按食品加工程度划分的食品消费与 2 型糖尿病风险：欧洲癌症与营养前瞻性调查 (EPIC) 的前瞻性队列分析

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2024-11-01 DOI:10.1016/j.lanepe.2024.101043

Samuel J. Dicken , Christina C. Dahm , Daniel B. Ibsen , Anja Olsen , Anne Tjønneland , Mariem Louati-Hajji , Claire Cadeau , Chloé Marques , Matthias B. Schulze , Franziska Jannasch , Ivan Baldassari , Luca Manfredi , Maria Santucci de Magistris , Maria-Jose Sánchez , Carlota Castro-Espin , Daniel Rodríguez Palacios , Pilar Amiano , Marcela Guevara , Yvonne T. van der Schouw , Jolanda M.A. Boer , Rachel L. Batterham

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引用次数: 0

摘要

背景超级加工食品（UPF）摄入量与2型糖尿病之间的关系是否不同于其他食品加工程度，目前尚不清楚。我们研究了食品加工程度与2型糖尿病发病之间的关系。方法这是欧洲癌症与营养前瞻性调查（EPIC）的一项前瞻性队列分析。通过膳食调查问卷对基线膳食摄入量进行评估，并根据诺瓦分类法将膳食摄入量分为未加工/微加工食品（MPF）、加工烹饪配料（PCI）、加工食品（PF）和UPF。通过多种方法核实了 2 型糖尿病病例。采用 Cox 回归和统计替代分析来估计 MPF + PCI、PF 和 UPF 摄入量与 2 型糖尿病发病率之间的关系。为了研究 UPF 与 2 型糖尿病发病率之间关系的异质性，进行了 UPF 亚组分析。结果在对 311,892 人平均 10.9 年的随访中，发现了 14,236 例 2 型糖尿病病例。从 UPF（%g/天）开始，每日食物摄入总量每增加 10%，2 型糖尿病发病率就会增加 17%（95% 置信区间 (95%CI)：1.14-1.19）。MPF + PCI 或 PF 摄入量每增加 10%，2 型糖尿病发病率就会降低（MPF + PCI 危险比：0.94（95% 置信区间：0.92-0.96）；PF 危险比：0.92（95% 置信区间：0.89-0.95））。用 MPF + PCI 或 PF 取代 UPF 与较低的 2 型糖尿病发病率相关。然而，在UPF亚组中观察到了异质性，面包、饼干和早餐谷物、糖果和甜点以及植物性替代品与较低的2型糖尿病发病率相关。

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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)

Background

It is unknown whether the association between ultra-processed food (UPF) intake and type 2 diabetes mellitus differs from other degrees of food processing. We examined the association between degree of food processing and incident type 2 diabetes mellitus.

Methods

This was a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline using dietary questionnaires and classified according to the Nova classification into unprocessed/minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF. Type 2 diabetes mellitus cases were verified through multiple methods. Cox regression and statistical substitution analysis was used to estimate associations between MPF + PCI, PF and UPF intake and incident type 2 diabetes mellitus. To investigate heterogeneity in the association between UPF and incident type 2 diabetes mellitus, UPF sub-group analysis was conducted. Different reference groups were used in each analysis.

Findings

Over an average 10.9 years follow-up of 311,892 individuals, 14,236 type 2 diabetes mellitus cases were identified. Each 10% increment of total daily food intake from UPF (%g/day) was associated with 17% (95% confidence interval (95%CI): 1.14–1.19) higher incident type 2 diabetes mellitus. Each 10% increment in MPF + PCI or PF intake was associated with lower incident type 2 diabetes mellitus (MPF + PCI hazard ratio: 0.94 (95%CI: 0.92–0.96); PF hazard ratio: 0.92 (95%CI: 0.89–0.95)). Replacing UPF with MPF + PCI or PF was associated with lower incident type 2 diabetes mellitus. However, heterogeneity was observed across UPF sub-groups, with breads, biscuits and breakfast cereals, sweets and desserts, and plant-based alternatives associated with lower incident type 2 diabetes mellitus.

Interpretation

These findings support recommendations to focus on reducing intake of specific UPF for lowering type 2 diabetes mellitus risk.

Funding

International Agency for Research on Cancer.

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.