TY - JOUR
T1 - Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease
AU - Key, Timothy J
AU - Appleby, Paul N
AU - Bradbury, Kathryn E
AU - Sweeting, Michael
AU - Wood, Angela
AU - Johansson, Ingegerd
AU - Kühn, Tilman
AU - Steur, Marinka
AU - Weiderpass, Elisabete
AU - Wennberg, Maria
AU - Lund Würtz, Anne Mette
AU - Agudo, Antonio
AU - Andersson, Jonas
AU - Arriola, Larraitz
AU - Boeing, Heiner
AU - Boer, Jolanda M A
AU - Bonnet, Fabrice
AU - Boutron-Ruault, Marie-Christine
AU - Cross, Amanda J
AU - Ericson, Ulrika
AU - Fagherazzi, Guy
AU - Ferrari, Pietro
AU - Gunter, Marc
AU - Huerta, José María
AU - Katzke, Verena
AU - Khaw, Kay-Tee
AU - Krogh, Vittorio
AU - La Vecchia, Carlo
AU - Matullo, Giuseppe
AU - Moreno-Iribas, Conchi
AU - Naska, Androniki
AU - Nilsson, Lena Maria
AU - Olsen, Anja
AU - Overvad, Kim
AU - Palli, Domenico
AU - Panico, Salvatore
AU - Molina-Portillo, Elena
AU - Quirós, J Ramón
AU - Skeie, Guri
AU - Sluijs, Ivonne
AU - Sonestedt, Emily
AU - Stepien, Magdalena
AU - Tjønneland, Anne
AU - Trichopoulou, Antonia
AU - Tumino, Rosario
AU - Tzoulaki, Ioanna
AU - van der Schouw, Yvonne T
AU - Verschuren, W M Monique
AU - di Angelantonio, Emanuele
AU - Langenberg, Claudia
AU - Forouhi, Nita
AU - Wareham, Nick
AU - Butterworth, Adam
AU - Riboli, Elio
AU - Danesh, John
PY - 2019/6/18
Y1 - 2019/6/18
N2 - BACKGROUND: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition).METHODS: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates.RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06-1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89-0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86-0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88-0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-high-density lipoprotein cholesterol.CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects.
AB - BACKGROUND: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition).METHODS: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates.RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06-1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89-0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86-0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88-0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-high-density lipoprotein cholesterol.CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects.
KW - Adult
KW - Aged
KW - Biomarkers/blood
KW - Blood Pressure
KW - Cholesterol, HDL/blood
KW - Cross-Sectional Studies
KW - Dairy Products/adverse effects
KW - Diet Surveys
KW - Diet, Healthy
KW - Eggs/adverse effects
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Male
KW - Meat/adverse effects
KW - Middle Aged
KW - Myocardial Ischemia/blood
KW - Nutritive Value
KW - Prospective Studies
KW - Protective Factors
KW - Recommended Dietary Allowances
KW - Risk Assessment
KW - Risk Factors
KW - Risk Reduction Behavior
KW - Seafood/adverse effects
KW - Time Factors
U2 - 10.1161/CIRCULATIONAHA.118.038813
DO - 10.1161/CIRCULATIONAHA.118.038813
M3 - Article
C2 - 31006335
SN - 0009-7322
VL - 139
SP - 2835
EP - 2845
JO - Circulation
JF - Circulation
IS - 25
ER -