The Dietary Approach to Stop Hypertension (DASH) diet is associated with a lower risk of heart failure: A cohort study

Aims Trials demonstrate that following the DASH diet lowers blood pressure, which may prevent development of heart failure (HF). We investigated the association between long-term adherence to the DASH diet and food substitutions within the DASH diet on the risk of HF. Methods Men and women aged 45-83 years without previous HF, ischemic heart disease or cancer at baseline in 1998 from the Cohort of Swedish Men (n = 41,118) and the Swedish Mammography Cohort (n = 35,004) were studied. The DASH diet emphasizes intake of fruit, vegetables, whole grains, nuts and legumes and low-fat dairy and deemphasizes red and processed meat, sugar-sweetened beverages and sodium. DASH diet scores were calculated based on diet assessed by food frequency questionnaires in late 1997 and 2009. Incidence of HF was ascertained using the Swedish Patient Register. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Results During the median 22 years of follow-up (1998-2019) 12,164 participants developed HF. Those with the greatest adherence to the DASH diet had a lower risk of HF compared to those with the lowest adherence (HR 0.85, 95% CI 0.80, 0.91 for baseline diet and HR 0.83, 95% CI 0.78, 0.89 for long-term diet, comparing quintiles). Replacing 1 serving/day of red and processed meat with emphasized DASH diet foods was associated with an 8-12% lower risk of HF. Conclusion Long-term adherence to the DASH diet and relevant food substitutions within the DASH diet were associated with a lower risk of HF.

Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study

Background The anti-inflammatory effect of exclusive enteral nutrition on the gut of children with Crohn’s disease is rapidly lost after food reintroduction. This study assessed disease dietary triggers following successful treatment with exclusive enteral nutrition. Methods Nutrient intake, dietary patterns and dietary biomarkers in faeces (gluten immunogenic peptides, undigestible starch, short chain fatty acids) were assessed in 14 children with Crohn’s disease during early food reintroduction, following exclusive enteral nutrition. Groups above (Group A) and below (Group B) the median levels of faecal calprotectin after food reintroduction were assigned for comparative analysis. Results Intakes of fibre, gluten-containing cereals and red and processed meat were significantly higher in Group A than Group B; (median [Q1, Q3], g/day; Fibre: 12.1 [11.2, 19.9] vs. 9.9 [7.6, 12.1], p = 0.03; Red and processed meat: 151 [66.7, 190] vs. 63.3 [21.7, 67], p = 0.02; gluten-containing cereals: 289 [207, 402] vs. 203 [61, 232], p = 0.035). A diet consisting of cereals and meat products was predictive (92% accuracy) of higher faecal calprotectin levels after food reintroduction. In faeces, butyrate levels, expressed as absolute concentration and relative abundance, were higher in Group A than Group B by 28.4 µmol/g (p = 0.015) and 6.4% (p = 0.008), respectively. Levels of gluten immunogenic peptide and starch in faeces did not differ between the two groups. Conclusions This pilot study identified potential dietary triggers of gut inflammation in children with Crohn’s disease after food reintroduction following treatment with exclusive enteral nutrition. Trial registration: Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL: https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered).

Socioeconomic Determinants of Diet Quality on Overweight and Obesity in Adults Aged 40–59 Years in Inner Mongolia: A Cross-Sectional Study

Objectives: This study investigated the relationship of socioeconomic status (SES), diet quality and overweight and obesity in adults aged 40–59 years in Inner Mongolia.Methods: This cross-sectional study was based on the survey of Chronic Disease and Nutrition Monitoring in Adults in Inner Mongolia in 2015. Diet quality was evaluated by the Alternate Mediterranean Diet score (aMeds). SES was measured by household annual income. Generalized estimating equations and path analysis were performed to determine the association of SES, diet quality and overweight and obesity.Results: Among participants, 63.0% had overweight and obesity. In high SES group, 66.4% had overweight and obesity. Higher SES was associated with a higher risk of overweight and obesity (OR = 1.352, 95%CI: 1.020–1.793). And higher aMeds was associated with a lower risk of overweight and obesity (OR = 0.597, 95%CI: 0.419–0.851). There was a positive correlation between SES and the intake of red and processed meat (r = 0.132, p < 0.05). Higher intake of red and processed meat was associated with lower diet quality (β = −0.34). And lower diet quality was associated with a higher risk of overweight and obesity (β = −0.10).Conclusion: In Inner Mongolia, during the period of economic transition, people aged 40–59 years in high SES had poor diet quality, which was related to a higher risk of overweight and obesity.

Global red and processed meat trade and non-communicable diseases

IntroductionRapid increases in the trade of global red and processed meat impede international efforts toward sustainable diets by increasing meat consumption. However, little research has examined cross-country variations in diet-related non-communicable diseases (NCDs) because of meat trade. We aimed to examine the impact of red and processed meat trade on diet-related NCDs and to identify which countries are particularly vulnerable to diet-related NCDs due to red and processed meat trade.MethodsBy selecting 14 red meat and six processed meat items, we investigated bilateral meat trade flows across 154 countries. Then, we integrated health data and information on red and processed meat trade to quantify the country-specific burden of diet-related NCDs attributable to the meat trade using a comparative risk assessment framework.ResultsResults show that global increases in red and processed meat trade contributed to the abrupt increase of diet-related NCDs, and the attributable burden of diet-related NCDs had large geographical variations among countries. We also identified responsible exporting countries that increase diet-related NCD risks in importing countries. Over the period from 1993 to 2018, island countries in the Caribbean and Oceania were particularly vulnerable to diet-related NCD incidents and mortality due to large meat imports. In addition, countries in Northern and Eastern Europe have exceedingly increased attributable death and disability-adjusted life year rates via meat imports.ConclusionOur findings suggest that both exporters and importers must urgently undertake cross-sectoral actions to reduce the meat trade’s health impacts. To prevent unintended health consequences due to red and processed meat trade, future interventions need to integrate health policies with agricultural and trade policies by cooperating with both responsible exporting and importing countries.

Who has a beef with reducing red and processed meat consumption? A media framing analysis

Objective: Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas emissions, and the global burden of chronic disease. High-profile reports have called for significant global RPM reduction, especially in high-income settings. Despite this, policy attention and political priority for the issue is low. Design: The study used a theoretically guided framing analysis to identify frames used by various interest groups in relation to reducing RPM in online news media articles published in the months around the release of four high-profile reports by authoritative organisations that included a focus on the impacts of high RPM production and/or consumption. Setting: Four major RPM producing and consuming countries – USA, United Kingdom, Australia, and New Zealand. Participants: None Results: 150 news media articles were included. Articles reported the views of academics, policymakers, industry representatives, and the article authors themselves. RPM reduction was remarkably polarising. Industry frequently framed RPM reduction as part of a ‘Vegan Agenda’ or as advocated by an elite minority. Reducing RPM was also depicted as an infringement on personal choice and traditional values. Many interest groups attempted to discredit the reports by citing a lack of consensus on the evidence, or that only certain forms of farming and processing were harmful. Academics and nutrition experts were more likely to be cited in articles that were aligned with the findings of the reports. Conclusions: The polarisation of RPM reduction has led to a binary conflict between pro- and anti-meat reduction actors. This division may diminish the extent to which political leaders will prioritise this in policy agendas. Using nuanced and context-dependent messaging could ensure the narratives around meat are less conflicting and more effective in addressing health and environmental harms associated with RPM.

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

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.