Unprocessed Red Meat Research Articles

Abstract 12322: Red Meat Consumption and The Risk of Cardiovascular Diseases and Diabetes: A Systematic Review and Meta-analysis of Observational Studies and Randomized Controlled Trials

Introduction: Observational studies show inconsistent associations of red meat consumption with cardiovascular disease (CVD) and diabetes. Moreover, red meat consumption varies by sex, whether the associations vary by sex remains unclear. Methods: This systematic review and meta-analysis was performed to summarize the evidence concerning the association of unprocessed and processed red meat consumption with CVD, coronary heart disease (CHD), stroke, type 2 diabetes (T2DM), and gestational diabetes mellitus (GDM). Two researchers independently searched PubMed, Web of Science, Embase, and the Cochrane Library for observational studies and randomized controlled trials (RCTs) published before September 2021. Results: A total of 44 observational studies (N=4,857,244) for CVD and 28 observational studies (N=1,897,591) for diabetes were included. Red meat consumption was positively associated with risk of CVD [relative risk (RR) 1.11, 95% confidence interval (CI) 1.05 to 1.17 for unprocessed red meat; RR 1.15, 95% CI 1.09 to 1.22) for processed red meat], CHD and stroke, with no clear sex disparity. Both unprocessed and processed red meat consumption were related to a higher risk of T2DM, and unprocessed red meat consumption was related to risk of GDM. The associations with T2DM were more evident in men than in women, and in western countries. Conclusions: Our study suggests that unprocessed and processed red meat consumption are both associated with higher risk of CVD, CHD, stroke, and diabetes, with a more obvious association in women for diabetes. These findings highlight the need for a better understanding of the mechanisms to facilitate improving cardiometabolic health.

Red and Processed Meat Consumption in Poland.

The aim of the study was to assess the quantity and frequency of meat consumption, especially of red and processed meat, in Poland. The amount of meat consumed was assessed using data from household budget surveys undertaken in 2000, 2010, and 2020. The frequency of consumption was assessed using Food Propensity Questionnaire data from 1831 adults in 2019–2020. Poles consumed 1.35 kg of unprocessed red meat and 1.96 kg of total processed meat per person per month in 2020. The consumption of red meat was lower than in the two previous decades; the consumption of processed meat fluctuated. Pork was the most commonly consumed red meat: 40% of adults consumed pork 2–3 times a week. Beef and other unprocessed red meat were most often consumed less than once a month (29.1%). Processed meat was often consumed: 37.8% of adults ate cold cuts, and 34.9% ate sausages and bacon 2–3 times a week. The consumption of red and processed meat in Poland was high and frequent. In particular, the consumption of processed meat exceeded the recommendations and might increase the risk of chronic diseases. It is necessary to implement activities aimed at reducing the consumption of red and processed meat in Poland.

Health effects associated with consumption of unprocessed red meat: a Burden of Proof study

Characterizing the potential health effects of exposure to risk factors such as red meat consumption is essential to inform health policy and practice. Previous meta-analyses evaluating the effects of red meat intake have generated mixed findings and do not formally assess evidence strength. Here, we conducted a systematic review and implemented a meta-regression—relaxing conventional log-linearity assumptions and incorporating between-study heterogeneity—to evaluate the relationships between unprocessed red meat consumption and six potential health outcomes. We found weak evidence of association between unprocessed red meat consumption and colorectal cancer, breast cancer, type 2 diabetes and ischemic heart disease. Moreover, we found no evidence of an association between unprocessed red meat and ischemic stroke or hemorrhagic stroke. We also found that while risk for the six outcomes in our analysis combined was minimized at 0 g unprocessed red meat intake per day, the 95% uncertainty interval that incorporated between-study heterogeneity was very wide: from 0–200 g d−1. While there is some evidence that eating unprocessed red meat is associated with increased risk of disease incidence and mortality, it is weak and insufficient to make stronger or more conclusive recommendations. More rigorous, well-powered research is needed to better understand and quantify the relationship between consumption of unprocessed red meat and chronic disease.

The Burden of Proof studies: assessing the evidence of risk

Exposure to risks throughout life results in a wide variety of outcomes. Objectively judging the relative impact of these risks on personal and population health is fundamental to individual survival and societal prosperity. Existing mechanisms to quantify and rank the magnitude of these myriad effects and the uncertainty in their estimation are largely subjective, leaving room for interpretation that can fuel academic controversy and add to confusion when communicating risk. We present a new suite of meta-analyses—termed the Burden of Proof studies—designed specifically to help evaluate these methodological issues objectively and quantitatively. Through this data-driven approach that complements existing systems, including GRADE and Cochrane Reviews, we aim to aggregate evidence across multiple studies and enable a quantitative comparison of risk–outcome pairs. We introduce the burden of proof risk function (BPRF), which estimates the level of risk closest to the null hypothesis that is consistent with available data. Here we illustrate the BPRF methodology for the evaluation of four exemplar risk–outcome pairs: smoking and lung cancer, systolic blood pressure and ischemic heart disease, vegetable consumption and ischemic heart disease, and unprocessed red meat consumption and ischemic heart disease. The strength of evidence for each relationship is assessed by computing and summarizing the BPRF, and then translating the summary to a simple star rating. The Burden of Proof methodology provides a consistent way to understand, evaluate and summarize evidence of risk across different risk–outcome pairs, and informs risk analysis conducted as part of the Global Burden of Diseases, Injuries, and Risk Factors Study.

Relative to processed red meat, alternative protein sources are associated with a lower risk of hypertension and diabetes in a prospective cohort of French women.

Many dietary guidelines recommend restricting the consumption of processed red meat (PRM) in favour of healthier foods such as fish, to reduce the risk of chronic conditions such as hypertension and diabetes. The objective of this study was to estimate the potential effect of replacing PRM for fatty fish, lean fish, red meat, eggs, pulses, or vegetables, on the risk of incident hypertension and diabetes. This was a prospective study of women in the E3N cohort study. Cases of diabetes and hypertension were based on self-report, specific questionnaires, and drug reimbursements. In the main analysis, information on regular dietary intake was assessed with a single food history questionaire, and food substitutions were modelled using cox proportional hazard models. 95 % confidence intervals were generated via bootstrapping. 71081 women free of diabetes and 45771 women free of hypertension were followed for an average of 18·7 and 18·3 years, respectively. 2681 incident cases of diabetes and 12327 incident cases of hypertension were identified. Relative to PRM, fatty fish was associated with a 15 % lower risk of diabetes (HR = 0·85, 95 CI (0·73, 0·97)) and hypertension (HR = 0 85 (0·79, 0·91)). Between 3 and 10 % lower risk of hypertension or diabetes was also observed when comparing PRM with vegetables, unprocessed red meat or pulses. Relative to PRM, alternative protein sources such as fatty fish, unprocessed red meat, vegetables or pulses was associated with a lower risk of hypertension and diabetes.

Dietary Meat, Trimethylamine N-Oxide-Related Metabolites, and Incident Cardiovascular Disease Among Older Adults: The Cardiovascular Health Study.

Effects of animal source foods (ASF) on atherosclerotic cardiovascular disease (ASCVD) and underlying mechanisms remain controversial. We investigated prospective associations of different ASF with incident ASCVD and potential mediation by gut microbiota-generated trimethylamine N-oxide, its L-carnitine-derived intermediates γ-butyrobetaine and crotonobetaine, and traditional ASCVD risk pathways. Among 3931 participants from a community-based US cohort aged 65+ years, ASF intakes and trimethylamine N-oxide-related metabolites were measured serially over time. Incident ASCVD (myocardial infarction, fatal coronary heart disease, stroke, other atherosclerotic death) was adjudicated over 12.5 years median follow-up. Cox proportional hazards models with time-varying exposures and covariates examined ASF-ASCVD associations; and additive hazard models, mediation proportions by different risk pathways. After multivariable-adjustment, higher intakes of unprocessed red meat, total meat, and total ASF associated with higher ASCVD risk, with hazard ratios (95% CI) per interquintile range of 1.15 (1.01-1.30), 1.22 (1.07-1.39), and 1.18 (1.03-1.34), respectively. Trimethylamine N-oxide-related metabolites together significantly mediated these associations, with mediation proportions (95% CI) of 10.6% (1.0-114.5), 7.8% (1.0-32.7), and 9.2% (2.2-44.5), respectively. Processed meat intake associated with a nonsignificant trend toward higher ASCVD (1.11 [0.98-1.25]); intakes of fish, poultry, and eggs were not significantly associated. Among other risk pathways, blood glucose, insulin, and C-reactive protein, but not blood pressure or blood cholesterol, each significantly mediated the total meat-ASCVD association. In this large, community-based cohort, higher meat intake associated with incident ASCVD, partly mediated by microbiota-derived metabolites of L-carnitine, abundant in red meat. These novel findings support biochemical links between dietary meat, gut microbiome pathways, and ASCVD.

Which components of the Mediterranean diet are associated with dementia? A UK Biobank cohort study

Cohort studies suggest that the Mediterranean diet is associated with better global cognition in older adults, slower cognitive decline and lower risk of dementia. However, little is known about the relative contribution of each component of the Mediterranean diet to dementia risk or whether the diet’s effects are due to one or more specific food components. We aimed to examine whether Mediterranean diet components are associated with all-cause dementia risk in the UK BioBank cohort. Participants joined the UK Biobank study from 2006 to 2010 and were followed until December 2020. 249,511 participants, who were at least 55 years old, without dementia at baseline were included. We used self-reported consumption of food groups, considered part of the Mediterranean diet including fruit, vegetables, processed meat, unprocessed red meat and unprocessed poultry, fish, cheese, wholegrains. Incident dementia was ascertained through electronic linkage to primary care records, hospital and mortality records or self-report. In this study with a total follow-up of 2,868,824 person-years (median 11.4), after adjusting for all covariates and other food groups, moderate fish consumption of between 2.0 and 3.9 times a week was associated with decreased risk of dementia (HR 0.84, 95%CI 0.71–0.98) compared to no consumption. Additionally, fruit consumption of between 1.0 and 1.9 servings a day was associated with reduced dementia risk (HR 0.85, 95%CI 0.74–0.99) compared to no consumption. No other Mediterranean diet components were associated with dementia risk suggesting that fish consumption may drive the beneficial effects seen from the Mediterranean diet. Further study of potential mechanisms and diet-based intervention trials are needed to establish this.

Red meat consumption, incident CVD and the influence of dietary quality in the Jackson Heart Study.

We investigated the prospective associations between meat consumption and CVD and whether these relationships differ by dietary quality among African American (AA) adults. Baseline diet was assessed with a regionally specific FFQ. Unprocessed red meat included beef and pork (120 g/serving); processed meat included sausage, luncheon meats and cured meat products (50 g/serving). Incident total CVD, CHD, stroke and heart failure were assessed annually over 9·8 years of follow-up. We characterised dietary quality using a modified Healthy Eating Index-2010 score (m-HEI), excluding meat contributions. Jackson, MS, USA. AA adults (n 3242, aged 55 y, 66 % female). Mean total, unprocessed red and processed meat intakes were 5·7 ± 3·5, 2·3 ± 1·8 and 3·3 ± 2·7 servings/week, respectively. Mostly, null associations were observed between meat categories and CVD or subtypes. However, greater intake of unprocessed red meat (three servings/week) was associated with significantly elevated risk of stroke (hazard ratio = 1·43 (CI: 1·07,1·90)). With the exception of a more positive association between unprocessed meat consumption and stroke among individuals in m-HEI Tertile 2, the strength of associations between meat consumption categories and CVD outcomes did not differ by m-HEI tertile. In formal tests, m-HEI did not significantly modify meat-CVD associations. In this cohort of AA adults, total and processed meat were not associated with CVD outcomes, with the exception that unprocessed red meat was related to greater stroke risk. Dietary quality did not modfiy these associations. Research is needed in similar cohorts with longer follow-up and greater meat consumption to replicate these findings.

Abstract 729: Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study

Abstract Background: An association between red and processed meat and esophageal cancer (EC) and gastric cancer (GC) has been suggested. Northern Iran is one of the most burdened countries by these malignancies. This study aims to investigate the effect exerted by different meat types on both EC and GC, including their subtypes, in a high risk population. Methods: Golestan cohort study (GCS) is a population-based cohort of 50,045 individuals aged 40-75 years from northeast Iran. The participants were selected by random sampling of people without a history of upper-GI cancer. Detailed data on different exposures were collected upon enrolment using validated questionnaires, in particular a 116-item food frequency questionnaire was specifically designed and validated for this population and was used to assess dietary habits among the cohort. Total meat items included unprocessed red meat (lamb, beef, and hamburger), organ meat (liver, kidney and heart), processed meat (sausage and deli meat), white meat (chicken and fish). For the analysis, a term for total red meat intake was created including the first three types of meat. We considered quintiles of meat consumption, using grams and density (g/total kcal). The outcomes were EC, carcinoma of the lower third of the esophagus, esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EA), GC, cardia GC and non-cardia GC. We used proportional hazards regression models to estimate hazard ratios (HRs) and corresponding 95% CIs for the association between meat types and cancers. Results: The cohort reported a mean intake of 18.4 g/day (95% CI=17.8-18.6) for total red meat, and 72.1 g/day (95% CI=70.3-73.8) for white meat. These values correspond to an intake density of 8.11 g per 1000 kcal (95% CI=8.05-8.19) and 32.3 g (95% CI= 32.0-32.5) per 1000 kcal for total red and white meat respectively. Of 49,585 participants included in the analyses after 12 year mean follow-up, 369 developed EC, including 141 cases of the lower esophagus, 309 ESCC cases and 20 EAC, and 368 developed GC, of whom 216 cardia and 97 non-cardia. No association was found for EC except for red meat among women (HR 1.13, 95% CI 1.00-1.27 for one-quintile increase in intake). The risk of GC was increased for total red meat (HR 1.08, 95% CI 1.00-1.17) and red meat intake separately (HR 1.09, 95% CI 1.00-1.18). These trends were stronger among men, non-cardia GC, and red meat (HR 1.23, 95% CI=1.02-1.48). Cooking type did not influence the risk of developing any cancer, while we observed strong associations between red meat unprocessed and overall and GC among opium users, suggesting an effect modification. Conclusions: Red meat intake is associated to GC, but not EC. Other types of meat show no relation. Lifestyle habits such as opium use can increase this risk of GC in high meat consumers. Citation Format: Giulia Collatuzzo, Arash Etemadi, Farin Kamangar, Abnet Christian, Sandy Dawsey, Paul Brennan, Masoud Sotoudeh, Hossein Poutschi, Masoud Khoshnia, Akram Pourshams, Reza Malekzadeh, Paolo Boffetta. Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 729.

1182-P: Is Prediabetes Awareness Associated with Leisure-Time Physical Activity and Dietary Behaviors?

Lifestyle modification –healthy diet and physical activity– can help prevent or delay type 2 diabetes in adults with prediabetes (preDM) . However, 84% of US adults with preDM are unaware they have it. Whether preDM status awareness is associated with leisure-time physical activity (LTPA) levels and dietary intake is unknown. Using data from US adults without DM ≥18 y from the National Health and Nutrition Examination Surveys 2013-2018, we classified preDM as ‘aware’ (self-report of preDM and 5.7%≤A1c<6.5%, n=456) , ‘unaware’ (no self-report; 5.7%≤A1c<6.5%, n=2,223) , and ‘normoglycemic’ (A1c<5.7% but self-reported as preDM, n=191) . We calculated means or medians for LTPA (self-reported minutes of moderate to vigorous physical activity per week) , dietary intake (total calories, fruit, vegetables, whole grains, added sugars, processed meat, unprocessed red meat from one day of 24-h recall data) , and the Healthy Eating Index (HEI) 2015, a marker of overall healthy diet (higher score indicates healthier diet) . Of adults with or reporting preDM, 77.9% were unaware (mean age [years]: 51.2 [standard error, 0.5]; 44.6% [1.4] female; mean BMI: 30.3 kg/m2[0.2]) , 14.3% were aware (mean age: 57.4 [0.9]; 56.5% [2.6] female; mean BMI: 31.8 kg/m2 [0.5]) , and 7.8% were normoglycemic (mean age: 43.6 [1.4]; 71.1% [3.7] female; mean BMI: 30.6 kg/m2 [0.6]) . PreDM-aware and normoglycemic adults consumed less calories (p=0.002) , added sugars (p<0.001) , and unprocessed red meat (p<0.001) than preDM-unaware adults. PreDM-aware and preDM-unaware adults consumed more processed meat than normoglycemic adults (p=0.002) . HEI scores and fruit, vegetables, and whole grains intake were low overall and across groups (all p>0.05) . Mean LTPA levels did not significantly vary across the 3 groups (p=0.22) . Overall, preDM awareness is associated with lower added sugars, red meat, and total overall calories intake, suggesting that efforts to increase awareness may lead to healthier eating among those with preDM. Disclosure K.R.Siegel: None. M.E.Pavkov: None. S.R.Benoit: None. G.Imperatore: None. K.M.Bullard: None.

The Effects of Red Meat Intake on Inflammation Biomarkers in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

ObjectivesRed meat is currently implicated to promote inflammation and compromise immune function. However, the consistency of the effects of red meat on these indices requires systematic assessment. Therefore, we conducted a systematic review and meta-analysis to assess the effects of higher versus lower red meat intakes on inflammation and immune biomarkers in humans.MethodsFour researchers independently screened 2957 articles published through May 2021 using PubMed, Scopus, CINAHL, and Cochrane databases. Randomized controlled trials (RCTs) with human participants were eligible for data extraction. We searched the literature for a complete profile of immune and inflammatory biomarkers, but only obtained data for meta-analyses of inflammatory biomarkers including c-reactive protein (CRP, 19 studies, 28 comparisons), interleukin-6 (IL-6, 10 studies, 12 comparisons), tumor necrosis factor-alpha (TNFα, 5 studies, 8 comparisons), leptin (2 studies, 2 comparisons), and anti-inflammatory biomarker adiponectin (5 studies, 5 comparisons).ResultsAmong all comparisons, higher total red meat intake led to higher blood CRP concentrations [0.12 mg/L (0.04, 0.19), 28 comparisons; weighted mean difference (95% CI), random effects]. This effect of red meat on CRP was also shown in the subgroup with diagnosed diseases [0.20 mg/L (0.08, 0.32), 7 comparisons], but not in the subgroup without diagnosed diseases [−0.04 mg/L (−0.17, 0.10), 12 comparisons]. Similar effects were observed when mixed processed and unprocessed red meat intakes were categorically combined as “mixed red meat” [0.18 mg/L (0.09, 0.27), 17 comparisons], but not for higher intake of unprocessed red meat [−0.07 mg/L (−0.21, 0.07), 11 comparisons]. Higher total red meat intake did not affect CRP when consuming red meat with uncontrolled habitual diets (8 comparisons) or comparing omnivorous to vegetarian or vegan diets (2 comparisons). Blood concentrations of leptin, IL-6, TNFα, or adiponectin were not affected.ConclusionsThere is a paucity of RCT-based research on red meat intake and a complete profile of inflammatory and especially anti-inflammatory markers. Results from our meta-analyses of RCTs suggest that total and mixed, but not unprocessed, red meat intakes affected blood CRP concentrations.Funding SourcesBeef Checkoff.

A Prospective Analysis of Red and Processed Meat Intake in Relation to Colorectal Cancer in the Black Women's Health Study

BackgroundBlack Americans have the highest incidence of colorectal cancer (CRC) of any racial/ethnic group in the United States. High intake of red and processed meats has been associated with an increased CRC risk in predominately White populations. However, 3 prior studies in Black populations, who have been reported to have high intakes of red and processed meats, have reported no associations. Data on a possible association between CRC risk and SFAs and MUFAs, the primary types of fat in red and processed meats, are inconclusive. ObjectivesWe prospectively assessed intakes of processed and unprocessed red meat, SFAs, and MUFAs in relation to CRC risk, utilizing data from the Black Women's Health Study (BWHS, 1995–2018). MethodsDietary data were derived from validated FFQs completed in 1995 and 2001. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. ResultsAmong 52,695 BWHS participants aged 21–69 y at baseline and followed for ≤22 y, 564 women developed incident CRC. Unprocessed red meat intake was associated with a 33% increased CRC risk per 100 g/d (HR: 1.33; 95% CI: 1.03–1.71). Examination of CRC anatomic sites revealed that unprocessed red meat was associated with 2-times increased rectal cancer risk (HR: 2.22; 95% CI: 1.15–4.26). There was no evidence of an interaction with age (pinteraction = 0.4), but unprocessed red meat intake was only associated with a significant increased risk of late-onset CRC (≥50 y of age, HR: 1.41; 95% CI: 1.05–1.88). Processed red meat and total SFA and MUFA intakes were not associated with CRC risk. ConclusionsUnprocessed red meat intake was associated with an increased CRC risk in the present study, the first positive evidence that red meat plays a role in the etiology of CRC in Black women. The findings suggest prevention opportunities.

Meat consumption and all-cause mortality in 5763 patients with inflammatory bowel disease: A retrospective cohort study

SummaryBackgroundWhether meat consumption is related to risk of mortality in patients with inflammatory bowel disease (IBD) remains poorly understood.MethodsIn the UK Biobank, 5763 patients with IBD were recruited from 2007 to 2010 and finished a brief food frequency questionnaire at baseline. We followed them until March 13, 2021 to document all-cause death events. Cox proportional hazard models were used to estimate hazard ratios (HRs) for all-cause mortality associated with consumptions of fish, unprocessed poultry, unprocessed red meat, and processed meat among the patients.FindingsDuring 67,095 person-years (mean follow-up 11·7 years, mean age 57·3, 52·5% female), we documented 590 death events. Higher consumption of processed meat was associated with an increased risk of all-cause mortality in patients with IBD (HR comparing >4·0 with 0–0·9 time/week=1·52, 95% confidence interval (CI) 1·05–2·19), but the P-trend for each 25 g increment was 0·075. This association remained significant in patients with Crohn's disease (HR 1·77, 95% CI 1·01–3·10) but not in patients with ulcerative colitis (HR 1·34, 95% CI 0·82–2·20). Consumptions of fish (HR 1·27, 95% CI 0·84–1·91), unprocessed poultry (HR 0·59, 95% CI 0·28–1·21), or unprocessed red meat (HR 0·87, 95% CI 0·60–1·26) were not significantly associated with the mortality of patients with IBD.InterpretationMore frequent consumption of processed meat was associated with an increased risk of mortality in patients with IBD, while no associations were observed for consumption of other types of meat. Our exploratory and speculative findings should be cautiously interpreted and need further replication in other cohorts.FundingThe National Natural Science Foundation of China (81,970,494); Key Project of Research and Development Plan of Hunan Province (2019SK2041).

Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies.

A high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat. A PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes. The PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021. The prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest. Thirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82-0.96; I2 = 0%), dairy (RR, 0.90, 95%CI, 0.88-0.92; I2 = 0%), eggs (RR, 0.86, 95%CI, 0.79-0.94; I2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74-0.95; I2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74-0.95; I2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79-1.04; I2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89-0.96; I2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90-0.95; I2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87-0.95; I2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87-0.97; I2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93-1.01; I2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93-1.01; I2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d. Keeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death. PROSPERO registration no. CRD42021259446.

Association of Meat Subtypes With Colorectal Polyp Prevalence: Finding From the Lanxi Pre-colorectal Cancer Cohort in China.

BackgroundAlthough the detrimental effect of red meat on colorectal cancer (CRC) incidence has been extensively reported, no previous studies have comprehensively linked different meat subtypes with colorectal polyp occurrence. The aim was to assess the association of meat and subtypes with colorectal polyp prevalence for the high-risk CRC Chinese population. Besides, we also focused on the association according to sizes, subsites, and multiplicity of polyps.MethodsHigh-risk CRC patients aged 40–80 years were enrolled into the Lanxi Pre-colorectal Cancer Cohort (LP3C) between March 2018 and December 2019. Cross-sectional analyses were conducted by using the baseline data from LP3C. A validated food frequency questionnaire (FFQ) was employed to collect dietary information. Odds ratios (ORs) and 95% confidence intervals (95% CIs) of colorectal polyp prevalence were estimated by multivariate logistic regression.Results2,064 colorectal polyp cases were identified among 6,783 eligible participants in the survey of LP3C (March 2018 and December 2019). Total meat intake was positively related to rectum polyp prevalence (Pfor trend = 0.01) but was not linked to total colorectal polyps after multivariable adjustment. For meat subtypes, higher poultry consumption was significantly related to a higher polyp prevalence [ORQ4vs.Q1 (95% CI): 1.20 (1.02–1.42); Pfor trend = 0.03]. Processed red meat intake was linked to an increased small polyp prevalence (Pfor trend = 0.03) while unprocessed red meat had a relation with a higher rectum polyp prevalence (Pfor trend = 0.04). Furthermore, seafood intake had a significant association with a higher multiple polyp prevalence [ORQ4vs.Q1 (95% CI): 1.70 (1.31–2.21); Pfor trend < 0.001].ConclusionThe finding was that poultry meat consumption was related to a higher polyp prevalence. Besides, total meat consumption, processed and unprocessed red meat consumption, seafood consumption had a positive relation with certain polyp subtypes prevalence. Generally recommending reducing total meat consumption, including poultry, processed and unprocessed red meat, and seafood intake, may prevent colorectal polyps.

Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database

SummaryBackgroundDiet is a major modifiable risk factor for human health and overall consumption patterns affect planetary health. We aimed to quantify global, regional, and national consumption levels of animal-source foods (ASF) to inform intervention, surveillance, and policy priorities.MethodsIndividual-level dietary surveys across 185 countries conducted between 1990 and 2018 were identified, obtained, standardised, and assessed among children and adults, jointly stratified by age, sex, education level, and rural versus urban residence. We included 499 discrete surveys (91·2% nationally or subnationally representative) with data for ASF (unprocessed red meat, processed meat, eggs, seafood, milk, cheese, and yoghurt), comprising 3·8 million individuals from 134 countries representing 95·2% of the world population in 2018. We used Bayesian hierarchical models to account for differences in survey methods and representativeness, time trends, and input data and modelling uncertainty, with five-fold cross-validation.FindingsIn 2018, mean global intake per person of unprocessed red meat was 51 g/day (95% uncertainty interval [UI] 48–54; region-specific range 7–114 g/day); 17 countries (23·9% of the world's population) had mean intakes of at least one serving (100 g) per day. Global mean intake of processed meat was 17 g/day (95% UI 15–21 g/day; region-specific range 3–54 g/day); seafood, 28 g/day (27–30 g/day; 12–44 g/day); eggs, 21 g/day (18–24 g/day; 6–35 g/day); milk 88 g/day (84–93 g/day; 45–185 g/day); cheese, 8 g/day (8–10 g/day; 1–34 g/day); and yoghurt, 20 g/day (17–23 g/day; 7–84 g/day). Mean national intakes were at least one serving per day for processed meat (≥50 g/day) in countries representing 6·9% of the global population; for cheese (≥42 g/day) in 2·3%; for eggs (≥55 g/day) in 0·7%; for milk (≥245 g/day) in 0·3%; for seafood (≥100 g/day) in 0·8%; and for yoghurt (≥245 g/day) in less than 0·1%. Among the 25 most populous countries in 2018, total ASF intake was highest in Russia (5·8 servings per day), Germany (3·8 servings per day), and the UK (3·7 servings per day), and lowest in Tanzania (0·9 servings per day) and India (0·7 servings per day). Global and regional intakes of ASF were generally similar by sex. Compared with children, adults generally consumed more unprocessed red meat, seafood and cheese, and less milk; energy-adjusted intakes of other ASF were more similar. Globally, ASF intakes (servings per week) were higher among more-educated versus less-educated adults, with greatest global differences for milk (0·79), eggs (0·47), unprocessed red meat (0·42), cheese (0·28), seafood (0·28), yoghurt (0·22), and processed meat (0·21). This was also true for urban compared to rural areas, with largest global differences (servings per week) for unprocessed red meat (0·47), milk (0·38), and eggs (0·20). Between 1990 and 2018, global intakes (servings per week) increased for unprocessed red meat (1·20), eggs (1·18), milk (0·63), processed meat (0·50), seafood (0·44), and cheese (0·14).InterpretationOur estimates of ASF consumption identify populations with both lower and higher than optimal intakes. These estimates can inform the targeting of intervention, surveillance, and policy priorities relevant to both human and planetary health.FundingBill & Melinda Gates Foundation and American Heart Association.

Associations of dairy, meat, and fish intakes with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD)

PurposeTo investigate if dairy, meat, and fish intakes associate with dementia and cognitive performance.MethodsWe included 2497 dementia-free men from Eastern Finland, aged 42–60 years in 1984–1989 at the baseline examinations. Data on cognitive tests [Mini Mental State Exam (MMSE), trail making test (TMT), verbal fluency test (VFL), selective reminding test (SRT), and Russell’s adaptation of the visual reproduction test (VRT)] at the 4-year re-examinations were available for 482 men and on the ApoE phenotype for 1259 men. Data on dementia events were obtained by linkage to national health registers. Diet was assessed with baseline 4-day food records. Cox regression and analysis of covariance were used for analyses.ResultsDuring a mean 22-year follow-up, 337 men had a dementia diagnosis. Among the foods, only cheese intake associated with dementia risk (hazard ratio in the highest vs. the lowest quartile = 0.72, 95% confidence interval = 0.52–0.99, P-trend = 0.05). In the cognitive tests, higher non-fermented dairy and milk intakes associated with worse verbal fluency (VFT). Higher processed red meat intake associated with worse verbal (SRT) and visual memory (VRT), whereas higher unprocessed red meat intake associated with better general cognitive functioning (MMSE) and processing speed and executive functioning (TMT). Higher fish intake associated with better verbal memory (SRT). Among APOE-ε4 carriers, especially non-fermented dairy intake associated with higher risk of dementia outcomes, and higher fish intake indicated better cognitive performance.ConclusionAlthough higher intake of some food groups associated with cognitive performance, we found little evidence for associations with dementia risk.

Associations Between Unprocessed Red Meat and Processed Meat With Risk of Recurrence and Mortality in Patients With Stage III Colon Cancer

The American Cancer Society and American Institute for Cancer Research recommend that cancer survivors limit intake of red and processed meats. This recommendation is based on consistent associations between red and processed meat intake and cancer risk, particularly risk of colorectal cancer, but fewer data are available on red and processed meat intake after cancer diagnosis. To examine whether intake of unprocessed red meat or processed meat is associated with risk of cancer recurrence or mortality in patients with colon cancer. This prospective cohort study used data from participants with stage III colon cancer enrolled in the Cancer and Leukemia Group B (CALGB 89803/Alliance) trial between 1999 and 2001. The clinical database for this analysis was frozen on November 9, 2009; the current data analyses were finalized in December 2021. Quartiles of unprocessed red meat and processed meat intake assessed using a validated food frequency questionnaire during and 6 months after chemotherapy. Hazard ratios (HRs) and 95% CIs for risk of cancer recurrence or death and all-cause mortality. This study was conducted among 1011 patients with stage III colon cancer. The median (IQR) age at enrollment was 60 (51-69) years, 442 patients (44%) were women, and 899 patients (89%) were White. Over a median (IQR) follow-up period of 6.6 (1.9-7.5) years, we observed 305 deaths and 81 recurrences without death during follow-up (386 events combined). Intake of unprocessed red meat or processed meat after colon cancer diagnosis was not associated with risk of recurrence or mortality. The multivariable HRs comparing the highest vs lowest quartiles for cancer recurrence or death were 0.84 (95% CI, 0.58-1.23) for unprocessed red meat and 1.05 (95% CI, 0.75-1.47) for processed meat. For all-cause mortality, the corresponding HRs were 0.71 (95% CI, 0.47-1.07) for unprocessed red meat and 1.04 (95% CI, 0.72-1.51) for processed meat. In this cohort study, postdiagnosis intake of unprocessed red meat or processed meat was not associated with risk of recurrence or death among patients with stage III colon cancer.

How Americans eat red and processed meat: an analysis of the contribution of thirteen different food groups.

Dietary patterns characterised by high intake of red and processed meat are associated with detrimental health and environmental outcomes. To better understand how Americans consume red and processed meat, this study examined the food groups that are the greatest contributors to red and processed meat intake in US diets. Cross-sectional analysis of total red and processed meat, unprocessed red meat and processed meat using data from the National Health and Nutrition Examination Survey (2015-2016 and 2017-2018). Items containing red or processed meat were classified into thirteen mutually exclusive food groups. For highly consumed food groups (≥10 % of meat intake), contribution to meat intake was further assessed by source, sex, income and education. Nationally representative sample of the US population. Teens (aged 12-19 years) and adults (aged ≥20 years) who reported meat consumption (n 8178). Meat mixed dishes (18·6 % (95 % CI 16·2, 20·9)), burgers (17·3 % (95 % CI 15·3, 19·3)) and beef excluding ground (17·0 % (95 % CI 13·8, 20·1)) were the top contributors to unprocessed red meat intake. For processed meat, four food groups made up about four-fifths of total intake: cold cuts and cured meats (37·7 % (95 % CI 34·6, 40·8)), sausages and frankfurters (20·3 % (95 % CI 18·6, 22·0)), bacon (14·0 % (95 % CI 12·3, 15·6)) and pizza (10·1 % (95 % CI 8·7, 11·5)). Fast-food restaurants were the top source for burgers and pizza, whereas stores were the top source for all other highly consumed food groups. Few differences were seen in patterns of intake by sociodemographic characteristics. No single food group accounts for a majority of meat intake in the USA. Many behaviour change opportunities for healthier, more sustainable substitutions exist.

Ambient air pollution, healthy diet and vegetable intakes, and mortality: a prospective UK Biobank study.

Recent studies suggest potential interactions of air pollutants with dietary factors and genetic susceptibility on mortality risk; however, evidence from prospective studies is still lacking. We aimed to assess the association between air pollution and mortality, and investigate the modification effects of a healthy diet and genetic susceptibility. A total of 386 937 participants were enrolled from 2006 to 2010 and followed up to 2018 in the UK Biobank study. The annual average air pollutant concentrations of particulate matter (PM) with diameters ≤2.5 (PM2.5), ≤10 (PM10) and between 2.5 and 10 µm (PM2.5-10) and nitrogen oxides (NO2 and NOx) were calculated and linked to participants' residential addresses. Healthy dietary patterns were evaluated by a healthy diet score (HDS) based on intakes of vegetables, fruit, fish, unprocessed red meat and processed meat. We also calculated genetic risk score (GRS) of the lifespan. We examined potential interactions by setting variable cross-product terms of air pollutants with diets or GRS in the models. We identified 11 881 deaths [2426 from cardiovascular diseases (CVD), 1211 from coronary heart disease (CHD) and 466 from stroke] during a median follow-up of 8.9 years. We found that PM2.5 [hazard ratio (HR), 1.27; 95% CI, 1.05-1.55], PM10 (HR, 1.18; 95% CI, 1.04-1.34), NO2 (HR, 1.05; 95% CI, 1.01-1.08), and NOx (HR, 1.02; 95% CI, 1.01-1.03) were associated with all-cause mortality. PM2.5 was also associated with increased risks of CVD mortality (HR, 1.68; 95% CI, 1.10-2.56) and CHD mortality (HR, 2.08; 95% CI, 1.16-3.75). In addition, we found that adherence to healthy dietary patterns modified associations of PM2.5, NO2 and NOx with all-cause mortality (P-interaction = 0.006, 0.006 and 0.02, respectively). Among the individual dietary components, vegetable intakes showed interactions with PM2.5, NO2 and NOx (P-interaction = 0.007, 0.004 and 0.02, respectively). The associations between air pollutants and increased risks of all-cause mortality were attenuated among participants with higher vegetable intakes. We did not observe interactions between air pollutants and HDS on CVD, CHD or stroke mortality (P-interaction > 0.05). Besides, we did not find interactions between air pollutants and genetic risk for lifespan on mortality risk. This study provides evidence linking long-term exposure to various air pollutants to the risk of all-cause, CVD and CHD mortality, and the potential attenuation of a healthy diet, especially high vegetable intakes, on such relations. Our findings highlight the importance of adherence to a healthy diet in lowering ambient air-pollution-related mortality risk.