Larsson, S. C. & Orsini, N. Red meat and processed meat consumption and all-cause mortality: a meta-analysis. J. Extended Data Fig. We estimated the exposure-averaged burden of proof RR to be 1.06, indicating that consuming unprocessed red meat in the range of 15th to 85th percentiles of exposure (0gd1 to 98gd1) was associated with at least a 6% higher risk of colorectal cancer. Nutr. In this paper we examined the relationship between unprocessed red meat and six health outcomes: breast cancer, colorectal cancer, type 2 diabetes, ischemic heart disease (IHD), ischemic stroke and hemorrhagic stroke. Environ. 16, 13061308 (2007). Fig. eCollection 2023 Apr. Efron, B., Hastie, T., Johnstone, I. Jrvinen, R., Knekt, P., Hakulinen, T., Rissanen, H. & Helivaara, M. Dietary fat, cholesterol and colorectal cancer in a prospective study. Kurotani, K. et al. http://health.gov/dietaryguidelines/2015/guidelines/ (2015). Unprocessed Red Meat Intake (g/day) 2: Zero Intake: Quartiles of Intake 3: p-trend: 90th vs. 0 4: 90th vs. 0 4: 0: Q1: Q2: Q3: Q4: Uncalibrated: Calibrated: No. 3. Math. Other, much older research has found that cooking meat on high heat or over open flame appears to produce carcinogens, or cancer-causing compounds. Extended Data Fig. are difficult to evaluate within our methodological framework. 39, 493498 (2004). Extended Data Fig. Red and processed meat consumption and cancer outcomes - ScienceDirect 116, 316325 (2016). provided critical feedback on methods or results. Accessibility The total number of participants across cohorts was 1,219,288 individuals and the mean duration of follow-up was 11.6 years (range, 5.530 years). A positive risk score indicates that across average levels of exposure, the UI bound that is closest to null is on the same side of null as the mean risk curve. Bechthold, A. et al. 2. Zhang, R., Fu, J., Moore, J. Red meat consumption is associated with the risk of type 2 diabetes in men but not in women: a Japan Public Health Center-based Prospective study. Red and processed meat intake and cancer risk: results from the prospective NutriNet-Sant cohort study. Unprocessed red meat consumption and ischemic heart disease. Further, the precautionary principle suggests that public policy should pay attention to all potential risks, as it is possible that as evidence accumulates, a stronger association may emerge for some pairs. Health effects associated with consumption of unprocessed red meat: a Nutr. Fig. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2015 Aug 25;10(8):e0135959. Follow-up time ranged from 4.6 to 28 years (mean 11.6 years). Previously, the guidelines suggested limiting meat consumption as part of an overall healthy eating pattern. Vegetarianism, low meat consumption and the risk of colorectal cancer in a population based cohort study. Eur. Br. 104). managed the overall research enterprise. Application of this analysis method to other diet components may yield insights into the shape of risk functions and burden of proof risk functions for a variety of dietary factors. Characterizing the potential health effects of exposure to risk factors such as red meat consumption is essential to inform health policy and practice. The PRISMA flow diagram covering unprocessed red meat and all 6 outcomes. For breast cancer, our finding of weak evidence of an association is generally consistent with previous literature, including a previous meta-analyses conducted by Farvid and colleagues (RR, 1.06; 0.991.14)77 and Anderson and colleagues (RR, 1.03; 0.991.08)78. Processed meats, such as sausage, hot dogs, bacon, ham, and luncheon meats Eggs with the yolk (The study findings also suggest that eating eggs with the yolk, also increases the risk of dying from prostate cancer.) Meat consumption and risk of ischemic heart disease: a systematic review and meta-analysis. 41, 26322640 (2020). Res. Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes. . However, policy makers should pay attention to all potential risks, even those that only receive one-star or two-star ratings and especially when exposure prevalence is high. Ingested nitrate, disinfection by-products, and risk of colon and rectal cancers in the Iowa Womens Health Study cohort. https://github.com/zhengp0/limetr. Correspondence to Qiang Wei a Add to Mendeley https://doi.org/10.1016/j.foodchem.2021.129697 Get rights and content Highlights Umbrella review of various cancer risks related to red and processed meat intake. Cancer Epidemiol. Christopher J. L. Murray. Intern. c, A modified funnel plot showing the residuals (relative to 0) on the x axis and the estimated s.d. Supplementary Table 1 (section 1) contains a summary of the main characteristics of all studies included in this analysis, including study design, end point, location, exposure assessment and other characteristics. 1. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health study: population-based cohort study. J. Stroke Cerebrovasc. Processed and Unprocessed Red Meat and Risk of Colorectal Cancer - PLOS Make meat go further by chopping it into small pieces, buying ground meat and using smaller amounts in stir-fries, salads and pasta sauces. Google Scholar. We found no evidence of publication or reporting bias in five of the six disease outcomes investigated, and mild evidence in ischemic stroke. Processed meats are meats that have been preserved by smoking or salting, curing or adding chemical preservatives. J. Clin. The estimates for our primary indicators from this workRRs across a range of exposures, BPRFs, ROSs and star ratings for each riskoutcome pairare not specific to, or disaggregated by, specific populations (we did not estimate by location, sex or age group; though this analysis evaluated the effects of unprocessed red meat consumption on selected chronic disease end points in adults 25 years and older only and breast cancer is only applicable to females). Tang, M. & Krebs, N. F. High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. At a lower level of intake, a wide range of healthy or unhealthy diet components might be substituted for red meat and could increase heterogeneity in the health effects of red meat across studies. Google Scholar. This study was approved by the University of Washington Institutional Review Board Committee (study 9060). Am. Pan, A. et al. Mnnist, S., Kontto, J., Kataja-Tuomola, M., Albanes, D. & Virtamo, J. 66, 687693 (2012). Unprocessed red meat such as steak and lamb shanks is classified as "probably carcinogenic." Balancing risks and benefits The WHO said the finding was important for public health since. Potential health hazards of eating red meat. Only one cohort reported the RR of diabetes mortality and the rest reported incidence. J. Nutr. A meta-analysis by Yang and colleagues reported a pooled RR of 0.88 (0.731.06) for each 100gd1 increase in intake of unprocessed red meat81. J. Clin. Intern Med 171, 756764 (2019). Virtanen, H. E. K. et al. High processed meat consumption is a risk factor of type 2 diabetes in the -Tocopherol, -Carotene Cancer Prevention study. The details of these model validations are available in Zheng et al.20. We found that removing trimming (including outliers) and removing the imposed model shape constraints did not significantly change the risk curve results. Biaek-Dratwa A, Kokot T, Czech E, Cayniuk B, Kiciak A, Stakiewicz W, Stanjek-Cichoracka A, Soma-Krzelak M, Sobek O, Kujawiska M, Grot M, Szczepaska E, Muc-Wierzgo M. Front Nutr. Stroke 43, 25562560 (2012). Red meat: Avoid the processed stuff - Harvard Health Whiteman, D., Muir, J., Jones, L., Murphy, M. & Key, T. Dietary questions as determinants of mortality: the OXCHECK experience. Global burden of 87 risk factors in 204 countries and territories, 19902019: a systematic analysis for the Global Burden of Disease Study 2019. Cancer 143, 27872799 (2018). That includes bacon, sausage, ham, hot dogs, and deli meats. The BPRF value was 1.01 and the corresponding ROS was 0.01, equating to a two-star rating at the lower threshold of two-star pairs (at the boundary between weak evidence and no evidence of an association between consumption of unprocessed red meat and increased risk of type 2 diabetes). BMC Med. Med. Authors reply. Processed and Unprocessed Red Meat and Risk of Colorectal Cancer Ann. Characterizing the potential health effects of exposure to risk factors such as red meat consumption is essential to inform health policy and practice. J. Clin. Circulation 122, 876883 (2010). 0, 114 (2022). J. We found weak evidence of association between unprocessed red meat consumption and colorectal cancer, breast cancer, type 2 diabetes and ischemic heart disease. a, Log-RR function. We have made our data and code available to foster reproducibility. The corresponding ROS of 0.02 resulted in a one-star rating, consistent with no evidence of an association between consumption of unprocessed red meat and increased risk of ischemic stroke. J. Nutr. These and other findings have led institutions such as the World Health Organization, the World Cancer Research Fund (WCRF), the EAT-Lancet Commission and the US Departments of Health and Human Services and Agriculture to recommend limiting red meat intake6,7,8,9. The association of meat intake and the risk of type 2 diabetes may be modified by body weight. We systematically searched PubMed for reports of cohort studies that included meat consumption, selecting reports evaluating the relationship between consumption of red meat and each of the outcomes. Star ratings are designed to offer individuals and policy makers a way to understand the strength of evidence about a risk in a way that is comparable across riskoutcome pairs. Following Zheng et al.20, we modeled each non-linear doseresponse as a quadratic spline21. PLoS ONE 9, e109552 (2014). Al-Shaar, L. et al. Pietinen, P. et al. Br. 354, i3857 (2016). PMC Work Environ. 104, 11371143 (2016). J. Epidemiol. By aggregating the outcome-specific risk curves computed in the present analysis, we generated a RR curve for the six outcomes combined that minimized risk at 0gd1 (95% UI 0200) of unprocessed red meat consumption. & Wolk, A. Until now, there have been few randomized trials that have investigated the consumption of red meat and the risk of colon cancer, as recently reviewed by Johnston and colleagues [].Similarly, only two trials have examined the effect of different dietary patterns on cancer risk, only one of which was . Red meat consumption and the risk of stroke: a doseresponse meta-analysis of prospective cohort studies. government site. The number of participants in each study ranged from 639 to 536,969 and the length of follow-up ranged from 4.1 to 32 years. 2016; PubMed Central For more information, visit: Would you like email updates of new search results? doi: 10.1080/10408398.2013.873886. We also included in the final estimation 10% trimming of the data to avoid sensitivity to outliers; trimming from within the likelihood is an efficient way to identify outliers without manually selecting them21,105. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Mueller, M. et al. For reports describing consumption in servings of red meat with no corresponding information about serving size, we assumed a serving size of 85gd1 (ref. The exposure-averaged BPRF value for ischemic stroke (averaged between 15th and 85th percentiles of red meat exposure) was 0.98 (Table 2 and Extended Data Fig. Any discrepancies between our findings and those in previous meta-analyses is primarily a reflection of our incorporation of between-study heterogeneity, not assuming a log-linear risk function and including newly available data. Recommendations and public health and policy implications. Stevens, G. A. et al. Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the doseresponse relationship: a systematic review and meta-analysis of cohort studies. Non-communicable disease risk associated with red and processed meat consumption-magnitude, certainty, and contextuality of risk? To capture bias within the studies and data points, we followed the approach of Zheng et al.20, using a Lasso106,107 covariate selection scheme to rank the potential bias covariates. Although visual inspection of the mean risk functions suggests a positive (harmful) relationship between unprocessed red meat intake and colorectal cancer, type 2 diabetes, IHD, ischemic stroke and breast cancer and a negative (protective) relationship with hemorrhagic stroke, the large degree of heterogeneity present, coupled with the moderate mean effects, generated wide UIs for the mean risk functions. Rossi F, Tucci P, Del Matto I, Marino L, Amadoro C, Colavita G. Microorganisms. In addition to this statistical test of publication or reporting bias, we generated funnel plots of the residuals of the risk function and s.d. We selected outcomes on the basis of the availability of epidemiological evidence on their potential relationship with red meat. 2. Circulation. J. Comput. Prev. (in the press). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines22, we systematically searched for literature on the RR of unprocessed red meat consumption, screened identified records and extracted data from reports meeting our inclusion criteria (Methods). WHO report says eating processed meat is carcinogenic: Understanding In our first model, higher unprocessed red meat intake was associated with lower risk of colon cancer recurrence and death (Table 2). Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. 179, 282289 (2014). Larsson, S. C., Rafter, J., Holmberg, L., Bergkvist, L. & Wolk, A. Liu C, Gong J, Zhang Q, Chen G, Yin S, Luo Z, Zeng W, Yu J, Lan P, He Z. 127, 607618 (2022). 315, 629634 (1997). Data sources and citations for each riskoutcome pair can be downloaded using the download button on each risk curve page available at https://vizhub.healthdata.org/burden-of-proof/. Zheng, P., Barber, R., Sorensen, R. J., Murray, C. J. In light of these findings, we contend that consuming no unprocessed red meat likely minimizes the risk of health consequences compared to consuming any, but that the wide uncertainty and low star ratings prevent us from making a strong intake-level recommendation. Back in 2015, the World Health Organization's International Agency for Research on Cancer (IARC) classified processed meat as a carcinogen, . However, for most healthy adults, the recommended daily value for protein is about 50 grams (5 ounces), depending on your weight, age, gender and physical . The .gov means its official. Kaluza, J., Wolk, A. 371, m4141 (2020). In most studies, dietary consumption of unprocessed red meat was assessed using food frequency questionnaires (42 of 55). Bernstein, A. M. et al. Wei, E. K. et al. -, Bellavia A, Stilling F, Wolk A. Health effects associated with consumption of unprocessed red meat: a Keywords: Review, Meat, Red meat, Processed meat, Cardiovascular disease, Diabetes Go to: Introduction Dose-response analysis showed that the intake of 120 g/d of red meat increases cancer risk by 24% and 30 g/day of processed meat increases this risk by 36% according to this meta-analysis. The RR was 1.09 (0.991.18) at 50gd1 and 1.12 (0.991.25) at 100gd1 (Table 2 and Fig. The corresponding ROS of 0.13 resulted in a one-star rating, consistent with no evidence of an association between consumption of unprocessed red meat and decreased risk of hemorrhagic stroke. Mehta, S. S. et al. Intake of different dietary proteins and risk of type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. But the fact is, there are NO control trials linking meat to cancer. (eds) GRADE Handbook (GRADE Working Group, 2013). Another notable issue is that meta-analyses attempting to synthesize findings from cohort studies typically do not account for between-study heterogeneity, which can be a prominent source of bias in epidemiological meta-analyses19. Diabetologia 56, 4759 (2013). PLoS ONE 6, e20456 (2011). Int. Get the inside scoop on todays biggest stories in business, from Wall Street to Silicon Valley delivered daily. The BPRF reflects a conservative interpretation of the available evidence and is a measure of the lowest level of excess risk (or risk reduction, for protective risks) that is consistent with the available data; the higher the BPRF, the higher the magnitude and strength of the relationship. Int. Meat intake, cooking methods and risk of proximal colon, distal colon and rectal cancer: the Norwegian Women and Cancer (NOWAC) cohort study. We present the sensitivity of the results based on this assumption in the Supplementary Information, section 2.1. 3), which put it opposite null from the mean RR of 1.15 (95% UI inclusive of between-study heterogeneity of 0.931.40) at 100gd1. This includes veal, pork, lamb, beef, or goat meat. 1 PRISMA flow diagram of unprocessed red meat data seeking approach. Red meats like beef, pork, veal, lamb, mutton, and goat have long been linked to health risks including cardiovascular illness. US Department of Health and Human Services and US Department of Agriculture. We standardized the exposure unit to grams of consumption per day. By Liam McAuliffe Updated on June 23, 2022 Tags: Animal meat, Cancer, Carnivore Diet Foods, Red Meat Does red meat cause cancer? Research has found that relative risk of colorectal cancer increases by 22% with each additional daily serving of red meat and 23% with each additional daily serving of processed meat, according to the ACS. Med. Substitution of unprocessed and processed red meat with poultry or fish We found weak evidence of a harmful association between unprocessed red meat consumption and risk of IHD. 19, 53 (2021). The overall findings suggest that neither unprocessed red nor processed meat consumption is beneficial for cardiometabolic health, and that clinical and public health guidance should especially prioritize reducing processed meat consumption. Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. This includes code for the meta-regression engine, the model specification interface, both parts of the data processing and risk-specific custom code, as appropriate. Int. Associations of processed meat and unprocessed red meat intake with incident diabetes: the Strong Heart Family study. For instance, a risk factor with high prevalence of exposure and a two-star relationship with a common and serious health outcome might warrant more policy focus than a risk factor with lower prevalence of exposure and a three-star or four-star relationship with a rare or less severe health outcome. The BPRF value (averaged across the 15th to 85th percentiles of red meat consumption, 069gd1) was 1.03, which was substantially lower than the mean RR of 1.26 (0.981.56) and 1.26 (0.981.56) at 50gd1 and 100gd1, respectively. Extended Data Fig. Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease Int. J. Epidemiol. Data Anal. J. Nutr. Page, M. J. et al. Diet and risk of colorectal cancer in a cohort of Finnish men. 2020;396:12231249. Exposures: Quartiles of unprocessed red meat and processed meat intake assessed using a validated food frequency questionnaire during and 6 months after chemotherapy. A.A., C.A., S.I.H., E.C.M. doi: 10.1136/bmj.n71. Am. Nat Med 28, 20752082 (2022). We defined red meat consumption as total consumption of unprocessed red meat, including beef, lamb and pork, excluding processed meat. Rajabi, A. Full texts of potentially relevant articles were manually assessed for eligibility by two investigators. In most studies (45 of 55), RRs were adjusted for major confounders including age, sex and smoking. 2 Red meat consumption and type 2 diabetes. So which is it? 4, the relationship between unprocessed red meat intake and combined-cause incidence and mortality was increasing across the entire exposure domain. We found weak evidence of harmful associations between unprocessed red meat consumption and risk of colorectal cancer; the mean RR at 50gd1 relative to no intake was 1.30 (95% UI inclusive of between-study heterogeneity of 1.011.64), while the mean RR at 100gd1 was 1.37 (1.011.78) (Table 2 and Fig. Red meat consumption. The best available evidence supports an increased cancer risk. The corresponding ROS is 0.03 (Table 2 and Fig. Med. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Whether unprocessed red meat consumption really leads to more cancer and heart issues is up for debate, with only 1-star and 2-star levels of association. P30 AG047845/AG/NIA NIH HHS/United States, R01 MH110163/MH/NIMH NIH HHS/United States, Pan A, et al. Unprocessed red meat, processed meat intake not linked to colon cancer We present an approach to doseresponse risk curve estimation that uses exposure ranges from cohort studies to infer flexible risk functions without imposing log-linear assumptions. Lancet 399, e23e26 (2022). 36, 148 (2010). Brit. J. Nutr. International Agency for Research on Cancer, World Health Organization. To validate key aspects of the meta-regression model used in this analysis, the following packages were used, as described by Zheng et al. Meat consumption and its association with C-reactive protein and incident type 2 diabetes: the Rotterdam study. Sign up for notifications from Insider! 4. Ollberding, N. J., Wilkens, L. R., Henderson, B. E., Kolonel, L. N. & & Le Marchand, L. Meat consumption, heterocyclic amines and colorectal cancer risk: the Multiethnic Cohort Study. 126, 242251 (2019). For some pairs, particularly for the one-star pairs, there may be smaller ranges of exposure within which the magnitude of the BPRF was larger and significant, indicating a significant association between risk and outcome at a certain level of exposure. Dietary iron modulates gut microbiota and induces SLPI secretion to promote colorectal tumorigenesis. Consumption of unprocessed red or processed meat did not impact risk for colon cancer recurrence or mortality, according to a prospective cohort study of patients with stage III colon. Extended Data Fig. Google Scholar. Dietary trends among Polish women in 2011-2022-cross-sectional study of food consumption frequency among women aged 20-50 in Silesia region, Poland. Nutr. J. Clin. The BPRF is a conservative risk function (offering an alternative to a mean risk function) that is defined as either the fifth (for harmful risks) or 95th (for protective risks) quantile curve closest to the line of RR equal to one (the null). Although our meta-analysis approach presents an analytic framework to quantify and account for a wide range of source data characteristics that may have obscured aspects of riskoutcome relationships investigated in previous studies, there were a number of limitations related to our source data, our methodological approach and our ability to interpret the data that we were unable to address. J. 3. J. Pediatr. Previous findings for IHD have been inconsistent, with Bechthold and colleagues finding an association between red meat intake and IHD16, but Abete and colleagues79 and Micha and colleagues80 reporting no association. Nutr. Papier, K. et al. 2023 May 8;15(9):2219. doi: 10.3390/nu15092219. They include deli meats, bacon and hot dogs. Unprocessed red meat consumption and. Most cohorts reported the RR of colorectal cancer incidence (n=18); no significant difference between incidence and mortality RRs was detected in covariate selection and no other bias covariates were identified by the covariate selection algorithm of the meta-regression. Chen, G.-C., Lv, D.-B., Pang, Z. Heart J. We identified 20 prospective cohorts27,28,35,38,39,42,45,49,50,54,57,58,60,61,63,72,73,75 and one nested casecontrol study67 to assess the relationship between unprocessed red meat consumption and colorectal cancer among 2,413,032 individuals in total (sample size was calculated as the number of unique data source-location pairs with observations of risk exposure and outcome) over an average of 8.0 years per individual (range of mean/median follow-up per cohort, 4.132 years). 18. J. Clin. Diet, Nutrition, Physical Activity and Colorectal Cancer. Tibshirani, R. Regression shrinkage and selection via the lasso. The researchers defined unprocessed red meat as any unprocessed meat from beef, lamb or pork, excluding poultry. J. Nutr. Meat consumption and risk of 25 common conditions: outcome-wide Thompson HJ, Lutsiv T, McGinley JN, Hussan H, Playdon MC. We then converted the doseresponse relationship previously estimated by non-linear meta-regression into a new signal covariate and used linear meta-regression to systematically test for significant modification of the signal by each bias covariateadding them to the model one at a time based on the Lasso ranking. Therefore, this analysis aims to investigate the association of such low intakes of red and processed meat with all-cause, CVD, and cancer mortality. Talking about eating less red and processed meat provokes strong doi: 10.1016/S0140-6736(20)30752-2. and P.Z. Rev. Medicine 98, e15987 (2019). developed methods or computational machinery. Public Health Nutr. Gut Microbes. FAQ: Exactly what processed meat should I avoid, and other questions - PBS 2023 May 17;11(5):1306. doi: 10.3390/microorganisms11051306. Unable to load your collection due to an error, Unable to load your delegates due to an error. Recommended consumption targets are inconsistent, however, ranging from 14gd1 (EAT8), to 5070gd1 (WCRF7), to unrestricted amounts (Nutritional Recommendations Consortium10). Red meat consumption and ischemic stroke. & Larsson, S. C. Red meat consumption and risk of stroke. 8th edn. Seventh, our trimming approach requires that the threshold for outliers be user-specified. To explain some of the between-study heterogeneity, the approach uses bias covariates automatically selected from an expert-defined candidate set consistent with GRADE86, Cochrane87 and other evidence-grading criteria. Zheng, P. et al. High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake? Int. doi: 10.1093/aje/kwt261. MeSH 4 Red meat consumption and hemorrhagic stroke. 143, 464472 (2013). Red meat is associated with an increased risk of colon and rectum cancer, and evidence also suggests it is associated with some other cancers, such as prostate and pancreatic cancer. 59, 441448 (2005). They should be taken seriously as a cancer risk, too, according to new cancer-prevention guidelines from the American Cancer Society, which take a stronger stand against red and processed meat than ever before. We quantified between-study heterogeneity (the level of disagreement in the inferred relationship between risk and outcome found in each study) by scaling the non-linear RR based on each study using a study-specific random slope with respect to the new bias covariate model. Food Sci.
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