超加工食品与 2 型糖尿病发病风险：在前瞻性 Lifelines 队列中研究潜在的消费模式，以揭示这种异质食品类别对健康的影响。
Ultra-processed food and incident type 2 diabetes: studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort.
机构信息
Department of Internal Medicine, Division Nephrology (AA52), University Medical Center Groningen, P.O. Box 30 001, 9700RB, Groningen, The Netherlands.
Department of Epidemiology (FA40), University Medical Center Groningen, P.O. Box 30 001, 9700RB, Groningen, The Netherlands.
出版信息
BMC Med. 2022 Jan 13;20(1):7. doi: 10.1186/s12916-021-02200-4.
BACKGROUND
The overall consumption of ultra-processed food (UPF) has previously been associated with type 2 diabetes. However, due to the substantial heterogeneity of this food category, in terms of their nutritional composition and product type, it remains unclear whether previous results apply to all underlying consumption patterns of UPF.
METHODS
Of 70,421 participants (35-70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. UPF was identified according to the NOVA classification. Principal component analysis (PCA) was performed to derive UPF consumption patterns. The associations of UPF and adherence to UPF consumption patterns with incidence of type 2 diabetes were studied with logistic regression analyses adjusted for age, sex, diet quality, energy intake, alcohol intake, physical activity, TV watching time, smoking status, and educational level.
RESULTS
During a median follow-up of 41 months, a 10% increment in UPF consumption was associated with a 25% higher risk of developing type 2 diabetes (1128 cases; OR 1.25 [95% CI 1.16, 1.34]). PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased risk of incident type 2 diabetes; a pattern high in traditional Dutch cuisine was not associated with type 2 diabetes incidence (OR 1.05 [95% CI 0.97, 1.14]), while a pattern high in sweet snacks and pastries was inversely associated with type 2 diabetes incidence (OR 0.82 [95% CI 0.76, 0.89]).
CONCLUSIONS
The heterogeneity of UPF as a general food category is reflected by the discrepancy in associations between four distinct UPF consumption patterns and incident type 2 diabetes. For better public health prevention, research is encouraged to further clarify how different UPF consumption patterns are related to type 2 diabetes.
背景
超加工食品（UPF）的总体消费先前与 2 型糖尿病有关。然而，由于该食品类别在营养成分和产品类型方面存在很大的异质性，因此尚不清楚之前的结果是否适用于 UPF 的所有潜在消费模式。
方法
在 Lifelines 队列研究的 70421 名参与者（35-70 岁，58.6%为女性）中，通过食物频率问卷评估饮食摄入。根据 NOVA 分类法确定 UPF。采用主成分分析（PCA）得出 UPF 消费模式。采用逻辑回归分析调整年龄、性别、饮食质量、能量摄入、酒精摄入、体力活动、看电视时间、吸烟状况和教育水平后，研究 UPF 和 UPF 消费模式的依从性与 2 型糖尿病发病的关系。
结果
在中位随访 41 个月期间，UPF 消费增加 10%与 2 型糖尿病发病风险增加 25%相关（1128 例；OR 1.25 [95%CI 1.16, 1.34]）。PCA 显示出四种习惯性 UPF 消费模式。高冷咸零食（OR 1.16 [95%CI 1.09, 1.22]）和高温咸零食（OR 1.15 [95%CI 1.08, 1.21]）模式与 2 型糖尿病发病风险增加相关；高传统荷兰菜模式与 2 型糖尿病发病无关（OR 1.05 [95%CI 0.97, 1.14]），而高甜零食和糕点模式与 2 型糖尿病发病呈负相关（OR 0.82 [95%CI 0.76, 0.89]）。
结论
作为一种通用食品类别，UPF 的异质性反映在四个不同 UPF 消费模式与 2 型糖尿病发病之间的差异上。为了更好地进行公共卫生预防，鼓励开展研究，进一步阐明不同的 UPF 消费模式与 2 型糖尿病的关系。
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