PP324 - ASSOCIATION OF SUBSTITUTING MEAT WITH PLANT-SOURCE FOODS AND TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL STUDIES

PP324

ASSOCIATION OF SUBSTITUTING MEAT WITH PLANT-SOURCE FOODS AND TYPE 2 DIABETES:

A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL STUDIES

E. Kiesswetter^1,*, A. Zink^1,2, J. Stadelmaier¹, S. Wallerer¹, J. Kleinknecht¹, M. Neuenschwander^3,4, E. Schaefer^3,4, J. J. Meerpohl^1,2, S. Schlesinger^3,4, L. Schwingshackl¹

¹Institute for Evidence in Medicine, Medical Center - University of Freiburg/Medical Faculty - University of Freiburg, ²Cochrane Germany, Cochrane Germany Foundation, Freiburg, ³Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, ⁴German Center for Diabetes Research (DZD), Partner Düsseldorf, Munich-Neuherberg, Germany

Rationale: Substitution analyses that estimate associations with health outcomes when a specified amount of one food is substituted with another may be informative for dietary guidelines. The aim of this project was to summarize and evaluate the evidence on substituting different types of meat with plant-source foods and type 2 diabetes (T2D; PROSPERO CRD420251026005).

Methods: We systematically searched 3 databases up to 02 April 2025. We performed random-effects meta-analyses and calculated pooled hazard ratios (HR) with 95% confidence intervals (95%CI). We assessed risk of bias (ROBINS-E) and certainty of evidence (CoE; GRADE).

Results: We included 8 reports of 12 prospective cohort studies (399,320 participants; follow-up range 4.3–28 years). We found moderate CoE for a lower risk of T2D associated with substituting total red meat with cereals (30 g/d; HR 0.82, 95%CI 0.79–0.86) and processed red meat (50 g/d) with nuts (10–45 g/d; HR 0.69, 95%CI 0.55–0.88) or starchy roots and tubers (50 g/d; HR 0.80, 95%CI 0.76–0.84). For unprocessed red meat (50 g/d), substitution with whole grains (24–30 g/d) was associated with a lower risk of T2D (HR 0.84, 95%CI 0.81–0.88, moderate CoE). Substituting unprocessed red meat (50 g/d) with legumes (19–50 g/d), vegetables (50–96 g/d) or fruits (50–61 g/d) was associated with little to no difference in T2D risk (moderate CoE). For poultry (50 g/d) substitutions with legumes or starchy roots and tubers (both 50 g/d) resulted in little to no differences in the association with T2D risk (moderate CoE). All other substitution analyses were based on low or very low certainty.

Conclusion: Our findings indicate that associations with T2D vary depending on the type of meat being substituted. In particular, substituting processed red meat with plant-source foods was associated with a lower risk of T2D.

Disclosure of Interest: None declared