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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

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  • Daniel B. Ibsen
  • Marinka Steur
  • Fumiaki Imamura
  • Kim Overvad
  • Matthias B. Schulze
  • Benedetta Bendinelli
  • Marcela Guevara
  • Antonio Agudo
  • Pilar Amiano
  • Dagfinn Aune
  • Aurelio Barricarte
  • Ulrika Ericson
  • Guy Fagherazzi
  • Paul W. Franks
  • Heinz Freisling
  • Jose R. Quiros
  • Sara Grioni
  • Alicia K. Heath
  • Inge Huybrechts
  • Verena Katze
  • Nasser Laouali
  • Francesca Mancini
  • Giovanna Masala
  • Anja Olsen
  • Keren Papier
  • Stina Ramne
  • Olov Rolandsson
  • Carlotta Sacerdote
  • Maria José Sánchez
  • Carmen Santiuste
  • Vittorio Simeon
  • Annemieke M.W. Spijkerman
  • Bernard Srour
  • 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

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.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind43
Udgave nummer11
Sider (fra-til)2660-2667
Antal sider8
ISSN0149-5992
DOI
StatusUdgivet - 2020

ID: 250862972