In the Journals

Processed, unprocessed meats slightly increase all-cause mortality, CVD risks

Photo of Victor W. Zhong
Victor W. Zhong

Eating more processed meat, unprocessed red meat and poultry, but not fish, was associated with a slightly increased risk for cardiovascular disease, according to a study published in JAMA Internal Medicine. Processed meat and unprocessed meat were also associated with a slight increased risk for all-cause mortality.

“Whether consuming foods of animal sources (i.e., meat, poultry and fish) is associated with cardiovascular disease [(CVD)] and mortality is an old topic, but scientific evidence has been inconsistent,” Victor W. Zhong, PhD, assistant professor in the division of nutritional sciences at Cornell University, told Healio Primary Care.

He explained that the controversy over meat consumption escalated after recently published guidance in the Annals of Internal Medicine contradicted existing guidelines by stating most people did not need to reduce their consumption of red and processed meat, as the risks associated with consumption were minimal.

“Therefore, understanding the associations of meat, poultry or fish intake with [CVD] and premature death is important for informing evidence-based dietary guidelines for chronic disease prevention,” Zhong said.

Image of red meat in store 
Eating more processed meat, unprocessed red meat and poultry, but not fish, was associated with a slightly increased risk for cardiovascular disease, according to a study published in JAMA Internal Medicine. Processed meat and unprocessed meat were also associated with a slight increased risk for all-cause mortality.
Source: Adobe Stock

Zhong and colleagues used baseline diet data from six cohorts in the United States involved in the Lifetime Risk Pooling Project. In those cohorts, consumption of processed meat, unprocessed red meat, poultry and fish was assessed using validated food frequency questionnaires or diet histories. Baseline data were taken between 1985 and 2002, and patients were followed through August 2016. Researchers determined the HRs and 30-year absolute risk differences (ARD) with each additional two servings of each meat per week compared with zero servings for incident CVD and all-cause mortality.

A total of 29,682 people with a mean age of 53.7 years at baseline were included in the study. During a mean 19 years of follow-up, there were 6,963 incident CVD events and 8,875 all-cause deaths.

Except for a nonmonotonic association between processed meat intake and incident CVD, all other associations between foods and CVD or all-cause mortality were monotonic, according to the researchers.

There was a significant association between CVD risk and consumption of processed meat (adjusted HR = 1.07; 95% CI, 1.04-1.11; adjusted ARD = 1.74%; 95% CI, 0.85-2.63), unprocessed red meat (adjusted HR = 1.03; 95% CI, 1.01-1.06; adjusted ARD = 0.62%;95% CI, 0.07-1.16), and poultry (adjusted HR = 1.04; 95% CI, 1.01-1.06; adjusted ARD = 1.03%; 95% CI ,0.36-1.7). Researchers did not identify a significant association between fish intake and incident CVD.

All-cause mortality was significantly associated with processed meat (adjusted HR = 1.03; 95% CI, 1.02-1.05; adjusted ARD = 0.9%; 95% CI, 0.43-1.38) and unprocessed red meat consumption (adjusted HR = 1.03; 95% CI, 1.01-1.05; adjusted ARD = 0.76%; 95% CI, 0.19-1.33). Poultry and fish intake were not significantly associated with all-cause mortality.

“Our study findings support current dietary guidelines that recommend limiting processed meat and unprocessed red meat intake for preventing chronic diseases,” Zhong said.

He noted that biological responses to these foods may vary for each individual, and as the study focused on preventing CVD, the findings may not apply to individuals with existing CVD.

Zhong added that physicians should make dietary recommendations “based on a holistic assessment of a patient’s disease status, existing risk factors and treatment goals, rather than taking a one-size-fits-all approach.”

“Nonetheless, limiting or stopping eating unprocessed red meat and processed meat can be an appropriate recommendation given the current evidence,” he said. “There are many other healthier choices including egg whites, fish and plant sources of protein such as nuts, legumes, and whole grains.”– by Erin Michael

Disclosures: Zhong reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.

Photo of Victor W. Zhong
Victor W. Zhong

Eating more processed meat, unprocessed red meat and poultry, but not fish, was associated with a slightly increased risk for cardiovascular disease, according to a study published in JAMA Internal Medicine. Processed meat and unprocessed meat were also associated with a slight increased risk for all-cause mortality.

“Whether consuming foods of animal sources (i.e., meat, poultry and fish) is associated with cardiovascular disease [(CVD)] and mortality is an old topic, but scientific evidence has been inconsistent,” Victor W. Zhong, PhD, assistant professor in the division of nutritional sciences at Cornell University, told Healio Primary Care.

He explained that the controversy over meat consumption escalated after recently published guidance in the Annals of Internal Medicine contradicted existing guidelines by stating most people did not need to reduce their consumption of red and processed meat, as the risks associated with consumption were minimal.

“Therefore, understanding the associations of meat, poultry or fish intake with [CVD] and premature death is important for informing evidence-based dietary guidelines for chronic disease prevention,” Zhong said.

Image of red meat in store 
Eating more processed meat, unprocessed red meat and poultry, but not fish, was associated with a slightly increased risk for cardiovascular disease, according to a study published in JAMA Internal Medicine. Processed meat and unprocessed meat were also associated with a slight increased risk for all-cause mortality.
Source: Adobe Stock

Zhong and colleagues used baseline diet data from six cohorts in the United States involved in the Lifetime Risk Pooling Project. In those cohorts, consumption of processed meat, unprocessed red meat, poultry and fish was assessed using validated food frequency questionnaires or diet histories. Baseline data were taken between 1985 and 2002, and patients were followed through August 2016. Researchers determined the HRs and 30-year absolute risk differences (ARD) with each additional two servings of each meat per week compared with zero servings for incident CVD and all-cause mortality.

A total of 29,682 people with a mean age of 53.7 years at baseline were included in the study. During a mean 19 years of follow-up, there were 6,963 incident CVD events and 8,875 all-cause deaths.

Except for a nonmonotonic association between processed meat intake and incident CVD, all other associations between foods and CVD or all-cause mortality were monotonic, according to the researchers.

There was a significant association between CVD risk and consumption of processed meat (adjusted HR = 1.07; 95% CI, 1.04-1.11; adjusted ARD = 1.74%; 95% CI, 0.85-2.63), unprocessed red meat (adjusted HR = 1.03; 95% CI, 1.01-1.06; adjusted ARD = 0.62%;95% CI, 0.07-1.16), and poultry (adjusted HR = 1.04; 95% CI, 1.01-1.06; adjusted ARD = 1.03%; 95% CI ,0.36-1.7). Researchers did not identify a significant association between fish intake and incident CVD.

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All-cause mortality was significantly associated with processed meat (adjusted HR = 1.03; 95% CI, 1.02-1.05; adjusted ARD = 0.9%; 95% CI, 0.43-1.38) and unprocessed red meat consumption (adjusted HR = 1.03; 95% CI, 1.01-1.05; adjusted ARD = 0.76%; 95% CI, 0.19-1.33). Poultry and fish intake were not significantly associated with all-cause mortality.

“Our study findings support current dietary guidelines that recommend limiting processed meat and unprocessed red meat intake for preventing chronic diseases,” Zhong said.

He noted that biological responses to these foods may vary for each individual, and as the study focused on preventing CVD, the findings may not apply to individuals with existing CVD.

Zhong added that physicians should make dietary recommendations “based on a holistic assessment of a patient’s disease status, existing risk factors and treatment goals, rather than taking a one-size-fits-all approach.”

“Nonetheless, limiting or stopping eating unprocessed red meat and processed meat can be an appropriate recommendation given the current evidence,” he said. “There are many other healthier choices including egg whites, fish and plant sources of protein such as nuts, legumes, and whole grains.”– by Erin Michael

Disclosures: Zhong reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.

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