Ultra-Processed Foods Increase the Risk of Death in Type 2 Diabetes

Highlights

Higher consumption of ultra-processed foods (UPF) is associated with poorer survival and higher cardiovascular mortality in patients with type 2 diabetes, according to a study published in the American Journal of Clinical Nutrition .
Marialaura Bonaccio, Ph.D., from IRCCS Istituto Neurologico Mediterraneo Neuromed in Pozzilli, Italy, and colleagues evaluated the association of UPF intake with all-cause and cardiovascular disease (CVD) mortality among 1,065 participants with type 2 diabetes. 2 followed for a median of 11.6 years .
The researchers found that the highest intake of ultra-processed foods (UPF) (quartile 4: ≥10.5% of total foods consumed for women and ≥9% for men) versus the lowest (quartile 1: UPF <4, 7 and <3.7% for women and men, respectively), was associated with an increased risk of all-cause (hazard ratio, 1.70) and CVD (hazard ratio, 2.64) mortality. .
The associations did not change substantially with the inclusion of the Mediterranean diet score in the model (hazard ratios, 1.64 and 2.55 for all-cause and CVD mortality, respectively). A linear dose-response relationship was observed between UPF intake and all-cause and CVD mortality.
"In addition to prioritizing the adoption of a diet based on nutritional requirements, dietary guidelines for the management of type 2 diabetes should also recommend limiting UPF," the authors write.

Summary

Background

Nutritional strategies for the prevention and management of type 2 diabetes traditionally emphasize dietary patterns that reflect nutritional goals, but the health implications of ultra-processed foods (UPF) for patients with type 2 diabetes remain unknown. .

Goals

This study aimed to evaluate the association of UPF intake with all-cause and cardiovascular disease (CVD) mortality among participants with type 2 diabetes in the Moli-sani Study in Italy (enrollment 2005-2010).

Methods

This was a prospective observational cohort study in 1065 people with type 2 diabetes at baseline , followed for 11.6 years (median).

Food intake was assessed using a 188-item food frequency questionnaire. UPF was defined following the Nova classification and was calculated as the ratio (weight proportion; %) between UPF (g/d) and the total food consumed (g/d).

General diet quality was assessed using the Mediterranean Diet Score (MDS). Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality.

Results

The average UPF consumption was 7.4% (±5.0%). In Cox analysis with multivariable adjustment, the highest UPF intake (Q4, ≥10.5% and ≥9% of total foods consumed for women and men, respectively), versus the lowest (Q1, UPF <4, 7% and <3.7% for women and men, respectively), was associated with increased risks of all-cause mortality (HR: 1.70; 95% CI: 1.25, 2.33) and CVD (HR: 2.64; 95% CI: 1.59, 4.40); The inclusion of MDS in the model did not substantially alter the magnitude of these associations (HR: 1.64; 95% CI: 1.19, 2.25 and HR: 2.55; 95% CI: 1.53, 4, 24 for all-cause and CVD mortality, respectively).

A linear dose-response relationship of UPF intake with all-cause and CVD mortality was also observed.

Conclusions

In participants with type 2 diabetes at study entry, higher UPF consumption was associated with reduced survival and a higher CVD mortality rate, regardless of diet quality.

In addition to prioritizing the adoption of a diet based on nutritional requirements, dietary guidelines for the management of type 2 diabetes should also recommend limiting the intake of ultra-processed foods (UPF).

Ultra-Processed Foods Increase the Risk of Death in Type 2 Diabetes

Consumption of ultra-processed foods is associated with increased risk of all-cause mortality and cardiovascular mortality among individuals with type 2 diabetes, highlighting the importance of dietary interventions in diabetes management.