Updated: Nov 8
One important risk factor for type 2 diabetes is the role of meat, especially red and processed meat. Seemingly the facts behind this are less well known than other risk factors. Perhaps because other factors have been prioritised and studied in greater depth. Or, perhaps because people don’t want to hear more bad news about meat.
Before we go any further, this article is not going to tell you not to eat meat. Some readers might find the evidence to be useful or applicable to their circumstances. Discuss the evidence with your medical practitioner if you have questions, concerns or are under treatment. Links to relevant studies are provided at the bottom of the page
So, what is the diabetes risk from meat, is it significant? While in the short-term there seems to be little effect of meat on diabetes risk (study, O'Conner et al), long-term studies seem to indicate otherwise.
A recent major study (O'Hearn et al) that analyses overall risk from various eating patterns estimates the risk factor as: 20.3% from excess processed meat and 20.1 % from unprocessed red meat, compared to the risk of consuming insufficient whole grains (26.1%) or consuming excess refined rice and wheat (24.6%).
Diabetes is an illness that is often but not always (learn about the personal fat threshold) associated with excess weight, a high BMI. Most people with diabetes or pre-diabetes focus their attention on managing sugar and, to a lesser degree fat, in their diet. Meat is a major source of saturated fat. Even seemingly lean cuts of meat contain fat, invisible within the muscular tissues and cells themselves.
Other factors relate to meat’s role in inflammation within the body. Meat is high in heme iron. Heme iron is linked to inflammation and oxidative stress. There is evidence that meat negatively affects the gut microbiome and increases insulin resistance. Grilling, frying and roasting meat creates advanced glycation end products. These compounds are associated with insulin resistance, oxidative stress, and chronic inflammation in patients with diabetes. All these factors affect the body and can result in chronic illness, not only diabetes.
Processed meat appears to hold the highest risk. Replacing meat with fish reduces risk. Whole food and plant forward diets like the popular Mediterranean diet (that does not exclude meat but rather limits it) are associated with decreased risk of diabetes. Lower in saturated fat, high in fibre and rich in anti-inflammatory compounds, especially polyphenols. The Mediterranean diet is just one of many traditional diets, or eating patterns, that can be enjoyed both for health and for taste. Providing that it is enjoyed in its traditional, whole foods focused, form.
Diabetes is complex, widespread and dangerous. If you live in Singapore the chance of developing type 2 diabetes is about 1 in 3. Various lifestyle factors are in involved: being-overweight, poor diet, being sedentary. The same issues that affect us all, right? Moderating meat consumption is one - often overlooked area - that could be of benefit to many.
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O'Hearn M, Lara-Castor L, Cudhea F, Miller V, Reedy J, Shi P, Zhang J, Wong JB, Economos CD, Micha R, Mozaffarian D; Global Dietary Database. Incident type 2 diabetes attributable to suboptimal diet in 184 countries. Nat Med. 2023 Apr;29(4):982-995. doi: 10.1038/s41591-023-02278-8. Epub 2023 Apr 17. PMID: 37069363; PMCID: PMC10115653.
O'Connor LE, Kim JE, Clark CM, Zhu W, Campbell WW. Effects of Total Red Meat Intake on Glycemic Control and Inflammatory Biomarkers: A Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2021 Feb 1;12(1):115-127. doi: 10.1093/advances/nmaa096. PMID: 32910818; PMCID: PMC7850054.
Ibsen DB, Warberg CK, Würtz AML, Overvad K, Dahm CC. Substitution of red meat with poultry or fish and risk of type 2 diabetes: a Danish cohort study. Eur J Nutr. 2019 Oct;58(7):2705-2712. doi: 10.1007/s00394-018-1820-0. Epub 2018 Sep 17. PMID: 30225630.
Prasad C, Davis KE, Imrhan V, Juma S, Vijayagopal P. Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification. Am J Lifestyle Med. 2017 May 15;13(4):384-404. doi: 10.1177/1559827617708991. PMID: 31285723; PMCID: PMC6600625.
Zelber-Sagi S, Ivancovsky-Wajcman D, Fliss Isakov N, Webb M, Orenstein D, Shibolet O, Kariv R. High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance. J Hepatol. 2018 Jun;68(6):1239-1246. doi: 10.1016/j.jhep.2018.01.015. Epub 2018 Mar 20. PMID: 29571924.
Guasch-Ferré M, Merino J, Sun Q, Fitó M, Salas-Salvadó J. Dietary Polyphenols, Mediterranean Diet, Prediabetes, and Type 2 Diabetes: A Narrative Review of the Evidence. Oxid Med Cell Longev. 2017;2017:6723931. doi: 10.1155/2017/6723931. Epub 2017 Aug 13. PMID: 28883903; PMCID: PMC5572601.
Hosseinpour-Niazi S, Mirmiran P, Hedayati M, Azizi F. Substitution of red meat with legumes in the therapeutic lifestyle change diet based on dietary advice improves cardiometabolic risk factors in overweight type 2 diabetes patients: a cross-over randomized clinical trial. Eur J Clin Nutr. 2015 May;69(5):592-7. doi: 10.1038/ejcn.2014.228. Epub 2014 Oct 29. PMID: 25351652.