Abstract
Aims/hypothesisPrevious evidence linking red meat consumption with diabetes risk mainly came from western countries, with little evidence from China, where patterns of meat consumption are different. Moreover, global evidence remains inconclusive about the associations of poultry and fish consumption with diabetes. Therefore we investigated the associations of red meat, poultry and fish intake with incidence of diabetes in a Chinese population.MethodsThe prospective China Kadoorie Biobank recruited ~512,000 adults (59% women, mean age 51 years) from ten rural and urban areas across China in 2004–2008. At the baseline survey, a validated interviewer-administered laptop-based questionnaire was used to collect information on the consumption frequency of major food groups including red meat, poultry, fish, fresh fruit and several others. During ~9 years of follow-up, 14,931 incidences of new-onset diabetes were recorded among 461,036 participants who had no prior diabetes, cardiovascular diseases or cancer at baseline. Cox regression analyses were performed to calculate adjusted HRs for incident diabetes associated with red meat, poultry and fish intake.ResultsAt baseline, 47.0%, 1.3% and 8.9% of participants reported a regular consumption (i.e. ≥4 days/week) of red meat, poultry and fish, respectively. After adjusting for adiposity and other potential confounders, each 50 g/day increase in red meat and fish intake was associated with 11% (HR 1.11 [95% CI 1.04, 1.20]) and 6% (HR 1.06 [95% CI 1.00, 1.13]) higher risk of incident diabetes, respectively. For both, the associations were more pronounced among men and women from urban areas, with an HR (95% CI) of 1.42 (1.15, 1.74) and 1.18 (1.03, 1.36), respectively, per 50 g/day red meat intake and 1.15 (1.02, 1.30) and 1.11 (1.01, 1.23), respectively, per 50 g/day fish intake. There was no significant association between diabetes and poultry intake, either overall (HR 0.96 [95% CI 0.83, 1.12] per 50 g/day intake) or in specific population subgroups.Conclusions/interpretationIn Chinese adults, both red meat and fish, but not poultry, intake were positively associated with diabetes risk, particularly among urban participants. Our findings add new evidence linking red meat and fish intake with cardiometabolic diseases.Data availabilityDetails of how to access the China Kadoorie Biobank data and rules of China Kadoorie Biobank data release are available from www.ckbiobank.org/site/Data+Access.
Highlights
Diabetes is a major public health problem affecting almost half a billion people worldwide [1]
Except for whole grain and preserved vegetables, consumption of other dietary variables was positively correlated with red meat, poultry and fish consumption, fresh fruit, dairy products and eggs
After adjustment for all above-mentioned covariates, consumption of red meat and fish was positively associated with risk of diabetes with HR 1.19 and 1.15, respectively, for the highest vs lowest consumption category (Table 2); no such association was noted for consumption of poultry
Summary
Diabetes is a major public health problem affecting almost half a billion people worldwide [1]. In China, the incidence of diabetes has increased rapidly since the early 1980s, currently affecting ~10% of adults [2] About half of this increase can be attributed to increasing adiposity [3] and other lifestyle factors (e.g. smoking [4], reduced physical activity and certain dietary habits [5]), which may influence diabetes risk either independently or through adiposity. Several prospective studies, conducted in western populations, have reported that higher consumption of red meat is associated with a higher risk of diabetes [6, 7]. Chinese people tend to consume pork, which contains lower amounts of iron than beef and lamb, which are more commonly consumed in western countries [13]. Reliable evidence about the association between red meat intake and risk of diabetes is needed in China and other populations with relatively low body iron status [14]
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