{"doi":"10.2337/dc25-0700","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—A Prospective Study","abstract":"OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: We included 4,207 women with a history of GDM from the Nurses' Health Study II (1991-2021). 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. RESULTS: T2D developed in 1,040 participants. Increased UPF consumption was associated with greater weight gain (P-trend < 0.0001; quartile 1 [Q1] 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. CONCLUSIONS: 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.","journal":"Diabetes Care","year":2025,"id":572700,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8623,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1381002,"name":"Xin Yin","orcid":"0000-0002-9599-9042","position":1,"is_corresponding":false},{"id":230957,"name":"Deirdre K. Tobias","orcid":"0000-0003-0020-9552","position":2,"is_corresponding":false},{"id":638402,"name":"Zhangling Chen","orcid":"0000-0002-4995-8485","position":3,"is_corresponding":false},{"id":246331,"name":"Qi Sun","orcid":"0000-0002-8480-1563","position":5,"is_corresponding":false},{"id":104573,"name":"Jorge E. Chavarro","orcid":"0000-0002-4436-9630","position":6,"is_corresponding":false},{"id":104570,"name":"Walter C. Willett","orcid":"0000-0003-1458-7597","position":7,"is_corresponding":false},{"id":55333,"name":"Frank B. Hu","orcid":"0000-0002-8233-6274","position":8,"is_corresponding":false},{"id":291978,"name":"Cuilin Zhang","orcid":"0000-0002-8014-2708","position":9,"is_corresponding":false},{"id":827747,"name":"Jiaxi Yang","orcid":"0000-0002-4497-9615","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:57:27.876396Z","pmid":"40824862","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}