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Session: Ultra-Processed Food Consumption and Health Outcomes (Poster Theater Flash Session 3)

(PTFS03-07-23) Consumption of Ultra-Processed Foods in Association With Long-Term Weight Change and Risk of Type 2 Diabetes Among Individuals With a History of Gestational Diabetes Mellitus

Sunday, July 23, 2023
8:29 AM – 8:33 AM ET
Location:  Fairfax
ELPC

    Presenting Author(s)

  • Jiaxi Yang, PhD (she/her/hers)

    Research Fellow
    National University of Singapore
    Singapore, Singapore

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • CZ

    Cuilin Zhang, MD PhD

    National University of Singapore

  • Jorge E. Chavarro, MD, PhD

    Associate Professor of Medicine, Harvard Medical School
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • Frank B. Hu, MD, MPH, PhD

    Chair, Department of Nutrition Harvard T.H. Chan School of Public Health Fredrick J. Stare Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health Professor of Medicine, Harvard Medical School and Brigham and Women’s Hospital
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • DT

    Deirdre K. Tobias, ScD (she/her/hers)

    Assistant Professor
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • ZC

    Zhangling Chen, MD, PhD

    Postdoctoral researcher
    Erasmus Medical Center
    Rotterdam, Zuid-Holland, Netherlands

Disclosure(s):
Jiaxi Yang, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Frank B. Hu, MD, MPH, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Deirdre K. Tobias, ScD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: To prospectively examine whether change in consumption of ultra-processed foods (UPF) was related to long-term weight change and whether UPF consumption was related to type 2 diabetes (T2D) risk in women with a history of gestational diabetes mellitus (GDM).

Methods: We followed 3,926 participants with a history of GDM in the Nurses' Health Study II for incident T2D between 1991 and 2017. Demographic, lifestyle factors including diet, and disease outcomes were updated every 2-4 years. Women reported diet on validated food frequency questionnaires, from which consumption of UPF (serving/day) was derived. Fasting blood samples were collected in 2012-2014 from a subset of women for measuring cardio-metabolism biomarkers (HbA1c, C-peptide, fasting insulin, hs-CRP, IL-6). We categorized longitudinal 4-year change in UPF intakes by quartiles and estimated its association with concurrent change in body weight (kg) (n=3,476). Multivariable Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for quartiles of UPF with T2D risk adjusted for major risk factors. We estimated the least squares means of the biomarkers according to UPF consumption among women free of diabetes (n=470).

Results: 864 women developed T2D (median follow-up: 27.9 years). Women with increasing UPF consumption had greater weight gain, independent of baseline UPF intake and concurrent changes in other diet and lifestyle factors. The average 4-year weight change (95% CI) for increasing quartiles of change in UPF consumption was 1.08 kg (0.76, 1.39), 1.29 kg (1.00, 1.59), 1.49 kg (1.20, 1.77), and 1.69 kg (1.38, 2.01). UPF consumption was positively associated with T2D risk (p-trend=0.008); the adjusted HR (95% CI) for increasing UPF quartiles was 1.00 (ref), 1.19 (0.95, 1.50), 1.39 (1.09, 1.76), and 1.40 (1.08, 1.82). After adjusting for energy intake, the adjusted HR of Q4 vs. Q1 remained significant (HR=1.27, 95% CI: 1.01, 1.58). UPF consumption was associated with higher fasting insulin and C-peptide (p-trend < 0.05).

Conclusions: In predominantly Caucasian women with a history of GDM, increased UPF consumption was related to greater long-term weight gain. Higher UPF consumption was associated with a less-favorable glucose metabolism and a greater risk of T2D.

Funding Sources: National Institutes of Health, American Diabetes Association