{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:49:46Z","timestamp":1755798586803,"version":"3.44.0"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"US Food and Drug Administration"},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIH","award":["CA50385","DK58845","P30 DK46200","R01 CA67262","U01 CA176726","U01 HL145386","UM1 CA186107"],"award-info":[{"award-number":["CA50385","DK58845","P30 DK46200","R01 CA67262","U01 CA176726","U01 HL145386","UM1 CA186107"]}]},{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health","award":["HHSN275201000020C"],"award-info":[{"award-number":["HHSN275201000020C"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We examined the associations of overall and group-specific ultra-processed food (UPF) consumption with long-term weight change and type 2 diabetes (T2D) progression following gestational diabetes mellitus (GDM)-complicated pregnancies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We included 4,207 women with a history of GDM from the Nurses' Health Study II (1991\u20132021). UPF intake (servings\/day) was assessed via food frequency questionnaires every 4 years and quantified per the NOVA classification. Diet quality was evaluated using the Alternate Healthy Eating Index-2010 (AHEI). Associations between UPF intake changes and weight changes (kg) were assessed using generalized estimating equations (GEE) (n = 3,781). Cox regression models estimated adjusted hazard ratios (HRs) and 95% CIs of habitual UPF intake modeled by time-updated cumulative averages with T2D risk. Joint associations of UPF and AHEI with weight change and T2D risk were examined using the same GEE and Cox regression models, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>T2D developed in 1,040 participants. Increased UPF consumption was associated with greater weight gain (P-trend &amp;lt; 0.0001; quartile [Q]1 vs. Q4: 0.52 kg vs. 1.65 kg). Habitual UPF consumption was positively associated with T2D risk: adjusted HRs (95% CIs) for Q1 to Q4 were 1.00 (ref), 1.07 (0.87, 1.32), 1.25 (1.03, 1.53), and 1.20 (0.99, 1.46), respectively (P-trend = 0.04). These associations persisted in women with higher AHEI scores. When modeling UPF and AHEI jointly, only women with stable or decreased UPF intake and increased AHEI achieved 4-year weight maintenance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In women with a history of GDM, UPF consumption was associated with weight gain and higher T2D risk, even among those with higher diet quality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc25-0700","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:20:30Z","timestamp":1755537630000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Ultra-processed Foods and Diet Quality in Association With Long-term Weight Change and Progression to Type 2 Diabetes Among Individuals With a History of Gestational Diabetes Mellitus\u2014A Prospective Study"],"prefix":"10.2337","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4497-9615","authenticated-orcid":false,"given":"Jiaxi","family":"Yang","sequence":"first","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Yin","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0020-9552","authenticated-orcid":false,"given":"Deirdre K.","family":"Tobias","sequence":"additional","affiliation":[{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"5Division of Preventive Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhangling","family":"Chen","sequence":"additional","affiliation":[{"name":"6Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"7Key Laboratory of Cardiometabolic Medicine in Hunan Province, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-8485","authenticated-orcid":false,"given":"Qi","family":"Sun","sequence":"additional","affiliation":[{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"9Channing Division of Network Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-1563","authenticated-orcid":false,"given":"JoAnn E.","family":"Manson","sequence":"additional","affiliation":[{"name":"5Division of Preventive Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"},{"name":"8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4436-9630","authenticated-orcid":false,"given":"Jorge E.","family":"Chavarro","sequence":"additional","affiliation":[{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"9Channing Division of Network Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter C.","family":"Willett","sequence":"additional","affiliation":[{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"9Channing Division of Network Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank B.","family":"Hu","sequence":"additional","affiliation":[{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"9Channing Division of Network Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8014-2708","authenticated-orcid":false,"given":"Cuilin","family":"Zhang","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2025,8,18]]},"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc25-0700\/839672\/dc250700.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc25-0700\/839672\/dc250700.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:20:32Z","timestamp":1755537632000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/doi\/10.2337\/dc25-0700\/163245\/Ultra-processed-Foods-and-Diet-Quality-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,18]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/dc25-0700","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"type":"print","value":"0149-5992"},{"type":"electronic","value":"1935-5548"}],"subject":[],"published":{"date-parts":[[2025,8,18]]},"article-number":"dc250700"}}