Abstract P205: Meat Intake and Risk of Coronary Heart Disease Mortality in Singapore Chinese Adults

Abstract

Introduction: Epidemiological studies have reported inconsistent association between meat intake and coronary heart disease (CHD) mortality. We aimed to evaluate this association in a Chinese population with high fish intake and consumption of pork as red meat. Hypothesis: We assessed the hypothesis that intake of red meat, poultry, and fish/shellfish is associated with CHD mortality risk in an Asian population. Methods: The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998 in Singapore. A validated 165-item semi-quantitative food-frequency questionnaire was used to assess usual diet at recruitment, and mortality information was identified via registry linkage up to December 31, 2014. Cox proportional hazard models were used to calculate HRs (95% CI) with adjustment for potential confounders in 60,298 eligible participants free of self-reported CHD and stroke at baseline. Results: Median intake of total meat in this population was 95.9 g/d (interquartile range: 66.5-133), averagely comprised of 27.9% red meat, 18.3% poultry, and 53.6% fish/shellfish.During 981,983 person-years of follow-up, we identified 2,610 CHD deaths among 57,078 subjects who were free of cardiovascular disease at baseline. After controlling for socio-demographic, lifestyle and dietary factors including intakes of poultry and fish/shellfish, red meat intake was associated with increased CHD mortality risk (HR comparing highest vs. lowest quartiles 1.17; 95% CI 1.04-1.32; P-trend=0.005), which became insignificant after adjusting for cholesterol intake (1.11; 0.97-1.26; P-trend=0.11). Conversely, an inverse association was observed for poultry intake (0.88; 0.78-0.99; P-trend=0.03) which remained significant when adjusted for dietary cholesterol (0.85; 0.75-0.96; P-trend=0.007). Fish/shellfish intake was marginally associated with decreased risk of CHD mortality after adjusting for cholesterol (0.91; 0.80-1.03; P-trend=0.045). Dietary cholesterol was associated with an increased risk even after adjusting for intake of red meat, poultry, and fish/shellfish (1.22; 1.07-1.39; P-trend=0.002) or dietary saturated fatty acids, monounsaturated fatty acids, n-3, and n-6 (1.23; 1.07-1.42; P-trend=0.003). Conclusions: In this large cohort study of Chinese adults, red meat intake was associated with a higher risk of CHD mortality that was partly mediated by its cholesterol content. Conversely, poultry was related to a lower risk of CHD mortality.