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Substitution of red meat with poultry or fish and risk of type 2 diabetes: a Danish cohort study

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Abstract

Purpose

We examined associations between substitution of red meat (total, processed and unprocessed, low fat and high fat) with poultry or fish and substitution of processed red meat with unprocessed red meat and the risk of type 2 diabetes.

Methods

A cohort of 53,163 participants from the Danish Diet, Cancer and Health study were followed for incident type 2 diabetes (6879 cases; median follow-up time 15.4 years). Diet was assessed by a validated 192-item food frequency questionnaire at baseline. Adjusted Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for type 2 diabetes associated with specified food substitutions of 150 g/week.

Results

Replacing total red meat with fish was associated with a lower risk of type 2 diabetes [HR 0.96 (95% CI 0.94, 0.99)] as was replacement of processed red meat with poultry or fish [HR poultry 0.96 (95% CI 0.93, 0.99)]; HR fish 0.94 [(95% CI 0.91, 0.97)]. Replacing low fat red meat or high fat red meat with fish was associated with a lower risk of type 2 diabetes whereas similar substitutions, with poultry, were not. Replacing processed red meat with unprocessed red meat was also associated with a lower risk of type 2 diabetes [HR 0.96 (95% CI 0.93, 0.99)].

Conclusions

Replacing processed red meat with poultry, replacing total or processed red meat with fish, and replacing processed red meat with unprocessed red meat were all associated with a lower risk of type 2 diabetes.

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Acknowledgements

The authors thank the Danish Cancer Society and the staff at the Diet, Cancer and Health study for the collection and administration of data. Additionally, we would like to thank Luke Johnston for help with the figure using the ggepi package (http://ggepi.lukewjohnston.com/). The authors’ contributions are as follows: DBI, CKW, CCD and AMLW contributed to the study design; KO collected the data; DBI, CKW performed the statistical analyses under guidance of CCD and AMLW; DBI, CKW, CCD, AMLW and KO were involved in the interpretation of the data and critical revision of the manuscript; DBI wrote the manuscript. DBI had the primary responsibility for the final content. All authors read and approved the final manuscript.

Funding

This work is part of the project ‘Diet and prevention of ischemic heart disease: a translational approach’ (DIPI, http://www.dipi.dk), which is supported by the Danish Council for Strategic Research (Contract 0603-00488B). The primary data collection was funded by the Danish Cancer Society.

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Authors and Affiliations

  1. Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark

    Daniel B. Ibsen, Christine K. Warberg, Anne Mette L. Würtz, Kim Overvad & Christina C. Dahm

  2. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

    Kim Overvad

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  1. Daniel B. Ibsen
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  2. Christine K. Warberg
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  3. Anne Mette L. Würtz
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Corresponding author

Correspondence to Daniel B. Ibsen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

Relevant scientific and ethical committees and the Danish Data Protection Agency gave approval to the study.

Informed consent

All study participants provided informed consent and approval to obtain relevant information from medical registers.

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Ibsen, D.B., Warberg, C.K., Würtz, A.M.L. et al. Substitution of red meat with poultry or fish and risk of type 2 diabetes: a Danish cohort study. Eur J Nutr 58, 2705–2712 (2019). https://doi.org/10.1007/s00394-018-1820-0

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  • DOI: https://doi.org/10.1007/s00394-018-1820-0

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