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Ultra-processed food and incident type 2 diabetes: studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort
Abstract
Background: The overall consumption of ultra-processed food (UPF) has previously been associated with type 2 diabetes. However, due to the substantial heterogeneity of this food category, in terms of their nutritional composition and product type, it remains unclear whether previous results apply to all underlying consumption patterns of UPF. Methods: Of 70,421 participants (35–70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. UPF was identified according to the NOVA classification. Principal component analysis (PCA) was performed to derive UPF consumption patterns. The associations of UPF and adherence to UPF consumption patterns with incidence of type 2 diabetes were studied with logistic regression analyses adjusted for age, sex, diet quality, energy intake, alcohol intake, physical activity, TV watching time, smoking status, and educational level. Results: During a median follow-up of 41 months, a 10% increment in UPF consumption was associated with a 25% higher risk of developing type 2 diabetes (1128 cases; OR 1.25 [95% CI 1.16, 1.34]). PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased risk of incident type 2 diabetes; a pattern high in traditional Dutch cuisine was not associated with type 2 diabetes incidence (OR 1.05 [95% CI 0.97, 1.14]), while a pattern high in sweet snacks and pastries was inversely associated with type 2 diabetes incidence (OR 0.82 [95% CI 0.76, 0.89]). Conclusions: The heterogeneity of UPF as a general food category is reflected by the discrepancy in associations between four distinct UPF consumption patterns and incident type 2 diabetes. For better public health prevention, research is encouraged to further clarify how different UPF consumption patterns are related to type 2 diabetes.
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“A three-cohort US study found 12% of associations with type 2 diabetes were mediated by dietary factors (eg, intake of fibre, refined starch, added sugar, sodium, minerals, and partially hydrogenated oils).135”
From Ultra-processed foods and human health: the main thesis and the evidence (2025) · cites this paper as [135]
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Ultra-processed foods: What they are and how to identify them
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Sugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk
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“So far, four studies have investigated the association of UPF with type 2 diabetes [6, 7, 22, 23].”
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Ultra-processed foods and human health: the main thesis and the evidence
Monteiro, C. A., Louzada, M. L., Steele-Martinez, E., Cannon, G., Andrade, G. C., Baker, P., Bes-Rastrollo, M., Bonaccio, M., Gearhardt, A. N., Khandpur, N., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01565-x · Cited by 339
Metadata
- Authors
- Duan, M.-J., Vinke, P. C., Navis, G., Corpeleijn, E., & Dekker, L. H.
- Venue
- BMC Medicine
- Published
- 2022-01-13
- Volume
- 20
- Issue
- 1
- ISSN
- 1741-7015
- PMC
- PMC8756643
- Cited by
- 75
- References
- 6
- Language
- en
- Funders
- h2020 marie skłodowska-curie actions (754425)
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