Ultra-processed foods linked to increased risk of Type 2 diabetes

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Ultra-processed food increases the risk of Type 2 diabetes, according to research. (Photo credit: Sweet Life/Unsplash)

A growing body of scientific evidence shows that consumption of ultra-processed foods leads to a higher risk of developing Type 2 diabetes.

Today, nearly 40 million people in the U.S. have diabetes, and more than 90% of those have Type 2. Diabetes is a chronic disease in which increased insulin resistance raises blood sugar levels. This condition, left unchecked, can inflict significant damage to nerves and blood vessels, heart, brain, kidneys, gastrointestinal tract, eyes, gums, and feet.

Type 1 diabetes is an autoimmune disease with symptoms typically appearing suddenly in childhood. Type 2 diabetes – up until recently – had primarily been diagnosed in adults older than the age of 45. But today, more children and young adults are developing Type 2 diabetes. In the next 40 years, the number of children with the disease is projected to increase by nearly 700%. Genetic factors can play a role in developing the disease, but the main factors for an elevated risk of Type 2 diabetes include obesity, waist circumference, and a sedentary lifestyle.

Today, more than half of the calories that American adults eat, and nearly 70% of children’s calories, come from ultra-processed food.

Lawmakers discuss diabetes risks of ultra-processed foods

Concerns around severe health risks related to ultra-processed food have made their way to Congress. In a letter to the FDA in February, Sen. Bernie Sanders noted the “skyrocketing” rates of Type 2 diabetes and obesity in the U.S. He then called for strong warning labels to be affixed on ultra-processed foods. 

Sanders also wrote an op-ed in USA Today in December 2023 titled, “We can’t allow the food and beverage industry to destroy our kids’ health.” He argued, “The time is long overdue for us to seriously combat the Type 2 diabetes and obesity epidemic in America. We must have the courage to take on the greed of the food and beverage industry that, every day, is attacking the health and well-being of our children.” 

In the same month, Ashley Gearhardt, a food addiction expert and professor of psychology at University of Michigan, testified to the U.S. Senate that a “scientific body of evidence suggests that addictive processes play an important role in contributing to patterns of ultra-processed food intake implicated in poor health, obesity, and diabetes. If addictive mechanisms are being triggered by ultra-processed foods, this may be an overlooked reason why it can be challenging to reduce intake of ultra-processed foods even in the face of health conditions like diabetes.” 

Read our fact sheet on ultra-processed foods and addiction here. And see our fact sheets on the studies that link ultra-processed foods to depression, dementia, cancer, obesity, and early death.

What is the evidence linking ultra-processed foods and diabetes?

In an observational study published in JAMA Internal Medicine in 2019, researchers sought to examine the association between Type 2 diabetes (T2D) and ultra-processed foods (UPF). The prospective analysis included data from more than 104,000 people. The researchers found that, after adjusting for lifestyle and socioeconomic factors and comorbidities, “consumption of UPF was associated with a higher risk of T2D. These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet, for other metabolic comorbidities, and for weight change. The absolute amount of UPF consumption (grams per day) was consistently associated with T2D risk, even when adjusting for unprocessed or minimally processed food intake.”

In an umbrella review published in 2024 in BMJ, researchers examined the consumption of ultra-processed foods and the risk of various adverse health outcomes. Using data from 45 analyses, researchers found that “the strongest available evidence pertained to direct associations between greater exposure to ultra-processed foods and higher risks of all cause mortality, cardiovascular disease related mortality, common mental disorder outcomes, overweight and obesity, and type 2 diabetes.” They concluded: “Coupled with existing population based strategies, we recommend urgent mechanistic research and the development and evaluation of comprehensive population based and public health strategies, including government led policy frameworks and dietary guidelines, aimed at targeting and reducing dietary exposure to ultra-processed foods for improved human health.”

A meta-analysis published in the International Journal of Epidemiology in 2022 aimed to examine research that linked ultra-processed food consumption to Type 2 diabetes risk. After screening more than 18 studies that included a total of more than 1 million people, researchers found that, “compared with non-consumption, moderate intake of ultra-processed food increased the risk of diabetes by 12%, whereas high intake increased risk by 31%.” They added that the increased risk had “a dose-response effect and moderate to high credibility of evidence.” The study authors concluded: “Strategies such as exchange for fresh or minimally processed foods and physical activity, in addition to alternative therapies, can be effective in preventing or treating diabetes, as long as they are accompanied by a reduction in the consumption of ultra-processed foods.”

“Studying the factors that cause diabetes and conducting clinical trials has become a priority,” starts a mini-review published in the journal Nutrients. The study authors noted the “significant” increased risk of developing diabetes mellitus with ultra-processed food consumption. Notably, one study found that the “consumption of sweet drinks and salty processed foods was found to enormously increase the risk of prediabetes by 248% and 48%, respectively, and the risk of Type 2 diabetes by 219% and 600%, respectively, compared to individuals who did not consume these products or had a rare consumption ratio.” 

In a longitudinal study published in 2023 in the journal Diabetology & Metabolic Syndrome, researchers assessed the link between ultra-processed food (UPF) consumption and Type 2 diabetes in more than 10,000 Brazilian adults. They found that, after adjusting for lifestyle and risk factors, “comparing the fourth with the first quartile of UPF distribution, relative risks (RR) was 1.24; every 150 g/day increments in UPF consumption resulted in a RR of 1.05. Reclassifying natural beverages with added sweeteners as UPF increased risk. Among UPF subgroupings, consumption of processed meats and sweetened beverages increased diabetes risk, while yogurt and dairy sweets decreased the risk.” They concluded, “These findings add to previous evidence for the role of UPFs in the development of diabetes and other chronic diseases, supporting recommendations to avoid their intake in diabetes prevention and management.” 

For a study published in BMC Medical in 2022, researchers in the Netherlands wanted to examine various ultra-processed foods and their health effects. The data included the self-reported food intake of more than 70,000 study participants between the ages of 35 and 70. In a follow-up of a little more than 3 years, “a 10% increment in UPF consumption was associated with a 25% higher risk of developing type 2 diabetes.” Consuming a significant amount of warm and cold savory snacks was specifically associated with an increased risk. Notably, “with increasing quartiles of UPF consumption, participants tended to be younger, have higher BMI, have lower type 2 diabetes risk scores, be less physically active, have worse overall diet quality, consume less alcohol, smoke less, be less highly educated, and spend more time on watching TV.” The researchers concluded: “In addition to promoting consumption of healthy food products, active discouragement of unhealthy food products such as savory UPF should be considered as part of diabetes prevention strategies.”

A meta-analysis and systematic review published in Nutrients in 2021 that included more than 200,000 adults from four different countries found that a higher consumption of ultra-processed foods was “significantly associated” with a higher risk of developing type 2 diabetes (T2DM). The researchers wrote: “Linear dose-response analysis indicated that each 10% increase in UPF consumption was associated with a 15% higher risk of type 2 diabetes mellitus among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM among adults. Non-linear dose-response analysis also demonstrated a positive linear association between UPF consumption and T2DM among adults.”

In a survey published in the journal Nutrients in 2022, researchers examined the link between ultra-processed food and Type 2 diabetes in more than 12,000 Chinese adults, with a mean age of 43.3 years old. They found, “both UPF consumption and the prevalence of diabetes increased during 1997–2011 in Chinese adults. Higher UPF consumers had a significantly higher risk of diabetes than non-consumers. The association between UPF consumption and diabetes was partly mediated by overweight/obesity.”

In a study published in the Journal of Nutrition, researchers aimed to investigate the associations between ultra-processed food consumption and diabetes risk in Asian populations, by assessing the data from more than 7,000 Koreans between the ages of 40 and 69. They found, “compared with the lowest quartile of ultra-processed food intake, the highest quartile was positively associated with diabetes risk. The association did not change after additional adjustment for diet quality or BMI.” The consumption of carbonated drinks, ham/sausage, instant noodles, and ice cream were particularly notable for their associations with increased risk of type 2 diabetes. In response to these findings, the study authors wrote: “Public health strategies should also focus on making unprocessed or minimally processed foods more affordable and accessible and provide support for industry actions to formulate less processed foods. Food manufacturers can reformulate their processing methods to reduce additives and harmful substances in their products. To encourage consumers to make informed choices, food labeling may also disclose more detailed information on food processing methods and contents of additives and preservatives in the food products.”

Non-fiction books:

Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine, by Dr. Robert Lustig, HarperCollins, May 2021

Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, by Dr. Robert H. Lustig, Penguin Random House, Dec. 2013

Pandora’s Lunchbox: How Processed Food Took Over the American Meal, by Melanie Warner, Scribner, Feb. 2014

Journalism and opinion:

Diabetes and obesity rising in young Americans, study finds, by Fenit Nirappil, Washington Post, March 5, 2023

Eating Ultra-Processed Foods Can Increase Risk of Death for People With Type 2 Diabetes, by Chantelle Pattemore, Healthline, July 27, 2023

The More Processed Foods You Eat, the Higher Your Diabetes Risk, by Nicholas Bakalar, New York Times, Dec. 18, 2019

Ultra-Processed Food: What We Know About the Potential Health Risks in American Diets, by Andrea Petersen, Wall Street Journal, Nov. 14, 2023

We are producing a series that reports on the science behind the health risks of ultra-processed foods (UPFs). Learn more about the risks at our other fact sheets on depression, dementia, addiction, all-cause mortality, obesity, and cancer, along with our fact sheet that offers a general overview of UPFs here. These fact sheets are works in progress and will be updated. Please feel free to email mikaela@usrtk.org with any research or articles that you feel should be included in this series.

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