Harvard University — Publications

Abstract P055: Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes: Three Cohorts of US Men and Women

Article

Introduction: Red meat consumption has been consistently associated with an increased risk of type 2 diabetes (T2D). However, it remains largely unknown whether changes in red meat intake are related to subsequent T2D risk. Methods: We followed 26,358 men in the Health Professionals Follow-up Study (HPFS, 1986-2006), 48,710 women in the Nurses’ Health Study (NHS, 1986-2006) and 74,077 women in NHS II (1991-2007). Diet was assessed by validated food frequency questionnaires and updated every 4 years. Incident T2D was confirmed by a validated supplementary questionnaire. Time-dependent Cox proportional hazard models were used to calculate relative risks (RRs) for changes in red meat consumption during a 4-year interval in relation to risk of T2D in the subsequent 4 years, with adjustment for age, family history, race, marital status, initial red meat consumption, initial and changes in other lifestyle factors (physical activity, smoking status, alcohol intake, and dietary quality). The results in the three cohorts were pooled by inverse-variance-weighted random-effects meta-analyses. Results: During 1,965,911 person-years of follow-up, we documented 7,521 incident T2D cases. In the multivariate-adjusted models, increasing red meat intake during a 4-year interval was associated with an increased risk of subsequent 4-year T2D risk in each cohort (all P-trend <0.001), and the pooled RR for one serving/d increment of red meat consumption was 1.30 (95% CI: 1.23, 1.38). The RR was attenuated to 1.20 (95% CI: 1.13, 1.27) after adjustment for baseline body mass index and concurrent weight change. We found significant interaction between initial red meat consumption and changes in red meat consumption with the subsequent risk of T2D; among participants with initial low (<2 servings/wk) or moderate (2-6 servings/wk) levels of red meat consumption, an increase of one serving/d during a 4-year interval was related to an elevated risk of incident T2D in the subsequent 4 years, and the pooled RR was 1.99 (95% CI: 1.47, 2.70) and 1.51 (95% CI: 1.25, 1.81), respectively. However, the association was much weaker (pooled RR 1.16; 95% CI: 1.05, 1.27) in individuals with high initial red meat consumption levels (≥1 serving/d), and the association was not linear in the HPFS and NHS II. Conclusions: Increasing red meat consumption over time is associated with an elevated subsequent risk of T2D, and the association is partly mediated by body weight changes. The association also depends on the initial red meat consumption levels. Our results add further evidence that limiting red meat consumption over time can confer benefits on diabetes prevention.

An Pan, Qi Sun, JoAnn E. Manson et al. 2013

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