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We tested the hypothesis that UPF intake score derived from dietary history is associated with measures of insulin secretion and sensitivity in a family setting even when the process of type 2 diabetes is still to ensue. Methods: We used data from our well-characterized San Antonio Family Assessment of Metabolic Risk Indicators in Youth (SAFARI) study cohort of nondiabetic children (aged 6\u201317 years). Dietary history was assessed using the Block Food Frequency Questionnaire. Outcomes of interest were 19 clinically useful indexes of insulin secretion\/sensitivity based on fasting and oral glucose tolerance test results. Since the SAFARI study employed a family study design, we used polygenic regression models that adjusted for complex interactions between age and sex and accounted for important comorbidities. Results: A total of 53.3% of daily energy intake was contributed by UPF. Of the 19 indexes tested for association with the UPF score, we found a statistically significant association with measures of insulin resistance and beta cell function and with three indexes based on the results of oral glucose tolerance test as follows: Matsuda index (\u03b2 = \u22120.0962, p = 0.0262), insulinogenic index at 30 min (\u03b2 = 0.1779, p = 0.0006) and disposition index at 30 min (\u03b2 = 0.1538, p = 0.0061). Conclusions: Even in nondiabetic children there was a significant and independent association of UPF intake with insulin secretion and sensitivity. Future studies need to investigate this association in larger, longitudinal settings and in randomized trials controlling potential systematic errors.<\/jats:p>","DOI":"10.3390\/nu18142361","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:32:08Z","timestamp":1784514728000},"page":"2361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Ultra-Processed Food Intake with Insulin Secretion and Sensitivity in Mexican American Children: Results from the SAFARI Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6950-3341","authenticated-orcid":false,"given":"Hemant","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rector","family":"Arya","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-6380","authenticated-orcid":false,"given":"Srinivas","family":"Mummidi","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon P.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Medicine, Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy G.","family":"Resendez","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0966-8766","authenticated-orcid":false,"given":"Juan Carlos","family":"Lopez-Alvarenga","sequence":"additional","affiliation":[{"name":"Division of Population Health and Biostatistics, Department of Primary & Community Care, School of Medicine, University of Texas Rio Grande Valley, 2102 Treasure Hills Blvd, Harlingen, TX 78550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6267-3591","authenticated-orcid":false,"given":"Alvaro","family":"Diaz-Badillo","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobha","family":"Puppala","sequence":"additional","affiliation":[{"name":"Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Farook","sequence":"additional","affiliation":[{"name":"Department of Human Genetics and South Texas Diabetes and Obesity Institute, College of Sciences, University of Texas Rio Grande Valley, Office 2.233, Biomedical Research and Health Building, One W University Boulevard, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Penn State Health and Penn State College of Medicine, Penn State University, 35 Hope Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-9885","authenticated-orcid":false,"given":"Jane L.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley C.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Nutrition, College of Agriculture and Life Science, Texas A&M University, College Station, TX 77840, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2163-303X","authenticated-orcid":false,"given":"Vijay","family":"Golla","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77843, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-9927","authenticated-orcid":false,"given":"Donna M.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3839-1724","authenticated-orcid":false,"given":"Ralph A.","family":"DeFronzo","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Department of Medicine, Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6250-5723","authenticated-orcid":false,"given":"John","family":"Blangero","sequence":"additional","affiliation":[{"name":"Department of Human Genetics and South Texas Diabetes and Obesity Institute, College of Sciences, University of Texas Rio Grande Valley, Office 2.233, Biomedical Research and Health Building, One W University Boulevard, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindranath","family":"Duggirala","sequence":"additional","affiliation":[{"name":"Department of Health and Behavioral Sciences, College of Arts and Sciences, Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, 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