Table 2.

Hazard ratios of type 2 diabetes according to updated 4-year changes in total red meat intake^a

	Changes in frequency of red meat consumption (categories in serving/d)					P for trendb
	Moderate to large decrease (>0.50)	Small to moderate decrease (0.15–0.50)	No change/relatively stable (±0.14)	Small to moderate increase (0.15–0.50)	Moderate to large increase (>0.50)
HPFS
Cases/person-years	336/69097	255/74221	458/133862	248/60190	264/44372
Multivariate model 1c	1.06 (0.89–1.27)	0.92 (0.78–1.09)	1.00	1.21 (1.03–1.43)	1.59 (1.34–1.88)	<0.001
Multivariate model 2d	1.08 (0.90–1.29)	0.94 (0.80–1.12)	1.00	1.20 (1.01–1.41)	1.48 (1.25–1.75)	0.001
NHS
Cases/person-years	658/128173	770/168022	1061/246411	587/117130	406/62021
Multivariate model 1c	0.90 (0.80–1.01)	0.96 (0.87–1.06)	1.00	1.16 (1.05–1.28)	1.36 (1.21–1.53)	<0.001
Multivariate model 2d	0.95 (0.84–1.07)	0.98 (0.89–1.08)	1.00	1.10 (0.99–1.21)	1.22 (1.08–1.38)	<0.001
NHS II
Cases/person-years	466/141889	433/179136	682/296201	452/146734	464/98366
Multivariate model 1c	1.00 (0.87–1.15)	0.98 (0.86–1.11)	1.00	1.30 (1.15–1.47)	1.55 (1.37–1.76)	<0.001
Multivariate model 2d	1.04 (0.90–1.19)	0.98 (0.86–1.11)	1.00	1.20 (1.06–1.36)	1.31 (1.16–1.49)	<0.001
Poolede
Multivariate model 1c	0.96 (0.89–1.04)	0.96 (0.89–1.03)	1.00	1.21 (1.13–1.30)	1.48 (1.37–1.59)	<0.001
Multivariate model 2d	1.00 (0.92–1.09)	0.97 (0.91–1.04)	1.00	1.15 (1.07–1.23)	1.30 (1.21–1.41)	<0.001

^aData are based on 20 years of follow-up (1986–2006) in the Health Professionals Follow-up Study (HPFS), 20 years of follow-up (1986–2006) in the Nurses’ Health Study (NHS), and 16 years of follow-up (1991–2007) in the Nurses’ Health Study II (NHS II). The exposure was change in red meat intake in each 4-year period, and the outcome was the incidence of type 2 diabetes in the subsequent 4 years.

^bP value for trend was derived from tests of linear trend across categories of changes in red meat consumption by treating the median value of the each category as a continuous variable.

^cMultivariate Model 1: adjusted for age, initial red meat intake (quintiles), race (white, non-white), marital status (with spouse, yes or not), family history of diabetes (yes or not), history of hypertension (yes or not), history of hypercholesterolemia (yes or not), and simultaneous changes in other lifestyle factors: smoking status (never to never, never to current, past to past, past to current, current to past, current to current, missing indicator), initial and change in alcohol intake (quintiles), initial and change in physical activity (quintiles), initial and change in total energy intake (quintiles), as well as initial and change in diet quality (Alternative Healthy Eating Index, quintiles). Among nurses, postmenopausal status and menopausal hormone use (NHS and NHS II) were also included.

^dMultivariate Model 2: model 1 plus initial BMI (<23, 23–24.9, 25–29.9, 30–34.9, ≥35 kg/m²) and weight change (quintiles) during the 4-year period.

^eThe results across the three cohorts were pooled using fixed-effect meta-analysis.