Those who eat more ultra-processed foods (UPF) are at an increased risk of developing type 2 diabetes (T2D) according to a study led by researchers at University College London (UCL) recently published in The Lancet Regional Health-Europe, but this increased risk can be reduced by consuming less processed foods.
Working in collaboration, experts at the University of Cambridge and Imperial College London, investigated the relationship between the degree of food processing and type 2 diabetes risk, including which kinds of UPF were most high-risk. The researchers analyzed intake and health outcomes for 311,892 people from eight European countries over a period of 10.9 years on average, during which time 14,236 individuals developed type 2 diabetes.
Every bite matters
For every 10% increase in the amount of ultra-processed food in the diet the researchers found a 17% increased risk for type 2 diabetes. However, they suggest that this can be lowered by consuming less processed food choices. The ultra-processed foods consumed in the highest amounts were processed meats, ready-made meals, and sugar-sweetened and artificially sweetened beverages.
“We know that ultra-processed foods are associated with a higher risk of certain diseases such as type 2 diabetes. As expected, our findings confirm this link and show that every 10% increase in the diet from UPF increases the risk of developing type 2 diabetes considerably,” said Samuel Dicken, first author of the study from UCL Division of Medicine.
“Most studies to date only consider UPF as a whole, but we also suspect that there may be different risks associated with different types of UPF, and the risks of other processing groups have not been well researched. Our analysis goes a step further than previous studies, by looking at all four processing groups in the Nova classification to gauge the impact on type 2 diabetes risk when we substitute UPF with less processed foods, as well as looking at nine UPF subgroups,” said Dicken adding that “The good news is that replacing UPF with less processed foods was associated with a reduced type 2 diabetes risk.”
Further analysis
Analyzing data from the EPIC Study the researchers investigated the relationship between diet, lifestyle, and environmental factors, and the incidence of chronic diseases in more than half a million Europeans over time. However, an additional analysis was done to separate the ultra-processed food into 9 subgroups to understand how the level of processing affects the risk:
- Breads, biscuits and breakfast cereals
- Sauces, spreads, and condiments
- Sweets and desserts
- Savory snacks
- Plant-based alternatives
- Processed meats
- Ready-to-eat/heat mixed dishes
- Artificially and sugar-sweetened beverages
- Alcoholic drinks
- Other ultra-processed foods
Along with analyzing how eating ultra-processed food affected the risk of developing T2D, substitution modeling was also performed to see how replacing one food group with another would affect the risk. According to the researchers, substituting 10% of UPF in the diet with 10% of unprocessed or minimally processed foods (MPF) reduced type 2 diabetes risk by 14%.
Substituting 10% of ultra-processed food in the diet with 10% of processed food (PF) reduced diabetes risk by 18%. The authors say this may be down to the fact that 30-50% of PF intake in this study came from beer and wine, which have been associated with a lower risk of type 2 diabetes in a previous EPIC study. PF also includes salted nuts, artisanal breads, and preserved fruits and vegetables.
The more you eat, the higher the risk
The analysis of the 9 subgroups revealed that savory snacks, processed meat products, ready meals, and sugar-sweetened and artificially-sweetened beverages were associated with a higher incidence of type 2 diabetes. The more of these less healthy choices that were consumed contributed to the overall risk of developing T2D. For example, among those in the top 25% of ultra-processed food consumption with 23.5% of their diet comprising UPFs, sweetened beverages accounted for nearly 40% of their UPF intake and 9% of their diet overall.
The researchers suggest that ultra-processed food breads, biscuits and breakfast cereals, sweets and desserts, were associated with lower incidence of type 2 diabetes.
“The UPF subgroup analysis in this study has been revealing and confirms that not all foods categorised as UPF are alike in terms of the health risks associated with them,” said Professor Rachel Batterham, senior author of the study from UCL Division of Medicine.”Breads and cereals, for example, are a staple of many people’s diets. Based on our results, I think we should treat them differently to savoury snacks or sugary drinks in terms of the dietary advice we provide.”
“The findings from this study add to the growing body of research that links consumption of UPF with higher risk of certain chronic diseases including obesity, cardiometabolic diseases and some cancers. While such a study cannot determine causal relationships, it does suggest that reducing consumption of some UPF and replacing them with unprocessed, whole foods, might lower risk of type 2 diabetes. Further research to understand mechanisms and potential causal pathways is now needed,” said Professor Marc Gunter, an author of the study from Imperial College London and one of the coordinators of the EPIC study.
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