Evidence map›Paper›PMID 42250107›Full record

ArticleEuropean journal of nutrition2026

The moderating role of central adiposity, sex and age, on the association between animal- and plant-based protein intake and the 20-year cumulative incidence of type 2 diabetes: the ATTICA cohort study (2002-2022).

Ioanna Kechagia, Fotios Barkas, Mary Yannakoulia, Evangelos Liberopoulos, Petros P Sfikakis, Christos Pitsavos, Demosthenes Panagiotakos

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Article in European journal of nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ioanna KechagiaDepartment of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676, Athens, Greece.
Fotios BarkasDepartment of Internal Medicine, Medical School, University of Ioannina, 45500, Ioannina, Greece.
Mary YannakouliaDepartment of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676, Athens, Greece.
Evangelos LiberopoulosFirst Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527, Athens, Greece.
Petros P SfikakisFirst Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527, Athens, Greece.
Christos PitsavosFirst Cardiology Clinic, Medical School, National and Kapodistrian University, Athens, Greece.
Demosthenes PanagiotakosDepartment of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676, Athens, Greece. dbpanag@hua.gr.ORCID http://orcid.org/0000-0001-8583-153X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to evaluate the role of central adiposity, sex and age, on the association between total-animal and total-plant based protein and the 20-year cumulative incidence of type 2 diabetes (T2D), among apparently healthy adults participating in the ATTICA cohort study (2002-2022).

methodsThe present analysis included data from 2,000 individuals free of atherosclerotic cardiovascular disease and T2D at baseline (age 43 ± 13 years; 51% women). Total, animal-based, and plant-based protein intake were measured, through a validated food frequency questionnaire.

resultsThe 20-year cumulative incidence of T2D was 26.3% (95%CI [24.4, 28.3%]). Total red meat intake was consistently associated with increased incidence of T2D in both sexes, with RRs ranging from 1.08 to 1.11 per 30 g/day increment (p's < 0.05), after adjustment for confounders. Among females, a higher intake of animal-based protein was significantly associated with increased incidence of T2D (RR 1.24, 95%CI [1.04, 1.48]), with no significant associations among males. The adverse association between animal-based protein intake and T2D was strongest among females with increased WHR (RR 2.06, 95%CI [1.21, 3.49]); no significant association was observed in males, regardless of WHR status. Among younger females (< 65 years) with increased WHR, the association between animal-based protein and T2D incidence was equally strong (RR 2.06, 95%CI [1.21, 3.49]), and plant-based protein intake retained a highly significant protective association (RR 0.24, 95%CI [0.08, 0.68]).

conclusionsLong-term animal protein intake, especially red meat, increases the likelihood of developing T2D, particularly in women with central obesity; plant protein appears protective in metabolically vulnerable subgroups.

Indexed as

Animal Proteins, DietaryDiabetes Mellitus, Type 2Dietary ProteinsDiet, Plant-BasedObesity, AbdominalPlant ProteinsAdiposityAdultAge FactorsAnimalsCohort StudiesDietFemaleGreeceHumansIncidenceAnimal Proteins, DietaryDietary ProteinsPlant ProteinsAnimal-based proteinMetabolic statusPlant-based proteinProtein intakeType 2 diabetes

Identifiers

PMID42250107
PMCPMC13242381

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.