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Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies.
Nutr Rev. 2022 08 08; 80(9):1959-1973.NR

Abstract

CONTEXT

A high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat.

OBJECTIVE

A PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes.

DATA SOURCES

The PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021.

DATA EXTRACTION

The prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest.

DATA ANALYSIS

Thirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82-0.96; I2 = 0%), dairy (RR, 0.90, 95%CI, 0.88-0.92; I2 = 0%), eggs (RR, 0.86, 95%CI, 0.79-0.94; I2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74-0.95; I2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74-0.95; I2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79-1.04; I2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89-0.96; I2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90-0.95; I2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87-0.95; I2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87-0.97; I2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93-1.01; I2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93-1.01; I2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d.

CONCLUSION

Keeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021259446.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Hidayat K
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Chen JS
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Wang HP
Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Wang TC
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Liu YJ
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Zhang XY
Department of Medical Technology, Suzhou Vocational Health College, Suzhou, China.
Rao CP
Department of Medical Technology, Suzhou Vocational Health College, Suzhou, China.
Zhang JW
Department of Nutrition, Suzhou Municipal Hospital, Suzhou, China.
Qin LQ
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.

MeSH

AnimalsCoronary DiseaseDietHumansObservational Studies as TopicProspective StudiesRed MeatRisk FactorsVegetables

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

35380734

Citation

Hidayat, Khemayanto, et al. "Is Replacing Red Meat With Other Protein Sources Associated With Lower Risks of Coronary Heart Disease and All-cause Mortality? a Meta-analysis of Prospective Studies." Nutrition Reviews, vol. 80, no. 9, 2022, pp. 1959-1973.
Hidayat K, Chen JS, Wang HP, et al. Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies. Nutr Rev. 2022;80(9):1959-1973.
Hidayat, K., Chen, J. S., Wang, H. P., Wang, T. C., Liu, Y. J., Zhang, X. Y., Rao, C. P., Zhang, J. W., & Qin, L. Q. (2022). Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies. Nutrition Reviews, 80(9), 1959-1973. https://doi.org/10.1093/nutrit/nuac017
Hidayat K, et al. Is Replacing Red Meat With Other Protein Sources Associated With Lower Risks of Coronary Heart Disease and All-cause Mortality? a Meta-analysis of Prospective Studies. Nutr Rev. 2022 08 8;80(9):1959-1973. PubMed PMID: 35380734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies. AU - Hidayat,Khemayanto, AU - Chen,Jing-Si, AU - Wang,Hai-Peng, AU - Wang,Tian-Ci, AU - Liu,Yu-Jie, AU - Zhang,Xue-Ying, AU - Rao,Chun-Ping, AU - Zhang,Jian-Wei, AU - Qin,Li-Qiang, PY - 2022/4/6/pubmed PY - 2022/8/12/medline PY - 2022/4/5/entrez KW - coronary heart disease KW - meta-analysis KW - mortality KW - prospective studies KW - protein KW - red meat KW - substitution SP - 1959 EP - 1973 JF - Nutrition reviews JO - Nutr Rev VL - 80 IS - 9 N2 - CONTEXT: A high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat. OBJECTIVE: A PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes. DATA SOURCES: The PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021. DATA EXTRACTION: The prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest. DATA ANALYSIS: Thirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82-0.96; I2 = 0%), dairy (RR, 0.90, 95%CI, 0.88-0.92; I2 = 0%), eggs (RR, 0.86, 95%CI, 0.79-0.94; I2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74-0.95; I2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74-0.95; I2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79-1.04; I2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89-0.96; I2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90-0.95; I2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87-0.95; I2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87-0.97; I2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93-1.01; I2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93-1.01; I2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d. CONCLUSION: Keeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021259446. SN - 1753-4887 UR - https://www.unboundmedicine.com/medline/citation/35380734/Is_replacing_red_meat_with_other_protein_sources_associated_with_lower_risks_of_coronary_heart_disease_and_all_cause_mortality_A_meta_analysis_of_prospective_studies_ DB - PRIME DP - Unbound Medicine ER -