Ultra-processed food intake is associated with altered glucose homeostasis in young adults with a history of overweight or obesity: a longitudinal study

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BACKGROUND: Ultra-processed foods (UPFs), often high in sodium, sugar, and unhealthy fats, compose more than half of total dietary energy consumption in the United States. A diet composed of a high amount of UPFs can contribute to glucose dysregulation and insulin resistance, which may lead to prediabetes and type 2 diabetes (T2D). However, few studies have assessed the associations between UPFs and T2D or obesity in young people. The goal of this study is to examine associations between UPF consumption and prediabetes and related biomarkers in youth. METHODS: Young adults (age 17-22, n = 85) with a history of overweight or obesity from the Metabolic and Asthma Incidence Research (Meta-AIR) study, a subset of the Children's Health Study, were enrolled between 2014 and 2018 and returned for a second visit between 2020 and 2022. Participants completed two 24-hour dietary recalls and an oral glucose tolerance test at each visit. Food items were categorized as either an UPF or non-UPF according to NOVA classification guidelines. The proportion of the diet composed of UPFs was calculated for each participant. Regression models were used to assess relationships of UPF consumption at baseline and change between visits with markers of glucose homeostasis at follow-up, adjusting for demographics, physical activity, and total energy intake. RESULTS: A 10%-point increase in UPF consumption between visits was associated with a 51% (OR: 1.51, 95% Cl: 1.04, 2.31) higher odds of having prediabetes and 158% (OR: 2.58, 95% CI: 1.43, 5.85) higher odds of impaired glucose tolerance at follow-up. Higher baseline UPF consumption was significantly positively associated with 2-hour insulin ([Formula: see text] = 45.11, 95% CI: 22.42, 67.80) and insulin area under the curve ([Formula: see text] = 63.56, 95% CI: 34.95, 92.17) at follow-up. CONCLUSION: UPF consumption may increase the risk for T2D among young adults. Our findings suggest that limiting UPF consumption could be an important strategy for T2D prevention in this population.

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