Effects of processed red meat consumption on the risk of type 2 diabetes and cardiovascular diseases among Korean adults: the Korean Genome and Epidemiology Study
- 255 Downloads
Few studies have evaluated the effects of processed red meat (PRM) consumption on chronic disease risk, especially among low average PRM consumption populations. This study examined association between PRM intake and type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) incidences in Korea.
Participants (n = 10,030; aged 40–69 years) were recruited from the Ansan–Ansung cohort study, a subset of Korean Genome Epidemiology Study. Validated 103-item semi-quantitative food frequency questionnaire was used to assess dietary information, at baseline (2001–2002) and at second follow-up (2005–2006). T2DM and CVD incidences were identified using biennial questionnaire-based interview during a 10-year follow-up period. Cox proportional hazards regression analysis was used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
Over the 10-year follow-up period, 668 and 493 incident cases of T2DM (62,130 person-years) and CVD (63,150 person-years), respectively, were documented. In crude models, comparing the highest and lowest levels of PRM intake, no significant association occurred with incident T2DM [HR, 95% CI (0.94, 0.76–1.17)], while significant association occurred with incident CVD (0.67, 0.51–0.88). However, in adjusted models, this association was no longer significant, showing HRs (95% CI) of PRM intake for T2DM and CVD of 1.07 (0.85–1.35) and 1.14 (0.85–1.55), respectively.
PRM intake did not affect T2DM and CVD incidences among Korean middle-aged adults, although extremely low average consumption of PRM may explain the finding. Therefore, limiting PRM intake may not be a top priority for the prevention of chronic diseases in Korean population.
KeywordsProcessed red meat Diabetes mellitus Cardiovascular disease Cohort study Korean
Data in this study were from the Korean Genome and Epidemiology Study (KoGES; 4851-302), National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea. This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (Grant number: NRF-2017R1A1A3A04069759). The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.
JS contributed to the writing original draft preparation, formal analysis, visualization, and software. JS, YL and KP contributed to the investigation, data curation, and writing the review and editing. KP contributed to the conceptualization, supervision, project administration, resources, funding acquisition, and validation. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the Institutional Review Board (IRB) of the Korea Centers for Disease Control and Prevention (IRB number: KU-IRB-15-EX-256-A-1), and the research procedure for the second analysis was approved by the Yeungnam University IRB (7002016-E-2016-003).
Written informed consent was obtained from all participants.
- 1.World Health Organization (2017) Cardiovascular diseases (CVDs). http://www.who.int/mediacentre/factsheets/fs317/en/. Accessed 8 Dec 2017
- 2.International Diabetes Federation (2015) IDF DIABETES ATLAS. http://www.diabetesatlas.org/. Accessed 13 Nov 2017
- 5.Ministry of Health and Welfare (2015) The major results of national health nutrition survey 2014. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=16&CONT_SEQ=326126. Accessed 27 Mar 2017
- 8.Isanejad M, LaCroix AZ, Thomson CA, Tinker L, Larson JC, Qi Q, Qi L, Cooper-DeHoff RM, Phillips LS, Prentice RL, Beasley JM (2017) Branched-chain amino acid, meat intake and risk of type 2 diabetes in the Women’s Health Initiative. Br J Nutr 117(11):1523–1530. https://doi.org/10.1017/S0007114517001568 CrossRefPubMedGoogle Scholar
- 9.Kim K, Hyeon J, Lee SA, Kwon SO, Lee H, Keum N, Lee JK, Park SM (2017) Role of total, red, processed, and white meat consumption in stroke incidence and mortality: a systematic review and meta-analysis of prospective cohort studies. J Am Heart Assoc. https://doi.org/10.1161/jaha.117.005983 CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Bendinelli B, Palli D, Masala G, Sharp SJ, Schulze MB, Guevara M, van der AD, Sera, Amiano F, Balkau P, Barricarte B, Boeing A, Crowe H, Dahm FL, Dalmeijer CC, de Lauzon-Guillain G, Egeberg B, Fagherazzi R, Franks G, Krogh PW, Huerta V, Jakszyn JM, Khaw P, Li KT, Mattiello K, Nilsson A, Overvad PM, Ricceri K, Rolandsson F, Sanchez O, Slimani MJ, Sluijs N, Spijkerman I, Teucher AM, Tjonneland B, Tumino A, van den Berg R, Forouhi SW, Langeberg NG, Feskens C, Riboli EJ, Wareham E NJ (2013) Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study. Diabetologia 56(1):47–59. https://doi.org/10.1007/s00125-012-2718-7 CrossRefPubMedGoogle Scholar
- 16.Rohrmann S, Overvad K, Bueno-de-Mesquita HB, Jakobsen MU, Egeberg R, Tjonneland A, Nailler L, Boutron-Ruault MC, Clavel-Chapelon F, Krogh V, Palli D, Panico S, Tumino R, Ricceri F, Bergmann MM, Boeing H, Li K, Kaaks R, Khaw KT, Wareham NJ, Crowe FL, Key TJ, Naska A, Trichopoulou A, Trichopoulos D, Leenders M, Peeters PH, Engeset D, Parr CL, Skeie G, Jakszyn P, Sanchez MJ, Huerta JM, Redondo ML, Barricarte A, Amiano P, Drake I, Sonestedt E, Hallmans G, Johansson I, Fedirko V, Romieux I, Ferrari P, Norat T, Vergnaud AC, Riboli E, Linseisen J (2013) Meat consumption and mortality—results from the European prospective investigation into cancer and nutrition. BMC Med 11:63. https://doi.org/10.1186/1741-7015-11-63 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Ministry of Food and Drug Safety (2015) The level of red meat and processed meat intake were not worrying level for Koreans. http://www.mfds.go.kr/index.do?searchkey=title:contents&mid=675&searchword=%C0%C7%BE%E0%C7%B0&pageNo=19&seq=29262&cmd=v. Accessed 27 Mar 2017
- 18.World Health Organization (2015) IARC monographs evaluate consumption of red meat and processed meat. http://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr240_E.pdf. Accessed 27 Mar 2017
- 19.U.S. Department of Health and Human Services, U.S. Department of Agriculture (2015) Dietary guidelines for Americans 2015–2020. https://health.gov/dietaryguidelines/2015/guidelines/. Accessed 27 Mar 2017
- 20.Public Health England (2014) A quick guide to the government’s healthy eating recommendations. http://elearning.ymca.co.uk/ymcafit/pluginfile.php/11442/mod_resource/content/1/A%20Quick%20Guide%20to%20Government%20Healthy%20Eating.pdf. Accessed 27 Mar 2017
- 21.National Health and Medical Research Council, Department of Health and Ageing (2013) Australian dietary guidelines. https://www.nhmrc.gov.au/guidelines-publications/n55. Accessed 27 Mar 2017
- 24.Willett W (2013) Nutritional epidemiology, 3rd edn. Oxford University Press, New YorkGoogle Scholar
- 27.Parr CL, Hjartaker A, Scheel I, Lund E, Laake P, Veierod MB (2008) Comparing methods for handling missing values in food-frequency questionnaires and proposing k nearest neighbours imputation: effects on dietary intake in the Norwegian Women and Cancer study (NOWAC). Public Health Nutr 11(4):361–370. https://doi.org/10.1017/s1368980007000365 CrossRefPubMedGoogle Scholar
- 28.National Rural Living Science Institute (1996) Food composition table, 5th edn. Rural Development Administration, Suwon KoreaGoogle Scholar
- 29.Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC (1995) Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273(5):402–407. https://doi.org/10.1001/jama.1995.03520290054029 CrossRefPubMedGoogle Scholar
- 30.World Health Organization (2000) The Asia–Pacific perspective: redefining obesity and its treatment. http://www.wpro.who.int/nutrition/documents/Redefining_obesity/en/. Accessed 8 Dec 2017
- 32.Fretts AM, Follis JL, Nettleton JA, Lemaitre RN, Ngwa JS, Wojczynski MK, Kalafati IP, Varga TV, Frazier-Wood AC, Houston DK, Lahti J, Ericson U, van den Hooven EH, Mikkila V, Kiefte-de Jong JC, Mozaffarian D, Rice K, Renstrom F, North KE, McKeown NM, Feitosa MF, Kanoni S, Smith CE, Garcia ME, Tiainen AM, Sonestedt E, Manichaikul A, van Rooij FJ, Dimitriou M, Raitakari O, Pankow JS, Djousse L, Province MA, Hu FB, Lai CQ, Keller MF, Perala MM, Rotter JI, Hofman A, Graff M, Kahonen M, Mukamal K, Johansson I, Ordovas JM, Liu Y, Mannisto S, Uitterlinden AG, Deloukas P, Seppala I, Psaty BM, Cupples LA, Borecki IB, Franks PW, Arnett DK, Nalls MA, Eriksson JG, Orho-Melander M, Franco OH, Lehtimaki T, Dedoussis GV, Meigs JB, Siscovick DS (2015) Consumption of meat is associated with higher fasting glucose and insulin concentrations regardless of glucose and insulin genetic risk scores: a meta-analysis of 50,345 Caucasians. Am J Clin Nutr 102(5):1266–1278. https://doi.org/10.3945/ajcn.114.101238 CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Kurotani K, Nanri A, Goto A, Mizoue T, Noda M, Oba S, Kato M, Matsushita Y, Inoue M, Tsugane S (2013) Red meat consumption is associated with the risk of type 2 diabetes in men but not in women: a Japan Public Health Center-Based Prospective Study. Br J Nutr 110(10):1910–1918. https://doi.org/10.1017/s0007114513001128 CrossRefPubMedGoogle Scholar
- 34.van Woudenbergh GJ, Kuijsten A, Tigcheler B, Sijbrands EJ, van Rooij FJ, Hofman A, Witteman JC, Feskens EJ (2012) Meat consumption and its association with C-reactive protein and incident type 2 diabetes: the Rotterdam Study. Diabetes Care 35(7):1499–1505. https://doi.org/10.2337/dc11-1899 CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Yang C, Pan L, Sun C, Xi Y, Wang L, Li D (2016) Red meat consumption and the risk of stroke: a dose–response meta-analysis of prospective cohort studies. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc 25(5):1177–1186. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.040 CrossRefGoogle Scholar
- 46.Kang M, Joung H, Lim J, Lee Y, Song Y (2011) Secular trend in dietary patterns in a Korean adult population, using the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey. (Secular Trend in Dietary Patterns in a Korean Adult Population, Using the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey). Korean J Nutr 44(2):152–161. https://doi.org/10.4163/kjn.2011.44.2.152 CrossRefGoogle Scholar
- 47.Korea Rural Economic Institute (2015) Consumption trend of food processing products and consumption activation plan. Korea Rural Economic Institute. Available via Nuri media. http://www.dbpia.co.kr/Article/NODE06597572. Accessed 27 Mar 2017
- 48.Brown JE, Lechtenberg E, Splett PL (2016) Nutrition through the life cycle, 6th edn. Cengage Learning, BostonGoogle Scholar