Original Source

Red Meat Intake and Risk of Coronary Heart Disease Among US Men: Prospective Cohort Study

BMJ

Volume: 371

02 DEC 2020

Al-Shaar, L., Satija, A., Wang, D. D., Rimm, E. B., Smith-Warner, S. A., Stampfer, M. J., et al.

125

Yes

From the source: "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."

From the source: "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."
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Summary

United States (US) male health care professionals who consumed the most red and processed meat, compared to those who consumed the least amount, had an increased risk for coronary heart disease. The findings remained significant after adjusting for health- and non-health related factors such as history of diabetes, smoking and physical activity. The authors calculated that replacing red meat with other protein sources, such as soy, nuts or legumes decreases the risks of coronary heart disease. Among the strengths of this study are the high number of participants, the long follow-up time (30 years), and the repeated measure of food intake. Some limitations of this research are that the population consists of mostly middle aged white US health care professionals with relatively high socioeconomic status, making the findings less generalizable to other populations. Furthermore, the assessment of food intake showed relatively low precision in some food groups. In conclusion, this article underscores the “health benefit of limiting red meat consumption and replacement with plant protein sources”.

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.