ArticleThe Lancet regional health. Europe2024
Food consumption by degree of food processing and risk of type 2 diabetes mellitus: a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC).
Article in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Ultra-processed food intake and risk of type 2 diabetes: a pooled analysis of three prospective cohorts of Korean adults and an updated meta-analysis.European journal of epidemiology · 2025Pooled it
- A Systematic Review of Evidence on the Role of Ready-to-Eat Cereals in Diet and Non-Communicable Disease Prevention.Nutrients · 2025Pooled it
- Spatiotemporal dynamics of the host-tumor metabolic interface: Implications for precision nutritional oncology.Genes & diseases · 2026Review
- When Ultra-Processed Foods are Eaten: The Missing Dimension in Exposure Measurement for Obesity Research.Current obesity reports · 2026Review
- Ultra-processed foods and continuous glucose monitoring metrics in adults with type 2 diabetes.Diabetes research and clinical practice · 2026Article
- Food Functional Factors and Nutritional Health.Nutrients · 2026Article
- Interpreting ultraprocessed food trial evidence: evidentiary limits, reporting practices, and policy relevance.The American journal of clinical nutrition · 2026Review
- Ultra-Processed Food Dietary Patterns and Obesity: A Cross-Sectional Analysis of NHANES 2021-2023.Health science reports · 2026Article
- The Gut-brain-adipose Axis in Ultra-processed Food and Obesity: A Mechanistic Synthesis and Its Implications for Food Classification.Current obesity reports · 2026Review
- Are All Ultra-Processed Foods Created Equal? Descriptive Analysis of Nutritional Composition, Nutritional Quality, Energy Density and Hyperpalatability in Relation to Non-Communicable Disease Risk.Foods (Basel, Switzerland) · 2026Article
- The Purpose of Food Processing and Ultra-Processed Food: the Potential, Pitfalls and Path Forward for Public Health.Current nutrition reports · 2026Review
- Food intakes based on degree of processing and metabolic dysfunction-associated steatotic liver disease (MASLD): the Tehran Lipid and Glucose Study (TLGS).Nutrition & metabolism · 2026Article
- Ultra-Processed Foods and the Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, and Translational Evidence.Nutrients · 2026Review
- Processed Diets and Food Additives Shape the Gut Microbiota and Chronic Disease Risk Across the Life Course-A Three-Layer Ecosystem Disruption Model (TLED) Model.Life (Basel, Switzerland) · 2026Review
- Sprouted Wheat Improves Liver Metabolism and Inflammation in T2DM Mice: 16S rRNA Gene Sequence, Metabolomics and Network Pharmacology Joint Analysis.Foods (Basel, Switzerland) · 2026Article
- Diabetes Mellitus as an Integrated Microbiome, Immune, and Metabolic Disorder with Clinical Implications for Multisystem Complications and Public Health.Journal of clinical medicine · 2026Review
- Ultra-processed food exposure and health outcomes: Current evidence, controversies, and future perspectives.EXCLI journal · 2026Review
- Not all ultra-processed foods are created equal: a review.BMJ nutrition, prevention & health · 2026Review
- Ultra-processed food consumption across early life: implications for pediatric health and disease risk.Frontiers in nutrition · 2026Review
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
Background: It is unknown whether the association between ultra-processed food (UPF) intake and type 2 diabetes mellitus differs from other degrees of food processing. We examined the association between degree of food processing and incident type 2 diabetes mellitus. Methods: This was a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline using dietary questionnaires and classified according to the Nova classification into unprocessed/minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF. Type 2 diabetes mellitus cases were verified through multiple methods. Cox regression and statistical substitution analysis was used to estimate associations between MPF + PCI, PF and UPF intake and incident type 2 diabetes mellitus. To investigate heterogeneity in the association between UPF and incident type 2 diabetes mellitus, UPF sub-group analysis was conducted. Different reference groups were used in each analysis. Findings: Over an average 10.9 years follow-up of 311,892 individuals, 14,236 type 2 diabetes mellitus cases were identified. Each 10% increment of total daily food intake from UPF (%g/day) was associated with 17% (95% confidence interval (95%CI): 1.14-1.19) higher incident type 2 diabetes mellitus. Each 10% increment in MPF + PCI or PF intake was associated with lower incident type 2 diabetes mellitus (MPF + PCI hazard ratio: 0.94 (95%CI: 0.92-0.96); PF hazard ratio: 0.92 (95%CI: 0.89-0.95)). Replacing UPF with MPF + PCI or PF was associated with lower incident type 2 diabetes mellitus. However, heterogeneity was observed across UPF sub-groups, with breads, biscuits and breakfast cereals, sweets and desserts, and plant-based alternatives associated with lower incident type 2 diabetes mellitus. Interpretation: These findings support recommendations to focus on reducing intake of specific UPF for lowering type 2 diabetes mellitus risk. Funding: International Agency for Research on Cancer.
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Registered trials
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