Association between ultra-processed food consumption and the incidence of type 2 diabetes: the ELSA-Brasil cohort

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art_CANHADA_Association_between_ultraprocessed_food_consumption_and_the_incidence_2023.PDF (939.03 KB)
Citações na Scopus
2
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BMC
Autores
CANHADA, Scheine L.
VIGO, Alvaro
LUFT, Vivian C.
FONSECA, Maria de Jesus M. da
GIATTI, Luana
MOLINA, Maria del Carmen B.
DUNCAN, Bruce B.
SCHMIDT, Maria Ines
Citação
DIABETOLOGY & METABOLIC SYNDROME, v.15, n.1, article ID 233, 10p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Ultra-processed food (UPF) consumption increases the risk of type 2 diabetes in various high-income countries, with some variation in the magnitude across studies. Our objective was to investigate the association of UPF consumption and specific subgroups with incident type 2 diabetes in Brazilian adults. Methods The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a multicenter cohort study of 15,105 adults (35-74 years) enrolled in public institutions in Brazil (2008-2010). We followed participants with two clinic visits (2012-2014; 2017-2019) and annual telephone surveillance. After excluding those with diabetes at baseline, who died or were lost in the follow-up, with missing data, with implausible energy food intake, or reporting bariatric surgery, there were 10,202 participants. We used the NOVA classification to assess UPF consumption based on a food frequency questionnaire. We defined type 2 diabetes by self-report, medication use, or comprehensive laboratory tests. We estimated relative risks (RR) and 95% confidence intervals (95% CI) using robust Poisson regression. Results Median UPF consumption was 372 g/day. Over 8.2 (0.7) years of follow-up, we detected 1799 (17.6%) incident cases. After adjustment for socio-demographics, family history of diabetes, and behavioral risk factors, comparing the fourth (>= 566 g/day) with the first (< 236 g/day) quartile of UPF distribution, RR was 1.24 (1.10-1.39); every 150 g/ day increments in UPF consumption resulted in a RR of 1.05 (1.03-1.07). Reclassifying natural beverages with added sweeteners as UPF increased risk (RR 1.40; 1.25-1.58). Among UPF subgroupings, consumption of processed meats and sweetened beverages increased diabetes risk, while yogurt and dairy sweets decreased the risk (p < 0.05). Conclusions UPF consumption increased the incidence of type 2 diabetes in Brazilian adults, with heterogeneity across specific food items. These findings add to previous evidence for the role of UPFs in the development of diabetes and other chronic diseases, supporting recommendations to avoid their intake in diabetes prevention and management.
Palavras-chave
Epidemiology, Non-communicable diseases, Public health, Type 2 diabetes, Ultra-processed food
URI
https://observatorio.fm.usp.br/handle/OPI/57616
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Coleções
Artigos e Materiais de Revistas Científicas - FM/Outros
Artigos e Materiais de Revistas Científicas - LIM/38
Artigos e Materiais de Revistas Científicas - ODS/03