Ultra-Processed Foods Linked to Higher Cardiovascular Risk for People With Type 2 Diabetes

In recent research, a concerning association between ultra-processed foods (UPFs) and cardiovascular disease (CVD) mortality has emerged, raising alarms for individuals with type 2 diabetes. This revelation challenges conventional wisdom, suggesting that even seemingly healthy diets may harbor hidden risks when highly processed foods are involved. This article delves into the intricacies of this study, its implications, and practical recommendations for individuals navigating the intersection of type 2 diabetes, heart health, and processed foods.

The Surprising Link: UPFs and CVD Mortality

Recent findings, published in The American Journal of Clinical Nutrition, have unveiled a startling connection between UPFs and CVD mortality in individuals with type 2 diabetes. While previous dietary guidelines for managing type 2 diabetes have primarily emphasized less processed, nutritionally balanced foods, this research suggests that the degree of food processing may be a critical factor influencing health outcomes.

The research, led by Dr. Marialaura Bonaccio from the Department of Epidemiology and Prevention at the IRCCS Neuromed Mediterranean Neurological Institute, challenges the conventional approach of assessing food solely based on its nutritional content. Instead, it underscores the importance of considering non-nutritional aspects, such as the extent of food processing, the use of additives, contaminants from plastics, and alterations to the food itself.

Understanding the Heart-Diabetes Connection

Before delving into the implications of UPFs on heart health in individuals with type 2 diabetes, it’s essential to grasp that this population is inherently more vulnerable to CVD. Statistics reveal that approximately 32.2% of all people with type 2 diabetes are affected by cardiovascular disease, compared to a prevalence of 5.5% in the general population.

The increased risk of CVD in people with type 2 diabetes is attributed to factors such as insulin resistance, which can elevate the risk of CVD. Moreover, comorbidities associated with diabetes, including hypertension and obesity, further compound the risk of cardiovascular disease.

Decoding the UPF-Heart Disease Connection

To investigate the relationship between UPFs and heart disease in type 2 diabetes, the researchers collected data from 1,065 participants with an average follow-up period of 11.6 years. During this time, participants recorded their dietary choices, which were later assessed for the level of processing using the NOVA classification system.

The NOVA classification system categorizes foods based on the extent and purpose of processing, irrespective of their nutritional quality. Among the 22 foods and beverages identified using this system were seemingly innocuous items like fruit yogurts, savory snacks, salty biscuits, aperitif biscuits, crackers, and carbonated drinks.

Participants were categorized based on their consumption of processed foods. Alarmingly, those with the highest intake of UPFs exhibited a 60% increased risk of all-cause mortality. Even more concerning was the fact that their risk of CVD-related mortality was over twice that of individuals consuming fewer UPFs.

Notably, the study highlighted that even individuals reporting adherence to a healthy Mediterranean-style diet did not experience significant mitigation of the adverse effects of UPFs on heart health. Instead, it was the non-nutritional factors, such as additives, contaminants, and processing-induced alterations, that seemed to correlate with detrimental cardiovascular outcomes.

The Further from Nature, the Higher the Risk

This study underscores a crucial concept: as foods move further from their natural state due to processing, the risk to cardiovascular health in individuals with type 2 diabetes appears to rise. It highlights that assessing food based solely on nutritional content may be insufficient in safeguarding health.

Identifying UPFs in Your Grocery Cart

While the NOVA classification system is not readily available to the average shopper, there are practical ways to recognize UPFs during your grocery shopping. According to dietitian Erin Palinski-Wade, ultra-processed foods are processed foods that have been modified to include added sugars, salt, fats (including oils), and starches. These can include commercially produced bread and cereals, soft drinks, hot dogs, crackers, cookies, and some frozen foods (e.g., chicken nuggets).

A telling sign of UPFs is often a lengthy ingredient list, even if the product appears healthy. Therefore, it is advisable to not only consider the length of the ingredient list but also its contents. A high number of additives and unfamiliar ingredients typically indicate a highly processed product.

Strategies for Managing UPFs with Type 2 Diabetes

For individuals with type 2 diabetes, managing UPF consumption for the sake of heart health is paramount. However, completely eliminating these foods from one’s diet may be a daunting task in a world that thrives on convenience.

Erin Palinski-Wade provides a practical perspective on this issue. She suggests that individuals with diabetes can incorporate UPFs into their diet but should focus on two critical aspects: the proportion of UPFs in the overall diet and the level of processing these foods have undergone.

For instance, while both roasted salted nuts and pork rinds can be classified as UPFs, they have vastly different health implications. It is essential to consider the impact of UPFs on your overall diet composition.

Moreover, it’s important to note that the study established an association, not causation. Various other factors influencing heart disease risk in people with diabetes may not have been accounted for. Lifestyle elements, such as low fruit and vegetable intake or high stress levels leading to reduced meal preparation time, could be contributing factors.

Therefore, while it’s advisable to limit UPFs, occasional consumption is unlikely to drastically affect cardiovascular health, provided it is balanced with a diet rich in whole foods, fiber, and slow-digesting carbohydrates.

Conclusion

The emerging link between UPFs and CVD mortality in individuals with type 2 diabetes underscores the importance of holistic dietary assessments. This research challenges the prevailing notion that nutritional content alone determines food’s impact on health. Instead, the degree of processing and non-nutritional factors play a pivotal role in cardiovascular outcomes.

While people with type 2 diabetes should be mindful of UPF consumption, a balanced approach is key. The focus should shift towards moderating the proportion of UPFs in the overall diet and considering the level of processing these foods undergo. Maintaining a diet rich in whole foods, fiber, and slow-digesting carbs remains a cornerstone of managing type 2 diabetes and promoting cardiovascular health.

In navigating the complex relationship between processed foods, diabetes, and heart health, it is evident that understanding the nuances of food processing can empower individuals to make informed dietary choices that promote their overall well-being.