These data support a causal role in prostate cancer for saturated fat intake but suggest that other factors are largely responsible for interethnic differences in risk.
Objective: To examine the association of meat consumption with diabetes risk in the Hawaii component of the Multiethnic Cohort and to assess effect modification by ethnicity. Design: A prospective cohort study. Baseline information on diet and lifestyle was assessed by questionnaire. The cohort was followed up for incident cases of diabetes, which were identified through self-reports, medication questionnaires, or health plan linkages. Cox regression was used to calculate hazard ratios (HR) and 95 % confidence intervals for diabetes associated with quintile of meat consumption. Setting: Hawaii, USA. . The association for processed poultry was weaker than for processed red meat, and fresh poultry intake was not associated with diabetes risk. For men only, we observed significant interactions of ethnicity with the red and processed red meat associations, with Caucasians experiencing slightly higher risks than Japanese-Americans. Conclusions: Our findings support the growing evidence that red and processed meat intake increase risk for diabetes irrespective of ethnicity and level of BMI. Keywords Type 2 diabetesMeat Ethnicity Prospective studyThe prevalence of type 2 diabetes mellitus is increasing worldwide; however, some ethnic groups, such as AsianAmericans or Pacific Islanders, suffer from extremely high rates compared with Caucasians (1) . In the Multiethnic Cohort (MEC), diabetes incidence rates of 15?5, 12?5 and 5?8 per 1000 person-years were found for Native Hawaiians, Japanese-Americans and Caucasians, respectively (2) . A higher BMI and lower education were associated with higher incidence rates. Established risk factors for diabetes are overweight, obesity and physical inactivity (3) ; still, dietary factors might play an important role. A meta-analysis on meat intake and diabetes risk concluded that particularly red meat and processed meat increase diabetes risk (4) . Thus far, no prospective study has examined whether this association is modified by ethnicity. We examined the association of meat consumption (red meat, processed red meat, fresh poultry and processed poultry) with diabetes risk in men and women of Caucasian, Japanese-American and Native Hawaiian ancestry in the Hawaii component of the MEC. Materials and methods Study populationThe MEC was designed to investigate the association between diet and cancer among different ethnic groups in Hawaii and California and detailed information on study design and recruitment can be found elsewhere (5) . In brief, between 1993 and 1996, more than 215 000 men and women, aged 45-75 years at recruitment, enrolled by completing a mailed questionnaire on diet, demographics, medical conditions, anthropometric measures and lifestyle factors.The Hawaiian component of the MEC comprises 103 898 participants, primarily Caucasians, Japanese-Americans and Native Hawaiians. Response rates ranged from 28 % to 51 % in the different ethnic-sex groups, and comparison with US Census data indicated that the study population represented all levels of education. For...
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