Red and Processed Meat and Mortality in a Low Meat Intake Population

Abstract

Associations of low-to-moderate consumption of red and processed meat with mortality would add to the evidence of possible adverse effects of these common foods. This study aims to investigate the association of red and processed meat intake with mortality. The Adventist Health Study-2 (AHS-2) is a prospective cohort study of ~96,000 Seventh-day Adventist men and women recruited in the US and Canada between 2002 and 2007. The final analytic sample after exclusions was 72,149. Cox proportional hazards regression was used and hazard ratios (HR) and confidence intervals (CI) were obtained. Diet was assessed by a validated quantitative food frequency questionnaire (FFQ), calibrated using six 24-h dietary recalls. Mortality outcome data were obtained from the National Death Index. During a mean follow-up of 11.8 years, there were 7961 total deaths, of which 2598 were Cardiovascular diseases (CVD) deaths and 1873 were cancer deaths. Unprocessed red meat was associated with risk of all-cause mortality (HR: 1.18; 95% CI: 1.07⁻1.31) and CVD mortality (HR: 1.26; 95% CI: 1.05⁻1.50). Processed meat alone was not significantly associated with risk of mortality. The combined intake of red and processed meat was associated with all-cause mortality (HR: 1.23; 95% CI: 1.11⁻1.36) and CVD mortality (HR: 1.34; 95% CI: 1.12⁻1.60). These findings suggest moderately higher risks of all-cause and CVD mortality associated with red and processed meat in a low meat intake population.

Keywords: Adventist; Adventist Health Study; cohort; mortality; processed meat; red meat.

Figure 1

Subgroup analysis by sex and race of the association between red meat and processed meat intake and all-cause, cardiovascular, and cancer mortality. Multivariable hazard ratios for mortality comparing the 90th percentiles (sex- and race-specific values) of unprocessed red and processed meats intakes and both combined with zero-intake (90th vs. 0) were adjusted for age; sex (not in sex subgroup analysis); race (not in race subgroup analysis); marital status; education level; multivitamin use; smoking; alcohol use; exercise; sleeping hours; body mass index (BMI); diabetes mellitus; hypertension; hypercholesterolemia; aspirin use; the use of blood pressure medications for at least 2 years in the last 5 years; the use of statin for at least 2 years in the last 5 years; menopausal status in women and hormone replacement therapy (HRT) among postmenopausal women; dietary energy; and dietary variables including cruciferous vegetables, fruits, whole grain, legumes, nuts and seeds, total dairy, eggs, fish, and unprocessed poultry.