Revisiting the Link Between Meat Intake and the Risk of Type 2 Diabetes in American Indians: Insights Based on Lipidomic Profiles

Type 2 diabetes is a burgeoning health crisis, affecting more than 500 million people worldwide ( 1 ). More alarmingly, the majority have developed complications when diagnosis is made ( 2 ). The epidemiology of type 2 diabetes differs among various racial and ethnic populations ( 3 ). In the U.S., prevalence of type 2 diabetes is highest among American Indians and is more than twice that among non-Hispanic Whites ( 4 ). Given the daunting diabetes disparities that American Indians face, effective intervention strategies are urgently needed to curb the high burden of type 2 diabetes in this population. The role of diet as one of the key modifiable factors in determining the risk of type 2 diabetes has been well established ( 5 ). Accumulating evidence from both large prospective studies and meta-analyses demonstrated positive associations of high consumption of processed meat and unprocessed red meat with risk of type 2 diabetes ( 6–9 ). Red meat contains heme iron and saturated fat, while meat processing can produce harmful chemicals like nitrates and advanced glycation end products, all of which were related to reduced insulin sensitivity, pancreatic β-cell function, or both and thereby were associated with increased risk of type 2 diabetes ( 10–12 ). However, the biological mechanisms that link processed and red meat intake with altered glucose hemostasis are not yet fully characterized. Further, data among minority populations, especially Indian Americans, remain limited.