新加坡研究：多吃红肉患上糖尿病风险增加两成以上

Cari_YWQ

据新加坡Today Online报道，杜克国大医学院（Duke-NUS Medical School）日前针对新加坡华人的一项研究发现，多吃红肉的人患上糖尿病的风险比起一般人增加两成以上。因此，医生特别建议大家以白肉和植物性蛋白类食物替代红肉。


这项研究涉及年龄介于45至74岁的4万5000名新加坡华裔，并对他们进行了长达数十年的追踪调查。


图片来源：网络




研究显示，多吃猪、牛、羊等红肉的人，和少吃红肉的人相比，患糖尿病风险增加23%。而多吃家禽类如鸡和鸭的人，比少吃的人，患糖尿病风险高出15%。鱼类和海鲜则与增加糖尿病风险无关。


研究人员表示，红肉含有较多的血红素铁，容易被人体吸收，并可能影响胰岛素的分泌，导致人们患上糖尿病。


杜克国大医学院教授许恩佩医生对此表示，希望公众能够采取一些简单的步骤，减少饮食中红肉的分量，并多吃血红素铁比较低的白肉，如鸡胸、鸡翅膀、鱼肉、海鲜，最好就是吃蛋白质比较高的蔬菜，黄豆或者奶制品。
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加工肉品、方便面都会致癌？营养学家：都是社会食品恐慌！

pingshien

一大堆这些狗屁研究！！

明天头条你就会看到

“美国研究：多吃红肉患上糖尿病风险减少两成以上 ”

Robotcarpoli

赞同。。最好吃素。。哈哈

joon_my

Robotcarpoli 发表于 6-9-2017 01:19 PM
赞同。。最好吃素。。哈哈

之前有研究讲吃素会短命喔

kimkim5

那么大家就要多吃鸡，白肉

无名好留

专家=仙家
都是拿钱做事而已，明天就有专家出来说吃x肉比吃红肉患糖尿病风险高。。

没来racer

是想阿拉族转吃oink?

Jason929

這個針對小新華裔罷了

等下人家會不會出來抗議?

thunder

大家就快被这些砖家搞到精神分裂，以前说胆固醇是邪恶的，现在说没问题，想吃就吃，然后又来个红肉会提高糖尿病风险，那是还让不让人活啊

tintin

红肉可以吃，不过要选瘦肉。烹调方式也要低油脂。相信牛肉羊肉一般都是煮咖喱，咖喱很下饭，不知不觉就吃多白饭然后提高患糖尿病的机率了

jinreung

以下是原文摘要（沒錢買全文）

We evaluated the relationships of red meat, poultry, fish, and shellfish intakes, as well as heme iron intake, with the risk of type 2 diabetes mellitus (T2D).The Singapore Chinese Health Study is a population-based cohort study that recruited 63,257 Chinese adults aged 45–74 years from 1993 to 1998. Usual diet was evaluated using a validated 165-item semiquantitative food frequency questionnaire at recruitment. Physician-diagnosed T2D was self-reported during 2 follow-up interviews in 1999–2004 and 2006–2010. During a mean follow-up of 10.9 years, 5,207 incident cases of T2D were reported. When comparing persons in the highest intake quartiles with those in the lowest, the multivariate-adjusted hazard ratio for T2D was 1.23 (95% confidence interval (CI): 1.14, 1.33) for red meat intake (P for trend < 0.001), 1.15 (95% CI: 1.06, 1.24) for poultry intake (P for trend = 0.004), and 1.07 (95% CI: 0.99, 1.16) for fish/shellfish intake (P for trend = 0.12). After additional adjustment for heme iron, only red meat intake remained significantly associated with T2D risk (multivariate-adjusted hazard ratio = 1.13, 95% CI: 1.01, 1.25; P for trend = 0.02). Heme iron was associated with a higher risk of T2D even after additional adjustment for red meat intake (multivariate-adjusted hazard ratio = 1.14, 95% CI: 1.02, 1.28; P for trend = 0.03). In conclusion, red meat and poultry intakes were associated with a higher risk of T2D. These associations were mediated completely for poultry and partially for red meat by heme iron intake.

https://academic.oup.com/aje/art ... rectedFrom=fulltext

而以下的應該是這篇文章數據來源：

Background & aims

The effect of total dairy products, milk, and calcium intake on risk of type 2 diabetes (T2D) is uncertain, particularly in the Chinese population.

Methods

The present study was based on a prospective cohort of 63,257 Chinese men and women aged 45–74 years during enrollment (1993–1998) in Singapore. Dietary information was obtained using a validated 165-item semi-quantitative food-frequency questionnaire. Information about newly diagnosed T2D was collected by self-report during two follow-up interviews in 1999–2004 and 2006–2010. Cox proportional hazard regression method was used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) in 45,411 eligible participants.

Results

Incidence rate (95% CI) of T2D was 10.5 (10.2–10.8) per 1000 person-years. Intake of dairy food was significantly associated with reduced T2D risk; compared with the lowest quartile, HRs (95% CI) for the second, third and fourth quartiles of dairy intake were 0.98 (0.91–1.06), 0.96 (0.89–1.03) and 0.90 (0.83–0.98), respectively, after adjustment for potential confounders at baseline (P-trend = 0.01). Daily drinkers of milk had a significant 12% reduction in T2D risk compared with non-drinkers. While dairy calcium was associated with a decreased risk of T2D (HR comparing extreme quartiles 0.84; 95% CI 0.76–0.93; P-trend = 0.001), no association was found for non-dairy calcium (HR 1.02; 95% CI 0.92–1.14; P-trend = 0.61).

Conclusions

In this large cohort study of Chinese adults, dairy product intake and daily milk consumption was associated with a statistically significant, although modest, decrease in risk of developing T2D, which may be independent of its calcium content.

http://www.sciencedirect.com/science/article/pii/S0261561417300948

原本63k最後變成45k，30+%的drop out rate，其實也蠻高的。
還有的是，這研究是以問卷調查方式，很多時候受訪者可能會無意地刻意地不誠實地回答問卷。


再來的就是，數據裡頭的群體，有80%的人平均一週只做少於半小時的「運動」，是典型熱帶不做運動型群體——本來就是很強的糖尿病風險。


身為academia、時常在statistic打轉的版主大人@wjleong15 ，你有什麼高見？

wjleong15

jinreung 发表于 7-9-2017 04:35 PM
以下是原文摘要（沒錢買全文）


而以下的應該是這篇文章數據來源：



原本63k最後變成45k，30+%的drop out rate，其實也蠻高的。
還有的是，這研究是以問卷調查方式，很多時候受訪者可能會無意地刻意地 ...

大哥
我看到statistics就恨死它
还好我不需要跟它有太深入的交流
够用就好

我也是没钱买那个OUP的那份journal，这里也没有subscribe

以下是从你的另一篇sciencedirect摘要出来的limitation部分
5个好像不少。。。

Our findings must be considered in light of the study limitations. First, measurement error due to self-reported dietary intake could have caused non-differential misclassification, which may, in turn, have led to underestimation of the risk reduction. Similarly, misclassification due to self-report of covariates may also lead to residual confounding. Second, our analysis relied on dietary measurements at baseline and subsequent changes in intake may lead to non-differential misclassification and underestimation of the risk estimate. Third, we used self-reported physician-diagnosed T2D as outcome, and would inherently have omitted undiagnosed T2D in our case ascertainment. If dairy intake is associated with asymptomatic disease, this may cause under-estimation of the risk estimate due to non-differential misclassification of undiagnosed cases as non-cases. Forth, information about fat content of dairy was not collected in this study, thus, we were not able to separately explore the association of low or high fat dairy with T2D risk, although low fat dairy products were generally less common during the 1990s (recruitment period) in Singapore. Finally, milk was the major source of dairy intake, and our results may not be generalizable to other populations with substantial variety of other dairy products such as cheese, butter, yogurt, and cream.

很同意你的说法
其实在那么多种study里面
questionnaire/survey的impact是最差的
接下来就属cohort study里面的retrospective再到prospective
然后就是randomize control trial
到最后的clinical trials

所以survey study要有好的study impact就要够多的sample size
而我们通常都会预算大约10-15%的drop out rate
30%其实很多了
而且也会影响整个study的power，bias，和 Generalisability

How much loss to follow-up is
acceptable in long-term
randomised trials and
prospective studies?
Mary S Fewtrell et al 2013
https://pdfs.semanticscholar.org ... b4143526eb1e287.pdf

他们一开始study的时候其实已经计算了预计的dropout rate
我不觉得他们会放30%

而这个需要biostatistician来说书了

samsilence

那么大只佬够力咯~