Financiado en parte por Novo Nordisk
A systematic review of ultra-processed food subtypes and risk of type 2 diabetes, combined with a cohort analysis, question the utility of broad food classifications for public health policy
Fridén M, Mai M, Olsen A, Dahm CC, Ibsen DB
BMC medicine · 1 cita
Etiquetas de revisión
Financiado por la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- Novo Nordisk
Según 1 financiador declarado.
Publicación
- Publicado
- 2026-06-26 · BMC Med · vol. 24 · número 1
- Editorial
- BioMed Central
- Citado
- 2 citas · más que el 95% de estudios similares · 5.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 45 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC-ND
- Áreas de investigación
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Global Public Health Policies and Epidemiology
- Palabras clave
- ultra-processed foods, type 2 diabetes, food classification, public health policy, causal inference, sugar-sweetened beverages, processed meat, dairy products, refined grains, vegetables, Danish Diet, Cancer and Health cohort, risk of bias, diet and health outcomes
- MeSH
- humans, diabetes mellitus, type 2, risk factors, cohort studies, health policy, female, male, fast foods
5 autores
- Michael Fridén🇸🇪🇩🇰Uppsala University; Aarhus University; Aarhus University Hospital; Steno Diabetes Center Aarhus
- Maria Mai🇩🇰Aarhus University
- Anja Olsen🇩🇰Aarhus University; Danish Cancer Society
- Christina Catherine Dahm🇩🇰Aarhus University
- Daniel Borch Ibsen🇩🇰 · autor de correspondenciaAarhus University; Aarhus University Hospital; Steno Diabetes Center Aarhus
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
A key underlying principle of causal inference is that of well-defined interventions. Although ultra-processed food (UPF) has been associated with a greater risk of type 2 diabetes (T2D), subtypes of UPFs may exert different strengths and directions of associations. The main objective of this study was to systematically evaluate the current literature on subtypes of UPFs and their associations with T2D and to contextualize these findings within the framework of sufficiently well-defined interventions for causal inference.
Methods
We searched PubMed and Embase for relevant articles. Cohort studies of adult men and women without T2D were included. Two independent researchers screened the articles and evaluated risk of bias using the ROBINS-E tool. UPFs were categorized into eight subtypes. A post-hoc analysis of 52,201participants in the Danish Diet, Cancer and Health (DCH) cohort was performed to illustrate the implications of vaguely defined interventions. We formed a fictive food group (the terrible five) combining foods that have been associated with T2D: sugar sweetened beverages, processed meat, red meat, refined grains and vegetables, and investigated the associations with T2D.
Results
Out of 222 articles screened for eligibility, 6 cohort studies with 635,332 participants (average follow-up of 6-26.1 years) were included. Most studies on UPF ready-to-eat-dishes; meat-based products; and artificially and sugar-sweetened beverages were positively associated with T2D whereas UPF dairy products; and sweets, snacks and confectionaries were generally inversely associated with T2D, although with some variation. Overall risk of bias was considered moderate to high in all included studies. In the DCH cohort, a positive association between the "terrible five" and T2D was observed. Intake of vegetables was inversely associated with T2D.
Conclusions
The systematic review showed different strengths and directions of associations on the risk of T2D across the different subtypes of UPFs. Aggregating these sources into a coarse food category such as UPF may therefore undermine the core principle of well-defined interventions and, as illustrated in our post-hoc analysis, can mask individual associations. This study illustrates potential unintended consequences of broad food categorizations such as UPFs and hamper implementation of UPF policies without further improvement of the definition or mechanistic understanding.
Trial registration
The protocol was registered in PROSPERO (ID: CRD420251058458).
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC-ND).
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