Impact of ultra-processed foods consumption on the burden of obesity and type 2 diabetes in Belgium: a comparative risk assessment

BACKGROUND: A high consumption of ultra-processed foods (UPFs) has been related to several chronic diseases such as obesity and type 2 diabetes. This study aimed to estimate the proportion of the burden of obesity and type 2 diabetes in Belgium that could be attributed to the consumption of UPFs. METHODS: A comparative-risk assessment framework was used. A literature search and a dose-response meta-analysis between UPFs intake and obesity and type 2 diabetes were performed. The risks were extracted from the curve dose-response meta-analysis and extrapolated to the mean of UPFs consumption by strata (5-year age category/sex/region) using the 2014/2015 Belgian Food Consumption Survey. The population attributable fraction and the attributable burden were then calculated for the prevalence of obesity and type 2 diabetes, and disability-adjusted life-years (DALYs) for type 2 diabetes. RESULTS: From the meta-analysis, for every 10% increase in UPFs intake (g/day), there was a 13% increase in risk of developing type 2 diabetes (RR:1.13, 95%IC 1.12-1.15, p<0.001) and for every 10% increase of energy intake from UPFs (kcal/day), there was a 5% increase in risk of developing obesity (RR:1.05, 95%IC 0.99-1.13, p=0.1321). Using these estimates, 21% of cases (277 056/1 286 454) of obesity in Belgium in 2014/2015 could be attributed to the UPFs intake. Similarly, for type 2 diabetes in Belgium in 2014/2015, 23% of cases (53 348/227 502) and 24% of DALYs (7 998/34 034) were attributed to UPFs consumption. CONCLUSIONS: The sizeable impact of UPFs on the burden of obesity and type 2 diabetes in Belgium emphasizes the need to design and implement policies to address UPF consumption in Belgium.