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.
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