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

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; Anne Tjønneland; 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

doi:10.2337/dc20-1038

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

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 KatzeNasser 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, Anne Tjønneland, 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

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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.

Original language	English
Journal	Diabetes Care
Volume	43
Issue number	11
Pages (from-to)	2660-2667
Number of pages	8
ISSN	1064-9131
DOIs	https://doi.org/10.2337/dc20-1038
Publication status	Published - Nov 2020

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Ibsen, D. B., Steur, M., Imamura, F., Overvad, K., Schulze, M. B., Bendinelli, B., Guevara, M., Agudo, A., Amiano, P., Aune, D., Barricarte, A., Ericson, U., Fagherazzi, G., Franks, P. W., Freisling, H., Quiros, J. R., Grioni, S., Heath, A. K., Huybrechts, I., ... Wareham, N. J. (2020). 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. Diabetes Care, 43(11), 2660-2667. Advance online publication. https://doi.org/10.2337/dc20-1038

@article{1e1bce4c89564490bab31ea7b71697db,

title = "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",

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.",

author = "Ibsen, {Daniel B} and Marinka Steur and Fumiaki Imamura and Kim Overvad and Schulze, {Matthias B} and Benedetta Bendinelli and Marcela Guevara and Antonio Agudo and Pilar Amiano and Dagfinn Aune and Aurelio Barricarte and Ulrika Ericson and Guy Fagherazzi and Franks, {Paul W} and Heinz Freisling and Quiros, {Jose R} and Sara Grioni and Heath, {Alicia K} and Inge Huybrechts and Verena Katze and Nasser Laouali and Francesca Mancini and Giovanna Masala and Anja Olsen and Keren Papier and Stina Ramne and Olov Rolandsson and Carlotta Sacerdote and Maria-Jos{\'e} S{\'a}nchez and Carmen Santiuste and Vittorio Simeon and Spijkerman, {Annemieke M W} and Bernard Srour and Anne Tj{\o}nneland and Tong, {Tammy Y N} and Rosario Tumino and {van der Schouw}, {Yvonne T} and Elisabete Weiderpass and Clemens Wittenbecher and Sharp, {Stephen J} and Elio Riboli and Forouhi, {Nita G} and Wareham, {Nick J}",

note = "{\textcopyright} 2020 by the American Diabetes Association.",

year = "2020",

month = nov,

doi = "10.2337/dc20-1038",

language = "English",

volume = "43",

pages = "2660--2667",

journal = "Diabetes Care",

issn = "1064-9131",

publisher = "American Diabetes Association",

number = "11",

}

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, Sánchez, M-J, Santiuste, C, Simeon, V, Spijkerman, AMW, Srour, B, Tjønneland, A, Tong, TYN, Tumino, R, van der Schouw, YT, Weiderpass, E, Wittenbecher, C, Sharp, SJ, Riboli, E, Forouhi, NG & Wareham, NJ 2020, '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', Diabetes Care, vol. 43, no. 11, pp. 2660-2667. https://doi.org/10.2337/dc20-1038

TY - JOUR

T1 - Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations

T2 - The EPIC-InterAct Study

AU - Ibsen, Daniel B

AU - Steur, Marinka

AU - Imamura, Fumiaki

AU - Overvad, Kim

AU - Schulze, Matthias B

AU - Bendinelli, Benedetta

AU - Guevara, Marcela

AU - Agudo, Antonio

AU - Amiano, Pilar

AU - Aune, Dagfinn

AU - Barricarte, Aurelio

AU - Ericson, Ulrika

AU - Fagherazzi, Guy

AU - Franks, Paul W

AU - Freisling, Heinz

AU - Quiros, Jose R

AU - Grioni, Sara

AU - Heath, Alicia K

AU - Huybrechts, Inge

AU - Katze, Verena

AU - Laouali, Nasser

AU - Mancini, Francesca

AU - Masala, Giovanna

AU - Olsen, Anja

AU - Papier, Keren

AU - Ramne, Stina

AU - Rolandsson, Olov

AU - Sacerdote, Carlotta

AU - Sánchez, Maria-José

AU - Santiuste, Carmen

AU - Simeon, Vittorio

AU - Spijkerman, Annemieke M W

AU - Srour, Bernard

AU - Tjønneland, Anne

AU - Tong, Tammy Y N

AU - Tumino, Rosario

AU - van der Schouw, Yvonne T

AU - Weiderpass, Elisabete

AU - Wittenbecher, Clemens

AU - Sharp, Stephen J

AU - Riboli, Elio

AU - Forouhi, Nita G

AU - Wareham, Nick J

PY - 2020/11

Y1 - 2020/11

N2 - 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.

AB - 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.

U2 - 10.2337/dc20-1038

DO - 10.2337/dc20-1038

M3 - Journal article

C2 - 32868270

SN - 1064-9131

VL - 43

SP - 2660

EP - 2667

JO - Diabetes Care

JF - Diabetes Care

IS - 11

ER -

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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