Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of US men and women
Pan A, Sun Q, Bernstein AM, Manson JE, Willett WC, Hu FB
JAMA internal medicine · 167 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NHLBI NIH HHS
- Government
- NIDDK NIH HHS
- Government
- NCI NIH HHS
- Grants
- National Cancer Institute (R01‐CA050385); National Cancer Institute (U54CA155626); National Heart, Lung, and Blood Institute (K99 HL098459); National Cancer Institute (P01 CA055075.); National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200); National Cancer Institute (P01 CA087969); National Institute of Diabetes and Digestive and Kidney Diseases (T-32 DK 007703); National Cancer Institute (U19 CA055075); National Heart, Lung, and Blood Institute (R00 HL098459); National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK058845)
Based on 6 listed funder(s).
Publication
- Published
- 2013-06-18 · JAMA Intern Med · vol. 173 · issue 14 · p. 1328
- Publisher
- American Medical Association
- Cited
- 231 citations · more than 100% of similar papers · 22.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 15 works
- Access
- Open access (repository copy)
- Research areas
- Nutritional Studies and Diet · Fatty Acid Research and Health · Diet and metabolism studies
- Keywords
- Medicine, Red meat, Hazard ratio, Prospective cohort study, Type 2 Diabetes Mellitus, Proportional hazards model, Environmental health, Diabetes mellitus, Demography, Cohort study, Cohort, Confidence interval, Internal medicine, Endocrinology
- MeSH
- humans, diabetes mellitus, type 2, weight gain, body mass index, diet, health surveys, proportional hazards models, follow-up studies, prospective studies, energy intake, meat, middle aged, united states, female, male, surveys and questionnaires
6 authors
From US, SG
- An PanHarvard University; National University of Singapore; National University Health System
- Qi SunBrigham and Women's Hospital
- Adam BernsteinCleveland Clinic
- JoAnn E. MansonBrigham and Women's Hospital; Harvard University
- Walter Churchill WillettBrigham and Women's Hospital
- Frank B. HuBrigham and Women's Hospital
Abstract
Importance
Red meat consumption has been consistently associated with an increased risk of type 2 diabetes mellitus (T2DM). However, whether changes in red meat intake are related to subsequent T2DM risk remains unknown.
Objective
To evaluate the association between changes in red meat consumption during a 4-year period and subsequent 4-year risk of T2DM in US adults.
Design and setting
Three prospective cohort studies in US men and women.
Participants
We followed up 26,357 men in the Health Professionals Follow-up Study (1986-2006), 48,709 women in the Nurses' Health Study (1986-2006), and 74,077 women in the Nurses' Health Study II (1991-2007). Diet was assessed by validated food frequency questionnaires and updated every 4 years. Time-dependent Cox proportional hazards regression models were used to calculate hazard ratios with adjustment for age, family history, race, marital status, initial red meat consumption, smoking status, and initial and changes in other lifestyle factors (physical activity, alcohol intake, total energy intake, and diet quality). Results across cohorts were pooled by an inverse variance-weighted, fixed-effect meta-analysis.
Main outcomes and measures
Incident T2DM cases validated by supplementary questionnaires.
Results
During 1,965,824 person-years of follow-up, we documented 7540 incident T2DM cases. In the multivariate-adjusted models, increasing red meat intake during a 4-year interval was associated with an elevated risk of T2DM during the subsequent 4 years in each cohort (all P < .001 for trend). Compared with the reference group of no change in red meat intake, increasing red meat intake of more than 0.50 servings per day was associated with a 48% (pooled hazard ratio, 1.48; 95% CI, 1.37-1.59) elevated risk in the subsequent 4-year period, and the association was modestly attenuated after further adjustment for initial body mass index and concurrent weight gain (1.30; 95% CI, 1.21-1.41). Reducing red meat consumption by more than 0.50 servings per day from baseline to the first 4 years of follow-up was associated with a 14% (pooled hazard ratio, 0.86; 95% CI, 0.80-0.93) lower risk during the subsequent entire follow-up through 2006 or 2007.
Conclusions and relevance
Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM, and the association is partly mediated by body weight. Our results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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