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Stina Ramne


ludc web

Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations : The EPIC-InterAct Study


  • Daniel B Ibsen
  • Marinka Steur
  • Fumiaki Imamura
  • Kim Overvad
  • Matthias B Schulze
  • Benedetta Bendinelli
  • Marcela Guevara
  • Antonio Agudo
  • Pilar Amiano
  • Dagfinn Aune
  • Aurelio Barricarte
  • Ulrika Ericson
  • Guy Fagherazzi
  • Paul W Franks
  • Heinz Freisling
  • Jose R Quiros
  • Sara Grioni
  • Alicia K Heath
  • Inge Huybrechts
  • Verena Katze
  • Nasser Laouali
  • Francesca Mancini
  • Giovanna Masala
  • Anja Olsen
  • Keren Papier
  • Stina Ramne
  • Olov Rolandsson
  • Carlotta Sacerdote
  • Maria-José Sánchez
  • Carmen Santiuste
  • Vittorio Simeon
  • Annemieke M W Spijkerman
  • Bernard Srour
  • Anne Tjønneland
  • Tammy Y N Tong
  • Rosario Tumino
  • Yvonne T van der Schouw
  • Elisabete Weiderpass
  • Clemens Wittenbecher
  • Stephen J Sharp
  • Elio Riboli
  • Nita G Forouhi
  • Nick J Wareham

Summary, in English

OBJECTIVE: There is sparse evidence for the association of suitable food substitutions for red and processed meat on the risk of type 2 diabetes. We modeled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact.

RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer (EPIC)-InterAct case cohort included 11,741 individuals with type 2 diabetes and a subcohort of 15,450 participants in eight countries. We modeled the replacement of self-reported red and processed meat with poultry, fish, eggs, legumes, cheese, cereals, yogurt, milk, and nuts. Country-specific hazard ratios (HRs) for incident type 2 diabetes were estimated by Prentice-weighted Cox regression and pooled using random-effects meta-analysis.

RESULTS: There was a lower hazard for type 2 diabetes for the modeled replacement of red and processed meat `(50 g/day) with cheese (HR 0.90, 95% CI 0.83-0.97) (30 g/day), yogurt (0.90, 0.86-0.95) (70 g/day), nuts (0.90, 0.84-0.96) (10 g/day), or cereals (0.92, 0.88-0.96) (30 g/day) but not for replacements with poultry, fish, eggs, legumes, or milk. If a causal association is assumed, replacing red and processed meat with cheese, yogurt, or nuts could prevent 8.8%, 8.3%, or 7.5%, respectively, of new cases of type 2 diabetes.

CONCLUSIONS: Replacement of red and processed meat with cheese, yogurt, nuts, or cereals was associated with a lower rate of type 2 diabetes. Substituting red and processed meat by other protein sources may contribute to the prevention of incident type 2 diabetes in European populations.


  • EpiHealth: Epidemiology for Health
  • Diabetes - Cardiovascular Disease
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Genetic and Molecular Epidemiology
  • Nutrition Epidemiology

Publishing year







Diabetes Care





Document type

Journal article


American Diabetes Association


  • Public Health, Global Health, Social Medicine and Epidemiology
  • Endocrinology and Diabetes
  • Nutrition and Dietetics



Research group

  • Diabetes - Cardiovascular Disease
  • Genetic and Molecular Epidemiology
  • Nutrition Epidemiology


  • ISSN: 1935-5548