New Delhi: A first-of-its-kind study conducted by Italian researchers has suggested that ultra-processed food (UPF) can increase the risk of mortality due to cardiovascular disease among those with Type 2 diabetes by 1.7 times.
Published in The American Journal of Clinical Nutrition on 26 July, the study was conducted by researchers from the Department of Epidemiology and Prevention, IRCCS NEUROMED, in Pozzilli, the Mediterranea Cardiocentro in Napoli, and the Department of Medicine and Surgery at University of Insubria’s Research Center in Epidemiology and Preventive Medicine (EPIMED).
According to the Nova Food Classification System — a widely-used system that rates food on the basis of degree of processing — UPF comprises eatables of mainly industrial origin, made mostly or entirely from substances derived from foods and additives using a series of processes and containing minimal whole foods.
Some examples of ultra-processed foods are soda, packaged cookies, chips, flavoured nuts, flavoured yogurt, distilled alcoholic beverages, and fast food.
The researchers, who followed 1,065 diabetic people for nearly 12 years from 2005 to 2017, found that participants reporting a higher consumption of UPF — that is, those who said such foods accounted for nearly 12 percent of their total diet — had a 60 percent increased risk of dying from any cause, not just cardiovascular, compared to people consuming less of these products.
The average UPF consumption of the study group was 7.4 percent of their total diet.
According to the researchers, the risk of mortality from cardiovascular diseases — a leading cause of death for people with diabetes — was more than double among people with Type 2 diabetes who consumed more UPF. This risk did not change much with the addition of a Mediterranean diet, a plan that focuses on plant-based foods and healthy fats, the researchers found.
The findings are important because this is the first time a study is assessing the risk of UPF consumption in diabetics.
It also assumes particular significance in a country like India, which is sometimes referred to as ‘the diabetes capital of the world’. According to the Indian Council of Medical Research and Madras Diabetes Research Foundation, 101 million people in India suffer from diabetes and 136 million people from prediabetes.
In the wake of the findings, Nutrition Advocacy in Public Interest (NAPi), a New Delhi-based nutrition think tank, has called on India’s dietary guidelines to address intake of ultra-processed food.
“In addition, policies to reduce the consumption of ultra-processed foods must be immediately adopted, such as mandatory Front of Pack Warning Labels (FOPL), restrictions of marketing and higher taxes on such food products,” the organisation said in a statement.
Officials at the Food Safety and Standards Authority of India (FSSAI) — the country’s apex food regulator — told ThePrint that such a policy was currently under discussion.
‘Under discussion’
Ultra-processed foods tend to be lower in nutrients and fibre and higher in sugar, fat and salt content compared to unprocessed or minimally processed foods.
With studies increasingly linking even seemingly healthy UPF options, such as quinoa bars, with lifestyle diseases and even cancers, there’s a growing call in India to make policy changes in its food labelling system.
In its statement, NAPi said the World Health Organization (WHO) has also called on governments to make mandatory policies to reduce the exposure of children to the aggressive marketing of high sugar/fat/salt foods (HFSS) — pre-packaged ultra-processed food that’s otherwise known as junk food.
“We request policymakers to show some urgency in coming up with policies that lead to decrease in consumption of ultra-processed food as there is much evidence available now to show how dangerous they are,” Dr Arun Gupta, a senior paediatrician and the convenor of NAPi, told ThePrint.
It’s disappointing, he said, that the FSSAI has so far not devised a policy on FOPL for packaged food items.
“Also, the current advertisement norms do not bar food items high in sugar, fat or salts from being advertised in any way. We need a relook at this policy too,” he added.
In March last year, the FSSAI had released a draft FOPL policy with plans to introduce a mandatory health star rating (HSR) on all packaged food items. A front-of-pack labeling system that rates the overall nutritional profile of packaged food, the HSR was aimed at providing key nutritional information of a product on the front of packaged foods to allow consumers to make comparisons between products within the same category.
However, several health and nutrition activists and organisations — including the Indian Council of Medical Research National Institute of Nutrition — had argued against the rating system, saying it would only confuse the consumers, according to media reports. Instead, they called for a more “scientific and health-friendly” policy such as a warning label, arguing that a front-of-the-package pictorial warning would serve the purpose better.
Officials at FSSAI told ThePrint that they were reconsidering their draft policy in the light of the feedback they had received.
“After our draft policy was released, we have received nearly 14,000 suggestions and currently our scientific panel is discussing these suggestions,” FSSAI chief executive officer G. Kamala Vardhana Rao said.
(Edited by Uttara Ramaswamy)