Wang Peilu, Zhang Yiwen, Giovannucci Edward L
Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Metabolism. 2025 Aug;169:156277. doi: 10.1016/j.metabol.2025.156277. Epub 2025 May 2.
It has been suggested that dietary factors correlated with red meat may contribute to its adverse health effects, while consuming red meat within a healthy diet may not necessarily increase disease risk.
Among 204,740 participants from three prospective cohorts, we examined the association between red meat consumption and risk of type 2 diabetes (T2D) across different levels of diet quality, measured by Alternative Healthy Eating Index (AHEI)-2010 (excluding red and processed meat component), using multivariable-adjusted Cox proportional hazards models. Dietary intake was assessed using repeated food frequency questionnaires.
During a median follow-up of 28 years, 18,868 cases were documented. Mean values were 47.3 (SD 8.5) for AHEI-2010 and 6.5 (SD 3.5), 1.8 (SD 1.5), and 4.8 (SD 2.5) servings/week for total, processed, and unprocessed red meat, respectively. Greater red meat consumption was consistently associated with a higher T2D risk across AHEI-2010 strata. Comparing the highest with the lowest quintile of red meat consumption in the highest diet quality quintile, the multivariable-adjusted HRs were 1.95 (1.72, 2.21) for total, 1.88 (1.67, 2.13) for processed, and 1.67 (1.47, 1.90) for unprocessed red meat. Substituting red meat with major food groups was associated with a lower T2D risk, particularly among those with high diet quality. The benefit of lowering red meat consumption was greater in participants with higher diet quality.
The risk associated with high red meat consumption persisted even among participants with a relatively high diet quality, underscoring the importance of limiting red meat consumption to prevent T2D.
有研究表明，与红肉相关的饮食因素可能导致其对健康产生不良影响，而在健康饮食中食用红肉不一定会增加疾病风险。
在来自三个前瞻性队列的204,740名参与者中，我们使用多变量调整的Cox比例风险模型，研究了通过替代健康饮食指数（AHEI）-2010（不包括红肉和加工肉类成分）衡量的不同饮食质量水平下红肉消费与2型糖尿病（T2D）风险之间的关联。使用重复食物频率问卷评估饮食摄入量。
在中位随访28年期间，记录了18,868例病例。AHEI-2010的平均值为47.3（标准差8.5），总红肉、加工红肉和未加工红肉的摄入量分别为每周6.5（标准差3.5）份、1.8（标准差1.5）份和4.8（标准差2.5）份。在AHEI-2010各分层中，红肉消费量越高，T2D风险始终越高。在最高饮食质量五分位数中，将红肉消费量最高的五分位数与最低五分位数进行比较，多变量调整后的风险比（HR）分别为：总红肉1.95（1.72, 2.21）、加工红肉1.88（1.67, 2.13）、未加工红肉1.67（1.47, 1.90）。用主要食物组替代红肉与较低的T2D风险相关，尤其是在饮食质量高的人群中。降低红肉消费量的益处在饮食质量较高的参与者中更大。
即使在饮食质量相对较高的参与者中，与高红肉消费量相关的风险仍然存在，这凸显了限制红肉消费以预防T2D的重要性。
