Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations: The EPIC-InterAct Study

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


OBJECTIVE: There is sparse evidence for the association of suitable food substitutions for red and processed meat on the risk of type 2 diabetes. We modeled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact.

RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer (EPIC)-InterAct case cohort included 11,741 individuals with type 2 diabetes and a subcohort of 15,450 participants in eight countries. We modeled the replacement of self-reported red and processed meat with poultry, fish, eggs, legumes, cheese, cereals, yogurt, milk, and nuts. Country-specific hazard ratios (HRs) for incident type 2 diabetes were estimated by Prentice-weighted Cox regression and pooled using random-effects meta-analysis.

RESULTS: There was a lower hazard for type 2 diabetes for the modeled replacement of red and processed meat `(50 g/day) with cheese (HR 0.90, 95% CI 0.83-0.97) (30 g/day), yogurt (0.90, 0.86-0.95) (70 g/day), nuts (0.90, 0.84-0.96) (10 g/day), or cereals (0.92, 0.88-0.96) (30 g/day) but not for replacements with poultry, fish, eggs, legumes, or milk. If a causal association is assumed, replacing red and processed meat with cheese, yogurt, or nuts could prevent 8.8%, 8.3%, or 7.5%, respectively, of new cases of type 2 diabetes.

CONCLUSIONS: Replacement of red and processed meat with cheese, yogurt, nuts, or cereals was associated with a lower rate of type 2 diabetes. Substituting red and processed meat by other protein sources may contribute to the prevention of incident type 2 diabetes in European populations.


  • Daniel B Ibsen
  • Marinka Steur
  • Fumiaki Imamura
  • Kim Overvad
  • Matthias B Schulze
  • Benedetta Bendinelli
  • Marcela Guevara
  • Antonio Agudo
  • Pilar Amiano
  • Dagfinn Aune
  • Aurelio Barricarte
  • Guy Fagherazzi
  • Heinz Freisling
  • Jose R Quiros
  • Sara Grioni
  • Alicia K Heath
  • Inge Huybrechts
  • Verena Katze
  • Nasser Laouali
  • Francesca Mancini
  • Giovanna Masala
  • Anja Olsen
  • Keren Papier
  • Olov Rolandsson
  • Carlotta Sacerdote
  • Maria-José Sánchez
  • Carmen Santiuste
  • Vittorio Simeon
  • Annemieke M W Spijkerman
  • Bernard Srour
  • Anne Tjønneland
  • Tammy Y N Tong
  • Rosario Tumino
  • Yvonne T van der Schouw
  • Elisabete Weiderpass
  • Clemens Wittenbecher
  • Stephen J Sharp
  • Elio Riboli
  • Nita G Forouhi
  • Nick J Wareham
Enheter & grupper
Externa organisationer
  • University of Cambridge
  • Aalborg University Hospital
  • University of Potsdam
  • Health Research Institute of Navarra (IDISNA)
  • Oslo university hospital
  • International Agency for Research on Cancer, World Health Organization
  • Public Health Directorate
  • Istituto Nazionale dei Tumori
  • Imperial College London
  • German Cancer Research Centre
  • Danish Cancer Society Research Center
  • University of Oxford
  • Umeå University
  • National Institute for Public Health and the Environment (RIVM)
  • University of Copenhagen
  • University Medical Center Utrecht
  • Harvard T.H. Chan School of Public Health
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • Bellvitge University Hospital-IDIBELL
  • Instituto BIO-Donostia
  • Institut Gustave Roussy
  • Centre for Cancer Epidemiology and Prevention (CPO Piemonte)
  • University of Granada
  • Murcia Regional Health Authority
  • University of Campania Luigi Vanvitelli
  • Associazione Iblea per la Ricerca Epidemiologica

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • Endokrinologi och diabetes
  • Näringslära
Sidor (från-till)2660-2667
TidskriftDiabetes Care
Utgåva nummer11
StatusPublished - 2020
Peer review utfördJa