Romaina Iqbal1, Mahshid Dehghan2, Andrew Mente2, Sumathy Rangarajan2, Andreas Wielgosz3, Alvaro Avezum4, Pamela Seron5, Khalid F AlHabib6, Patricio Lopez-Jaramillo7, Sumathi Swaminathan8, Noushin Mohammadifard9, Katarzyna Zatońska10, Hu Bo11, Ravi Prasad Varma12, Omar Rahman13, AfzalHussein Yusufali14, Yin Lu11, Noorhassim Ismail15, Annika Rosengren16, Neşe Imeryuz17, Karen Yeates18, Jephat Chifamba19, Antonio Dans20, Rajesh Kumar21, Liu Xiaoyun11, Lungi Tsolekile22, Rasha Khatib23,24, Rafael Diaz25, Koon Teo2, Salim Yusuf2. 1. Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan. 2. McMaster University, Population Health Research Institute, Hamilton, Ontario, Canada. 3. Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 4. International Research Centre, Hospital Alemao Oswaldo Cruz, University of Santo Amaro (UNISA), Sao Paulo, SP Brazil. 5. Faculty of Medicine, University of La Frontera, Temuco, Chile. 6. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 7. Masira Research Institute, Medical School, University of Santander, Bucaramanga, Colombia. 8. Division of Nutrition, St John's Research Institute, Koramangala, Bangalore, India. 9. Isfahan University of Medical Sciences, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan, Iran. 10. Department of Medicine, Wroclaw Medical University, Wroclaw, Poland. 11. Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 12. Health Action by People, Thiruvananthapuram and Achutha Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. 13. University of Liberal Arts, Dhaka, Bangladesh. 14. Dubai Medical University, Hatta Hospital, Dubai Health Authority, Dubai, United Arab Emirates. 15. Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia. 16. University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden. 17. Department of Internal Medicine and Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey. 18. Queen's University, Department of Medicine, Canada and Pamoja Tunaweza Research Center, Moshi, Tanzania. 19. University of Zimbabwe College of Health Sciences, Harare, Zimbabwe. 20. Department of Medicine, University of the Philippines, Manila, Philippines. 21. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 22. School of Public Health, University of the Western Cape, Bellville, South Africa. 23. Birzeit University, Institute for Community and Public Health, Birzeit, Palestine. 24. Advocate Research Institute, Advocate Health Care, Chicago, IL, USA. 25. Clinical Studies Latin America, Rosario, Santa Fe, Argentina.
Abstract
BACKGROUND: Dietary guidelines recommend limiting red meat intake because it is a major source of medium- and long-chain SFAs and is presumed to increase the risk of cardiovascular disease (CVD). Evidence of an association between unprocessed red meat intake and CVD is inconsistent. OBJECTIVE: The study aimed to assess the association of unprocessed red meat, poultry, and processed meat intake with mortality and major CVD. METHODS: The Prospective Urban Rural Epidemiology (PURE) Study is a cohort of 134,297 individuals enrolled from 21 low-, middle-, and high-income countries. Food intake was recorded using country-specific validated FFQs. The primary outcomes were total mortality and major CVD. HRs were estimated using multivariable Cox frailty models with random intercepts. RESULTS: In the PURE study, during 9.5 y of follow-up, we recorded 7789 deaths and 6976 CVD events. Higher unprocessed red meat intake (≥250 g/wk vs. <50 g/wk) was not significantly associated with total mortality (HR: 0.93; 95% CI: 0.85, 1.02; P-trend = 0.14) or major CVD (HR: 1.01; 95% CI: 0.92, 1.11; P-trend = 0.72). Similarly, no association was observed between poultry intake and health outcomes. Higher intake of processed meat (≥150 g/wk vs. 0 g/wk) was associated with higher risk of total mortality (HR: 1.51; 95% CI: 1.08, 2.10; P-trend = 0.009) and major CVD (HR: 1.46; 95% CI: 1.08, 1.98; P-trend = 0.004). CONCLUSIONS: In a large multinational prospective study, we did not find significant associations between unprocessed red meat and poultry intake and mortality or major CVD. Conversely, a higher intake of processed meat was associated with a higher risk of mortality and major CVD.
BACKGROUND: Dietary guidelines recommend limiting red meat intake because it is a major source of medium- and long-chain SFAs and is presumed to increase the risk of cardiovascular disease (CVD). Evidence of an association between unprocessed red meat intake and CVD is inconsistent. OBJECTIVE: The study aimed to assess the association of unprocessed red meat, poultry, and processed meat intake with mortality and major CVD. METHODS: The Prospective Urban Rural Epidemiology (PURE) Study is a cohort of 134,297 individuals enrolled from 21 low-, middle-, and high-income countries. Food intake was recorded using country-specific validated FFQs. The primary outcomes were total mortality and major CVD. HRs were estimated using multivariable Cox frailty models with random intercepts. RESULTS: In the PURE study, during 9.5 y of follow-up, we recorded 7789 deaths and 6976 CVD events. Higher unprocessed red meat intake (≥250 g/wk vs. <50 g/wk) was not significantly associated with total mortality (HR: 0.93; 95% CI: 0.85, 1.02; P-trend = 0.14) or major CVD (HR: 1.01; 95% CI: 0.92, 1.11; P-trend = 0.72). Similarly, no association was observed between poultry intake and health outcomes. Higher intake of processed meat (≥150 g/wk vs. 0 g/wk) was associated with higher risk of total mortality (HR: 1.51; 95% CI: 1.08, 2.10; P-trend = 0.009) and major CVD (HR: 1.46; 95% CI: 1.08, 1.98; P-trend = 0.004). CONCLUSIONS: In a large multinational prospective study, we did not find significant associations between unprocessed red meat and poultry intake and mortality or major CVD. Conversely, a higher intake of processed meat was associated with a higher risk of mortality and major CVD.
Authors: Erin L Van Blarigan; Fang-Shu Ou; Tiffany M Bainter; Charles S Fuchs; Donna Niedzwiecki; Sui Zhang; Leonard B Saltz; Robert J Mayer; Alexander Hantel; Al B Benson; Daniel Atienza; Michael Messino; Hedy L Kindler; Alan P Venook; Shuji Ogino; Hanna K Sanoff; Edward L Giovannucci; Kimmie Ng; Jeffrey A Meyerhardt Journal: JAMA Netw Open Date: 2022-02-01
Authors: Victoria Miller; Julia Reedy; Frederick Cudhea; Jianyi Zhang; Peilin Shi; Josh Erndt-Marino; Jennifer Coates; Renata Micha; Patrick Webb; Dariush Mozaffarian Journal: Lancet Planet Health Date: 2022-03