Ultraprocessed food consumption is associated with all-cause and cardiovascular mortality in participants with type 2 diabetes independent of diet quality: a prospective observational cohort study

Nutritional strategies for prevention and management of type 2 diabetes traditionally emphasize dietary patterns reflecting nutrient goals, but the health implications of ultraprocessed food (UPF) for patients with type 2 diabetes remain unknown. This study aimed to evaluate the association of UPF i...

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Bibliographic Details
Published in:The American journal of clinical nutrition 2023-09, Vol.118 (3), p.627-636
Main Authors: Bonaccio, Marialaura, Di Castelnuovo, Augusto, Costanzo, Simona, Ruggiero, Emilia, Esposito, Simona, Persichillo, Mariarosaria, Cerletti, Chiara, Donati, Maria Benedetta, de Gaetano, Giovanni, Iacoviello, Licia
Format: Article
Language:English
Subjects:
cardio-cerebrovascular mortality
Cardiovascular diseases
Cohort analysis
Diabetes
Diabetes mellitus (non-insulin dependent)
Diet
diet quality
Females
Food
Food consumption
Food intake
Hazard assessment
Health hazards
Heart diseases
Males
Mortality
Nova classification
Nutritional requirements
Observational studies
Processed foods
Quality assessment
Statistical models
type 2 diabetes
ultraprocessed food
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Summary:Nutritional strategies for prevention and management of type 2 diabetes traditionally emphasize dietary patterns reflecting nutrient goals, but the health implications of ultraprocessed food (UPF) for patients with type 2 diabetes remain unknown. This study aimed to evaluate the association of UPF intake with all-cause and cardiovascular disease (CVD) mortality among participants with type 2 diabetes from the Moli-sani Study in Italy (enrollment 2005–2010). This was a prospective observational cohort study on 1065 individuals with type 2 diabetes at baseline, followed up for 11.6 y (median). Food intake was assessed by a 188-item food-frequency questionnaire. UPF was defined following the Nova classification and calculated as the ratio (weight ratio; %) between UPF (g/d) and total food eaten (g/d). Overall diet quality was assessed through 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. The average UPF consumption was 7.4% (±5.0%). In multivariable-adjusted Cox analyses, greater UPF intake (Q4, ≥10.5% and ≥9% of total food eaten for females and males, respectively), as opposed to the lowest (Q1, UPF
ISSN:0002-9165
1938-3207
DOI:10.1016/j.ajcnut.2023.07.004