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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.

Accepted version
Peer-reviewed

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Type

Article

Change log

Authors

Steur, Marinka 
Imamura, Fumiaki 
Overvad, Kim 
Schulze, Matthias B  ORCID logo  https://orcid.org/0000-0002-0830-5277

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. 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.

Description

Keywords

Aged, Animals, Diabetes Mellitus, Type 2, Diet, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Milk, Proportional Hazards Models, Prospective Studies, Red Meat, Risk Factors, Seafood, Self Report, Yogurt

Journal Title

Diabetes Care

Conference Name

Journal ISSN

0149-5992
1935-5548

Volume Title

43

Publisher

American Diabetes Association

Rights

All rights reserved
Sponsorship
Medical Research Council (MC_UU_12015/5)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
European Commission (602068)
Medical Research Council (MC_UU_12015/1)
European Commission (37197)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
MRC (MC_UU_00006/3)
National Institute for Health and Care Research (IS-BRC-1215-20014)
Funding for the InterAct project was provided by the European Union Sixth Framework Programme (grant no. LSHM_CT_2006_037197). Additionally, InterAct investigators acknowledge funding from the following agencies: NJW and NGF acknowledge funding from the Medical Research Council 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). MS reports Core MRC Unit support through the Nutritional Epidemiology Programme (MC_UU_12015/5). MBS acknowledges funding by the German Ministry of Education and Research (BMBF) and the State of Brandenburg (DZD grant 82DZD00302). MG acknowledges funding by the Regional Government of Navarre. VS was supported by the 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.