British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

High intakes of protein and processed meat associate with increased incidence of type 2 diabetes

Ulrika Ericsona1 c1, Emily Sonestedta1, Bo Gullberga2, Sophie Hellstranda1, George Hindya1, Elisabet Wirfälta2 and Marju Orho-Melandera1

a1 Department of Clinical Sciences, Malmö, Diabetes and Cardiovascular Disease, Genetic Epidemiology, Lund University, Clinical Research Centre, Building 60, Floor 13, SUS in Malmö, Entrance 72, SE-205 02 Malmö, Sweden

a2 Department of Clinical Sciences, Malmö, Nutrition Epidemiology, Lund University, SE-205 02 Malmö, Sweden


Diets high in protein have shown positive effects on short-term weight reduction and glycaemic control. However, the understanding of how dietary macronutrient composition relates to long-term risk of type 2 diabetes is limited. The aim of the present study was to examine intakes of macronutrients, fibre and protein sources in relation to incident type 2 diabetes. In total, 27 140 individuals, aged 45–74 years, from the population-based Malmö Diet and Cancer cohort, were included. Dietary data were collected with a modified diet history method, including registration of cooked meals. During 12 years of follow-up, 1709 incident type 2 diabetes cases were identified. High protein intake was associated with increased risk of type 2 diabetes (hazard ratio (HR) 1·27 for highest compared with lowest quintile; 95 % CI 1·08, 1·49; P for trend = 0·01). When protein consumption increased by 5 % of energy at the expense of carbohydrates (HR 1·20; 95 % CI 1·09, 1·33) or fat (HR 1·21; 95 % CI 1·09, 1·33), increased diabetes risk was observed. Intakes in the highest quintiles of processed meat (HR 1·16; 95 % CI 1·00, 1·36; P for trend = 0·01) and eggs (HR 1·21; 95 % CI 1·04, 1·41; P for trend = 0·02) were associated with increased risk. Intake of fibre-rich bread and cereals was inversely associated with type 2 diabetes (HR 0·84; 95 % CI 0·73, 0·98; P for trend = 0·004). In conclusion, results from the present large population-based prospective study indicate that high protein intake is associated with increased risk of type 2 diabetes. Replacing protein with carbohydrates may be favourable, especially if fibre-rich breads and cereals are chosen as carbohydrate sources.

(Received January 11 2012)

(Revised April 12 2012)

(Accepted May 25 2012)

(Online publication August 01 2012)

Key Words:

  • Dietary proteins;
  • Type 2 diabetes mellitus;
  • Cohort studies


c1 Corresponding author: U. Ericson, fax +46 40 39 13 22, email


  Abbreviations: En%, percentage of energy; EPIC-NL, European Prospective Investigation into Cancer and Nutrition-Netherlands; HR, hazard ratios; MDC, Malmö Diet and Cancer