Associations of unprocessed and processed meat intake with mortality and cardiovascular disease in 21 countries [Prospective Urban Rural Epidemiology (PURE) Study]: a prospective cohort study

Authors

Romaina Iqbal
Mahshid DehghanFollow
Andrew Mente
Sumathy Rangarajan
Andreas Wielgosz
Alvaro AvezumFollow
Pamela Seron
Khalid F AlHabibFollow
Patricio Lopez-Jaramillo
Sumathi Swaminathan
Noushin Mohammadifard
Katarzyna Zatońska
Hu BoFollow
Ravi Prasad Varma
Omar Rahman
AfzalHussein Yusufali
Yin Lu
Noorhassim Ismail
Annika Rosengren
Neşe Imeryuz
Karen Yeates
Jephat ChifambaFollow
Antonio DansFollow
Rajesh Kumar
Liu Xiaoyun
Lungi Tsolekile
Rasha Khatib, Advocate Aurora HealthFollow
Rafael Diaz
Koon Teo
Salim Yusuf

Recommended Citation

Iqbal R, Dehghan M, Mente A, et al. Associations of unprocessed and processed meat intake with mortality and cardiovascular disease in 21 countries [Prospective Urban Rural Epidemiology (PURE) Study]: a prospective cohort study. Am J Clin Nutr. 2021;114(3):1049-1058. doi:10.1093/ajcn/nqaa448

Affiliations

Advocate Research Institute, Advocate Health Care

Abstract

BACKGROUND: Dietary guidelines recommend limiting red meat intake because it is a major source of medium- and long-chain SFAs and is presumed to increase the risk of cardiovascular disease (CVD). Evidence of an association between unprocessed red meat intake and CVD is inconsistent.

OBJECTIVE: The study aimed to assess the association of unprocessed red meat, poultry, and processed meat intake with mortality and major CVD.

METHODS: The Prospective Urban Rural Epidemiology (PURE) Study is a cohort of 134,297 individuals enrolled from 21 low-, middle-, and high-income countries. Food intake was recorded using country-specific validated FFQs. The primary outcomes were total mortality and major CVD. HRs were estimated using multivariable Cox frailty models with random intercepts.

RESULTS: In the PURE study, during 9.5 y of follow-up, we recorded 7789 deaths and 6976 CVD events. Higher unprocessed red meat intake (≥250 g/wk vs./wk) was not significantly associated with total mortality (HR: 0.93; 95% CI: 0.85, 1.02; P-trend = 0.14) or major CVD (HR: 1.01; 95% CI: 0.92, 1.11; P-trend = 0.72). Similarly, no association was observed between poultry intake and health outcomes. Higher intake of processed meat (≥150 g/wk vs. 0 g/wk) was associated with higher risk of total mortality (HR: 1.51; 95% CI: 1.08, 2.10; P-trend = 0.009) and major CVD (HR: 1.46; 95% CI: 1.08, 1.98; P-trend = 0.004).

CONCLUSIONS: In a large multinational prospective study, we did not find significant associations between unprocessed red meat and poultry intake and mortality or major CVD. Conversely, a higher intake of processed meat was associated with a higher risk of mortality and major CVD.

Document Type

Article

PubMed ID

33787869