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

Study Questions:

Is there an association between changes in red meat consumption during a 4-year period and subsequent 4-year risk of type 2 diabetes mellitus (T2DM) in US adults?


The study was conducted in 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 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.


Mean age was 56 years, and body mass index was approximately 25.5 kg/m2. During 1,965,824 person-years of follow-up, there were 7,540 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 < 0.001 for trend). Compared with the reference group of no change in red meat intake, increasing red meat intake of >0.50 servings per day was associated with a 48% (pooled hazard ratio [HR], 1.48; 95% confidence interval [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 (pooled HR, 1.30; 95% CI, 1.21-1.41). Reducing red meat consumption by >0.50 servings per day from baseline to the first 4 years of follow-up was associated with a 14% (pooled HR, 0.86; 95% CI, 0.80-0.93) lower risk during the subsequent entire follow-up through 2006 or 2007.


Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM, and the association is partly mediated by body weight. The results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention.


The biologic plausibility of meat intake causing an increase in T2DM independent of weight, physical activity, and carbohydrate intake is unclear. The authors acknowledged that residual and unmeasured confounding from other lifestyle behaviors is still possible.

Clinical Topics: Prevention, Smoking

Keywords: Follow-Up Studies, Food Habits, Diabetes Mellitus, Type 2, Risk Factors, Weight Gain, Smoking, Incidence, Body Mass Index, Motor Activity, Cardiovascular Diseases, Confidence Intervals

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