Substituting ultraprocessed foods may lower the risk for type 2 diabetes

Key takeaways:

• Each 10% increase in daily UPF intake was tied to a 17% increased risk for type 2 diabetes.
• Substituting these with minimally, unprocessed or processed foods reduced the risk by 14% to 18%.

Replacing ultraprocessed foods with lesser or nonprocessed options may decrease the risk of developing type 2 diabetes, results from a prospective cohort analysis in the Lancet Regional Health Europe showed.

Not all ultraprocessed foods (UPFs) increased the likelihood of type 2 diabetes, leading study investigators to recommend targeted guidance on reduction of ultraprocessed dietary options that is limited to specific subgroups.

The findings build upon those from a recent study showing that UPFs did not significantly increase the risk for type 2 diabetes.

“There’s been much talk regarding UPF and poor health outcomes, but few have considered the risks associated with other food processing groups — minimally processed foods , processed culinary ingredients or processed foods — and whether the risk differs across UPF subgroups.” Samuel J. Dicken, MSc, a clinical scientist at University College London, told Healio. “Therefore, there’s a number of important questions that are unanswered.”

In the study, the researchers assessed the dietary intake of 311,892 individuals from eight European countries to determine the effect of UPFs and UPF subgroups on the risk for developing type 2 diabetes and the impact that substituting increments of UPFs with processed foods, processed culinary ingredients and minimally processed foods would have on risk.

During an average follow-up period of 10.9 years, 14,236 cases of type 2 diabetes occurred in the study cohort.

The researchers found that each 10% increase of total daily food intake from UPFs corresponded to a 17% (95% CI, 1.14-1.19) increase in risk for type 2 diabetes.

They added that substituting 10% of UPF intake with 10% of minimally processed foods or processed culinary ingredients reduced the risk for type 2 diabetes by 14% (HR = 0.94; 95% CI, 0.92-0.96).

Meanwhile, substituting 10% of UPF intake with 10% of processed foods reduced the risk for type 2 diabetes by 18% (HR = 0.92; 95% CI, 0.89-0.95).

Dicken and colleagues pointed out that 30% to 50% of PF intake came from beer and wine, whereas sweetened beverages made up 40% of UPF intake.

Analyses of UPF subgroups showed that several items had corresponding associations with an increased risk for type 2 diabetes, which included:

• savory snacks (HR = 2.77; 95% CI, 1.09-7.05);
• animal-based products (HR = 2.25; 95% CI, 1.96-2.57);
• ready-to-eat/heat mixed dishes (HR = 1.16; 95% CI, 1.01-1.35); and
• artificially and sugar-sweetened beverages (HR = 1.25; 95% CI, 1.22-1.28).

In contrast, researchers noted links between lower type 2 diabetes risk and consumption of breads, biscuits and breakfast cereals (HR = 0.65; 95% CI, 0.57-0.73), sweets and desserts (HR = 0.89; 95% CI: 0.84-0.95) and plant-based alternatives (HR = 0.46; 95% CI, 0.26-0.82). There are several possible reasons why UPFs are tied to type 2 diabetes, according to Dicken.

“These include changes to the food matrix — making them easier and quicker to consume — their typically higher energy density or, that it’s due to specific UPF subgroups, as we seemed to find,” he said.

For primary care providers, “our healthy diet guidance is still important, such as the Eatwell Guide in the U.K. and the U.S. MyPlate,” Dicken explained. “This should still be our general focus. However, generally consuming a less processed diet, particularly avoiding sugary drinks, animal-based foods and savory snacks — such as potato chips — is also a good idea for reducing our risk of type 2 diabetes.”

References:

• Dicken S, et al. Lancet Reg Health Eur. 2024;doi:10.1016/j.lanepe.2024.101043.
• Replacing ultra-processed foods in diet reduces type 2 diabetes risk. Available at: https://www.ucl.ac.uk/news/2024/sep/replacing-ultra-processed-foods-diet-may-reduce-type-2-diabetes-risk. Published Sept. 15, 2024. Accessed Sept. 25, 2024.