Towards refining WCRF/AICR cancer prevention recommendations for red and processed meat intake: Insights from Alberta’s Tomorrow Project cohort

ABSTRACT Current cancer prevention recommendations advise limiting red meat intake to <500g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red vs. non-red meats with cancer risk in a prospective cohort of 26,218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median (IQR) follow-up of 13.3 (5.1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and gender. The median (IQR) consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat were 267.9 (269.9), 53.6 (83.3), and 11.9 (31.8), respectively. High intakes (4th Quartile) of processed meat from red meat was associated with increased risk of gastro-intestinal cancer Adjusted Hazard Ratio (AHR) (95% CI): 1.68 (1.09 – 2.57) and colorectal cancers AHR (95% CI): 1.90 (1.12 – 3.22), respectively in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggests that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence toward refining cancer prevention recommendations for red and processed meat intake.

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Meat intake and risk of diverticulitis among men

Gut ◽

10.1136/gutjnl-2016-313082 ◽

2017 ◽

Vol 67 (3) ◽

pp. 466-472 ◽

Cited By ~ 38

Author(s):

Yin Cao ◽

Lisa L Strate ◽

Brieze R Keeley ◽

Idy Tam ◽

Kana Wu ◽

...

Keyword(s):

Proportional Hazards ◽

Red Meat ◽

Cox Proportional Hazards ◽

Common Disease ◽

Processed Meat ◽

Meat Intake ◽

Relative Risks ◽

Cox Proportional Hazards Models ◽

Increased Risk

ObjectiveDiverticulitis is a common disease with a substantial clinical and economic burden. Besides dietary fibre, the role of other foods in the prevention of diverticulitis is underexplored.DesignWe prospectively examined the association between consumption of meat (total red meat, red unprocessed meat, red processed meat, poultry and fish) with risk of incident diverticulitis among 46 461 men enrolled in the Health Professionals Follow-Up Study (1986–2012). Cox proportional hazards models were used to compute relative risks (RRs) and 95% CIs.ResultsDuring 651 970 person-years of follow-up, we documented 764 cases of incident diverticulitis. Compared with men in the lowest quintile (Q1) of total red meat consumption, men in the highest quintile (Q5) had a multivariable RR of 1.58 (95% CI 1.19 to 2.11; p for trend=0.01). The increase in risk was non-linear, plateauing after six servings per week (p for non-linearity=0.002). The association was stronger for unprocessed red meat (RR for Q5 vs Q1: 1.51; 95% CI 1.12 to 2.03; p for trend=0.03) than for processed red meat (RR for Q5 vs Q1: 1.03; 95% CI 0.78 to 1.35; p for trend=0.26). Higher consumption of poultry or fish was not associated with risk of diverticulitis. However, the substitution of poultry or fish for one serving of unprocessed red meat per day was associated with a decrease in risk of diverticulitis (multivariable RR 0.80; 95% CI 0.63 to 0.99).ConclusionsRed meat intake, particularly unprocessed red meat, was associated with an increased risk of diverticulitis. The findings provide practical dietary guidance for patients at risk of diverticulitis.

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Meat intake and risk of hepatocellular carcinoma in two large US prospective cohorts of women and men

International Journal of Epidemiology ◽

10.1093/ije/dyz146 ◽

2019 ◽

Cited By ~ 5

Author(s):

Yanan Ma ◽

Wanshui Yang ◽

Tricia Li ◽

Yue Liu ◽

Tracey G Simon ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Proportional Hazards ◽

Red Meat ◽

Cox Proportional Hazards ◽

Fish Intake ◽

Health Study ◽

Meat Intake ◽

Red Meats ◽

Processed Red Meat

Abstract Background Epidemiological evidence on the associations between meat intake and risk of hepatocellular carcinoma (HCC) was limited and inconsistent. Methods We prospectively examined the association between consumption of meats and meat mutagens with HCC risk using data from the Nurses’ Health Study and the Health Professionals Follow-up Study. Cox proportional-hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for known liver-cancer risk factors. Results During up to 32 years of follow-up, we documented 163 incident HCC cases. The HRs of HCC for the highest vs the lowest tertile intake levels were 1.84 (95% CI: 1.16–2.92, Ptrend = 0.04) for processed red meats and 0.61 (95% CI: 0.40–0.91, Ptrend = 0.02) for total white meats. There was a null association between unprocessed red meats and HCC risk (HR = 1.06, 95% CI: 0.68–1.63, Ptrend = 0.85). We found both poultry (HR = 0.60, 95% CI: 0.40–0.90, Ptrend = 0.01) and fish (HR = 0.70, 95% CI: 0.47–1.05, Ptrend = 0.10) were inversely associated with HCC risk. The HR for HCC risk was 0.79 (95% CI: 0.61–1.02) when 1 standard deviation of processed red meats was substituted with an equivalent amount of poultry or fish intake. We also found a suggestive positive association of intake of meat-derived mutagenicity or heterocyclic amines with risk of HCC. Conclusions Processed red meat intake might be associated with higher, whereas poultry or possibly fish intake might be associated with lower, risk of HCC. Replacing processed red meat with poultry or fish might be associated with reduced HCC risk.

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Red and Processed Meat and Mortality in a Low Meat Intake Population

Nutrients ◽

10.3390/nu11030622 ◽

2019 ◽

Vol 11 (3) ◽

pp. 622 ◽

Cited By ~ 13

Author(s):

Saeed Alshahrani ◽

Gary Fraser ◽

Joan Sabaté ◽

Raymond Knutsen ◽

David Shavlik ◽

...

Keyword(s):

Proportional Hazards ◽

Outcome Data ◽

Cox Proportional Hazards ◽

Health Study ◽

Processed Meat ◽

Meat Intake ◽

All Cause Mortality ◽

Mortality Outcome ◽

Red And Processed Meat ◽

Cvd Mortality

Associations of low-to-moderate consumption of red and processed meat with mortality would add to the evidence of possible adverse effects of these common foods. This study aims to investigate the association of red and processed meat intake with mortality. The Adventist Health Study-2 (AHS-2) is a prospective cohort study of ~96,000 Seventh-day Adventist men and women recruited in the US and Canada between 2002 and 2007. The final analytic sample after exclusions was 72,149. Cox proportional hazards regression was used and hazard ratios (HR) and confidence intervals (CI) were obtained. Diet was assessed by a validated quantitative food frequency questionnaire (FFQ), calibrated using six 24-h dietary recalls. Mortality outcome data were obtained from the National Death Index. During a mean follow-up of 11.8 years, there were 7961 total deaths, of which 2598 were Cardiovascular diseases (CVD) deaths and 1873 were cancer deaths. Unprocessed red meat was associated with risk of all-cause mortality (HR: 1.18; 95% CI: 1.07–1.31) and CVD mortality (HR: 1.26; 95% CI: 1.05–1.50). Processed meat alone was not significantly associated with risk of mortality. The combined intake of red and processed meat was associated with all-cause mortality (HR: 1.23; 95% CI: 1.11–1.36) and CVD mortality (HR: 1.34; 95% CI: 1.12–1.60). These findings suggest moderately higher risks of all-cause and CVD mortality associated with red and processed meat in a low meat intake population.

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Meat consumption and risk of ischemic heart disease and stroke: results from the UK Biobank

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004024 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Keren Papier ◽

Georgina Fensom ◽

Anika Knuppel ◽

Timothy Key ◽

Aurora Perez-Cornago

Keyword(s):

Meat Consumption ◽

Haemorrhagic Stroke ◽

Red Meat ◽

Processed Meat ◽

Uk Biobank ◽

Meat Intake ◽

Increased Risk ◽

Total Meat ◽

Red And Processed Meat

AbstractIntroductionMeat consumption may be associated with a higher risk of cardiovascular diseases, but the evidence remains inconclusive. We prospectively examined the association between meat (total meat, red and processed meat, red meat, processed meat and poultry) intake and risk of ischemic heart disease (IHD) and stroke, including ischemic and haemorrhagic subtypes, in a large British cohort.Materials and methodsData were from UK Biobank participants who were free of IHD, stroke and cancer at recruitment (2006–2010), with available information on meat intake in the baseline touchscreen survey, and linked hospital admissions and death data for IHD, stroke, and stroke subtypes over follow-up (n = 441,700). We used multivariable Cox proportional hazards models to assess associations between meat consumption and risk of IHD, total stroke and ischemic and haemorrhagic stroke subtypes.ResultsOver a mean of 8.1 years of follow-up, 13,590 incident cases of IHD, 5,441 cases of total stroke, 2,258, cases of ischaemic stroke, and 949 cases of haemorrhagic stroke occurred. The risk of IHD was positively associated with intakes of total meat (Hazard ratio (HR) = 1.18, 95% Confidence Interval (CI) 1.09, 1.27 per 100 g/day higher intake), red and processed meat (HR = 1.15, 95% CI 1.08, 1.24 per 70 g/day higher intake), red meat (HR = 1.15, 95%, CI 1.07–1.24 per 50 g/day higher intake), processed meat (HR = 1.11, 95% CI 1.05, 1.16 per 20 g/day higher intake), and poultry (HR = 1.07, 95% CI 1.01, 1.13 per 30 g/day higher intake). The risk of total stroke was positively associated with intakes of total meat (HR = 1.15, 95% CI 1.02–1.29 per 100 g/day higher intake) and red and processed meat (HR = 1.14, 95% CI 1.03–1.27 per 70 g/day higher intake). Meat intake was not associated with ischaemic or haemorrhagic stroke.DiscussionThis large prospective study found that any meat consumption was associated with an increased risk of IHD and that red and processed meat consumption was associated with an increased risk of total stroke. Our findings for IHD and total stroke in relation to red and processed meat are in line with previous studies but our positive findings for poultry and IHD and null findings for red meat and ischaemic stroke are not, thus warranting further study.

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

Current Developments in Nutrition ◽

10.1093/cdn/nzab036_030 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 288-288

Author(s):

Ioanna Yiannakou ◽

Lauren E. Barber ◽

Shanshan Sheehy ◽

Julie R. Palmer ◽

Lynn Rosenberg ◽

...

Keyword(s):

African American ◽

African American Women ◽

Red Meat ◽

Health Study ◽

Processed Meat ◽

Meat Intake ◽

Processed Meats ◽

Increased Risk ◽

Red Meat Intake ◽

Red And Processed Meat

Abstract Objectives African Americans have the highest incidence of colorectal cancer (CRC) of any racial/ethnic group in the US. High intake of red and processed meats has been shown to increase CRC risk in populations of European ancestry, but evidence in African American populations is limited. The association between saturated and monounsaturated fatty acid intakes, the primary types of fat in red and processed meat, and CRC is inconclusive. Thus, we prospectively assessed the intake of red and processed meats and dietary saturated and monounsaturated fatty acids in relation to CRC risk, utilizing the Black Women's Health Study (BWHS, 1995–2018). Methods Dietary data were derived from validated food frequency questionnaires completed in 1995 and 2001 by 52,695 BWHS participants. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression adjusted for energy, fiber, and discretionary fat. Results Over a median follow-up of 22 years, 564 women developed incident CRC. Total red meat intake was associated with a 25% increased risk of CRC per 100 g/day (HR = 1.25; 95% CI: 0.94–1.66), which was primarily due to intake of unprocessed red meat (HR = 1.33, 95% CI: 1.05–1.70). Processed meat and total saturated and monounsaturated fatty acid intakes were not associated with an increased risk of CRC. Conclusions Unprocessed red meat intake was associated with an increased risk of CRC in this cohort of African American women. The strong evidence, now including African American women, that red meat plays a role in the etiology of CRC suggests opportunities for prevention. Funding Sources This research was funded by National Institutes of Health grants U01 CA164974 and R01 CA058420, the Karin Grunebaum Cancer Research Foundation, and the Boston University Peter Paul Career Development Professorship.

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Meat intake, meat cooking methods, and meat-derived mutagen exposure and risk of sessile serrated lesions

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa030 ◽

2020 ◽

Vol 111 (6) ◽

pp. 1244-1251 ◽

Cited By ~ 1

Author(s):

Dominique Mosley ◽

Timothy Su ◽

Harvey J Murff ◽

Walter E Smalley ◽

Reid M Ness ◽

...

Keyword(s):

Mutagenic Activity ◽

Colorectal Neoplasia ◽

Colorectal Polyp ◽

Red Meat ◽

Cooking Methods ◽

Processed Meat ◽

Meat Intake ◽

Logistic Regression Models ◽

Meat Cooking ◽

Increased Risk

Abstract Background Red and processed meat, recognized carcinogens, are risk factors for colorectal neoplasia, including polyps, the precursor for colorectal cancer. The mechanism is unclear. One possible explanation is the mutagenic activity of these foods, perhaps due to generation during cooking [e.g., heterocyclic amine (HCA) intake]. Few studies have evaluated meat intake and sessile serrated lesion (SSL) risk, a recently recognized precursor, and no study has evaluated meat cooking methods and meat-derived mutagens with SSL risk. Objective We evaluated intakes of meat, meat cooking methods, and inferred meat mutagens with SSL risk and in comparison to risk of other polyps. Methods Meat, well-done meat, and inferred meat mutagen intakes were evaluated. Polytomous logistic regression models were used to estimate ORs and 95% CIs among cases (556 hyperplastic polyp, 1753 adenoma, and 208 SSL) and controls (3804) in the large colonoscopy-based, case-control study, the Tennessee Colorectal Polyp Study. Results The highest quartile intakes of red meat (OR: 2.38; 95% CI: 1.44, 3.93), processed meat (OR: 2.03; 95% CI: 1.30, 3.17), well-done red meat (OR: 2.19; 95% CI: 1.34, 3.60), and the HCA 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQX; OR: 2.48; 95% CI: 1.49, 4.16) were associated with increased risk of SSLs in comparison to the lowest quartile intake. Conclusions High intakes of red and processed meats are strongly and especially associated with SSL risk and part of the association may be due to HCA intake. Future studies should evaluate other mechanism(s) and the potential for primary prevention.

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Co-consumption of Vegetables and Fruit, Whole Grains, and Fiber Reduces the Cancer Risk of Red and Processed Meat in a Large Prospective Cohort of Adults from Alberta’s Tomorrow Project

Nutrients ◽

10.3390/nu12082265 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2265

Author(s):

Katerina Maximova ◽

Elham Khodayari Moez ◽

Julia Dabravolskaj ◽

Alexa R. Ferdinands ◽

Irina Dinu ◽

...

Keyword(s):

Cancer Risk ◽

Cancer Prevention ◽

Prospective Cohort ◽

Failure Time ◽

Adult Population ◽

Whole Grains ◽

Processed Meat ◽

Meat Intake ◽

Cancer Occurrence ◽

Red And Processed Meat

We examined whether co-consumption of red and processed meat with key foods items and food constituents recommended for cancer prevention (vegetables and fruit, whole grains, and fiber) mitigates cancer incidence. In a prospective cohort of 26,218 adults aged 35–69 years at baseline, dietary intake was collected through 124-item past-year food frequency questionnaire. Incidence of all-cause and 15 cancers previously linked to red and processed meat intake was obtained through data linkage with a cancer registry (average follow-up 13.5 years). Competing risk Cox Proportional Hazard models estimated cancer risk and Accelerated Failure Time models estimated time-to-cancer occurrence for different combinations of intake levels while considering mortality from vital statistics and established confounders. Co-consumption of low vegetables and fruit intake with high processed meat was associated with higher incidence of all-cause and 15 cancers (men: HR = 1.85, 1.91; women: HR = 1.44, 1.49) and accelerated time-to-cancer occurrence (men: 6.5 and 7.1 years and women: 5.6 and 6.3 years, respectively), compared to high vegetables and fruit with low processed meat intake. Less pronounced and less consistent associations were observed for whole grains and fiber and for red meat. The findings provide initial evidence toward refining existing cancer prevention recommendations to optimize the intake and combination of foods in the general adult population.

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Meat intake and cancer risk: prospective analyses in UK Biobank

10.1101/19003822 ◽

2019 ◽

Cited By ~ 1

Author(s):

Anika Knuppel ◽

Keren Papier ◽

Georgina K. Fensom ◽

Paul N. Appleby ◽

Julie A. Schmidt ◽

...

Keyword(s):

Prostate Cancer ◽

Colorectal Cancer ◽

Cancer Risk ◽

Meat Consumption ◽

Red Meat ◽

Processed Meat ◽

Uk Biobank ◽

Meat Intake ◽

Incidence Trends ◽

Red And Processed Meat

AbstractBackgroundRed and processed meat has been consistently associated with risk for colorectal cancer, but evidence for other cancer sites is limited and few studies have examined the association between poultry intake and cancer risk. We examined associations between total meat, red meat, processed meat and poultry intake and incidence for 20 common cancer sites.Methods and FindingsWe analysed data from 475,023 participants (54% women) in UK Biobank. Participants were aged 37-73 years and cancer free at baseline. Information on meat consumption was based on a touchscreen questionnaire completed at baseline covering type and frequency of meat intake. Diet intake was re-measured a minimum of three times in a subsample (15%) using a web-based 24h dietary recall questionnaire. Multivariable-adjusted Cox proportional hazards models were used to determine the association between baseline meat intake and cancer incidence. Trends in risk across baseline meat intake categories were calculated by assigning a mean value to each category using estimates from the re-measured meat intakes. During a mean follow-up of 6.9 years, 28,955 participants were diagnosed with a malignant cancer. Total, red and processed meat intakes were each positively associated with risk of colorectal cancer (e.g. hazard ratio (HR) per 70 g/day higher intake of red and processed meat combined 1.31, 95%-confidence interval (CI) 1.14-1.52).Red meat intake was positively associated with breast cancer (HR per 50 g/day higher intake 1.12, 1.01-1.24) and prostate cancer (1.15, 1.03-1.29). Poultry intake was positively associated with risk for cancers of the lymphatic and hematopoietic tissues (HR per 30g/day higher intake 1.16, 1.03-1.32). Only the associations with colorectal cancer were robust to Bonferroni correction for multiple comparisons. Study limitations include unrepresentativeness of the study sample for the UK population, low case numbers for less common cancers and the possibility of residual confounding.ConclusionsHigher intakes of red and processed meat were associated with a higher risk of colorectal cancer. The observed positive associations of red meat consumption with breast and prostate cancer, and poultry intake with cancers of the lymphatic and hematopoietic tissues, require further investigation.

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Background Diet Influences TMAO Concentrations Associated with Red Meat Intake without Influencing Apparent Hepatic TMAO-Related Activity in a Porcine Model

Metabolites ◽

10.3390/metabo10020057 ◽

2020 ◽

Vol 10 (2) ◽

pp. 57 ◽

Cited By ~ 4

Author(s):

Rebekka Thøgersen ◽

Martin Krøyer Rasmussen ◽

Ulrik K. Sundekilde ◽

Sophie A. Goethals ◽

Thomas Van Hecke ◽

...

Keyword(s):

Mrna Expression ◽

Red Meat ◽

Processed Meat ◽

Related Activity ◽

Cvd Risk ◽

Meat Intake ◽

Expression Of Genes ◽

Background Diet ◽

The Impact ◽

Red And Processed Meat

Red meat has been associated with an increased cardiovascular disease (CVD) risk, possibly through gut microbial-derived trimethylamine-N-oxide (TMAO). However, previous reports are conflicting, and influences from the background diet may modulate the impact of meat consumption. This study investigated the effect of red and white meat intake combined with two different background diets on urinary TMAO concentration and its association with the colon microbiome in addition to apparent hepatic TMAO-related activity. For 4 weeks, 32 pigs were fed chicken or red and processed meat combined with a prudent or western background diet. 1H NMR-based metabolomics analysis was conducted on urine samples and hepatic Mrna expression of TMAO-related genes determined. Lower urinary TMAO concentrations were observed after intake of red and processed meat when consumed with a prudent compared to a western background diet. In addition, correlation analyses between urinary TMAO concentrations and relative abundance of colon bacterial groups suggested an association between TMAO and specific bacterial taxa. Diet did not affect the hepatic Mrna expression of genes related to TMAO formation. The results suggest that meat-induced TMAO formation is regulated by mechanisms other than alterations at the hepatic gene expression level, possibly involving modulations of the gut microbiota.

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Variation in Red Meat Categories Meaningfully Influences Red Meat Intake Estimates of the U.S. Population Aged 2 + Years

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_064 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1071-1071

Author(s):

Lauren O'Connor ◽

Kirsten Herrick ◽

Ruth Parsons ◽

Jill Reedy

Keyword(s):

Red Meat ◽

Dietary Guidelines ◽

Processed Meat ◽

Pairwise Comparisons ◽

Eating Patterns ◽

Meat Intake ◽

Lean Meat ◽

Red Meat Intake ◽

The U.S ◽

Red And Processed Meat

Abstract Objectives Limitations in dietary assessment methodology lead to broad and inconsistent red meat intake categories. For example, red meat is often combined with processed meat, which includes processed poultry. Our objective was to quantitatively assess how these limitations influence red meat intake estimates of the U.S. population. Methods Three distinct red meat categories were identified from a series of systematic literature reviews. By systematically disaggregating and reaggregating meat variables (lean meat oz-eq) from the USDA's Food Pattern Equivalents Database, the following categories were created: 1) ‘unprocessed red meat’, 2) ‘total red meat’ [unprocessed red meat + processed red meat], and 3) ‘mixed red and processed meat’ [unprocessed red meat + total processed meat which includes processed poultry]. The 2015–16 and 2017–18 cycles of NHANES (n = 15,039) were combined to estimate and compare mean intakes across these three categories as well as the proportion of the population that exceeded age- and sex-specific red meat allotments in the Dietary Guidelines for Americans recommended eating patterns for those aged 2 + years. The two-part correlated model of the NCI Usual Intake method in SAS was used. Estimates were adjusted for age, sex, race, and ethnicity and pairwise comparisons were made across categories; P < 0.05. Results Mean intake estimates (lean meat oz-eq/day) differed by red meat category (pairwise comparisons P < 0.00,001): 1.5 ± 0.04 for unprocessed red meat, 2.2 ± 0.05 for total red meat, 2.4 ± 0.05 for mixed red and processed meat. The % of the population exceeding their respective age-sex red meat allotment in the DGA eating patterns also differed by category (pairwise comparisons P < 0.00,001): 18.3 ± 1.9% for unprocessed red meat, 45.1 ± 1.8% for total red meat, 55.2 ± 1.8% for mixed red and processed meat. Conclusions Our results emphasize the importance of accurate and transparent red meat categories in nutrition epidemiology when estimating population intakes. Future research should examine how differences in these intake categories can influence associations between red meat intake and chronic disease. Funding Sources Not applicable.

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