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Topical Area: Nutritional Epidemiology

Nutritional Epidemiology (I) (Poster Session)

(P19-028-23) Association of Ultra-Processed Food Consumption With Risk of Cardiovascular Disease Among Individuals With Type 2 Diabetes in the UK Biobank

Sunday, July 23, 2023
12:45 PM – 1:45 PM ET
Location: Poster Board 125

    Presenting Author(s)

  • YL

    Yue Li, graduate

    School of Public Health
    Wuhan, Hebei, China (People's Republic)

    • Co-Author(s)

  • YL

    Yuwei Lai

    School of Public Health, Huazhong University of Science and Technology

  • TG

    Tingting Geng

    School of Public Health, Institute of Nutrition, Fudan University

  • PX

    Peng-Fei Xia

    School of Public Health, Huazhong University of Science and Technology

  • Jun-Xiang Chen, MBBS (he/him/his)

    PhD candidate
    School of Public Health, Huazhong University of Science and Technology
    Wuhan, Hubei, China (People's Republic)

  • ZT

    Zhou-Zheng Tu

    School of Public Health, Huazhong University of Science and Technology

  • GL

    Gang Liu

    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health

  • AP

    An Pan, PhD

    Professor
    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health
    Wuhan, Hubei, China (People's Republic)

Disclosure(s):
Jun-Xiang Chen, MBBS: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Ultra-processed foods (UPFs) were formulated from substances not commonly used in kitchens and food additives. Previous studies have linked diets rich in UPFs with a higher risk of cardiovascular disease (CVD) in general populations. However, among patients with diabetes, who have modified nutritional behavior and a higher risk of CVD, the influence of UPFs on CVD remains unknown. In addition, whether potential pathways could relate UPFs to CVD among individuals with type 2 diabetes (T2D) is unclear. We aimed to evaluate the associations between UPF intake and the risk of CVD among individuals with T2D and further examine potential metabolic biomarkers linking the associations.

Methods: This study included 5,405 participants with T2D providing at least one 24-h dietary recall from the UK Biobank study. UPFs were defined using the NOVA classification, which is widely used to classify foods based on the degree of processing. Incident CVD was ascertained through self-report, primary care records, hospital in-patient records, and death register records. Multivariable cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD outcomes. Mediation analyses were used to estimate the mediating effects of 14 biomarkers relating to renal function, lipid profile, inflammation, blood pressure, and body weight.

Results: During a median of 11.7 years of follow-up, 1,089 incident CVD events occurred, including 829 coronary heart disease (CHD), 225 stroke, and 310 heart failure events. In the multivariable-adjusted models, a 10% increase in the proportion of UPFs was associated with higher hazards of overall CVD (HR: 1.10; 95% CI: 1.04, 1.15), CHD (HR: 1.10; 95% CI: 1.04, 1.16), heart failure (HR: 1.14; 95% CI: 1.05, 1.25), but not stroke (HR: 1.01; 95% CI: 0.90, 1.12). Cystatin C, HDL-C, apolipoprotein A, C-reactive protein, and body mass index collectively explained 26.9% (12.8%, 48.5%) of the association between UPF intake and overall CVD.

Conclusions: Higher UPF intakes were associated with increased hazards of CVD among individuals with T2D, and the associations were partly mediated through worsening biomarkers of renal function, lipid metabolism, inflammation, and body weight.

Funding Sources: National Nature Science Foundation of China