Ultra-processed foods (UPF) have been in the news a lot lately. I recently wrote about them, too, pointing out that UPF can easily undermine a healthy plant-based diet. We need to eat real food, not processed junk. But not all ultra-processed foods are equal. In this article I share a more nuanced analysis that I found very helpful, and think it will help you make better food choices, too. So let’s dig in.
A recent study was published in the journal Diabetes Care that exposed the link between ultra-processed food consumption and the risk of getting type 2 diabetes. The study pooled together results from three large U.S. cohorts: the Nurses' Health Study, Nurses' Health Study II, and the Health Professionals Follow-Up Study.
Ultra-Processed Foods Increase Risk of Diabetes
Harvard University has been following these cohorts for many years now. The study included over 5 million person-years of follow-up, and it showed overall that higher total intake of ultra-processed food (UPFs) was associated with a 46% increased risk of type 2 diabetes when they compared the highest to lowest consumption groups.
The result that UPF consumption leads to more diabetes is kind of a “duh” moment for all of us, right? Of course it does. But there's more to this story, in the more detailed analysis. This is what's really interesting here.
Not All Ultra-Processed Food is the Same
When the researchers dug into the different kinds of UPFs, they found some critical distinctions: Refined breads, sauces, spreads, condiments, artificially and sugar-sweetened beverages, as well as animal-based products and ready-to-eat mixed dishes (maybe like pasta dishes, lasagna, processed meat and refined grain dinners, TV dinners, etc.,) all contributed to higher T2D risk. This is what we would expect, but there's more.
Ultra-processed cereals, dark and whole grain breads, packaged and savory snacks (chips?), fruit-based products, and yogurt and dairy-based desserts were associated with a lower T2D risk.
These foods have more fiber in them, more minerals, maybe some more beneficial dairy fats, some of the odd-chain fats like C15. These may give some protective effects.
The key finding here is that even in the ultra-processed food category, what you choose to eat does make a difference. When you need a snack or something that's ready to eat, choose whole grain cereals, whole grain breads, fruit-based snacks, or even nuts and seeds ( they weren’t on the list, but those would be a good snack as well).
In the Figure below, from the Diabetes Care article, the categories underlined in green gave positive results, while the categories underlined red (my editing, of course) increased the risk of T2D.
Daily Health Choices Become Habits, Habits Become Lifestyle, Lifestyle Leads to Health Destiny
Avoid sugar-sweetened drinks and processed meats to lower your risk of type 2 diabetes. We can all make these decisions.
- Apples instead of apple pie.
- Oranges instead of orange juice.
- Nuts and seeds or trail mix instead of candy bars or meat snacks.
- Pure water or even flavored unsweetened water instead of soda pop.
- Whole grain breads instead of refined white bread. (Clean-label national brands like Dave’s Killer Bread are now widely available.)
- Raisins, prunes, and dried apricots instead of candy.
These are all easy choices and readily available to many people. Once you get into the habit of making good food choices they will stick with you and become automatic. Cravings die down, your body is fed with real food, and your health improves. Replacement instead of deprivation is a key concept in improving your diet. We have a whole list of healthy substitutes to make for your favorite unhealthy foods. Take a step and choose better. Don't beat yourself up if you can't choose "best" right now. Take it one step at a time, and celebrate the small wins to build momentum to keep going.
Choices become habits and habits form your lifestyle. Follow a lifestyle consistently and you get the outcomes, the destiny of that lifestyle. Choose wisely and live with intention.
Reference: Chen Z, et al. Ultra-Processed Food Consumption and Risk of Type 2 Diabetes: Three Large Prospective U.S. Cohort Studies. Diabetes Care. 2023;46(7):1335–1344. https://pmc.ncbi.nlm.nih.gov/articles/PMC10300524/
