Evidence map›Paper›PMID 37968763›Full record

ArticleDiabetology & metabolic syndrome2023

Association between ultra-processed food consumption and the incidence of type 2 diabetes: the ELSA-Brasil cohort.

Scheine L Canhada, Álvaro Vigo, Renata Levy, Vivian C Luft, Maria de Jesus M da Fonseca, Luana Giatti, Maria Del Carmen B Molina, Bruce B Duncan, Maria Inês Schmidt

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetology & metabolic syndrome, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.

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  10. Not all ultra-processed foods are created equal: a review.BMJ nutrition, prevention & health · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Scheine L CanhadaPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0002-4324-9848
Álvaro VigoPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0002-5797-9470
Renata LevyDepartment of Preventive Medicine, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0001-5388-7002
Vivian C LuftPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0003-2371-9264
Maria de Jesus M da FonsecaNational School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.ORCID http://orcid.org/0000-0002-5319-5513
Luana GiattiPostgraduate Program in Public Health and School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.ORCID http://orcid.org/0000-0001-5454-2460
Maria Del Carmen B MolinaPostgraduate Program in Nutrition and Health, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.ORCID http://orcid.org/0000-0002-8614-988X
Bruce B DuncanPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil.ORCID http://orcid.org/0000-0002-7491-2630
Maria Inês SchmidtPostgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil. maria.schmidt@ufrgs.br.ORCID http://orcid.org/0000-0002-3837-0731
Universidade Federal do Rio Grande do Sul · BRFundação Oswaldo Cruz · BRUniversidade de São Paulo · BRUniversidade Federal de Minas Gerais · BRUniversidade Federal do Espírito Santo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUltra-processed food (UPF) consumption increases the risk of type 2 diabetes in various high-income countries, with some variation in the magnitude across studies. Our objective was to investigate the association of UPF consumption and specific subgroups with incident type 2 diabetes in Brazilian adults.

methodsThe Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a multicenter cohort study of 15,105 adults (35-74 years) enrolled in public institutions in Brazil (2008-2010). We followed participants with two clinic visits (2012-2014; 2017-2019) and annual telephone surveillance. After excluding those with diabetes at baseline, who died or were lost in the follow-up, with missing data, with implausible energy food intake, or reporting bariatric surgery, there were 10,202 participants. We used the NOVA classification to assess UPF consumption based on a food frequency questionnaire. We defined type 2 diabetes by self-report, medication use, or comprehensive laboratory tests. We estimated relative risks (RR) and 95% confidence intervals (95% CI) using robust Poisson regression.

resultsMedian UPF consumption was 372 g/day. Over 8.2 (0.7) years of follow-up, we detected 1799 (17.6%) incident cases. After adjustment for socio-demographics, family history of diabetes, and behavioral risk factors, comparing the fourth (≥ 566 g/day) with the first (< 236 g/day) quartile of UPF distribution, RR was 1.24 (1.10-1.39); every 150 g/day increments in UPF consumption resulted in a RR of 1.05 (1.03-1.07). Reclassifying natural beverages with added sweeteners as UPF increased risk (RR 1.40; 1.25-1.58). Among UPF subgroupings, consumption of processed meats and sweetened beverages increased diabetes risk, while yogurt and dairy sweets decreased the risk (p < 0.05).

conclusionsUPF consumption increased the incidence of type 2 diabetes in Brazilian adults, with heterogeneity across specific food items. 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.

Indexed as

EpidemiologyNon-communicable diseasesPublic healthType 2 diabetesUltra-processed food

Identifiers

PMID37968763
PMCPMC10647077
OpenAlexW4388702835

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.