- New research indicates that ultra-processed foods can increase mortality risk among those with type 2 diabetes.
- Risk of mortality from cardiovascular disease was particularly elevated among these individuals.
- Further research is required into how and why ultra-processed foods may lead to worse health outcomes among people with diabetes.
For those with type 2 diabetes, diet is critical — and eating foods with high nutritional content is crucial for a healthy weight and controlled blood sugar levels.
However, a new study, led by researchers at the Department of Epidemiology and Prevention at the I.R.C.C.S. Neuromed and published July 26 in the American Journal of Clinical Nutrition, highlights the significance of another factor: the level of processing a food has undergone.
“To our knowledge, this is the first cohort study analyzing the impact of ultra-processed foods (UPFs) among people diagnosed with diabetes,” stated Marialaura Bonaccio, PhD, an epidemiologist at the Department of Epidemiology and Prevention at IRCCS Neuromed in Italy and lead author of the research.
To explore the impact of ultra-processed foods on type 2 diabetics, the researchers analyzed data from 1,065 individuals with the metabolic condition.
Data was collected from the ongoing Moli-Sani Study, which began in 2005 and records health information of around 25,000 individuals living in Italy’s Molise Region. Researchers collected participants’ data from 2005-2010 and followed up with them for a median of 11.6 years.
They found that those who ate higher amounts of ultra-processed foods were at greater risk of all-cause mortality and mortality from cardiovascular disease. The difference in risk level was rather unexpected, Bonaccio told Healthline.
“We were somewhat surprised by the magnitude of the risks associated with an elevated ultra-processed foods intake, which is 2.5 times higher for [cardiovascular disease] mortality compared to people having less [ultra-processed foods] in their diet,” she said. “This is huge.”
Importantly, the researchers also learned that eating healthy foods alongside ultra-processed foods (such as those in the Mediterranean Diet) didn’t negate or “undo” their harmful effects.
“Our data indicate that [ultra-processed foods] intake is a key risk factor for mortality in this population of people with type 2 diabetes independently of adherence to the Mediterranean Diet,” revealed Bonaccio.
“This means that, even if you report a high adherence to a healthful, nutritious diet, such as the Mediterranean Diet, this is not enough if you still consume lots of UPFs.”
While the researchers only reviewed the impacts of ultra-processed foods, and not processed foods in general, they believe the findings are still significant.
In addition to being the first cohort study to explore the impact of ultra-processed foods on people with type 2 diabetes, “our findings have important implications for public health policies,” asserted Bonaccio.
“[They] suggest that dietary guidelines for people with type 2 diabetes should also recommend strongly reducing UPF consumption.”
Ultra-processed foods are abundant in US diets, accounting for almost 60% of an average individual’s energy intake. But what are they?
Essentially, making something ultra-processed involves “taking a food in its natural (homegrown) state and changing it by adding salt, sugar, oil, and additives like chemicals, colors, flavorings, stabilizers, and preservatives,” explained Kimberly Gomer, MS, a registered dietitian and licensed dietitian nutritionist, and director of nutrition at Body Beautiful Miami.
Gomer told Healthline that adding such ingredients gives foods “an extremely long shelf life — which is attractive to both people and industry.”
The addition of salt, sugar, and fats also makes ultra-processed foods highly addictive.
“I call them the ‘trifecta,’ as that combination can cause a large dopamine rush to the brain and signals the body to crave more of the same,” explained Kara Burnstine, MSRD, LDN, CDCES, a registered nutritionist and certified diabetes educator at Pritikin Longevity Center.
Some well-known ultra-processed foods include:
- Instant or frozen microwavable meals
- Baked goods (such as cake, cookies, and bread)
- Processed meat (like sausages and lunch meats)
- Sweet breakfast cereals
- Chips
- Ice cream
- Soda
However, there are other everyday foods that many of us might consider “healthy” but are actually ultra-processed.
Gomer noted that protein bars and shakes are two culprits, while Bonaccio added that certain types of spreadable or sliced cheeses are also ultra-processed.
And the list doesn’t end there. “Other examples would be flavored yogurts, low-fat muffins, granola bars, packaged smoothie mixes, and plant-based meat alternatives,” said Burnstein.
“Many of these foods have hidden sugars and salts that are often overlooked,” she added.
There are a few reasons why ultra-processed foods are so bad for people with type 2 diabetes.
“UPFs are loaded with sugar and have less fiber, which leads to rapid glucose spikes,” explained Dr. Srujana Yada, an endocrinologist with Texas Diabetes and Endocrinology.
“[This], in turn, causes bad glycemic control in diabetes patients,” she told Healthline. Furthermore, “processed food can cause weight gain, increased insulin resistance, and worsened diabetes control.”
Unsurprisingly, ultra-processed foods’ addictive-like properties often make reigning in their consumption a struggle — and this can make managing diabetes even more challenging, said Brea Lofton, MS, RDN, a registered dietitian at Lumen.
To help keep things in check, “Always consult with a healthcare professional or a registered dietitian for personalized dietary recommendations for diabetes management,” she added.
Utra-processed foods can contribute to adverse health outcomes among all of us — not just diabetics.
First, these foods “can cause vitamin and mineral deficiencies,” said Yada — which can contribute to everything from weakened immunity to more fragile bones.
Ultra-processed foods have also been associated with chronic inflammation, Yada shared. Inflammation is linked to increased risk of cardiovascular disease and other health concerns, including inflammatory bowel disease (IBD), arthritis, and depression.
But IBD isn’t the only gut-related issue that can occur. “The high levels of refined sugars and unhealthy fats can disrupt the gut microbiome,” Lofton shared with Healthline.
As a result, this can “potentially lead to digestive issues and related problems,” she added.
Experts believe an unbalanced gut microbiome may influence everything from immunity and weight to mental well-being and heart health.
The inclusion of sugar and fat means that ultra-processed foods are typically high in calories but “often low in satiety-inducing nutrients like fiber and protein,” Lofton stated.
Add these factors into the mix alongside their addictive qualities, and “people tend to overconsume these foods, leading to weight gain and increased risk of obesity,” she continued.
However, Gomer explained it’s important to understand that the impacts of eating UPFs (and other foods) vary between people.
For instance, “a very active individual may tolerate foods very differently based on their genetics, metabolic, and health status,” she stated.
While it’s beneficial to recognize the positives and negatives of different ingredients, “It’s important not to become hyper-focused on cutting [one] out,” Gomer said — “as doing so can lead to disordered eating habits.”
With so many different words and marketing taglines on food packaging, it can be challenging to identify what foods are UPFs and which are not.
Fortunately, a couple of tactics can aid in spotting UPFs on the shelves.
Checking the ingredients list is the best approach to take. See a whole lot of words that you don’t recognize? There’s a good chance the food is processed.
“Generally, highly processed foods have long lists of ingredients, many of which are hard to pronounce or unfamiliar,” Lofton explained.
On the other hand, “whole and minimally processed foods typically have shorter ingredient lists, often consisting of recognizable, whole-food items.”
Certain ingredients indicate that something is a UPF, said Burnstein. These include:
“The higher up these ingredients are on the list, the more they are present in the product,” she added.
While these might appear healthy at first glance, “their actual nutritional content can be compromised due to extensive processing and the addition of unhealthy ingredients,” said Lofton.
For instance, they “often contain high levels of sugar or additives that decrease their nutritional content to a large extent,” she noted.
That said, some natural or low-fat products are healthy and don’t contain added ingredients — it’s all about checking that label. “It’s essential to examine the ingredient list and nutritional content for the full picture,” stated Lofton.
A new study finds that eating more ultra-processed food can increase mortality risk for people with type 2 diabetes.
