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

(PTFS03-02-23) Ultra-Processed Food Consumption Is Associated With Higher Type 2 Diabetes Risk in the Hispanic Community Health Study / Study of Latinos

Sunday, July 23, 2023
8:09 AM – 8:13 AM ET
Location:  Fairfax
ELPC
Disclosure(s):
Kenny Mendoza, BS, MS, PhD Candidate: 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.
Objectives: Ultra-processed foods (UPF) are associated with low-quality diets and type 2 diabetes (T2D) in non-Latino populations. We assessed these associations in US Hispanic/Latino (H/L) adults.

Methods: Data from the Hispanic Community Health Study/Study of Latinos were used, comprising 8,010 adults (18-74y) of Central/South American, Dominican, Cuban, Mexican, and Puerto Rican heritage, completing follow-up (2014-17), and without diabetes, cardiovascular disease, and cancer at baseline (2008-11). Up to two 24h dietary recalls assessed baseline diet; the weighted average proportion of NOVA-classified UPF intake in the total diet weight was calculated. The Alternative Healthy Eating Index (AHEI) captured diet quality. Incident T2D was defined by self-report, anti-diabetic drugs, fasting glucose ≥126 mg/dL, post-OGTT ≥200 mg/dL, or A1C ≥6.5%. Survey-based linear regression tested associations between UPF quintiles and AHEI, adjusting for sex, age, heritage, education, nativity, and energy. Survey-based logistic regression estimated the odds ratio (95%CI) of T2D per 10-percentage-point increase in UPF intake, adjusting for these covariates, physical activity, smoking, and diabetes family history. A priori-based stratification by heritage, nativity, BMI, and AHEI tertiles was done.

Results: The dietary UPF proportion median by weight was 17.4% (quartile range: 11.4–25.2). UPF intake was highest in men (19.3%; 12.9–27.6), adults aged 18–44y (19.8%; 13.5–27.8), and Puerto Ricans (25%; 17.4–34.5). The overall mean AHEI score (SE) in the highest UPF quintile was 5.3 (0.3) points lower than in the lowest quintile, p-trend < 0.0001, being this difference more pronounced in Puerto Ricans [-7.5 (1.0); p-trend < 0.0001]. We ascertained 1,265 incident T2D cases. Overall, a 10-percentage-point increase in UPF was associated with 1.18 (1.01, 1.38) higher odds of T2D over 6 years. Groups with the strongest association were Puerto Ricans (1.29; 1.01, 1.65), US-born (1.42; 1.09, 1.85), and with obesity (1.19; 1.02, 1.40). The association was non-significant at the highest AHEI tertile.

Conclusions: Widespread evidence regarding the adverse role of UPF intake on T2D risk extends to US H/L adults, particularly with Puerto Rican heritage, US nativity, or obesity. Limiting UPF intake may lessen this risk.

Funding Sources: NIH, CONACYT, Fundación México en Harvard