title: The association of meat intake and the risk of type 2 diabetes may be modified by body weight.
abstract: OBJECTIVE
  To investigate the association between meat intake and incidence of type 2 diabetes (type 2 DM) in a large cohort of middle-aged women.
  
  
  METHODS
  Incident cases of type 2 DM were identified during an average of 4.6 years of follow-up in a prospective cohort study of 74,493 middle-aged, Chinese women (mean age +/- SD =51.7+/- 8.97 years). Participants completed in-person interviews that collected information on type 2 DM risk factors such as dietary factors and physical activity in adulthood. Anthropometric indices were measured. Dietary intake was assessed using a validated food frequency questionnaire (FFQ). We included in the current analysis 70,609 women who had no prior history of type 2 DM at study recruitment and who had valid dietary data. The association of type 2 DM with unprocessed meat intake (g/day) and the frequency of consumption of processed meat was evaluated using the Cox model with adjustment for age, kcals/day, body mass index (BMI), waist to hip ratio (WHR), vegetable intake, smoking, alcohol consumption, physical activity, income level, education level, occupation status, and history of hypertension and chronic disease at baseline.
  
  
  RESULTS
  We identified 1972 incident cases of type 2 DM during a total of 326,581 person-years of follow up. Intake of unprocessed meat, particularly poultry, was associated with a decrease in the risk of type 2 DM in this cohort. The fully adjusted relative risks (RRs) for quintiles of total unprocessed meat intake were 1.00, 0.78, 0.83, 0.74, and 0.83 (P for trend: <0.01). When the joint effect between meat intake and BMI categories was evaluated, high intake of total unprocessed meat appeared to be associated with an increased risk of type 2 DM among obese women but a reduced risk among lean women (P value for the interaction tests = 0.05). Processed meat consumption was positively associated with the risk of type 2 DM. The adjusted RR was 1.15 (95% 1.01-1.32) in women consuming processed meats compared to those who did not consume processed meats (P=0.04).
  
  
  CONCLUSIONS
  Processed meat intake was positively associated with the risk of type 2 DM. There was an indication that the effect of unprocessed meat intake on type 2 DM may be modified by BMI.
authors.affiliation: Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN 37232-8300, USA.
authors.forename: Raquel
authors.initials: R
authors.lastname: Villegas
authors.forename: Xiao Ou
authors.initials: XO
authors.lastname: Shu
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.forename: Gong
authors.initials: G
authors.lastname: Yang
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.forename: Honglan
authors.initials: H
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng