TY - JOUR
T1 - Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations
T2 - The EPIC-InterAct Study
AU - Ibsen, Daniel B
AU - Steur, Marinka
AU - Imamura, Fumiaki
AU - Overvad, Kim
AU - Schulze, Matthias B
AU - Bendinelli, Benedetta
AU - Guevara, Marcela
AU - Agudo, Antonio
AU - Amiano, Pilar
AU - Aune, Dagfinn
AU - Barricarte, Aurelio
AU - Ericson, Ulrika
AU - Fagherazzi, Guy
AU - Franks, Paul W
AU - Freisling, Heinz
AU - Quiros, Jose R
AU - Grioni, Sara
AU - Heath, Alicia K
AU - Huybrechts, Inge
AU - Katze, Verena
AU - Laouali, Nasser
AU - Mancini, Francesca
AU - Masala, Giovanna
AU - Olsen, Anja
AU - Papier, Keren
AU - Ramne, Stina
AU - Rolandsson, Olov
AU - Sacerdote, Carlotta
AU - Sánchez, Maria-José
AU - Santiuste, Carmen
AU - Simeon, Vittorio
AU - Spijkerman, Annemieke M W
AU - Srour, Bernard
AU - Tjønneland, Anne
AU - Tong, Tammy Y N
AU - Tumino, Rosario
AU - van der Schouw, Yvonne T
AU - Weiderpass, Elisabete
AU - Wittenbecher, Clemens
AU - Sharp, Stephen J
AU - Riboli, Elio
AU - Forouhi, Nita G
AU - Wareham, Nick J
N1 - © 2020 by the American Diabetes Association.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
U2 - 10.2337/dc20-1038
DO - 10.2337/dc20-1038
M3 - Article
C2 - 32868270
SN - 1935-5548
VL - 43
SP - 2660
EP - 2667
JO - Diabetes Care
JF - Diabetes Care
IS - 11
ER -