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

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

British Journal Of Nutrition ◽

10.1017/s0007114521001240 ◽

2021 ◽

pp. 1-38

Author(s):

Ala Al Rajabi ◽

Geraldine Lo Siou ◽

Alianu K. Akawung ◽

Kathryn L McDonald ◽

Tiffany R. Price ◽

...

Keyword(s):

Cancer Prevention ◽

Proportional Hazards ◽

Red Meat ◽

Cox Proportional Hazards ◽

Processed Meat ◽

Carcinogenic Effect ◽

Meat Intake ◽

Increased Risk ◽

Red Meats ◽

Red And Processed Meat

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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A Prospective Study of Red and Processed Meat Intake in Relation to Cancer Risk

PLoS Medicine ◽

10.1371/journal.pmed.0040325 ◽

2007 ◽

Vol 4 (12) ◽

pp. e325 ◽

Cited By ~ 274

Author(s):

Amanda J Cross ◽

Michael F Leitzmann ◽

Mitchell H Gail ◽

Albert R Hollenbeck ◽

Arthur Schatzkin ◽

...

Keyword(s):

Cancer Risk ◽

Prospective Study ◽

Processed Meat ◽

Meat Intake ◽

A Prospective Study ◽

Red And Processed Meat

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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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Red and Processed Meat Intake Is Associated with Higher Gastric Cancer Risk: A Meta-Analysis of Epidemiological Observational Studies

PLoS ONE ◽

10.1371/journal.pone.0070955 ◽

2013 ◽

Vol 8 (8) ◽

pp. e70955 ◽

Cited By ~ 56

Author(s):

Hongcheng Zhu ◽

Xi Yang ◽

Chi Zhang ◽

Chen Zhu ◽

Guangzhou Tao ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Risk ◽

Observational Studies ◽

Meta Analysis ◽

Processed Meat ◽

Gastric Cancer Risk ◽

Meat Intake ◽

Red And Processed Meat

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Values and Preferences Related to Cancer Risk among Red and Processed Meat Eaters: A Pilot Cross-Sectional Study with Semi-Structured Interviews

Foods ◽

10.3390/foods10092182 ◽

2021 ◽

Vol 10 (9) ◽

pp. 2182

Author(s):

Victoria Howatt ◽

Anna Prokop-Dorner ◽

Claudia Valli ◽

Joanna Zajac ◽

Malgorzata Bala ◽

...

Keyword(s):

Cancer Risk ◽

Meat Consumption ◽

Cross Sectional Study ◽

Red Meat ◽

Processed Meat ◽

Sectional Study ◽

Cross Sectional ◽

Meat Intake ◽

Processed Meat Consumption ◽

Red And Processed Meat

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.

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Meat intake and cancer risk: prospective analyses in UK Biobank

International Journal of Epidemiology ◽

10.1093/ije/dyaa142 ◽

2020 ◽

Vol 49 (5) ◽

pp. 1540-1552

Author(s):

Anika Knuppel ◽

Keren Papier ◽

Georgina K Fensom ◽

Paul N Appleby ◽

Julie A Schmidt ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Multiple Testing ◽

Red Meat ◽

Colorectal Cancer Risk ◽

Processed Meat ◽

Uk Biobank ◽

Meat Intake ◽

Incidence Trends ◽

Red And Processed Meat

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.

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Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study

International Journal of Cancer ◽

10.1002/ijc.31046 ◽

2017 ◽

Vol 142 (2) ◽

pp. 230-237 ◽

Cited By ~ 32

Author(s):

Abou Diallo ◽

Mélanie Deschasaux ◽

Paule Latino-Martel ◽

Serge Hercberg ◽

Pilar Galan ◽

...

Keyword(s):

Cohort Study ◽

Cancer Risk ◽

Processed Meat ◽

Meat Intake ◽

Red And Processed Meat

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Meat intake and cancer risk: prospective analyses in UK Biobank

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000634 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Anika Knuppel ◽

Keren Papier ◽

Paul N. Appleby ◽

Timothy J. Key ◽

Aurora Perez-Cornago

Keyword(s):

Prostate Cancer ◽

Colorectal Cancer ◽

Cancer Risk ◽

Meat Consumption ◽

Red Meat ◽

Processed Meat ◽

Uk Biobank ◽

Meat Intake ◽

Red And Processed Meat

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.

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