UPF linked to type 2 diabetes

Ultra-processed foods (UPF) have been subject to significant and growing criticism over the past five years, with consumers believing they’re damaging to health and the environment​. In fact, such is the strength of concern, surrounding the damaging effects of UPF, the World Health Organization (WHO) published a damning report, likening their consumption to smoking and drinking alcohol​. And it went on to criticise the industry itself for its conduct in the marketing of UPF.

“Industry tactics include exploitation of vulnerable people through targeted marketing strategies, misleading consumers and making false claims about the benefits of their products or their environmental credentials,” said Dr Hans Henri P Kluge, WHO Regional Director for Europe.

Now a study, led by University College London (UCL), is again placing ultra-processed foods under the microscope and the findings are not good.

UPF linked to type 2 diabetes​Researchers have found that consuming high volumes of ultra-processed foods elevates the risk of developing type 2 diabetes.

The study, published in The Lancet Regional Health – Europe, and conducted in collaboration with the University of Cambridge and Imperial College London, investigated the relationship between the degree of food processing and the risk of developing type 2 diabetes.

The research team analysed UPF intake and health outcomes of 311,892 individuals, from eight European countries, over the course of 10 years. During this time, 14,236 people developed type 2 diabetes, and it was discovered that for every 10% increase in the amount of ultra-processed foods consumed, the risk of developing type 2 diabetes increased by 17%.

The highest risk UPF food and beverage groups were savoury snacks, animal-based products such as processed meats, ready meals, and sugar-sweetened and artificially sweetened beverages.

The researchers were unable to identify the exact causes of the link between UPF and type 2 diabetes, though they believe overconsumption and weight gain to be major contributing factors.

“We know that ultra-processed foods are associated with a higher risk of certain diseases such as type 2 diabetes,” said Samuel Dicken, first author of the study. “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.”

The researchers also looked at the impact of reducing the amount of ultra-processed foods consumed, to see if this could help to mitigate the problem, finding that substituting 10% of UPF in the diet with 10% of minimally processed foods and ingredients, reduced the risk of developing type 2 diabetes by 14%.

“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 ultra-processed foods with less processed foods,” said Dicken. “The good news is that replacing ultra-processed foods with less processed foods was associated with a reduced type 2 diabetes risk.”

How are ultra-processed foods defined in Europe?​Ultra-processed foods (UPF) are currently defined by the NOVA Classification System

What is the NOVA classification system?​The Nova classification system is a framework for grouping edible substances based on the extent to which they have been processed and the reason for process applied. The term was established in 2009 by researchers at the University of São Paulo, Brazil.

Foods in the NOVA classification system are placed into one of four groups, as follows:​Group 1:​​ Unprocessed or minimally processed foods
Examples include fruit, vegetables, milk, fish, pulses, eggs, nutsGroup 2:​​ Processed culinary ingredients
This includes foods that are added to other foods rather than eaten by themselves, such as salt, sugar and oils.Group 3:​​ Processed foods
These are foods, which are made by combining foods from groups 1 and 2. They are altered in a way that home cooks could do themselves and include foods such as jams, pickles, tinned fruits and vegetables and homemade breads and cheeses.Group 4:​​ Ultra-processed foods
These typically contain five or more ingredients. They tend to include additives and ingredients that are not typically used in home cooking, such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours. These foods generally have a long shelf life such as crisps, mass-produced bread, breakfast cereals, biscuits, carbonated drinks, fruit-flavoured yogurts, instant soups.How will this research impact the food and beverage industry?​Though this research might appear hugely negative for the food and beverage industry, it does create a clear directive for manufacturers. Reducing the processing methods in products will improve their negative health impacts. And many brands are already making the move towards reducing the ultra-processing in their products, as well as reducing the number of additives and preservatives.

“With so many different and often short-lived health trends currently bouncing around on social media, it would be tempting to think that the current UPF furore will also quickly die down,” Alice Pilkington, senior global food and drink analyst at Mintel, told FoodNavigator. “However, that many Europeans do not think it’s just another healthy eating fad, demonstrates the need for food and drink brands to take this seriously. Indeed, it would be arguable that the UPF focus marks a watershed moment for the industry.”

However, there is also the need for better consumer education on the different types of ultra-processed foods and their effects, and this must come from the industry. One of the reasons so many consumers have a negative view of all ultra-processed foods is because the industry has failed to effectively communicate the reasons behind certain processing methods.

“There is a wide and confusing array of information on ultra-processed food, some of which is conflicting and some that is simply misinformation,” Klaus Grunert, professor at Denmark’s Aarhus University and director of the EIT Food Consumer Observatory, told FoodNavigator. “To compound this issue, there is no sector-wide consensus on what foods constitute as UPF, how to include UPF into a balanced diet, and what processing levels relate to the overall healthiness of a product. This is leaving consumers without the information they need on which foods are healthy and which they should avoid, preventing them from making informed choices.” 

What is diabetes?​Diabetes is a chronic, metabolic disease, characterised by elevated levels of blood glucose (or blood sugar). This elevated blood sugar can, over time, lead to serious damage to the heart, blood vessels, eyes, kidneys and nervous system.

There are two types of diabetes, type 1 and type 2.

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself.Type 2 diabetes is the more common form of diabetes and occurs when the body becomes resistant to insulin or doesn’t make enough insulin. The prevalence of type 2 diabetes has risen dramatically over the last three decades.According to the World Health Organization (WHO), approximately 422 million people worldwide have diabetes, with the majority living in low- and middle-income countries. Approximately 1.5 million deaths are directly attributed to diabetes each year.

The food and beverage industry needs to better communicate the differences in the types of ultra-processed foods, and the reasons behind the methods used. GettyImages/LauriPattersonSource: Food consumption by degree of food processing and risk of type 2 diabetes mellitus: a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC)
Published online: 16 September 2024
DOI: 10.1016/j.lanepe.2024.101043
Authors: Samuel J. Dicken, Christina C. Dahm, Daniel B. Ibsen et al.