Red and Processed Meat and Mortality in a Low Meat Intake Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Assessment of Exposures
2.3. Ascertainment of Outcomes
2.4. Assessment of Covariates
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Zero Intake | Quartiles of Intake g/day 1 | ||||
Characteristic | 0 | Q1 | Q2 | Q3 | Q4 |
Age (year), mean (SD) * | 57.3 (14.0) | 56.4 (13.8) | 55.7 (13.4) | 54.1 (12.7) | 52.7 (12.4) |
Female, n (%) | 31,124 (66.8) | 4306 (66.0) | 4266 (66.9) | 3989 (62.7) | 3704 (58.2) |
Blacks, n (%) | 11,985 (25.7) | 2089 (32.5) | 2153 (33.8) | 1805 (28.4) | 1631 (25.6) |
Married, n (%) | 34,550 (74.1) | 4409 (68.0) | 4446 (69.7) | 4565 (71.8) | 4632 (72.7) |
Graduate degree, n (%) | 9956 (21.4) | 987 (15.4) | 903 (14.2) | 817 (12.9) | 684 (10.7) |
Current multivitamin users, n (%) | 22,462 (48.2) | 3238 (50.4) | 3086 (48.4) | 2905 (45.7) | 2790 (43.8) |
Current smokers, n (%) | 121 (0.3) | 82 (1.3) | 116 (1.8) | 205 (3.2) | 291 (4.6) |
Alcohol daily users, n (%) | 140 (0.3) | 53 (0.8) | 79 (1.2) | 122 (1.9) | 171 (2.7) |
Exercise (≥150 min/week), n (%) 2 | 9812 (21.1) | 1109 (17.2) | 1118 (17.5) | 975 (15.3) | 896 (14.1) |
Postmenopausal, n (%) 3 | 22,538 (72.4) | 3082 (71.6) | 3020 (70.8) | 2744 (68.8) | 2418 (65.3) |
Current HRT users, n (%) 4 | 11,659 (37.5) | 1701 (39.5) | 1682 (39.4) | 1572 (39.4) | 1348 (36.4) |
Diabetes, n (%) | 2698 (5.8) | 636 (9.9) | 692 (10.9) | 711 (11.2) | 698 (11.0) |
Hypertension, n (%) | 8328 (17.9) | 1626 (25.3) | 1635 (25.6) | 1601 (25.2) | 1649 (25.9) |
Hypercholesterolemia, n (%) | 7309 (15.7) | 1439 (22.4) | 1383 (21.7) | 1326 (20.9) | 1399 (22.0) |
Current aspirin users, n (%) | 6264 (13.4) | 1233 (19.2) | 1308 (20.5) | 1236 (19.4) | 1312 (20.6) |
BMI (kg/m2), mean (SD) * | 26.1 (5.3) | 28 (6.0) | 28.7 (6.0) | 29.2 (6.4) | 29.9 (6.7) |
Total energy (kcal), mean (SD) * | 1901.3 (739.2) | 1934.3 (800.7) | 1853.7 (768.2) | 1844.7 (777.6) | 2071.2 (783.3) |
Dietary variables (g/day), median, mean (SD) * | |||||
Cruciferous vegetables | 22.9 32.6 (32.1) | 18.5 27.7 (29.7) | 18.6 26.6 (27.4) | 17.7 24.6 (24.2) | 15.4 23.1 (26.7) |
Fruits | 306 356 (250.0) | 246 302.7 (241.9) | 231 281.9 (226.0) | 199.1 243.2 (199.0) | 155.9 200.3 (184.1) |
Whole grain | 162.1 185.4 (123.1) | 122.1 149.4 (109.5) | 107.7 139 (110.5) | 92.9 120.5 (97.2) | 77.5 102.3 (87.5) |
Legumes | 42.4 56 (48.0) | 32.3 45.1 (43.6) | 30.4 42 (41.9) | 27.1 36.7 (36.9) | 23.5 33.5 (34.6) |
Nuts and seeds | 20.21 25.34 (21.7) | 14.06 19.80 (19.9) | 12.33 17.89 (18.4) | 11.55 16.33 (16.3) | 9.82 14.58 (15.5) |
Total dairy | 46.8 115.7 (170.5) | 143.6 199.1 (202.7) | 163.7 215.1 (206.3) | 178 228.1 (205.9) | 184.1 232.9 (200.3) |
Eggs | 3.3 7.7 (13.3) | 6.7 12.6 (17.4) | 7.1 13.7 (17.6) | 8.5 15.4 (18.5) | 15.2 18.9 (23.7) |
Unprocessed poultry | 0 4.4 (13.9) | 5.9 14.5 (20.5) | 7.9 16.8 (21.1) | 12.2 21.3 (22.4) | 28.7 27.9 (23.3) |
Processed meat | 0 0.3 (2.5) | 0.5 1.8 (5.6) | 0.9 2.6 (6.0) | 1.9 4 (6.9) | 3.3 7.4 (12.7) |
Fish | 0 7.1 (17.3) | 9.0 14.9 (20.7) | 11.6 16 (19.5) | 12.1 16.4 (18.9) | 11.5 16 (18.8) |
Unprocessed Red Meat Intake (g/day) 2 | ||||||||
Zero Intake | Quartiles of Intake 3 | p-trend | 90th vs. 0 4 | 90th vs. 0 4 | ||||
0 | Q1 | Q2 | Q3 | Q4 | Uncalibrated | Calibrated | ||
No. of participants | 46,613 | 6431 | 6377 | 6359 | 6369 | |||
All-cause mortality | ||||||||
No. of deaths (n = 7961) | 5376 | 727 | 673 | 593 | 592 | |||
Model 1 | 1.00 | 1.16 (1.07–1.26) | 1.27 (1.17–1.38) | 1.39 (1.27–1.52) | 1.58 (1.45–1.72) | <0.0001 | 1.56 (1.46–1.67) | 2.37 (1.99–2.93) |
Model 2 | 1.00 | 1.08 (0.99–1.18) | 1.16 (1.06–1.27) | 1.19 (1.08–1.32) | 1.26 (1.14–1.39) | <0.0001 | 1.25 (1.15–1.36) | 1.69 (1.40–2.16) |
Model 3 | 1.00 | 1.06 (0.97–1.17) | 1.12 (1.02–1.24) | 1.14 (1.02–1.27) | 1.17 (1.05–1.32) | <0.001 | 1.18 (1.07–1.31) | 1.51 (1.22–1.98) |
CVD mortality | ||||||||
No. of deaths (n = 2598) | 1785 | 250 | 204 | 178 | 181 | |||
Model 1 | 1.00 | 1.24 (1.08–1.43) | 1.27 (1.09–1.48) | 1.41 (1.20–1.65) | 1.55 (1.33–1.82) | <0.0001 | 1.58 (1.40–1.78) | 2.41 (1.86–3.24) |
Model 2 | 1.00 | 1.20 (1.03–1.39) | 1.18 (1.01–1.39) | 1.27 (1.07–1.50) | 1.32 (1.10–1.57) | <0.001 | 1.36 (1.18–1.57) | 2.02 (1.44–3.04) |
Model 3 | 1.00 | 1.15 (0.98–1.34) | 1.11 (0.93–1.32) | 1.17 (0.96–1.43) | 1.20 (0.97–1.47) | 0.051 | 1.26 (1.05–1.50) | 1.64 (1.09–2.57) |
Cancer mortality | ||||||||
No. of deaths (n = 1873) | 1228 | 175 | 160 | 159 | 151 | |||
Model 1 | 1.00 | 1.13 (0.96–1.34) | 1.16 (0.98–1.37) | 1.38 (1.16–1.63) | 1.53 (1.29–1.82) | <0.0001 | 1.50 (1.31–1.72) | 2.17 (1.66–2.95) |
Model 2 5 | 1.00 | 1.04 (0.88–1.23) | 1.04 (0.87–1.24) | 1.14 (0.95–1.37) | 1.19 (0.95–1.37) | 0.047 | 1.16 (0.99–1.37) | 1.41 (0.98–2.05) |
Model 3 5 | 1.00 | 1.01 (0.85–1.21) | 1.00 (0.83–1.22) | 1.08 (0.88–1.33) | 1.07 (0.86–1.34) | 0.357 | 1.04 (0.85–1.27) | 1.18 (0.78–1.84) |
Processed Meat Intake (g/day) 2 | ||||||||
No. of participants | 48,127 | 6014 | 6044 | 6016 | 5948 | |||
All-cause mortality | ||||||||
No. of deaths (n = 7961) | 5544 | 657 | 598 | 552 | 610 | |||
Model 1 | 1.00 | 1.04 (0.96–1.13) | 1.24 (1.14–1.35) | 1.27 (1.16–1.40) | 1.59 (1.46–1.74) | <0.0001 | 1.54 (1.43–1.66) | 1.81 (1.59–2.12) |
Model 2 | 1.00 | 0.98 (0.90–1.08) | 1.10 (0.99–1.21) | 1.09 (0.99–1.21) | 1.27 (1.15–1.40) | <0.0001 | 1.20 (1.10–1.30) | 1.38 (1.18–1.68) |
Model 3 | 1.00 | 0.95 (0.86–1.05) | 1.03 (0.94–1.14) | 1.02 (0.91–1.13) | 1.16 (1.04–1.29) | 0.018 | 1.08 (0.98–1.20) | 1.25 (0.95–1.94) |
CVD mortality | ||||||||
No. of deaths (n = 2598) | 1821 | 224 | 199 | 176 | 178 | |||
Model 1 | 1.00 | 1.11 (0.95–1.28) | 1.32 (1.13–1.55) | 1.38 (1.15–1.67) | 1.53 (1.30–1.80) | <0.0001 | 1.54 (1.34–1.76) | 1.90 (1.56–2.37) |
Model 2 | 1.00 | 1.05 (0.89–1.24) | 1.21 (1.02–1.44) | 1.24 (1.01–1.51) | 1.31 (1.09–1.57) | <0.001 | 1.28 (1.09–1.51) | 1.68 (1.28–2.32) |
Model 3 | 1.00 | 1.01 (0.84–1.21) | 1.13 (0.93–1.37) | 1.14 (0.92–1.42) | 1.19 (0.97–1.47) | 0.054 | 1.12 (0.93–1.36) | 1.62 (0.97–3.71) |
Cancer mortality | ||||||||
No. of deaths (n = 1873) | 1294 | 142 | 148 | 128 | 161 | |||
Model 1 | 1.00 | 0.92 (0.77–1.10) | 1.15 (0.95–1.39) | 1.12 (0.92–1.36) | 1.58 (1.32–1.88) | <0.0001 | 1.49 (1.28–1.73) | 1.61 (1.28–2.04) |
Model 2 5 | 1.00 | 0.85 (0.71–1.02) | 1.00 (0.82–1.21) | 0.94 (0.77–1.15) | 1.19 (0.98–1.45) | 0.229 | 1.12 (0.94–1.33) | 1.09 (0.79–1.50) |
Model 3 5 | 1.00 | 0.80 (0.66–0.96) | 0.93 (0.75–1.14) | 0.86 (0.69–1.06) | 1.06 (0.86–1.32) | 0.994 | 1.01 (0.83–1.23) | 0.74 (0.32–1.38) |
Combined intake of red and processed meat (g/day) 2 | ||||||||
No. of participants | 40,287 | 7966 | 7965 | 7966 | 7965 | |||
All-cause mortality | ||||||||
No. of deaths (n = 7961) | 4706 | 860 | 890 | 752 | 753 | |||
Model 1 | 1.00 | 1.07 (0.99–1.15) | 1.20 (1.11–1.30) | 1.35 (1.24–1.46) | 1.60 (1.47–1.73) | <0.0001 | 1.55 (1.45–1.65) | 1.86 (1.68–2.09) |
Model 2 | 1.00 | 1.03 (0.95–1.12) | 1.11 (1.02–1.21) | 1.18 (1.08–1.29) | 1.27 (1.16–1.40) | <0.0001 | 1.25 (1.16–1.36) | 1.44 (1.27–1.65) |
Model 3 6 | 1.00 | 1.02 (0.93–1.12) | 1.09 (0.99–1.21) | 1.17 (1.04–1.30) | 1.25 (1.12–1.40) | <0.0001 | 1.23 (1.11–1.36) | 1.50 (1.26–1.83) |
CVD mortality | ||||||||
No. of deaths (n = 2598) | 1564 | 291 | 290 | 230 | 223 | |||
Model 1 | 1.00 | 1.11 (0.96–1.27) | 1.27 (1.11–1.45) | 1.38 (1.20–1.58) | 1.56 (1.35–1.80) | <0.0001 | 1.57 (1.40–1.77) | 1.90 (1.59–2.26) |
Model 2 | 1.00 | 1.09 (0.93–1.27) | 1.21 (1.04–1.40) | 1.25 (1.07–1.47) | 1.33 (1.12–1.57) | <0.0001 | 1.37 (1.19–1.58) | 1.66 (1.32–2.12) |
Model 3 6 | 1.00 | 1.08 (0.90–1.28) | 1.18 (0.99–1.40) | 1.21 (1.00–1.47) | 1.29 (1.06–1.58) | 0.005 | 1.34 (1.12–1.60) | 1.73 (1.27–2.51) |
Cancer mortality | ||||||||
No. of deaths (n = 1873) | 1080 | 196 | 206 | 194 | 197 | |||
Model 1 | 1.00 | 1.00 (0.85–1.18) | 1.12 (0.96–1.30) | 1.25 (1.05–1.48) | 1.57 (1.35–1.84) | <0.0001 | 1.48 (1.29–1.69) | 1.73 (1.44–2.09) |
Model 2 5 | 1.00 | 0.94 (0.80–1.11) | 1.00 (0.85–1.18) | 1.05 (0.88–1.26) | 1.19 (1.00–1.43) | 0.103 | 1.14 (0.97–1.34) | 1.25 (0.97–1.60) |
Model 3 5,6 | 1.00 | 0.88 (0.73–1.05) | 0.92 (0.77–1.10) | 0.97 (0.78–1.20) | 1.07 (0.87–1.32) | 0.604 | 1.00 (0.82–1.22) | 1.02 (0.70–1.42) |
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Alshahrani, S.M.; Fraser, G.E.; Sabaté, J.; Knutsen, R.; Shavlik, D.; Mashchak, A.; Lloren, J.I.; Orlich, M.J. Red and Processed Meat and Mortality in a Low Meat Intake Population. Nutrients 2019, 11, 622. https://doi.org/10.3390/nu11030622
Alshahrani SM, Fraser GE, Sabaté J, Knutsen R, Shavlik D, Mashchak A, Lloren JI, Orlich MJ. Red and Processed Meat and Mortality in a Low Meat Intake Population. Nutrients. 2019; 11(3):622. https://doi.org/10.3390/nu11030622
Chicago/Turabian StyleAlshahrani, Saeed Mastour, Gary E. Fraser, Joan Sabaté, Raymond Knutsen, David Shavlik, Andrew Mashchak, Jan Irene Lloren, and Michael J. Orlich. 2019. "Red and Processed Meat and Mortality in a Low Meat Intake Population" Nutrients 11, no. 3: 622. https://doi.org/10.3390/nu11030622