The Association of Ultra-Processed Foods Intake with Prevalence of Diabetes in Adult Population, Shiraz, Southern Iran: A Cohort-Based Study

Document Type : Original Article

Authors

1 Student Research Committee, Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

5 Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

6 Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: The expansion of the food industry and the rise in food processing have changed dietary habits, leading to concerns about excessive consumption. This study examined the relationship between the intake of ultra-processed foods (UPFs) and the prevalence of diabetes in an adult population in Shiraz, Southern Iran.
Methods: Data from 3,285 participants in Employee Health Cohort of the Shiraz University of Medical Sciences were collected between August 2017 and February 2020 and analyzed using logistic regression analysis. The associations, yielding odds ratios with corresponding 95% confidence intervals were determined.
Results: The relationship between higher consumption of UPFs and diabetes prevalence did not reach statistical significance. Even after adjusting for potential confounders, including age, gender, body mass index (BMI), educational level, smoking habit, intake of energy drinks, and physical activity did not reveal a significant association.
Conclusion: Our findings did not show any statistically significant association between higher consumption of UPFs and diabetes prevalence. Comprehensive judgments require further investigations with more comprehensive study designs, larger sample sizes, and other populations.

Highlights

Seyed Jalil Masoumi (Google Scholar)

Keywords

References

  1. Masoumi SJ, Nekooeian AA, Tanideh N, et al. Effect of allium porrum on streptozotocin-induced diabetes mellitus hyperglycemia and insulin resistance in male Sprague Dawley rats. Onl J Vet Res. 2020;24:573-577.
  2. Davies MJ, Aroda VR , Collins BS, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45:S17. DOI: 10.2337/dci22-0034. PMID: 36148880.
  3. Asgari Q, Motazedian MH, Khazanchin A, et al. High prevalence of toxoplasma gondii infection in type I diabetic patients. J Parasitol Res. 2021;2021:8881908. DOI: 10.1155/2021/8881908. PMID: 33628471.
  4. Magliano DJ, Boyko EJ, committee IDFDAtes: IDF Diabetes Atlas. In: Idf diabetes atlas. edn. Brussels: International Diabetes Federation © International Diabetes Federation, 2021.
  5. Nikkhah A, Farzi Y, Azizpour Y, et al. Prevalence, awareness, treatment, and control of prediabetes and diabetes mellitus in older adults: findings from Iranian STEPS surveys (2016 and 2021). BMC Public Health. 2025;25:2658. DOI: 10.1186/s12889-025-23654-8. PMID: 40764559.
  6. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157:107843. DOI: 10.1016/j.diabres.2019.107843. PMID: 31518657.
  7. ElSayed NA, Aleppo G, Aroda VR, et al. Summary of revisions: standards of care in diabetes—2023. Diabetes Care. 2023;46:S5-S9. DOI: 10.2337/dc23-Srev. PMID: 36507641.
  8. Hosseini SE, Mehrabani D, Rezaei E. Effects of pomegranate juice on liver enzymes (ALT, ALP, AST) in diabetic and non-diabetic rats. J Anim Physiol Develop. 2014;24:59-64.
  9. Hosseini SE, Mehrabani D, Ghaedi HR. The effect of pomegranate juice on hemogram and weight profile in streptozotocin-induced diabetic adult male rats. Damghan J Zool. 2013;6:1-8.
  10. Hosseini SE, Rezaei E, Mehrabani D, et al. Effect of pomegranate juice on lipid profile in streptozotocin-induced diabetic adult male rats. J Exp Anim Biol. 2013;2:13-20.
  11. Forbes JM, Cooper ME: Mechanisms of diabetic complications. Physiol Rev. 2013;93:137-188. DOI: 10.1152/physrev.00045.2011. PMID: 23303908.
  12. Rezaei E, Hosseini SE, Mehrabani D. Effects of pomegranate juice on insulin and glucose in diabetic and non-diabetic male rats. J Birjand Univ Med Sci. 2013;20:1-8.
  13. Hosseini SV, Niknahad H, Fakhar N, et al. The Healing Effect Of Honey, Putty, Vitriol And Olive Oil In Psudomonas Areoginosa Infected Burns In Experiental Rat Model. Asian J Anim Vet Adv. 2011;6:572-579.
  14. Amirian P, Zarpoosh M, Najafi F, et al. Ultra-processed foods and type 2 diabetes mellitus incidence in RaNCD project: a prospective cohort study. Acta Diabetol. 2025;62:651-660. DOI: 10.1007/s00592-024-02385-z. PMID: 39373941.
  15. Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22:936-941. DOI: 10.1017/S1368980018003762. PMID: 30744710.
  16. Masoumi SJ, Mehrabani D, Saberifiroozi  M, et al. The effect of yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. probiotic in patients with lactose intolerance. Food Sci Nutr. 2021;9:1704-1711. DOI: 10.1002/fsn3.2145. PMID: 33747481.
  17. Srour B, Fezeu LK, Kesse-Guyot E, et al. Ultraprocessed food consumption and risk of type 2 diabetes among participants of the NutriNet-Santé prospective cohort. JAMA Intern Med. 2020;180:283-291. DOI: 10.1001/jamainternmed.2019.5942. PMID: 31841598.
  18. Elizabeth L, Machado P, Zinöcker M, et al. Ultra-processed foods and health outcomes: a narrative review. Nutrients. 2020;12:1955. DOI: 10.3390/nu12071955. PMID: 32630022.
  19. Poustchi H, Eghtesad S, Kamangar F, et al. Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design. Am J Epidemiol. 2018;187:647-655. DOI: 10.1093/aje/kwx314. PMID: 29145581.
  20. Mirmiran P, Esfahani FH, Mehrabi Y, et al. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr. 2010;13:654-662. DOI: 10.1017/S1368980009991698. PMID: 19807937.
  21. Monteiro C, Cannon G, Lawrence M, et al. FAO. Ultra-processed foods, diet quality, and health using the NOVA classification system. Food and Agriculture Organization of the United Nations, Rome, 2019.
  22. Craig CL, Marshall AL, Sjöström M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381-1395. DOI: 10.1249/01.MSS.0000078924.61453.FB. PMID: 12900694.
  23. Moradi S, Hojjati Kermani Ma, Bagheri R, et al. Ultra-processed food consumption and adult diabetes risk: a systematic review and dose-response meta-analysis. Nutrients. 2021;13:4410. DOI: 10.3390/nu13124410. PMID: 34959961.
  24. Llavero-Valero M, Escalada-San Martín J, Martínez-González MA, et al. Ultra-processed foods and type-2 diabetes risk in the SUN project: a prospective cohort study. Clin Nutr. 2021;40:2817-2824. DOI: 10.1016/j.clnu.2021.03.039. PMID: 33933748.
  25. Moslehi N, Mahdavi M, Mirmiran P, et al. Ultra-processed foods and the incidence of pre-diabetes and type 2 diabetes among Iranian adults: the Tehran lipid and glucose study. Nutr Metab. 2024;21:79. DOI: 10.1186/s12986-024-00854-4. PMID: 39385202.
  26. Levy RB, Rauber F, Chang K, et al. Ultra-processed food consumption and type 2 diabetes incidence: a prospective cohort study. Clin Nutr. 2021;40:3608-3614. DOI: 10.1016/j.clnu.2020.12.018. PMID: 33388205.
  27. Hwang S, Lim J, Choi Y, et al. Bisphenol A exposure and type 2 diabetes mellitus 788 risk: a meta-analysis. BMC Endocr Disord. 2018;18:81. DOI: 10.1186/s12902-018-0310-y. PMID: 30400886.
  28. Almarshad MI, Algonaiman R, Alharbi HF, et al. Relationship between ultra-processed food consumption and risk of diabetes mellitus: a mini-review. Nutrients. 2022;14:2366. DOI: 10.3390/nu14122366. PMID: 35745095.
  29. Zakerinia M, Pakrooh R, Amirghofran S, et al. The correlation between breast cancer and plastic bras in Fars province, southern Iran. World Appl Sci J. 2013;27:1275-77. DOI: 10.5829/idosi.wasj.2013.27.10.8186.
  30. Guasch-Ferré M, Becerra-Tomas N, Ruiz-Canela M, et al. Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevención con Dieta Mediterránea (PREDIMED) study. Am J Clin Nutr. 2017;105:723-735. DOI: 10.3945/ajcn.116.142034. PMID: 28202478.
  31. Breen C, Ryan M, McNulty B, et al. High saturated-fat and low-fibre intake: a comparative analysis of nutrient intake in individuals with and without type 2 diabetes. Nutr Diabetes 2014;4:e104-e104. DOI: 10.1038/nutd.2014.2. PMID: 24492470.
  32. DiNicolantonio JJ, O'Keefe JH, Lucan SC. Added fructose: a principal driver of type 2 diabetes mellitus and its consequences. Mayo Clin Proc. 2015;90:372-81. DOI: 10.1016/j.mayocp.2014.12.019. PMID: 25639270.
  33. Amirian P, Zarpoosh M, Najafi F, et al. Ultra-processed foods and type 2 diabetes mellitus incidence in RaNCD project: a prospective cohort study. Acta Diabetol. 2025;62:651-660. DOI: 10.1007/s00592-024-02385-z. PMID: 39373941.

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