Abstract

Importance: The role of high-temperature cooking methods (broiling, barbequing, or roasting) on the association of meat consumption with risk of type 2 diabetes (T2D) is unknown. Objective: To examine cooking methods for meats (chicken, fish, and red meat) in relation to T2D risk among men and women who consumed meats regularly (≥2 servings/week). Design, Setting, and Participants: The prospective studies included 52,720 women from the Nurses’ Health Study (NHS 1996-2012), 60,809 women from the Nurses’ Health Study II (NHS II 2001-2013), and 24,679 men from the Health Professionals Follow-Up Study (HPFS 1996-2012) who were free of diabetes, cardiovascular disease, and cancer at baseline. Main Outcomes and Measures: Incident cases of T2D were identified through self-report and confirmed by validated supplementary questionnaires. Results: We documented 7,893 incident T2D cases during 1.74 million person-years of follow up. After multivariate adjustment of demographics, lifestyle factors, and total intake of chicken, fish, and red meat, a higher frequency of high-temperature cooking of meats was independently associated with an increased T2D risk. When comparing >15 times/month with <4 times/month, the hazard ratios (HRs) and 95% confidence intervals (CIs) of T2D were 1.36 (1.22, 1.52; P trend<0.001) in NHS, 1.82 (1.56, 2.12; P trend<0.001) in NHS II, and 1.10 (0.90, 1.36; P trend=0.78) in HPFS; and the pooled HR was 1.43 (1.32, 1.56; P trend <0.001). The results remained significant when analyzing by source of meats; and the pooled HRs (95% CI) were 1.64 (1.49, 1.81; P trend <0.001) for red meat and 1.22 (1.13, 1.32; P trend <0.001) for white meat. In addition, a higher frequency of high-temperature cooking of meats was associated with greater weight gain and higher risk of obesity, especially among women. Mediational analyses showed that the significant associations of high-temperature cooking with T2D risk were partially explained by changes in body mass index (41.6% in NHS and 46.6% in NHS II) in women. Conclusions and Relevance: Our results suggest that, independent of meat consumption, high-temperature cooking methods may further increase diabetes risk, especially in women.

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