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Red meat intake and risk of coronary heart disease among US men: prospective cohort study.
BMJ. 2020 12 02; 371:m4141.BMJ

Abstract

OBJECTIVES

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.

Authors+Show Affiliations

Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA wwillett@hsph.harvard.edu. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33268459

Citation

Al-Shaar, Laila, et al. "Red Meat Intake and Risk of Coronary Heart Disease Among US Men: Prospective Cohort Study." BMJ (Clinical Research Ed.), vol. 371, 2020, pp. m4141.
Al-Shaar L, Satija A, Wang DD, et al. Red meat intake and risk of coronary heart disease among US men: prospective cohort study. BMJ. 2020;371:m4141.
Al-Shaar, L., Satija, A., Wang, D. D., Rimm, E. B., Smith-Warner, S. A., Stampfer, M. J., Hu, F. B., & Willett, W. C. (2020). Red meat intake and risk of coronary heart disease among US men: prospective cohort study. BMJ (Clinical Research Ed.), 371, m4141. https://doi.org/10.1136/bmj.m4141
Al-Shaar L, et al. Red Meat Intake and Risk of Coronary Heart Disease Among US Men: Prospective Cohort Study. BMJ. 2020 12 2;371:m4141. PubMed PMID: 33268459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Red meat intake and risk of coronary heart disease among US men: 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, Y1 - 2020/12/02/ PY - 2020/12/3/entrez PY - 2020/12/4/pubmed PY - 2020/12/23/medline SP - m4141 EP - m4141 JF - BMJ (Clinical research ed.) JO - BMJ VL - 371 N2 - OBJECTIVES: 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. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/33268459/Red_meat_intake_and_risk_of_coronary_heart_disease_among_US_men:_prospective_cohort_study_ DB - PRIME DP - Unbound Medicine ER -