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

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Keren Papier ◽  
Georgina Fensom ◽  
Anika Knuppel ◽  
Timothy Key ◽  
Aurora Perez-Cornago

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.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Anika Knuppel ◽  
Keren Papier ◽  
Paul N. Appleby ◽  
Timothy J. Key ◽  
Aurora Perez-Cornago

AbstractIntroductionMeat intake is thought to play a role in the risk of cancer. The Third Expert Report of the World Cancer Research Fund/American Institute for Cancer Research concluded that red meat was a probable cause and processed meat a convincing cause of colorectal cancer. However, evidence for associations between red and processed meat intake and other cancer sites is limited. Furthermore, few studies have investigated the association between poultry intake and cancer risk. Therefore, this study aimed to examine the associations between red, processed meat and poultry intake and incidence for 20 common cancer sites.Material and methodsWe analysed data from 475,264 participants (54 % women) in UK Biobank. Participants were aged 37–73 years and cancer free at baseline. Cancer diagnosis and death due to cancer without prior diagnosis during follow-up were determined using data-linkage with cancer and death registries (with follow-up until 31 March 2016 for England and Wales and until 31 October 2015 for Scotland, respectively). Information on meat consumption was based on a touchscreen questionnaire completed at baseline covering type and frequency of meat intake. We used multivariable-adjusted Cox proportional hazards models to determine the association between baseline meat intake and cancer incidence. Analyses of lung cancer risk were restricted to never smokers. All analyses were adjusted for socio-demographic, lifestyle and women-specific factors.ResultsOver a mean 6.9 (SD 1.3) years of follow-up, 28,431 participants were diagnosed with any type of cancer. Red meat intake was positively associated with risk for colorectal cancer (n cases = 3,164; Hazard ratio (HR) per 50 g/day higher intake 1.22, 95% Confidence Interval (CI) 1.05–1.41), breast cancer (n cases = 5,536; 1.12, 1.01–1.24) and prostate cancer (n cases = 5,807; 1.16, 1.03–1.30). Processed meat intake was positively associated with risk for colorectal cancer (n cases = 3,189; HR per 20 g/day higher intake 1.17, 95% CI 1.06–1.30). Poultry intake was positively associated with risk for cancers of the lymphatic and hematopoietic tissues (n cases = 2,431; HR per 30g/day increment in intake 1.16, 95%-CI 1.03, 1.32).DiscussionIn summary, higher intakes of red and processed meat were associated with a higher risk of colorectal cancer. Red meat consumption was also positively associated with risk of breast and prostate cancer, but these associations are not supported by most previous prospective studies. The positive association of poultry intake with cancers of the lymphatic and hematopoietic tissues requires further investigation.


2019 ◽  
Author(s):  
Anika Knuppel ◽  
Keren Papier ◽  
Georgina K. Fensom ◽  
Paul N. Appleby ◽  
Julie A. Schmidt ◽  
...  

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.


2021 ◽  
Author(s):  
Keren Papier ◽  
Lilian Hartman ◽  
Tammy Y N Tong ◽  
Timothy J Key ◽  
Anika Knuppel

ABSTRACT Background High meat consumption might play a role in promoting low-grade systemic inflammation, but evidence is limited. Objectives We examined cross-sectional associations of habitual meat consumption with serum C-reactive protein (CRP) and total white blood cell count (WBCC) in British adults. Methods We included 403,886 men and women (aged 38–73 y) participating in the UK Biobank who provided information on meat intake (via touchscreen questionnaire) and a nonfasting blood sample at recruitment (2006–2010). For a subset of participants (∼5%), an additional blood sample was collected (median 4.4 y later). We used multivariable linear regression models to estimate associations of meat intake (total meat, unprocessed red meat, processed meat, and poultry) with logCRP and logWBCC. Results The difference in the serum CRP (mg/L) for each 50-g/d higher intake for total meat was 11.6% (95% CI: 11.1, 12.0%), for processed meat was 38.3% (95% CI: 36.0, 40.7%), for unprocessed red meat was 14.4% (95% CI: 13.6, 15.1%), and for poultry was 12.8% (95% CI: 12.0, 13.5%). The difference in the WBCC (×10–9L) for each 50 g/d higher intake of total meat was 1.5% (95% CI: 1.4, 1.6%), for processed meat was 6.5% (95% CI: 6.1, 6.9%), for unprocessed red meat was 1.6% (95% CI: 1.4, 1.7%), and for poultry was 1.6% (95% CI: 1.4, 1.7%). All associations were attenuated after adjustment for adiposity; by 67% with BMI (in kg/m2) and by 58% with waist circumference for total meat and CRP, and by 53% and 47%, respectively, for WBCC, although associations remained statistically significant. Findings of sensitivity analyses in 15,420 participants were similar prospectively, except there were no associations between unprocessed red meat and WBCC. Conclusions Higher meat consumption, particularly of processed meat, was positively associated with inflammatory markers in these British adults; however, the magnitudes of associations are small and predominantly due to higher adiposity.


2021 ◽  
pp. 1-38
Author(s):  
Ala Al Rajabi ◽  
Geraldine Lo Siou ◽  
Alianu K. Akawung ◽  
Kathryn L McDonald ◽  
Tiffany R. Price ◽  
...  

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.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Keren Papier ◽  
Georgina K. Fensom ◽  
Anika Knuppel ◽  
Paul N. Appleby ◽  
Tammy Y. N. Tong ◽  
...  

Abstract Background There is limited prospective evidence on the association between meat consumption and many common, non-cancerous health outcomes. We examined associations of meat intake with risk of 25 common conditions (other than cancer). Methods We used data from 474,985 middle-aged adults recruited into the UK Biobank study between 2006 and 2010 and followed up until 2017 (mean follow-up 8.0 years) with available information on meat intake at baseline (collected via touchscreen questionnaire), and linked hospital admissions and mortality data. For a large sub-sample (~ 69,000), dietary intakes were re-measured three or more times using an online, 24-h recall questionnaire. Results On average, participants who reported consuming meat regularly (three or more times per week) had more adverse health behaviours and characteristics than participants who consumed meat less regularly, and most of the positive associations observed for meat consumption and health risks were substantially attenuated after adjustment for body mass index (BMI). In multi-variable adjusted (including BMI) Cox regression models corrected for multiple testing, higher consumption of unprocessed red and processed meat combined was associated with higher risks of ischaemic heart disease (hazard ratio (HRs) per 70 g/day higher intake 1.15, 95% confidence intervals (CIs) 1.07–1.23), pneumonia (1.31, 1.18–1.44), diverticular disease (1.19, 1.11–1.28), colon polyps (1.10, 1.06–1.15), and diabetes (1.30, 1.20–1.42); results were similar for unprocessed red meat and processed meat intakes separately. Higher consumption of unprocessed red meat alone was associated with a lower risk of iron deficiency anaemia (IDA: HR per 50 g/day higher intake 0.80, 95% CIs 0.72–0.90). Higher poultry meat intake was associated with higher risks of gastro-oesophageal reflux disease (HR per 30 g/day higher intake 1.17, 95% CIs 1.09–1.26), gastritis and duodenitis (1.12, 1.05–1.18), diverticular disease (1.10, 1.04–1.17), gallbladder disease (1.11, 1.04–1.19), and diabetes (1.14, 1.07–1.21), and a lower IDA risk (0.83, 0.76–0.90). Conclusions Higher unprocessed red meat, processed meat, and poultry meat consumption was associated with higher risks of several common conditions; higher BMI accounted for a substantial proportion of these increased risks suggesting that residual confounding or mediation by adiposity might account for some of these remaining associations. Higher unprocessed red meat and poultry meat consumption was associated with lower IDA risk.


Foods ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2182
Author(s):  
Victoria Howatt ◽  
Anna Prokop-Dorner ◽  
Claudia Valli ◽  
Joanna Zajac ◽  
Malgorzata Bala ◽  
...  

Introduction: Over the last decade, the possible impact of meat intake on overall cancer incidence and mortality has received considerable attention, and authorities have recommended decreasing consumption; however, the benefits of reducing meat consumption are small and uncertain. As such, individual decisions to reduce consumption are value- and preference-sensitive. Consequently, we undertook a pilot cross-sectional study to explore people’s values and preferences towards meat consumption in the face of cancer risk. Methods and analysis: The mixed-method pilot study included a quantitative questionnaire followed by qualitative evaluation to explore the dietary habits of 32 meat eaters, their reasons for eating meat, and willingness to change their meat consumption when faced with a potential risk reduction of cancer over a lifetime based on a systematic review and dose–response meta-analysis. We recruited a convenience sample of participants from two Canadian provinces: Nova Scotia and Prince Edward Island. This project was approved by the Research Ethics Board for Health Sciences research at Dalhousie University, Canada. Results: The average weekly consumption of red meat was 3.4 servings and the average weekly consumption of processed meat was 3 servings. The determinants that influenced meat intake were similar for both red and processed meat. Taste, cost, and family preferences were the three most commonly cited factors impacting red meat intake. Taste, cost, and (lack of) cooking time were the three most commonly cited factors impacting processed meat intake. None of the participants were willing to eliminate red or processed meat from their diet. About half of participants were willing to potentially reduce their meat consumption, with one third definitely willing to reduce their consumption. Strengths and limitations: This study is the first that we are aware of to share data with participants on the association of red meat and processed meat consumption and the risk of cancer mortality and cancer incidence, including the certainty of evidence for the risk reduction. The limitations of this study include its small sample size and its limited geographic sampling. Conclusions: When presented explicit information about the small uncertain cancer risk associated with red and processed meat consumption, study participants were unwilling to eliminate meat, while about one-third were willing to reduce their meat intake.


2019 ◽  
Vol 49 (1) ◽  
pp. 246-258 ◽  
Author(s):  
Kathryn E Bradbury ◽  
Neil Murphy ◽  
Timothy J Key

Abstract Background Most of the previous studies on diet and colorectal cancer were based on diets consumed during the 1990s. Methods We used Cox-regression models to estimate adjusted hazard ratios for colorectal cancer by dietary factors in the UK Biobank study. Men and women aged 40–69 years at recruitment (2006–10) reported their diet on a short food-frequency questionnaire (n = 475 581). Dietary intakes were re-measured in a large sub-sample (n = 175 402) who completed an online 24-hour dietary assessment during follow-up. Trends in risk across the baseline categories were calculated by assigning re-measured intakes to allow for measurement error and changes in intake over time. Results During an average of 5.7 years of follow-up, 2609 cases of colorectal cancer occurred. Participants who reported consuming an average of 76 g/day of red and processed meat compared with 21 g/day had a 20% [95% confidence interval (CI): 4–37] higher risk of colorectal cancer. Participants in the highest fifth of intake of fibre from bread and breakfast cereals had a 14% (95% CI: 2–24) lower risk of colorectal cancer. Alcohol was associated with an 8% (95% CI: 4–12) higher risk per 10 g/day higher intake. Fish, poultry, cheese, fruit, vegetables, tea and coffee were not associated with colorectal-cancer risk. Conclusions Consumption of red and processed meat at an average level of 76 g/d that meets the current UK government recommendation (≤90 g/day) was associated with an increased risk of colorectal cancer. Alcohol was also associated with an increased risk of colorectal cancer, whereas fibre from bread and breakfast cereals was associated with a reduced risk.


2020 ◽  
Vol 49 (5) ◽  
pp. 1540-1552
Author(s):  
Anika Knuppel ◽  
Keren Papier ◽  
Georgina K Fensom ◽  
Paul N Appleby ◽  
Julie A Schmidt ◽  
...  

Abstract Background Red and processed meat have been consistently associated with colorectal cancer risk, but evidence for other cancer sites and for poultry intake is limited. We therefore examined associations between total, red and processed meat and poultry intake and incidence for 20 common cancers. Methods We analyzed data from 474 996 participants (54% women) in UK Biobank. Participants were aged 37–73 years and cancer-free at baseline (2006–10). Multivariable-adjusted Cox proportional hazards models were used to determine associations between baseline meat intake and cancer incidence. Trends in risk across the baseline categories were calculated, assigning re-measured intakes from a subsample. Results During a mean follow-up of 6.9 years, 28 955 participants were diagnosed with malignant cancer. After correction for multiple testing, red and processed meat combined, and processed meat, were each positively associated with colorectal cancer risk [hazard ratio (HR) per 70 g/day higher intake of red and processed meat 1.32, 95% confidence interval 1.14–1.53; HR per 20 g/day higher intake of processed meat 1.18, 1.03–1.31] and red meat was associated with colon cancer risk (HR per 50 g/day higher intake of red meat 1.36, 1.13–1.64). Positive associations of red meat intake with colorectal and prostate cancer, processed meat intake with rectal cancer and poultry intake with cancers of the lymphatic and haematopoietic tissues did not survive multiple testing. Conclusions Higher intake of red and processed meat was specifically associated with a higher risk of colorectal cancer; there was little evidence that meat intake was associated with risk of other cancers.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1457-1457
Author(s):  
Dustin Moore ◽  
Sabrina Noel ◽  
Xiyuan Zhang ◽  
Sameera Talegawker ◽  
Teresa Carithers ◽  
...  

Abstract Objectives Red and processed meat consumption is adversely related to cardiometabolic risk, but the impact of overall dietary quality on this association has not been systematically investigated. We examined the influence of dietary quality on associations of meat intake with biomarkers of cardiometabolic risk. Methods Data are from the Jackson Heart Study, a cohort of African Americans (baseline age 55 y, 66% female, 20% diabetes, 9% CVD). We analyzed those with biomarker data available at Visit 1 (2000–04) and at Visit 2 (2005–09) or 3 (2009–13). Diet was assessed by food frequency questionnaire (Visit 1). Total observations used were: Visit 1 (n = 3725), Visit 2 (n = 2736), and Visit 3 (n = 3319). Unprocessed red meat included beef and pork, and processed meat included sausage, lunch, and cured meats. Diet quality was measured by a modified Healthy Eating Index 2010 score (m-HEI) that excluded meat contributions. Modified HEI stratified and unstratified analyses were conducted using linear mixed modeling. Fasting HbA1c and CRP values were log transformed. Results Meat consumption was not associated with HbA1c in m-HEI stratified or unstratified analyses. A 1 oz/1000 kcal/wk increase in unprocessed red and total meat was associated with a 1.3% ± 0.5% (P = 0.02) and 1.1% ± 0.3% (P = 0.005) higher CRP in unstratified analyses, respectively. Unprocessed red meat was positively associated with CRP in m-HEI tertiles 1 (2.0% ± 0.8%, P = 0.01) and 3 (2.2% ± 0.8%, P = 0.008). Total meat was associated with CRP in m-HEI tertile 1 (2.0% ± 0.6%, P = 0.001) and trended in tertile 3 (1.1% ± 0.6%, P = 0.09); processed meat also approached significance in m-HEI tertile 1 (2.1% ± 1.2%, P = 0.08). There was evidence that m-HEI modified the associations between processed meat and CRP (P-interaction = 0.04), but not for other associations. Excluding those with diabetes or CVD did not alter these results. Conclusions Our results do not support that meat intake is associated with HbA1c, or that overall dietary quality modifies these associations. Unprocessed red and total meat intakes were associated with greater CRP in unstratified and subsets of stratified analyses. Associations of processed meat with CRP appeared stronger among those with the poorest diet quality. These data suggest that reduction in red meat intake could benefit inflammation among African American adults. Funding Sources The Beef Checkoff.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
An Pan ◽  
Qi Sun ◽  
JoAnn E Manson ◽  
Walter C Willett ◽  
Frank B Hu

Introduction: Red meat consumption has been consistently associated with an increased risk of type 2 diabetes (T2D). However, it remains largely unknown whether changes in red meat intake are related to subsequent T2D risk. Methods: We followed 26,358 men in the Health Professionals Follow-up Study (HPFS, 1986-2006), 48,710 women in the Nurses’ Health Study (NHS, 1986-2006) and 74,077 women in NHS II (1991-2007). Diet was assessed by validated food frequency questionnaires and updated every 4 years. Incident T2D was confirmed by a validated supplementary questionnaire. Time-dependent Cox proportional hazard models were used to calculate relative risks (RRs) for changes in red meat consumption during a 4-year interval in relation to risk of T2D in the subsequent 4 years, with adjustment for age, family history, race, marital status, initial red meat consumption, initial and changes in other lifestyle factors (physical activity, smoking status, alcohol intake, and dietary quality). The results in the three cohorts were pooled by inverse-variance-weighted random-effects meta-analyses. Results: During 1,965,911 person-years of follow-up, we documented 7,521 incident T2D cases. In the multivariate-adjusted models, increasing red meat intake during a 4-year interval was associated with an increased risk of subsequent 4-year T2D risk in each cohort (all P-trend <0.001), and the pooled RR for one serving/d increment of red meat consumption was 1.30 (95% CI: 1.23, 1.38). The RR was attenuated to 1.20 (95% CI: 1.13, 1.27) after adjustment for baseline body mass index and concurrent weight change. We found significant interaction between initial red meat consumption and changes in red meat consumption with the subsequent risk of T2D; among participants with initial low (<2 servings/wk) or moderate (2-6 servings/wk) levels of red meat consumption, an increase of one serving/d during a 4-year interval was related to an elevated risk of incident T2D in the subsequent 4 years, and the pooled RR was 1.99 (95% CI: 1.47, 2.70) and 1.51 (95% CI: 1.25, 1.81), respectively. However, the association was much weaker (pooled RR 1.16; 95% CI: 1.05, 1.27) in individuals with high initial red meat consumption levels (≥1 serving/d), and the association was not linear in the HPFS and NHS II. Conclusions: Increasing red meat consumption over time is associated with an elevated subsequent risk of T2D, and the association is partly mediated by body weight changes. The association also depends on the initial red meat consumption levels. Our results add further evidence that limiting red meat consumption over time can confer benefits on diabetes prevention.


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