Att dra ner på kött och chark kan minska risken för att utveckla typ 2-diabetes. De slutsatserna drar forskare av en omfattande internationell studie.
När de uppdaterade nordiska näringsrekommendationerna presenterades 2023 var rådet tydligt: Begränsa mängden kött till max 350 gram i veckan.
- Av processat kött, som skinka, salami och bacon, bör vi äta "så lite som möjligt", sade projektledaren Rune Blomhoff till TT då.
Råden får nu stöd i en stor så kallad metaanalys där forskare från flera länder, däribland Sverige, har analyserat data om mängden kött och chark i kosten och typ 2-diabetes. Totalt omfattas nästan två miljoner deltagare från 20 länder.
Slutsatsen i studien, som publicerats i The Lancet Diabetes & Endocrinology, är att risken att utveckla diabetes typ 2 ökar stegvis ju mer kött man äter. Även konsumtion av fågel kopplas till ökad risk, om än inte lika hög.
– Det här är en av de största observationsstudierna kring köttkonsumtion och diabetes som har gjorts. Den är väldigt gedigen, säger Mai-Lis Hellénius, läkare och professor vid Karolinska Institutet, som inte själv deltagit i studien.
I den här typen av studier går det inte att slå fast att det är köttkonsumtionen som ger den ökade risken men Hellénius säger att den är ytterligare ett tecken på att dagens näringsrekommendationer om att begränsa köttintaget ligger rätt.
– Diabetes typ 2 ökar i hela världen och kryper ner i åldrarna. I ljuset av det är den här studien en viktig pusselbit.
Forskarna tar upp några exempel: För varje 100 gram rött, icke-processat, kött om dagen som äts ökar risken att utveckla typ 2-diabetes med 10 procent. För processat kött ger varje intag à 50 gram en riskökning på 15 procent.
Men Hellénius tycker inte att man ska vara rädd för skinkskivan på smörgåsen.
– Det handlar om balans och vilken livsstil vi har i övrigt. Både kost och fysisk aktivitet är viktigt. Människor är allätare och det finns plats för både snabba kolhydrater och kött. Men många i Sverige, framförallt unga män, äter för mycket kött.
Varför kött och chark skulle öka risken för typ 2-diabetes svarar inte studien på. Men det finns några teorier. Exempelvis att kött kan innehålla nitrosaminer, som kan vara cancerframkallande och även påverka många celler och funktioner i kroppen vilket påverkar risken för diabetes. Kött innehåller också mättade fettsyror som inte är bra för oss.
– Men även protein och järn som är bra. Än en gång – det handlar om att inte äta för mycket, säger Hellénius.
Rättad: I en tidigare version fanns en felaktig uppgift om hur näringsrekommendationen såg ut för kött.
Fakta: Chark eller rött?
Vad är skillnaden?
Med rött kött menas kött från fyrbenta djur som nöt, gris, får/lamm, vilt och ren.
Med charkprodukter menar man kött som har rökts, behandlats med nitrit eller konserverats på annat sätt. Det kan vara till exempel korv, bacon, rökt skinka, salami och leverpastej.
Sedan tidigare är det känt att en hög konsumtion av kött, framför allt processat, ökar risken för bland annat tjocktarmscancer och hjärt-kärlsjukdomar.
Källa: Livsmedelsverket, Mai-Lis Hellénius
Från TT
LÄS HELA STUDIEN PDF FREE
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext#seccestitle160
Meat consumption and incident type 2 diabetes: an individual-participant federated meta-analysis of 1·97 million adults with 100 000 incident cases from 31 cohorts in 20 countries
Summary
Background
Meat consumption could increase the risk of type 2 diabetes. However, evidence is largely based on studies of European and North American populations, with heterogeneous analysis strategies and a greater focus on red meat than on poultry. We aimed to investigate the associations of unprocessed red meat, processed meat, and poultry consumption with type 2 diabetes using data from worldwide cohorts and harmonised analytical approaches.
Methods
This individual-participant federated meta-analysis involved data from 31 cohorts participating in the InterConnect project. Cohorts were from the region of the Americas (n=12) and the Eastern Mediterranean (n=2), European (n=9), South-East Asia (n=1), and Western Pacific (n=7) regions. Access to individual-participant data was provided by each cohort; participants were eligible for inclusion if they were aged 18 years or older and had available data on dietary consumption and incident type 2 diabetes and were excluded if they had a diagnosis of any type of diabetes at baseline or missing data. Cohort-specific hazard ratios (HRs) and 95% CIs were estimated for each meat type, adjusted for potential confounders (including BMI), and pooled using a random-effects meta-analysis, with meta-regression to investigate potential sources of heterogeneity.
Findings
Among 1 966 444 adults eligible for participation, 107 271 incident cases of type 2 diabetes were identified during a median follow-up of 10 (IQR 7–15) years. Median meat consumption across cohorts was 0–110 g/day for unprocessed red meat, 0–49 g/day for processed meat, and 0–72 g/day for poultry. Greater consumption of each of the three types of meat was associated with increased incidence of type 2 diabetes, with HRs of 1·10 (95% CI 1·06–1·15) per 100 g/day of unprocessed red meat (I2=61%), 1·15 (1·11–1·20) per 50 g/day of processed meat (I2=59%), and 1·08 (1·02–1·14) per 100 g/day of poultry (I2=68%). Positive associations between meat consumption and type 2 diabetes were observed in North America and in the European and Western Pacific regions; the CIs were wide in other regions. We found no evidence that the heterogeneity was explained by age, sex, or BMI. The findings for poultry consumption were weaker under alternative modelling assumptions. Replacing processed meat with unprocessed red meat or poultry was associated with a lower incidence of type 2 diabetes.
Interpretation
The consumption of meat, particularly processed meat and unprocessed red meat, is a risk factor for developing type 2 diabetes across populations. These findings highlight the importance of reducing meat consumption for public health and should inform dietary guidelines.
Funding
The EU, the Medical Research Council, and the National Institute of Health Research Cambridge Biomedical Research Centre.
FROM THE ARTICLE
Research in context
Evidence before this study
We searched PubMed for articles published between Jan 1, 1970, and Dec 1, 2023, using the terms “meat” OR “poultry” OR “chicken” AND “diabetes”, with no language restrictions; this search returned 2583 results. 21 individual cohort studies and nine meta-analysis studies that evaluated associations between meat consumption and type 2 diabetes in populations were considered. The reference lists of these studies were also screened to identify other relevant publications.
All the existing meta-analyses were conducted on the basis of published summary data and the included studies were primarily from high-income countries, mainly within Europe and North America. Limitations of these meta-analyses included publication bias and large heterogeneity. Additionally, previous studies focused primarily on the consumption of unprocessed red meat and processed meat, with little evidence for poultry, and had conflicting conclusions.
A few reviews indicated that consuming red meat might be associated with a slightly higher risk of incident type 2 diabetes, and some critiqued the current evidence as being insufficient to guide dietary recommendations or intervention.
Added value of this study
Our prospective study of almost 1·97 million participants—with more than 100 000 incident cases during follow-up—examined associations of the consumption of unprocessed red meat, processed meat, and poultry with incident type 2 diabetes across global populations, in a federated meta-analysis of individual-participant data. This study included 31 cohorts from 20 countries, which—to our knowledge—exceeds the scale of any previous research on this topic. Notably, our study included previously under-represented populations from the Eastern Mediterranean and Western Pacific regions and from South America and south Asia, and we used harmonised data and unified analytical methods.
We found that higher meat consumption, particularly of unprocessed red meat and processed meat, was associated with higher incidence of type 2 diabetes across populations. Positive associations were observed in the region of the Americas and in the European and Western Pacific regions; the CIs were broader in the Eastern Mediterranean region and in south Asia.
The positive association between poultry consumption and type 2 diabetes was smaller and more heterogeneous across cohorts than that for red meat consumption. Moreover, our findings indicated that replacing processed meat with either unprocessed red meat or poultry was associated with a lower risk of type 2 diabetes.
Implications of all the available evidence
Our federated meta-analysis supports dietary recommendations to limit the consumption of processed meat and unprocessed red meat to reduce the risk of type 2 diabetes. Evidence regarding the effect of poultry consumption is less consistent, highlighting the need for further research.
The consumption of unprocessed red meat and poultry had a lower risk association with type 2 diabetes than the consumption of processed meat, and further comparison between these types of meat is warranted.
This study is, to our knowledge, the most comprehensive evidence base to date on the consumption of different types of meat and the risk of developing type 2 diabetes and, together with previous evidence, provides support for public health initiatives to reduce the consumption of meat to improve human health and planetary sustainability.
FROM DISCUSSION
In conclusion, higher meat consumption was associated with higher type 2 diabetes incidence in a global individual-participant-based federated meta-analysis. The current findings support the notion that lowering the consumption of unprocessed red meat and processed meat could benefit public health by reducing the incidence of type 2 diabetes. Uncertainty remains regarding the positive association between poultry consumption and the incidence of type 2 diabetes, and this association should be further investigated. Beyond research on type 2 diabetes, our integrative work stimulates further investigation on sustainable dietary patterns to reduce meat consumption and its effect on other non-communicable diseases, multi-morbidity, and planetary health.
Nyhetsinfo
www red DiabetologNytt