Department of Epidemiology, University of Washington, Seattle, WA 98101, USA.
Am J Clin Nutr. 2012 Mar;95(3):752-8. doi: 10.3945/ajcn.111.029942. Epub 2012 Jan 25.
Fifty percent of American Indians (AIs) develop diabetes by age 55 y. Whether processed meat is associated with the risk of diabetes in AIs, a rural population with a high intake of processed meat (eg, canned meats in general, referred to as "spam") and a high rate of diabetes, is unknown.
We examined the associations of usual intake of processed meat with incident diabetes in AIs.
This prospective cohort study included AI participants from the Strong Heart Family Study who were free of diabetes and cardiovascular disease at baseline and who participated in a 5-y follow-up examination (n = 2001). Dietary intake was ascertained by using a Block food-frequency questionnaire at baseline. Incident diabetes was defined on the basis of 2003 American Diabetes Association criteria. Generalized estimating equations were used to examine the associations of dietary intake with incident diabetes.
We identified 243 incident cases of diabetes. In a comparison of upper and lower quartiles, intake of processed meat was associated with a higher risk of incident diabetes (OR: 1.63; 95% CI: 1.21, 2.63), after adjustment for potential confounders. The relation was particularly strong for spam (OR for the comparison of upper and lower quartiles: 2.06; 95% CI: 1.30, 3.27). Intake of unprocessed red meat was not associated with incident diabetes (OR for the comparison of upper and lower quartiles: 0.90; 95% CI: 0.59, 1.37).
The consumption of processed meat, such as spam, but not unprocessed red meat, was associated with higher risk of diabetes in AIs, a rural population at high risk of diabetes and with limited access to healthy foods.
50%的美国印第安人（AI）在 55 岁前会患上糖尿病。在一个加工肉类摄入量高（例如，一般的罐装肉类，称为“垃圾邮件”）且糖尿病发病率高的农村 AI 人群中，加工肉类是否与糖尿病风险相关尚不清楚。
我们研究了 AI 人群中加工肉类的通常摄入量与新发糖尿病之间的关联。
这项前瞻性队列研究包括来自“强壮心脏家族研究”的 AI 参与者，他们在基线时无糖尿病和心血管疾病，并参加了为期 5 年的随访检查（n=2001）。通过基线时的 Block 食物频率问卷来确定饮食摄入量。新发糖尿病的定义基于 2003 年美国糖尿病协会标准。使用广义估计方程来检验饮食摄入与新发糖尿病之间的关联。
我们确定了 243 例新发糖尿病病例。在上下四分位数的比较中，加工肉类的摄入量与新发糖尿病的风险增加相关（OR：1.63；95%CI：1.21，2.63），在调整了潜在混杂因素后。这种关系对于垃圾邮件尤为强烈（上下四分位数比较的 OR：2.06；95%CI：1.30，3.27）。未加工的红肉摄入量与新发糖尿病无关（上下四分位数比较的 OR：0.90；95%CI：0.59，1.37）。
在一个糖尿病高危且健康食品获取有限的农村 AI 人群中，加工肉类（如垃圾邮件）的消费与糖尿病风险增加相关，而未加工的红肉消费则与糖尿病风险无关。
