JAMA子刊:多吃红肉或加工肉类或增加心血管疾病及全因死亡风险
创作:aluba 审核:aluba 2020年02月09日
  • 纳入29682名受试者,中位随访19.0年期间,共发生6963例心血管疾病(CVD)死亡及8875例全因死亡;
  • 加工肉类、未加工红肉、家禽或鱼类的摄入与CVD死亡及全因死亡的关联均为单调性的(除了加工肉类与CVD死亡的关联);
  • 加工肉类、未加工红肉或家禽的摄入,均与CVD死亡显著相关,而鱼类的摄入与CVD死亡无显著关联;
  • 加工肉类或未加工红肉的摄入与全因死亡显著相关,而家禽或鱼类的摄入与全因死亡无显著关联。
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aluba
JAMA Internal Medicine上发表的一项前瞻性队列研究结果,对近3万名受试者进行了近20年的随访后发现,加工肉类及未加工红肉的摄入,与更高的心血管疾病死亡率及全因死亡率相关,而家禽的摄入也与更高的心血管疾病死亡率相关。
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Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality

加工肉类、未加工红肉、家禽或鱼类摄入与心血管疾病死亡率及全因死亡率之间的关联

10.1001/jamainternmed.2019.6969

2020-02-03, Article

Abstract & Authors:展开

Abstract:收起
Importance : Although the associations between processed meat intake and cardiovascular disease (CVD) and all-cause mortality have been established, the associations of unprocessed red meat, poultry, or fish consumption with CVD and all-cause mortality are still uncertain.
Objective : To identify the associations of processed meat, unprocessed red meat, poultry, or fish intake with incident CVD and all-cause mortality.
Design, Setting, and Participants : This cohort study analyzed individual-level data of adult participants in 6 prospective cohort studies in the United States. Baseline diet data from 1985 to 2002 were collected. Participants were followed up until August 31, 2016. Data analyses were performed from March 25, 2019, to November 17, 2019.
Exposures : Processed meat, unprocessed red meat, poultry, or fish intake as continuous variables.
Main Outcomes and Measures : Hazard ratio (HR) and 30-year absolute risk difference (ARD) for incident CVD (composite end point of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality, based on each additional intake of 2 servings per week for monotonic associations or 2 vs 0 servings per week for nonmonotonic associations.
Results: Among the 29 682 participants (mean [SD] age at baseline, 53.7 [15.7] years; 13 168 [44.4%] men; and 9101 [30.7%] self-identified as non-white), 6963 incident CVD events and 8875 all-cause deaths were adjudicated during a median (interquartile range) follow-up of 19.0 (14.1-23.7) years. The associations of processed meat, unprocessed red meat, poultry, or fish intake with incident CVD and all-cause mortality were monotonic (P for nonlinearity ≥ .25), except for the nonmonotonic association between processed meat intake and incident CVD (P for nonlinearity = .006). Intake 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%]), or poultry (adjusted HR, 1.04 [95% CI, 1.01-1.06]; adjusted ARD, 1.03% [95% CI, 0.36%-1.70%]) was significantly associated with incident CVD. Fish intake was not significantly associated with incident CVD (adjusted HR, 1.00 [95% CI, 0.98-1.02]; adjusted ARD, 0.12% [95% CI, −0.40% to 0.65%]). Intake of processed meat (adjusted HR, 1.03 [95% CI, 1.02-1.05]; adjusted ARD, 0.90% [95% CI, 0.43%-1.38%]) or unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.05]; adjusted ARD, 0.76% [95% CI, 0.19%-1.33%]) was significantly associated with all-cause mortality. Intake of poultry (adjusted HR, 0.99 [95% CI, 0.97-1.02]; adjusted ARD, −0.28% [95% CI, −1.00% to 0.44%]) or fish (adjusted HR, 0.99 [95% CI, 0.97-1.01]; adjusted ARD, −0.34% [95% CI, −0.88% to 0.20%]) was not significantly associated with all-cause mortality.
Conclusions and Relevance : These findings suggest that, among US adults, higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with a small increased risk of incident CVD, whereas higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality. These findings have important public health implications and should warrant further investigations.

First Authors:
Victor W Zhong

Correspondence Authors:
Victor W Zhong

All Authors:
Victor W Zhong,Linda Van Horn,Philip Greenland,Mercedes R Carnethon,Hongyan Ning,John T Wilkins,Donald M Lloyd-Jones,Norrina B Allen

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