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
Ibsen, Daniel B.; Steur, Marinka; Imamura, Fumiaki; Overvad, Kim; Schulze, Matthias B.; Bendinelli, Benedetta; Guevara, Marcela; Agudo, Antonio; Amiano, Pilar; Aune, Dagfinn; Barricarte, Aurelio; Ericson, Ulrika; Fagherazzi, Guy; Franks, Paul W.; Freisling, Heinz; Quiros, Jose R.; Grioni, Sara; Heath, Alicia K.; Huybrechts, Inge; Katze, Verena; Laouali, Nasser; Mancini, Francesca; Masala, Giovanna; Olsen, Anja; Papier, Keren; Ramne, Stina; Rolandsson, Olov; Sacerdote, Carlotta; Sanchez, Maria-Jose; Santiuste, Carmen; Simeon, Vittorio; Spijkerman, Annemieke M. W.; Srour, Bernard; Tjonneland, Anne; Tong, Tammy Y. N.; Tumino, Rosario; van der Schouw, Yvonne T.; Weiderpass, Elisabete; Wittenbecher, Clemens; Sharp, Stephen J.; Riboli, Elio; Forouhi, Nita G.; Wareham, Nick J.
(2020) Diabetes Care, volume 43, issue 11, pp. 2660 - 2667
(Article)
Abstract
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.
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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.
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Keywords: Internal Medicine, Endocrinology, Diabetes and Metabolism, Advanced and Specialised Nursing
ISSN: 0149-5992
Publisher: American Diabetes Association Inc.
Note: Funding Information: Acknowledgments. The authors thank all EPIC participants and staff for their contribution to the study and Nicola Kerrison, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, U.K., for data management. Funding. Funding for the InterAct project was provided by the European Union Sixth Frame-work Programme (grant no. LSHM_CT_2006_ 037197). Additionally, InterAct investigators acknowledge funding from the following agencies: N.J.W. and N.G.F. acknowledge funding from the MRC Epidemiology Unit (MC_UU_12015/1 and MC_UU_12015/5) and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014). M.S. and F.I. report core MRC Unit support through the Nutritional Epidemiology Programme (MC_UU_ 12015/5). M.B.S. acknowledges funding by the German Ministry of Education and Research (BMBF) and the State of Brandenburg (DZD grant 82DZD00302). M.G. acknowledges funding by the Regional Government of Navarre. V.S. was supported by Programma VALERE, University of Campania Luigi Vanvitelli. Funding Information: The authors thank all EPIC participants and staff for their contribution to the study and Nicola Kerrison, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, U.K., for data management. Funding. Funding for the InterAct project was provided by the European Union Sixth Frame-work Programme (grant no. LSHM_CT_2006_ 037197). Additionally, InterAct investigators acknowledge funding from the following agencies: N.J.W. and N.G.F. acknowledge funding from the MRC Epidemiology Unit (MC_UU_12015/1 and MC_UU_12015/5) and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014). M.S. and F.I. report core MRC Unit support through the Nutritional Epidemiology Programme (MC_UU_ 12015/5). M.B.S. acknowledges funding by the German Ministry of Education and Research (BMBF) and the State of Brandenburg (DZD grant 82DZD00302). M.G. acknowledges funding by the Regional Government of Navarre. V.S. was supported by Programma VALERE, University of Campania Luigi Vanvitelli. The funding sources did not participate in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. Publisher Copyright: © 2020 by the American Diabetes Association.
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