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.

  • Deep Digital Phenotyping Research Unit
November 01, 2020 By:
  • Ibsen DB
  • Steur M
  • Imamura F
  • Overvad K
  • Schulze MB
  • Bendinelli B
  • Guevara M
  • Agudo A
  • Amiano P
  • Aune D
  • Barricarte A
  • Ericson U
  • Fagherazzi G
  • Franks PW
  • Freisling H
  • Quiros JR
  • Grioni S
  • Heath AK
  • Huybrechts I
  • Katze V
  • Laouali N
  • Mancini F
  • Masala G
  • Olsen A
  • Papier K
  • Ramne S
  • Rolandsson O
  • Sacerdote C
  • Sanchez MJ
  • Santiuste C
  • Simeon V
  • Spijkerman AMW
  • Srour B
  • Tjonneland A
  • Tong TYN
  • Tumino R
  • van der Schouw YT
  • Weiderpass E
  • Wittenbecher C
  • Sharp SJ
  • Riboli E
  • Forouhi NG
  • Wareham NJ.

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.

2020 Nov. Diabetes Care.43(11):2660-2667. Epub 2020 Aug 31.
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