scholarly journals High Consumption of Red Meat Is Associated with Excess Mortality Among African-American Women

2020 ◽  
Vol 150 (12) ◽  
pp. 3249-3258
Author(s):  
Shanshan Sheehy ◽  
Julie R Palmer ◽  
Lynn Rosenberg
Keyword(s):  
African American Women ◽  
Cardiovascular Mortality ◽  
Excess Mortality ◽  
Meat Consumption ◽  
Red Meat ◽  
Dietary Factors ◽  
Health Study ◽  
High Consumption ◽  
Increased Risk ◽  
All Cause Mortality

ABSTRACT Background Red meat is a rich source of nutrients but is typically high in saturated fats. Carcinogenic chemicals can be formed during cooking and processing. Little is known about the relation of red meat consumption to mortality in African Americans (AAs), a group with excess mortality and high consumption of red meat relative to whites. Objective Our objective was to assess the association between red meat consumption and mortality in AA women. Methods The Black Women's Health Study (BWHS) is a prospective cohort study of AA women across the USA who completed health questionnaires at enrollment in 1995 (median age 38 y, median BMI 27.9 kg/m2) and every 2 y thereafter. The analyses included 56,314 women who completed a validated FFQ and were free of cardiovascular disease and cancer at baseline in 1995. Exposures were total red meat, processed red meat, and unprocessed red meat consumption. Outcomes were all-cause and cause-specific mortality. Cox proportional hazards models with control for age, socioeconomic status, lifestyle factors, medical history, and dietary factors were used to estimate HRs with 95% CIs. Results During 22 y of follow-up through to 2017, we identified 5054 deaths, which included 1354 cardiovascular deaths and 1801 cancer deaths. The HR for all-cause mortality was 1.47 (95% CI: 1.33, 1.62) for the highest quintile of total red meat consumption relative to the lowest. Each 1 serving/d increase in red meat consumption was associated with a 7% (95% CI: 5%, 9%) increased risk of all-cause mortality. Red meat consumption was also associated with increased cardiovascular mortality, but not with cancer mortality. Results were similar for the consumption of processed and unprocessed red meat. Conclusions Red meat consumption is associated with increased all-cause and cardiovascular mortality among AA women.

scholarly journals Modeling Effects of Complex Diet Mixtures on Cardiovascular Incidence in African American Women: The Women's Health Initiative

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1512-1512
Author(s):  
Yi Zhao ◽  
Gitanjali Singh
Keyword(s):  
African American ◽  
African American Women ◽  
Meat Consumption ◽  
Red Meat ◽  
Dietary Factors ◽  
Whole Grain ◽  
Cvd Risk ◽  
American Women ◽  
Kernel Machine ◽  
Health Initiative

Abstract Objectives Cardiovascular disease (CVD) is the leading cause of premature morbidity and mortality among African American women, and diet plays a crucial role in its prevention. Diet consists of a complex mixture of foods and nutrients, yet few existing statistical methods can account for potential nonlinear and interactive relationships between multiple dietary factors and their effects on health. To realistically assess dietary impacts on CVD risk among African American women, we utilized an innovative statistical approach, Bayesian Kernel Machine Regression (BKMR), which takes into consideration the relationship between multiple dietary factors, as mixtures and as individual components, and CVD risk. Methods Using data from 2724 healthy African American participants of the Women's Health Initiative Observational Study, we examined the association of nine dietary factors (fruits, vegetables, fish, red meat, poultry, nuts, whole grains, dairy, and sodium), collected through a validated food frequency questionnaire, with both systolic blood pressure (SBP) and CVD incidence. Through a kernel machine representation, BKMR regresses the outcome on a smooth function of the exposures, adjusting for potential confounders and allowing for possible nonlinearities and interactions. We used BKMR for modeling the continuous outcome, SBP, and its probit extension for the binary outcome, CVD incidence. Results Whole grain and fish had the strongest associations with SBP. SBP decreased by 0.78 mmHg (95% credible interval (CI): −1.70, 0.14) and increased by 0.70 mmHg (95% CI: −0.12, 1.52) for an interquartile range (IQR) increase in whole grain and fish consumption, respectively. We saw a linear and increasing association between the diet mixture and CVD incidence. This trend was mainly driven by red meat consumption as the primary dietary risk factor to CVD incidence: an IQR increase in red meat consumption was associated with a 0.06-unit (95% CI: −0.02, 0.14) increase in the probit CVD risk. No evidence for interactions and nonlinearities was observed. Conclusions BKMR is a novel method for modeling complex dietary mixtures by incorporating potential nonlinearities and interactions, allowing identification of major dietary factors associated with elevated SBP and CVD incidence among a population disproportionally affected by CVD. Funding Sources NHLBI.

scholarly journals Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis

2011 ◽  
Vol 94 (4) ◽  
pp. 1088-1096 ◽  
Author(s):  
An Pan ◽  
Qi Sun ◽  
Adam M Bernstein ◽  
Matthias B Schulze ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Meat Consumption ◽  
Red Meat ◽  
Health Study ◽  
Increased Risk ◽  
Red Meats ◽  
Processed Red Meat

ABSTRACT Background: The relation between consumption of different types of red meats and risk of type 2 diabetes (T2D) remains uncertain. Objective: We evaluated the association between unprocessed and processed red meat consumption and incident T2D in US adults. Design: We followed 37,083 men in the Health Professionals Follow-Up Study (1986–2006), 79,570 women in the Nurses’ Health Study I (1980–2008), and 87,504 women in the Nurses’ Health Study II (1991–2005). Diet was assessed by validated food-frequency questionnaires, and data were updated every 4 y. Incident T2D was confirmed by a validated supplementary questionnaire. Results: During 4,033,322 person-years of follow-up, we documented 13,759 incident T2D cases. After adjustment for age, BMI, and other lifestyle and dietary risk factors, both unprocessed and processed red meat intakes were positively associated with T2D risk in each cohort (all P-trend <0.001). The pooled HRs (95% CIs) for a one serving/d increase in unprocessed, processed, and total red meat consumption were 1.12 (1.08, 1.16), 1.32 (1.25, 1.40), and 1.14 (1.10, 1.18), respectively. The results were confirmed by a meta-analysis (442,101 participants and 28,228 diabetes cases): the RRs (95% CIs) were 1.19 (1.04, 1.37) and 1.51 (1.25, 1.83) for 100 g unprocessed red meat/d and for 50 g processed red meat/d, respectively. We estimated that substitutions of one serving of nuts, low-fat dairy, and whole grains per day for one serving of red meat per day were associated with a 16–35% lower risk of T2D. Conclusion: Our results suggest that red meat consumption, particularly processed red meat, is associated with an increased risk of T2D.

Abstract P180: Intake of soy protein and isoflavones with risk of cardiovascular mortality: the Singapore Chinese Health Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
An Pan ◽  
Mohammad Talaei ◽  
Rob M van Dam ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh
Keyword(s):  
Food Intake ◽  
Soy Protein ◽  
Cardiovascular Mortality ◽  
Vascular Reactivity ◽  
Population Based ◽  
Dietary Factors ◽  
Soy Isoflavones ◽  
Health Study ◽  
Increased Risk ◽  
Singapore Chinese

Introduction: These is a long-standing interest in the plausible cardiovascular benefits of soy protein and isoflavones, given the effects on several cardio-metabolic pathways (e.g., lipid profile, blood pressure, endothelial function, vascular reactivity, inflammation, insulin resistance) from pre-clinical studies and short-term intervention trials. However, the long-term prospective association between habitual soy food intake and cardiovascular mortality remains unclear. Thus, we evaluated the relation of soy protein and isoflavones intake with risk of cardiovascular mortality in middle-aged and elderly Chinese residing in Singapore. Methods: The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semi-quantitative food-frequency questionnaire, and mortality information was identified via registry linkage to December 31, 2011. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for potential confounders. Results: The median intake was 5.17 g/d for soy protein, 15.83 mg/d for soy isoflavones and 88.06 g/d for units of plain tofu-equivalent. We documented 4,780 total cardiovascular deaths during 890,473 person-years of follow-up. After adjustment for socio-demographic, lifestyle and other dietary factors, soy protein intake was not significantly associated with cardiovascular mortality: the HR (95% confidence interval) was 1.00 (reference), 1.02 (0.94-1.11), 1.02 (0.93-1.11), and 1.06 (0.97-1.17) for increasing quartiles of soy protein (P-trend=0.24). Null associations were also found for intakes of soy isoflavones (P-trend=0.83) and total tofu-equivalent (P-trend=0.79), as well as with deaths from CHD (n=2,697; P-trend=0.58) or stroke (n=1,298; P-trend=0.96). A statistically significant interaction with gender (P-interaction=0.04) was found for the relation between soy protein and cardiovascular mortality: the HRs (95% confidence intervals) across quartiles were 1.00 (reference), 1.00 (0.87-1.12), 1.05 (0.93-1.17), and 1.16 (1.03-1.31) in men (P-trend=0.02), and 1.00 (reference), 1.01 (0.88-1.16), 0.96 (0.84-1.11), and 0.95 (0.81-1.10) in women (P-trend=0.31). Conclusions: In this large cohort study of Chinese men and women, intake of soy foods (soy protein, isoflavones, tofu products) was not significantly associated with risk of cardiovascular mortality. However, a moderately increased risk in men cannot be excluded and requires further investigation. Overall, our results do not provide evidence for the recommendation of increasing soy food intake alone as a cardiovascular disease prevention strategy.

scholarly journals Red Meat Consumption and Risk of Frailty in Older Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 52-52
Author(s):  
Ellen Struijk ◽  
Teresa Fung ◽  
Frank Hu ◽  
Walter Willett ◽  
Fernando Rodriguez-Artalejo ◽  
...  
Keyword(s):  
Red Meat ◽  
Dietary Factors ◽  
Health Study ◽  
The European Union ◽  
Protein Sources ◽  
Funding Sources ◽  
Increased Risk ◽  
Prospective Association ◽  
Incident Cases ◽  
Processed Red Meat

Abstract Objectives The aim of this study was to examine the prospective association between the consumption of total, unprocessed, and processed red meat and the risk of frailty in older adults. Methods We analyzed data from 85,870 women aged ≥60 participating in the Nurses’ Health Study. Consumption of red meat was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every four years from 1992 to 2014. Results During follow-up we identified 13,279 incident cases of frailty. Women with a higher intake of red meat showed an increased risk of frailty after adjustment for lifestyle factors, medication use, and dietary factors. The relative risk (95% confidence interval) for one serving/day increment in consumption was 1.13 (1.08, 1.18) for total red meat, 1.08 (1.02, 1.15) for unprocessed red meat, and 1.26 (1.15, 1.39) for processed red meat. Replacing one serving/day of unprocessed red meat with other protein sources was associated with significantly lower risk of frailty; the risk reduction estimates were 21% for fish and 14% for nuts, while for replacement of processed red meat the percentages were 32% for fish, 26% for nuts, 13% for legumes, and 16% for dairy. Conclusions Habitual consumption of red meat was associated with a higher risk of frailty. Replacement of red meat by other protein sources might reduce the risk of frailty. Funding Sources This work was supported by grants from the Instituto de Salud Carlos III, State Secretary of R+D+I of Spain and FEDER/FSE (FIS 16/609, 16/1512, 19/319); the European Union (JPI A Healthy Diet for a Healthy Life, SALAMANDER project); and the Nurses´ health study is supported by grant UM1 CA186107 from National Institutes of Health.

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

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.

scholarly journals Low HbA1c levels and all-cause or cardiovascular mortality among people without diabetes: the US National Health and Nutrition Examination Survey 1999–2015

2020 ◽  
Author(s):  
Kosuke Inoue ◽  
Roch Nianogo ◽  
Donatello Telesca ◽  
Atsushi Goto ◽  
Vahe Khachadourian ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Regression Models ◽  
Machine Learning Algorithms ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
Increased Risk ◽  
The Us ◽  
All Cause Mortality ◽  
Hba1c Levels

Abstract Objective It is unclear whether relatively low glycated haemoglobin (HbA1c) levels are beneficial or harmful for the long-term health outcomes among people without diabetes. We aimed to investigate the association between low HbA1c levels and mortality among the US general population. Methods This study includes a nationally representative sample of 39 453 US adults from the National Health and Nutrition Examination Surveys 1999–2014, linked to mortality data through 2015. We employed the parametric g-formula with pooled logistic regression models and the ensemble machine learning algorithms to estimate the time-varying risk of all-cause and cardiovascular mortality by HbA1c categories (low, 4.0 to <5.0%; mid-level, 5.0 to <5.7%; prediabetes, 5.7 to <6.5%; and diabetes, ≥6.5% or taking antidiabetic medication), adjusting for 72 potential confounders including demographic characteristics, lifestyle, biomarkers, comorbidities and medications. Results Over a median follow-up of 7.5 years, 5118 (13%) all-cause deaths, and 1116 (3%) cardiovascular deaths were observed. Logistic regression models and machine learning algorithms showed nearly identical predictive performance of death and risk estimates. Compared with mid-level HbA1c, low HbA1c was associated with a 30% (95% CI, 16 to 48) and a 12% (95% CI, 3 to 22) increased risk of all-cause mortality at 5 years and 10 years of follow-up, respectively. We found no evidence that low HbA1c levels were associated with cardiovascular mortality risk. The diabetes group, but not the prediabetes group, also showed an increased risk of all-cause mortality. Conclusions Using the US national database and adjusting for an extensive set of potential confounders with flexible modelling, we found that adults with low HbA1c were at increased risk of all-cause mortality. Further evaluation and careful monitoring of low HbA1c levels need to be considered.

scholarly journals Dietary patterns related to total mortality and cancer mortality in the United States

2021 ◽  
Author(s):  
Marcela R. Entwistle ◽  
Donald Schweizer ◽  
Ricardo Cisneros
Keyword(s):  
United States ◽  
Dietary Patterns ◽  
Cancer Mortality ◽  
Cox Regression ◽  
Total Mortality ◽  
Principal Component ◽  
The United States ◽  
Red Meat ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Purpose This study investigated the association between dietary patterns, total mortality, and cancer mortality in the United States. Methods We identified the four major dietary patterns at baseline from 13,466 participants of the NHANES III cohort using principal component analysis (PCA). Dietary patterns were categorized into ‘prudent’ (fruits and vegetables), ‘western’ (red meat, sweets, pastries, oils), ‘traditional’ (red meat, legumes, potatoes, bread), and ‘fish and alcohol’. We estimated hazard ratios for total mortality, and cancer mortality using Cox regression models. Results A total of 4,963 deaths were documented after a mean follow-up of 19.59 years. Higher adherence to the ‘prudent’ pattern was associated with the lowest risk of total mortality (5th vs. 1st quintile HR 0.90, 95% CI 0.82–0.98), with evidence that all-cause mortality decreased as consumption of the pattern increased. No evidence was found that the ‘prudent’ pattern reduced cancer mortality. The ‘western’ and the ‘traditional’ patterns were associated with up to 22% and 16% increased risk for total mortality (5th vs. 1st quintile HR 1.22, 95% CI 1.11–1.34; and 5th vs. 1st quintile HR 1.16, 95% CI 1.06–1.27, respectively), and up to 33% and 15% increased risk for cancer mortality (5th vs. 1st quintile HR 1.33, 95% CI 1.10–1.62; and 5th vs. 1st quintile HR 1.15, 95% CI 1.06–1.24, respectively). The associations between adherence to the ‘fish and alcohol’ pattern and total mortality, and cancer mortality were not statistically significant. Conclusion Higher adherence to the ‘prudent’ diet decreased the risk of all-cause mortality but did not affect cancer mortality. Greater adherence to the ‘western’ and ‘traditional’ diet increased the risk of total mortality and mortality due to cancer.

scholarly journals Sudden death in patients with sleep apnea: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Emily S. Heilbrunn ◽  
Paddy Ssentongo ◽  
Vernon M. Chinchilli ◽  
Anna E. Ssentongo
Keyword(s):  
Sleep Apnea ◽  
Sudden Death ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Cardiac Mortality ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality

AbstractBackgroundOver 1 billion individuals across the globe experience some form of sleep apnea, and this number is steadily rising. Obstructive sleep apnea (OSA) can negatively influence one’s quality of life and potentially increase the risk of mortality. However, this association between OSA and mortality has not been comprehensively and thoroughly explored. This meta-analysis was conducted to conclusively estimate the risk of death for all-cause mortality and cardiovascular mortality in OSA patients.Study Design4,613 articles from databases including PUBMED, OVID & Joana Briggs, and SCOPUS were comprehensively assessed by two reviewers (AES & ESH) for inclusion criteria. 28 total articles were included, with 22 of them being used for quantitative analysis. Pooled effects of all-cause mortality, cardiac mortality, and sudden death were calculated by utilizing the metaprop function in R Statistical Software and the random-effects model with appropriate 95% confidence intervals.ResultsAnalysis on 42,032 individuals revealed that those with OSA were twice as likely to die from cardiac mortality compared to those without sleep apnea (HR= 1.94, 95%CI 1.39-2.70). Likewise, individuals with OSA were 1.7 times as likely to die from all-cause sudden death compared to individuals without sleep apnea (HR= 1.74, 95%CI 1.40-2.10). There was a significant dose response relationship between severity of sleep apnea and incidence risk of death, where those with severe sleep apnea wereConclusionsIndividuals with obstructive sleep apnea are at an increased risk for all-cause mortality and cardiac mortality. Further research related to appropriate interventions and treatments are necessary in order to reduce this risk and optimize survival in this population.Key MessagesWhat is the key question?Are individuals with sleep apnea at an increased risk for cardiovascular mortality and sudden death?What is the bottom Line?Sleep apnea is associated with an increased risk of cardiovascular mortality and sudden death, with a dose response relationship, where those with severe sleep apnea are at the highest risk of mortality.Why read on?This is the first systematic review and meta-analyses to synthesize and quantify the risk of mortality in those with sleep apnea, highlighting important directions for future research.Prospero Registration IDCRD42020164941

scholarly journals Left Ventricular Mass Regression, All-Cause and Cardiovascular Mortality in Chronic Kidney Disease: A Meta-Analysis

2021 ◽  
Author(s):  
Kevin C. Maki ◽  
Meredith L. Wilcox ◽  
Mary R. Dicklin ◽  
Rahul Kakkar ◽  
Michael H. Davidson
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular Mass ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Secondary Outcome ◽  
Ventricular Mass ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Cardiovascular disease is an important driver of the increased mortality associated with chronic kidney disease (CKD). Higher left ventricular mass (LVM) predicts increased risk of adverse cardiovascular outcomes and total mortality, but previous reviews have shown no clear association between intervention-induced LVM change and all-cause or cardiovascular mortality in CKD. Methods The primary objective of this meta-analysis was to investigate whether treatment-induced reductions in LVM over periods ≥ 12 months were associated with all-cause mortality in patients with CKD. Cardiovascular mortality was investigated as a secondary outcome. Measures of association in the form of relative risks (RRs) with associated variability and precision (95% confidence intervals [CIs]) were extracted directly from each study, when reported, or were calculated based on the published data, if possible, and pooled RR estimates were determined. Results The meta-analysis included 38 trials with duration ≥ 12 months: 6 of erythropoietin stimulating agents treating to higher vs. lower hemoglobin targets, 10 of renin-angiotensin-aldosterone system inhibitors vs. placebo or another blood pressure lowering agent, 14 of modified hemodialysis regimens, and 8 of other types of interventions. All-cause mortality was reported in 116/2385 (4.86%) subjects in intervention groups and 161/2404 (6.70%) subjects in control groups. The pooled RR estimate of the 24 trials ≥ 12 months with ≥ 1 event in ≥ 1 group was 0.72 (95% CI 0.57 to 0.91, p = 0.005), with little heterogeneity across studies. Directionalities of the associations in intervention subgroups were the same. Sensitivity analyses of ≥ 6 months (31 trials), ≥ 9 months (26 trials), and > 12 months (9 trials), and including studies with no events in either group, demonstrated similar risk reductions to the primary analysis. The point estimate for cardiovascular mortality was similar to all-cause mortality, but not statistically significant: RR 0.66, 95% CI 0.38 to 1.15. Conclusions These results suggest that LVM regression may be a useful surrogate marker for benefits of interventions intended to reduce mortality risk in patients with CKD.

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