TY - JOUR
T1 - Red meat intake and risk of coronary heart disease among US men
T2 - Prospective cohort study
AU - Al-Shaar, Laila
AU - Satija, Ambika
AU - Wang, Dong D.
AU - Rimm, Eric B.
AU - Smith-Warner, Stephanie A.
AU - Stampfer, Meir J.
AU - Hu, Frank B.
AU - Willett, Walter C.
N1 - Funding Information:
We thank the participants and staff of the Health Professionals Study for their invaluable contributions. Contributors: LA, AS, DW, and WCW conceived the study. LA and AS analyzed the data. LA, AS, DW, and WCW provided statistical expertise. LA wrote the first draft of the paper. WCW, EBR, and MJS obtained funding. All authors contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The authors assume full responsibility for analyses and interpretation of these data. LA is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Funding: The cohort was supported by the National Institutes of Health (grants U01 CA167552 and R01 HL35464). LA received research support from the National Institutes of Health (training grant T32 HL 098048). The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from the National Institutes of Health for the submitted work. no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Publisher Copyright:
©
PY - 2020/12/2
Y1 - 2020/12/2
N2 - AbstractObjectives To study total, processed, and unprocessed red meat in relation to risk of coronary heart disease (CHD) and to estimate the effects of substituting other protein sources for red meat with CHD risk. Design Prospective cohort study with repeated measures of diet and lifestyle factors. Setting Health Professionals Follow-Up Study cohort, United States, 1986-2016. Participants 43 272 men without cardiovascular disease or cancer at baseline. Main outcome measures The primary outcome was total CHD, comprised of acute non-fatal myocardial infarction or fatal CHD. Cox models were used to estimate hazard ratios and 95% confidence intervals across categories of red meat consumption. Substitution analyses were conducted by comparing coefficients for red meat and the alternative food in models, including red meat and alternative foods as continuous variables. Results During 1 023 872 person years of follow-up, 4456 incident CHD events were documented of which 1860 were fatal. After multivariate adjustment for dietary and non-dietary risk factors, total, unprocessed, and processed red meat intake were each associated with a modestly higher risk of CHD (hazard ratio for one serving per day increment: 1.12 (95% confidence interval 1.06 to 1.18) for total red meat, 1.11 (1.02 to 1.21) for unprocessed red meat, and 1.15 (1.06 to 1.25) for processed red meat). Compared with red meat, the intake of one serving per day of combined plant protein sources (nuts, legumes, and soy) was associated with a lower risk of CHD (0.86 (0.80 to 0.93) compared with total red meat, 0.87 (0.79 to 0.95) compared with unprocessed red meat, and 0.83 (0.76 to 0.91) compared with processed red meat). Substitutions of whole grains and dairy products for total red meat and eggs for processed red meat were also associated with lower CHD risk. Conclusions Substituting high quality plant foods such as legumes, nuts, or soy for red meat might reduce the risk of CHD. Substituting whole grains and dairy products for total red meat, and eggs for processed red meat, might also reduce this risk.
AB - AbstractObjectives To study total, processed, and unprocessed red meat in relation to risk of coronary heart disease (CHD) and to estimate the effects of substituting other protein sources for red meat with CHD risk. Design Prospective cohort study with repeated measures of diet and lifestyle factors. Setting Health Professionals Follow-Up Study cohort, United States, 1986-2016. Participants 43 272 men without cardiovascular disease or cancer at baseline. Main outcome measures The primary outcome was total CHD, comprised of acute non-fatal myocardial infarction or fatal CHD. Cox models were used to estimate hazard ratios and 95% confidence intervals across categories of red meat consumption. Substitution analyses were conducted by comparing coefficients for red meat and the alternative food in models, including red meat and alternative foods as continuous variables. Results During 1 023 872 person years of follow-up, 4456 incident CHD events were documented of which 1860 were fatal. After multivariate adjustment for dietary and non-dietary risk factors, total, unprocessed, and processed red meat intake were each associated with a modestly higher risk of CHD (hazard ratio for one serving per day increment: 1.12 (95% confidence interval 1.06 to 1.18) for total red meat, 1.11 (1.02 to 1.21) for unprocessed red meat, and 1.15 (1.06 to 1.25) for processed red meat). Compared with red meat, the intake of one serving per day of combined plant protein sources (nuts, legumes, and soy) was associated with a lower risk of CHD (0.86 (0.80 to 0.93) compared with total red meat, 0.87 (0.79 to 0.95) compared with unprocessed red meat, and 0.83 (0.76 to 0.91) compared with processed red meat). Substitutions of whole grains and dairy products for total red meat and eggs for processed red meat were also associated with lower CHD risk. Conclusions Substituting high quality plant foods such as legumes, nuts, or soy for red meat might reduce the risk of CHD. Substituting whole grains and dairy products for total red meat, and eggs for processed red meat, might also reduce this risk.
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U2 - 10.1136/bmj.m4141
DO - 10.1136/bmj.m4141
M3 - Article
C2 - 33268459
AN - SCOPUS:85097123181
SN - 0959-8146
VL - 371
JO - The BMJ
JF - The BMJ
M1 - m4141
ER -