Oral Presentation 49th Nutrition Society of Australia Annual Scientific Meeting 2025

Ultra-processed food consumption and risk of type-2 diabetes in the Melbourne Collaborative Cohort study   (129695)

Priscila Machado 1 2 3 , Natalia Tolstova 1 , Melissa Lane 4 , Caroline Costa 3 , Euridice Martinez Steele 3 , Fernanda Rauber 3 , Renata Levy 3 5 , Sarah McNaughton 1 6 , Mark Lawrence 1 2 , Carlos Monteiro 3 , Allison Hodge 7 8
  1. School of Exercise and Nutrition Sciences, Deakin University, Burwood, 3125, Victoria, Australia
  2. Institute for Physical Activity and Nutrition, Deakin University, Geelong, 3216, Victoria, Australia
  3. Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paolo, 01246-904, Brazil
  4. IMPACT Institute (the Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, 3220, Victoria, Australia
  5. Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paolo, 01246-903, Brazil
  6. Health and Well-Being Centre for Research Innovation, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, 4072, Queensland, Australia
  7. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, 3002, Victoria, Australia
  8. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010, Victoria, Australia

In Australia, ultra-processed foods (UPFs) contribute to 42% of total energy intake(1) and have been associated with excessive intakes of nutrients of concern for non-communicable diseases and increased odds of obesity (1, 2). Evidence from systematic reviews have shown associations between UPF consumption and the risk of type-2 diabetes(3). Such prospective evidence is lacking in Australia. This study aimed to prospectively investigate the association between UPF consumption and risk of type-2 diabetes in Australian adults. Participants from the Melbourne Collaborative Cohort Study (MCCS) aged 40-69 years, without diabetes at baseline (1990-1994), and who provided dietary and follow-up data were included. Dietary assessment was conducted at baseline using a 121-item food frequency questionnaire developed for the MCCS, and UPFs were categorised using the Nova system. Incidence of type-2 diabetes was assessed at follow-up 1 (1995 – 2002; self-report) and follow-up 2 (2003 – 2007; self-report, elevated plasma glucose (≥ 7.0 mmol/l fasting or ≥ 11.1 mmol/l non-fasting), or medication use). Poisson regression models were used to estimate Incidence Rate Ratios (IRRs) and 95% confidence intervals (CIs) for the risk of type-2 diabetes per 10% increase and by quartiles of UPF consumption (as a percentage of total energy intake per day), using age as the time metric. Models were adjusted for sociodemographic (i.e., sex, age, marital status, country of birth, number of people occupying the household, education and Socio-Economic Indexes for Areas) and behavioural (i.e., smoking, physical activity and alcohol intake) variables. A total of 25,214 participants were included in the analysis (mean ± SD age = 54.3 ± 8.4 years at baseline, 61% female). In average, UPFs contributed to 40.4% of total energy intake, ranging from 25.6% in the first quartile to 55.8% in the fourth quartile. The proportion of males, individuals living in households with ≤2 people, those born in Australia, with lower education levels, greater socioeconomic disadvantage, and physically inactive increased with higher UPF consumption. During the follow-up period, 1,734 cases of type-2 diabetes occurred. Each 10% increase in UPF consumption was associated with an estimated 5% increase in risk of type-2 diabetes (IRR 1.05; 95% CI: 1.004 - 1.09; p-value = 0.031). Participants in the highest quartile of UPF consumption had a 14% higher risk of type-2 diabetes (IRRhigh (quartile 4) vs. low (quartile 1) category = 1.16, 95% CI: 1.01 – 1.34, p-value = 0.037). In this large cohort of Australian adults, higher UPF consumption was associated with an increased risk of type-2 diabetes. Limiting UPF consumption may reduce type-2 diabetes risk. These findings contribute to the body of research on the impacts of UPFs on chronic diseases, supporting recommendations to limit UPF consumption as part of a healthy diet.

  1. 1. Machado PP, Steele EM, Levy RB et al (2019) BMJ Open 9:e029544.
  2. 2. Machado PP, Steele EM, Levy RB et al (2020) Nutr Diabetes 10(1):39.
  3. 3. Lane MM, Gamage E, Du S et al (2024) BMJ 384:e077310.