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, University of Cambridge, School of Clinical Medicine., Storbritannien
  • Fumiaki Imamura, University of Cambridge, School of Clinical Medicine., Storbritannien
  • Kim Overvad
  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany., German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany., Tyskland
  • Benedetta Bendinelli, Institute for Cancer Research, Italien
  • Marcela Guevara, Navarre Public Health Institute, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Antonio Agudo, Catalan Institute of Oncology-ICO, Spanien
  • Pilar Amiano, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Public Health Division of Gipuzkoa, San Sebastian, Spain., Instituto Biodonostia, Basque Government, San Sebastian, Spanien
  • Dagfinn Aune, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Department of Nutrition, Bjørknes University College, Oslo, Norway., Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Storbritannien
  • Aurelio Barricarte, Navarre Public Health Institute, Spanien
  • Ulrika Ericson, Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden., Sverige
  • Guy Fagherazzi, Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg., Center of Epidemiology and Population Health, UMR 1018, INSERM, Paris South - Paris Saclay University, Gustave Roussy Institute, Villejuif, Luxemborg
  • Paul W Franks, Lund Universitet, Malmø, Sverige
  • Heinz Freisling, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Jose R Quiros, Public Health Directorate, Asturias, Spain., Spanien
  • Sara Grioni, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Italien
  • Alicia K Heath, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien
  • Inge Huybrechts, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Verena Katze, German Cancer Research Center (DKFZ), Tyskland
  • Nasser Laouali, CESP UMR1018, INSERM, Institut Gustave Roussy, Paris South University-Paris-Saclay University, Villejuif, France., Frankrig
  • Francesca Mancini, CESP UMR1018, INSERM, Institut Gustave Roussy, Paris South University-Paris-Saclay University, Villejuif, France., Frankrig
  • Giovanna Masala, Institute for Cancer Research, Italien
  • Anja Olsen
  • Keren Papier, Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom., Storbritannien
  • Stina Ramne, Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden., Sverige
  • Olov Rolandsson, Umeå University, Sverige
  • Carlotta Sacerdote, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino and Center for Cancer Prevention (CPO), Italien
  • Maria-José Sánchez, Biosanitary Investigation Institute (IBS) of Granada, University Hospital and University of Granada, Granada, Spain., CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Escuela Andaluza de Salud Pública, Granada, Department of Preventive Medicine and Public Health, University of Granada, Granada, Spanien
  • Carmen Santiuste, Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain., CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Vittorio Simeon, University of Campania Luigi Vanvitelli, Italien
  • Annemieke M W Spijkerman, National Institute for Public Health and the Environment (RIVM), Holland
  • Bernard Srour, German Cancer Research Center (DKFZ), Tyskland
  • Anne Tjønneland, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Københavns Universitet, Danmark
  • Tammy Y N Tong, Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom., Storbritannien
  • Rosario Tumino, Associazone Iblea per la Ricerca Epidemiologica - Organizazione Non Lucrativa di Utilità Sociale (AIRE-ONLUS), Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale (ASP) Ragusa, Italy., Italien
  • Yvonne T van der Schouw, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 Utrecht, The Netherlands., Holland
  • Elisabete Weiderpass, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Clemens Wittenbecher, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany., German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany., Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA., Tyskland
  • Stephen J Sharp, University of Cambridge, School of Clinical Medicine., Storbritannien
  • Elio Riboli, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK., Storbritannien
  • Nita G Forouhi, University of Cambridge, School of Clinical Medicine., Storbritannien
  • Nick J Wareham, University of Cambridge, School of Clinical Medicine., Storbritannien

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
Nummer11
Sider (fra-til)2660-2662
Antal sider8
ISSN0149-5992
DOI
StatusUdgivet - nov. 2020

Bibliografisk note

© 2020 by the American Diabetes Association.

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