A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus

Kim, Yoona; Keogh, Jennifer B.; Clifton, Peter

doi:10.1016/j.metabol.2015.03.008

Cited by 151 publications

(111 citation statements)

References 121 publications

(149 reference statements)

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“…Therefore the contrast in dietary intake of meat was smaller between vegetarians and non-vegetarians in South Asia compared to the US Given that reduced meat intake has been implicated as a key driver of the health benefits of a vegetarian diet in US and European populations given its association with obesity (38) and diabetes (39–41) , this may partially explain the lower magnitude of association in the South Asian versus US sample.…”

Section: Discussionmentioning

confidence: 94%

Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults

et al. 2016

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Background Cardiometabolic diseases are increasing disproportionately in South Asia compared to other regions of the world despite high levels of vegetarianism. This unexpected discordance may be explained by differences in the healthfulness of vegetarian and non-vegetarian diets in South Asia versus the US. Objective (1) To compare the food group intake of vegetarians versus non-vegetarians in South Asia and the US and (2) to evaluate associations between vegetarianism and cardiometabolic disease risk factors (overweight/obesity, central obesity, diabetes, hypertension, high triglycerides, high LDL, low HDL, and high Framingham Heart Score). Design Using cross-sectional data from adults (20–69 years) in South Asia (CARRS 2010–2011; n=15,665) and the US (NHANES 2003–2006; n=2159), adherence to a vegetarian diet was assessed using food propensity questionnaires. Multivariable logistic regression was used to estimate odds ratios and predicted margins (e.g. adjusted prevalence of the outcomes). Results One-third (33.0%; n=4968) of adults in the South Asian sample were vegetarian in contrast to only 2.4% (n=59) in the US sample. Among South Asians, compared with non-vegetarians, vegetarians more frequently ate dairy, legumes, vegetables, fruit, desserts, and fried foods (all p<0.05). Among Americans, compared with non-vegetarians, vegetarians more frequently ate legumes, fruit, and whole grains, and less frequently ate refined cereals, desserts, fried foods, fruit juice, and soft drinks (all p<0.05). After adjustment for confounders (age, sex, education, tobacco, alcohol, and also city in CARRS), South Asian vegetarians were slightly less frequently overweight/obese compared to non-vegetarians – 49% (95% CI: 45%, 53%) versus 53% (51%, 56%), respectively – while US vegetarians were considerably less frequently overweight/obese compared to non-vegetarians: 48% (32%, 63%) versus 68% (65%, 70%), respectively. Furthermore, US vegetarians were less likely to exhibit central obesity compared to non-vegetarians: 62% (43%, 78%) versus 78% (76%, 80%), respectively. Conclusions There is greater divergence between vegetarian and non-vegetarian diets in the US compared to South Asia, and US vegetarians have more consistently healthier food group intakes compared to South Asian vegetarians. Vegetarians in both populations have a lower probability of overweight/obesity compared to non-vegetarians. The strength of this association may be stronger for US vegetarian diets, which were also protective against central obesity.

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Section: Discussionmentioning

confidence: 94%

Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults

et al. 2016

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“…Log-rank P value for difference in survival was ,0.001. and advanced lipoxidation endproducts (ALEs) found in red meat. 27 Specifically, dietary AGEs and ALEs have been postulated to play a role in diabetes mellitus due to their oxidative properties, and it has been shown that patients with CKD and ESRD have higher levels of circulatory AGEs and ALEs. 28 Finally, previously published results have shown that the methods of cooking meats in this population were similar, with boiling or steaming being the most common method.…”

Section: Discussionmentioning

confidence: 99%

Red Meat Intake and Risk of ESRD

Lew

Jafar

Koh

et al. 2016

JASN

187

135

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Randomized controlled trials suggest that protein restriction may retard the progression of CKD toward ESRD. However, the effects of dietary protein intake level and the food sources of dietary protein on the risk of ESRD in the general population remain unclear. We investigated these effects in the Singapore Chinese Health Study, a prospective population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. We collected habitual diet information via a validated semiquantitative food frequency questionnaire and identified ESRD via record linkage with a nationwide registry. In all, 951 cases of ESRD occurred over a mean follow-up of 15.5 years. Regarding total protein intake, compared with the lowest quartile, the three higher quartiles combined had a hazard ratio for ESRD of 1.24 (95% confidence interval [95% CI], 1.05 to 1.46), but the dose-dependent association across the quartiles was not statistically significant (P trend =0.16). Red meat intake strongly associated with ESRD risk in a dosedependent manner (hazard ratio for highest quartile versus lowest quartile,1.40 [95% CI, 1.15 to 1.71; P trend ,0.001]). Intake of poultry, fish, eggs, or dairy products did not associate with risk of ESRD. In substitution analysis, replacing one serving of red meat with other food sources of protein associated with a maximum relative risk reduction of 62.4% (95% CI, 33.1 to 78.9; P,0.01). Our study shows that red meat intake may increase the risk of ESRD in the general population and substituting alternative sources of protein may reduce the incidence of ESRD.

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“…172, 178 Mechanisms require further study, but risk for diabetes may be linked to iron content 179, 180 as well as possibly lipid and amino acid metabolites, advanced glycation end products, trimethylamine N-oxide, and nitrates/nitrites. 181, 182 …”

Section: Foods and Cardiometabolic Healthmentioning

confidence: 99%

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

2016

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Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not just obesity and blood lipids; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO. Evidence-based personalized nutrition appears to depend more on non-genetic characteristics (e.g., physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies, including those targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce burdens of diet-related cardiometabolic diseases.

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A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus

Cited by 151 publications

References 121 publications

Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults

Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults

Red Meat Intake and Risk of ESRD

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

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