Meat consumption and incident type 2 diabetes: an individual-participant federated meta-analysis of 1·97 million adults with 100 000 incident cases from 31 cohorts in 20 countries

Chunxiao Li, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Tom R. Bishop, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Fumiaki Imamura, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Stephen J. Sharp, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Matthew Pearce, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Soren Brage, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Ken K. Ong, Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Habibul Ahsan, Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA.
Maira Bes-Rastrollo, University of Navarra, Idisna, Department of Preventive Medicine and Public Health, CIBEROBN-Instituto de Salud Carlos III, Pamplona, Spain.
Joline W. Beulens, Department of Epidemiology and Data Science, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Nicole den Braver, Department of Epidemiology and Data Science, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Liisa Byberg, Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Scheine Canhada, Postgraduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Zhengming Chen, Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Hsin-Fang Chung, Australian Women and Girls' Health Research Centre, School of Public Health, University of Queensland, Brisbane, QLD, Australia.
Adrian Cortés-Valencia, Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico.
Luc Djousse, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Jamaica Plain, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Jean-Philippe Drouin-Chartier, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Faculté de Pharmacie, Université Laval, Quebec City, QC, Canada.
Huaidong Du, Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Shufa Du, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Bruce B. Duncan, Postgraduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
J Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Jamaica Plain, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Penny Gordon-Larsen, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Atsushi Goto, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan; Department of Public Health, School of Medicine, Yokohama City University, Yokohama, Japan.
Fahimeh Haghighatdoost, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Tommi Härkänen, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
Maryam Hashemian, Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Frank B. Hu, Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Till Ittermann, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Ritva Järvinen, Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.
Maria G. Kakkoura, Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Nithya Neelakantan, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.

Document Type

Journal Article

Publication Date

9-1-2024

Journal

The lancet. Diabetes & endocrinology

Volume

12

Issue

9

DOI

10.1016/S2213-8587(24)00179-7

Abstract

BACKGROUND: Meat consumption could increase the risk of type 2 diabetes. However, evidence is largely based on studies of European and North American populations, with heterogeneous analysis strategies and a greater focus on red meat than on poultry. We aimed to investigate the associations of unprocessed red meat, processed meat, and poultry consumption with type 2 diabetes using data from worldwide cohorts and harmonised analytical approaches. METHODS: This individual-participant federated meta-analysis involved data from 31 cohorts participating in the InterConnect project. Cohorts were from the region of the Americas (n=12) and the Eastern Mediterranean (n=2), European (n=9), South-East Asia (n=1), and Western Pacific (n=7) regions. Access to individual-participant data was provided by each cohort; participants were eligible for inclusion if they were aged 18 years or older and had available data on dietary consumption and incident type 2 diabetes and were excluded if they had a diagnosis of any type of diabetes at baseline or missing data. Cohort-specific hazard ratios (HRs) and 95% CIs were estimated for each meat type, adjusted for potential confounders (including BMI), and pooled using a random-effects meta-analysis, with meta-regression to investigate potential sources of heterogeneity. FINDINGS: Among 1 966 444 adults eligible for participation, 107 271 incident cases of type 2 diabetes were identified during a median follow-up of 10 (IQR 7-15) years. Median meat consumption across cohorts was 0-110 g/day for unprocessed red meat, 0-49 g/day for processed meat, and 0-72 g/day for poultry. Greater consumption of each of the three types of meat was associated with increased incidence of type 2 diabetes, with HRs of 1·10 (95% CI 1·06-1·15) per 100 g/day of unprocessed red meat (I=61%), 1·15 (1·11-1·20) per 50 g/day of processed meat (I=59%), and 1·08 (1·02-1·14) per 100 g/day of poultry (I=68%). Positive associations between meat consumption and type 2 diabetes were observed in North America and in the European and Western Pacific regions; the CIs were wide in other regions. We found no evidence that the heterogeneity was explained by age, sex, or BMI. The findings for poultry consumption were weaker under alternative modelling assumptions. Replacing processed meat with unprocessed red meat or poultry was associated with a lower incidence of type 2 diabetes. INTERPRETATION: The consumption of meat, particularly processed meat and unprocessed red meat, is a risk factor for developing type 2 diabetes across populations. These findings highlight the importance of reducing meat consumption for public health and should inform dietary guidelines. FUNDING: The EU, the Medical Research Council, and the National Institute of Health Research Cambridge Biomedical Research Centre.

Department

Exercise and Nutrition Sciences

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