies, including the NutriNet-Santé cohort ( N = 104,707; mean follow-up 6.0 years) (53), the UK Biobank cohort ( n = 21,730; median follow-up 5.4 years) (73), the Lifelines cohort study ( n = 70,421; median follow-up 3.4 years) (72),…”
BackgroundInfluentialZapata, M. E., Cediel, G., Arrieta, E. M., Rovirosa, A., Carmuega, E., & Monteiro, C. A. (2022) · Public Health Nutrition · doi:10.1017/s1368980022002543 · Cited by 26
“…years, several studies revealed associations of high consumption of UPF with several NCD such as for overweight and obesity (19,20) , type 2 diabetes (21) , hypertension (22) , dyslipidemias (23) , coronary diseases, stroke (24) , metabolic syndrome (19,20) , all cancers and breast cancer (25) .”
BackgroundSelf-citationKong, W., Xie, Y., Hu, J., Ding, W., & Cao, C. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1280665 · Cited by 20
Suárez-González, M., Bousoño-García, C., Jiménez-Treviño, S., & Díaz-Martín, J. J. (2021) · Nutrients · doi:10.3390/nu13041108 · Cited by 19
“Ultra-processed food consumption drives non-communicable diseases (NCDs) [39], such as obesity [40,41], diabetes [42], heart disease [43] and cancer [44].”
BackgroundSilk for post-harvest horticultural produce safety and quality control
Tracey, C., Kryuchkova, A., Bhatt, T. K., Krivoshapkin, P. V., & Krivoshapkina, E. F. (2022) · Journal of Food Engineering · doi:10.1016/j.jfoodeng.2022.111231 · Cited by 22
Zhang, W., Wang, X., Huang, J., Wang, S., Yao, Q., & Li, H. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2022.1043901 · Cited by 19
Vitamin K-dependent carboxylation regulates Ca2+ flux and adaptation to metabolic stress in β cells
Lacombe, J., Guo, K., Bonneau, J., Faubert, D., Gioanni, F., Vivoli, A., Muir, S. M., Hezzaz, S., Poitout, V., & Ferron, M. (2023) · Cell Reports · doi:10.1016/j.celrep.2023.112500 · Cited by 21
Vatovec, T. P., Pražnikar, Z. J., & Petelin, A. (2023) · Nutrients · doi:10.3390/nu15143219 · Cited by 17
“Current evidence suggests that adherence to the MD is slowly declining, mainly due to the increased availability of processed, ready-to-use, energy-dense foods, the globalised market, modern lifestyles, and a lack of time to prepare meals [28].”
BackgroundUltra-processed foods and incident cardiovascular disease and hypertension in middle-aged women
Pant, A., Gribbin, S., Machado, P. P., Hodge, A. M., Wasfy, J. H., Moran, L., Marschner, S. L., Chow, C. K., & Zaman, S. J. (2023) · European Journal of Nutrition · doi:10.1007/s00394-023-03297-4 · Cited by 25
Dean, E., Jia, X., JONES, A. Y. M., Vongsirinavarat, M., Lomi, C., Kumar, P. L., Ngeh, E. N., & Storz, M. A. (2024) · Nutrition Journal · doi:10.1186/s12937-024-01018-z · Cited by 23
Madalosso, M. M., Martins, N. N. F., Medeiros, B. M., Rocha, L. L., Mendes, L. L., Schaan, B. D., & Cureau, F. V. (2023) · European Journal of Clinical Nutrition · doi:10.1038/s41430-023-01329-0 · Cited by 25
Vadiveloo, M. K., Gardner, C. D., Bleich, S. N., Khandpur, N., Lichtenstein, A. H., Otten, J. J., Rebholz, C. M., Singleton, C. R., Vos, M. B., & Wang, S. (2025) · Circulation · doi:10.1161/cir.0000000000001365 · Cited by 27
Rybak, G., Burton, S., & Berry, C. (2024) · Journal of Business Research · doi:10.1016/j.jbusres.2024.114588 · Cited by 20
Ultra-processed products and risk of liver cancer: A prospective cohort study
Zhao, L., Zhang, X., Yu, D., Wang, L., Shrubsole, M. J., Zheng, W., Sudenga, S. L., & Zhang, X. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.08.011 · Cited by 19
Rossato, S. L., Oakes, E. G., Barbhaiya, M., Sparks, J. A., Malspeis, S., Willett, W. C., Khandpur, N., & Costenbader, K. H. (2024) · Arthritis Care & Research · doi:10.1002/acr.25395 · Cited by 23
“16,17 18 – 28 Although consumption of some UPFs has been inversely associated with risks of major health outcomes, for example whole grain breads and breakfast cereals and commercial yogurt, overall UPF dietary intake and its increase over time have been hypothesized to be related to disease…”
Nutri-Score and ultra-processing: two different, complementary, non-contradictory dimensions
Galan, P. (2020) · Nutrición Hospitalaria · doi:10.20960/nh.03483 · Cited by 17
Self-citationTomás-Navarro, M., Navarro‐Sánchez, J., Vallejo, F., & Tomás-Barberán, F. A. (2021) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.0c08144 · Cited by 17
Lehoczki, A., Csípő, T., Lipécz, Á., Major, D., Fazekas‐Pongor, V., Csík, B., Mózes, N., Fehér, Á., Dósa, N., Árva, D., et al. (2025) · Nutrients · doi:10.3390/nu17152446 · Cited by 23
“Individuals following a Western dietary pattern are at increased risk of developing chronic conditions, such as obesity, type 2 diabetes, cardiovascular diseases, hypertension, and metabolic syndrome, all of which are closely linked to accelerated aging and a reduced lifespan [127–129].”
Lychee Seed as a Potential Hypoglycemic Agent, and Exploration of its Underlying Mechanisms
Zhang, Y., Jin, D., An, X., Duan, L., Duan, Y., & Lian, F. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.737803 · Cited by 19
Pedro-Botet, L., Muns, M. D., Solà, R., Fontané, L., Climent, E., Benaiges, D., Roux, J. A. F., & Pedro‐Botet, J. (2021) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2021.11.002 · Cited by 18
Harlan, T. S., Gow, R. V., Kornstädt, A., Alderson, P. W., & Lustig, R. H. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1098453 · Cited by 26
“, the ultraprocessed food category, portends the greatest risks of morbidity and mortality, as numerous culturally diverse studies illustrate that ultraprocessed food consumption is correlated with obesity (14), diabetes (15), heart disease (16), cancer (17), dementia (18), and other mental health disorders (19).”
BackgroundWang, L., Steele, E. M., Du, M., Luo, H., Zhang, X., Mozaffarian, D., & Zhang, F. F. (2025) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2024.11.014 · Cited by 16
Silva, K. D., Lim, S. S., Mousa, A., Teede, H. J., Forbes, A. B., Demmer, R. T., Jönsson, D., & Enticott, J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0250832 · Cited by 16
“Noteworthily, ultra-processed food consumption has been found an emerging risk factor of type 1- [53], type 2- [54] as well as gestational [55] diabetes by recent studies which is supported by findings in the present study as well.”
ResultScaranni, P. D. O. D. S., Cardoso, L. D. O., Griep, R. H., Lotufo, P. A., Barreto, S. M., & da Fonseca, M. D. J. M. (2022) · British Journal Of Nutrition · doi:10.1017/s0007114522001131 · Cited by 23
“In the French NutriNet-Sante ́ cohort (10) , this proportion was similar, namely, 17.”
Mapping ultra-processed foods (UPFs) in India: a formative research study
Ghosh‐Jerath, S., Khandpur, N., Kumar, G., Kohli, S., Singh, M., Bhamra, I. K., Leite, F. H. M., & Reddy, K. S. (2024) · BMC Public Health · doi:10.1186/s12889-024-19624-1 · Cited by 23
de Souza, M. H. G., Moura, F. S., Lima, L. C. V., & Amaral, M. J. M. (2025) · Metabolism · doi:10.1016/j.metabol.2025.156134 · Cited by 18
Kim, Y., Cho, Y., Kim, J. E., Lee, D. H., & Oh, H. (2025) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2024.0706 · Cited by 16
“Previous studies suggested a positive association between UPF intake (highest vs. lowest categories) and the risk of T2DM [10,11,14-21].”
Huang, Y.-C., Huang, P.-R., Lo, Y. C., Sun, C.-W., Pan, W., Wang, S., & Huang, H.-B. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.766992 · Cited by 17
“Ultra-processed food consumption has been associated with an increased risk of obesity (2), type 2 diabetes (3), cardiovascular disease (4), cancer (5), and premature death (6).”
BackgroundThe direct and indirect costs of cardiovascular diseases in Brazil
de Araújo, J. M., Rodrigues, R. E. D. A., Neta, A. D. C. P. D. A., Ferreira, F. E. L. D. L., de Lima, R. L. F. C., Vianna, R. P. D. T., Moreira, L. V. L., Neto, J. M. D. S., & Moreira, P. V. L. (2022) · PLoS ONE · doi:10.1371/journal.pone.0278891 · Cited by 15
“These UPF have high levels of the above mentioned nutrients, with scientific evidence of their relation to obesity [15, 16], diabetes mellitus [17, 18], hypertension [19] and cardiovascular diseases [20–22].”
BackgroundSakir, N. A. I., Hwang, S. B., Park, H. J., & Lee, B. (2024) · Nutrition Research and Practice · doi:10.4162/nrp.2024.18.1.132 · Cited by 33
Lifestyle Medicine for the Prevention and Treatment of Pancreatitis and Pancreatic Cancer
Subramanian, S. K., Brahmbhatt, B. S., Bailey, J. M., Thosani, N. C., & Mutha, P. R. (2024) · Diagnostics · doi:10.3390/diagnostics14060614 · Cited by 17
“Furthermore, the consumption of ultra-processed foods has been linked to an increased risk of type II diabetes mellitus and obesity, which are well-established risk factors for pancreatic cancer [110,111].”
Background
Metadata
- 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)
- 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
- FWCI
- 49.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
