Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study

Abstract

Background Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice. Objective We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM. Methods We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses’ Health Study, and 75,196 females in the Nurses’ Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source. Results During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat. Conclusions Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.

Processed and Unprocessed Red Meat Consumption and Risk for Type 2 Diabetes Mellitus: An Updated Meta-Analysis of Cohort Studies

“…Such initiatives are likely to be most effective in the U.S., where red meat intake is high. One study conducted in 2019 reported that T2DM incidence decreased when red meat was substituted with poultry (HR: 0.96, 95% CI 0.93, 0.99) or fish (HR: 0.94, 95% CI 0.91, 0.97) [51], and, recently, a cohort study including 148,853 participants found that replacing red meat consumption (both PRM and URM) with other protein sources (poultry, seafood, egg, legumes and nuts) was associated with a lower risk of T2DM, and stronger for the replacement of PRM [57]. Further research is demanded to explore the effect of a decreased intake of red meat and simultaneous increased intake of other high-protein foods on diabetes.…”

Nutritional Viewpoints on Eggs and Cholesterol

“…In this context, eating white potatoes with eggs appears to control glycemic response [112]. There is an increasing prevalence of obesity and DM in the US during these decades [113,114]. The different responses to egg consumption between the US and other countries are probably attributable to residual confounding by dietary behaviors or food preparation methods restricted to certain populations.…”

“…Choline is listed up in US dietary guidelines as an essential nutrient, but not in Japan, and egg, milk and meat are the major sources of choline not only in the US but in Western diets. Replacing red meat consumption with other protein sources, including egg, was associated with a lower risk of T2DM in US cohorts [114] (refer section of "Debates around Trimethylamine Oxide"). However, it is not clear at present whether this mechanism is also responsible for cases in other Western countries.…”

Animal-based food choice and associations with long-term weight maintenance and metabolic health after a large and rapid weight loss: The PREVIEW study

“…In terms of HbA 1c , we found that after adjustment for weight change, no associations of replacement of processed meat with other foods showed significance. However, Würtz et al [14] reported that the association of replacement of red meat with both plant-and animal-based foods with risk of type 2 diabetes was independent of weight change in 3 US prospective cohorts.…”

“…Animal-based foods have recently been connected to worsened metabolic outcomes and emerging epidemiological evidence suggests that red and processed meat intake is associated with an increased risk of weight gain [8], type 2 diabetes [9], and CVD [10e12]. Prospective cohort studies show that replacing red meat with other foods such as nuts and grains is associated with a lower risk of type 2 diabetes and CVD [10,13,14]. Regarding other animal-based foods including dairy products, poultry, fish and seafood, and eggs, null or conflicting findings have been reported [8,15e18].…”