Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease

Key TJ, Appleby PN, Bradbury KE, Sweeting M, Wood A, Johansson I, Kühn T, Steur M, Weiderpass E, Wennberg M, Lund Würtz AM, Agudo A, Andersson J, Arriola L, Boeing H, Boer JMA, Bonnet F, Boutron-Ruault MC, Cross AJ, Ericson U, Fagherazzi G, Ferrari P, Gunter M, Huerta JM, Katzke V, Khaw KT, Krogh V, La Vecchia C, Matullo G, Moreno-Iribas C, Naska A, Nilsson LM, Olsen A, Overvad K, Palli D, Panico S, Molina-Portillo E, Quirós JR, Skeie G, Sluijs I, Sonestedt E, Stepien M, Tjønneland A, Trichopoulou A, Tumino R, Tzoulaki I, van der Schouw YT, Verschuren WMM, di Angelantonio E, Langenberg C, Forouhi N, Wareham N, Butterworth A, Riboli E, Danesh J

Circulation · 113 citations

Review labels

Author industry tiesFood frequency questionnaireIndustry fundedLumps processed with unprocessed meatNo stated lifestyle adjustment

Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.

How it was studied

Design: Cohort study (indexed by PubMed)
Studied in: People
Main outcome: Clinical events such as disease or death
Intake measured by: Food frequency questionnaire

Who paid for it

Funding: Industry funded
Government: World Health Organization
University or hospital: Deutsches Krebsforschungszentrum
Nonprofit: Wellcome Trust
Government: Dipartimenti di Eccellenza
Nonprofit: Cancer Research UK
Government: National Institute for Health and Care Research
Nonprofit: British Heart Foundation
Government: European Commission
Government: Institut National de la Santé et de la Recherche Médicale
Government: Bundesministerium für Bildung und Forschung
Nonprofit: Cancerfonden
Government: Ministero dell’Istruzione, dell’Università e della Ricerca
Nonprofit: Ligue Contre le Cancer
Government: Vetenskapsrådet
Nonprofit: Associazione Italiana per la Ricerca sul Cancro
Nonprofit: Deutsche Krebshilfe
University or hospital: Institut Gustave-Roussy
Nonprofit: Mutuelle Générale de l'Education Nationale
Company: Alpro Foundation
Nonprofit: Hellenic Health Foundation
Government: Medical Research Council
Nonprofit: World Cancer Research Fund
Government: Instituto de Salud Carlos III
Government: National Institute for Health Research (NIHR)
Government: European Research Council
Authors: At least one author declares a financial tie to industry
Grants: Vetenskapsrådet (14136); Hellenic Health Foundation (C8221/A19170); Deutsche Krebshilfe (RD06/0020); Medical Research Council (M012190/1); Hellenic Health Foundation (PI13/01162); Cancer Research UK (RD06/0020); Mutuelle Générale de l'Education Nationale (MR/M012190/1); European Commission (PI13/01162); Institut National de la Santé et de la Recherche Médicale (PI13/01162); Institut Gustave-Roussy (C570/A16491); Associazione Italiana per la Ricerca sul Cancro (PI13/01162); Cancerfonden (C8221/A19170); National Institute for Health and Care Research (NF-SI-0617-10113); Deutsche Krebshilfe (14136); Cancer Research UK (C570/ A16491); Institut Gustave-Roussy (PI13/00061); Instituto de Salud Carlos III (RD06/0020); World Cancer Research Fund (14136); Ligue Contre le Cancer (MR/M012190/1); Ligue Contre le Cancer (PI13/00061); Medical Research Council (C570/A16491); Cancer Research UK (25004); Institut National de la Santé et de la Recherche Médicale (C570/A16491); Ligue Contre le Cancer (C570/A16491); World Cancer Research Fund (PI13/01162); Mutuelle Générale de l'Education Nationale (14136); World Cancer Research Fund (MR/M012190/1); British Heart Foundation (RG/18/13/33946); Bundesministerium für Bildung und Forschung (14136); Associazione Italiana per la Ricerca sul Cancro (PI13/00061); Institut Gustave-Roussy (MR/M012190/1); Ligue Contre le Cancer (C8221/A19170); Deutsche Krebshilfe (MR/M012190/1); Medical Research Council (MC_UU_12015/5); Deutsches Krebsforschungszentrum (C8221/A19170); World Cancer Research Fund (C8221/A19170); Ligue Contre le Cancer (14136); Mutuelle Générale de l'Education Nationale (PI13/00061); National Institute for Health and Care Research ([IS-BRC-1215-20014); Bundesministerium für Bildung und Forschung (C8221/A19170); Institut Gustave-Roussy (C8221/A19170); Medical Research Council (14136); European Commission (RD06/0020); Cancerfonden (14136); Medical Research Council (MR/M012190); Hellenic Health Foundation (PI13/00061); World Cancer Research Fund (C570/A16491); Bundesministerium für Bildung und Forschung (RD06/0020); Institut Gustave-Roussy (14136); Hellenic Health Foundation (C570/A16491); Institut Gustave-Roussy (RD06/0020); Bundesministerium für Bildung und Forschung (MR/M012190/1); British Heart Foundation (G0800270); Hellenic Health Foundation (14136); Ligue Contre le Cancer (PI13/01162); Ligue Contre le Cancer (RD06/0020); Medical Research Council (C8221/A19170); European Commission (C570/A16491); European Commission (C8221/A19170); Medical Research Council (MR/L003120/1); Medical Research Council (RD06/0020); Institut National de la Santé et de la Recherche Médicale (MR/M012190/1); European Commission (14136); Institut National de la Santé et de la Recherche Médicale (C8221/A19170); Medical Research Council (MR/M012190/1); British Heart Foundation (SP/09/002); Deutsche Krebshilfe (C570/A16491); British Heart Foundation (RG/08/014); Ministero dell’Istruzione, dell’Università e della Ricerca (D15D18000410001); Associazione Italiana per la Ricerca sul Cancro (MR/M012190/1); Cancer Research UK (PI13/01162); Wellcome Trust (205212); Associazione Italiana per la Ricerca sul Cancro (14136); Institut National de la Santé et de la Recherche Médicale (RD06/0020); Deutsche Krebshilfe (PI13/00061); Medical Research Council (PI13/01162); European Commission (MR/M012190/1); Vetenskapsrådet (RD06/0020); Institut National de la Santé et de la Recherche Médicale (PI13/00061); Institut National de la Santé et de la Recherche Médicale (14136); Deutsches Krebsforschungszentrum (PI13/01162); Medical Research Council (G0800270); Deutsche Krebshilfe (PI13/01162); World Cancer Research Fund (PI13/00061); Deutsche Krebshilfe (C8221/A19170); Bundesministerium für Bildung und Forschung (PI13/01162); Mutuelle Générale de l'Education Nationale (RD06/0020); Cancer Research UK (14136); Medical Research Council (MR/M012190/1); National Institute for Health and Care Research (NF-SI-0512-10114); Bundesministerium für Bildung und Forschung (PI13/00061); Institut Gustave-Roussy (PI13/01162); European Commission (PI13/00061); Dipartimenti di Eccellenza (D15D18000410001); Deutsches Krebsforschungszentrum (RD06/0020); Cancer Research UK (MR/M012190/1); European Commission (279233); Medical Research Council (PI13/00061); Medical Research Council (MR/N003284/1); Mutuelle Générale de l'Education Nationale (PI13/01162); Cancer Research UK (C8221/A19170); Medical Research Council (MC_UU_12015/1); Cancer Research UK (PI13/00061); Associazione Italiana per la Ricerca sul Cancro (RD06/0020); Mutuelle Générale de l'Education Nationale (C570/A16491); Associazione Italiana per la Ricerca sul Cancro (C570/A16491); Cancer Research UK (570/A16491); Deutsches Krebsforschungszentrum (C570/A16491); Deutsches Krebsforschungszentrum (14136); British Heart Foundation (RG/13/13/30194); Cancerfonden (C570/A16491); Vetenskapsrådet (PI13/00061); Wellcome Trust (205212/Z/16/Z); Medical Research Council (MR/L003120); Mutuelle Générale de l'Education Nationale (C8221/A19170); World Cancer Research Fund (RD06/0020); Associazione Italiana per la Ricerca sul Cancro (C8221/A19170); Deutsches Krebsforschungszentrum (MR/M012190/1); Vetenskapsrådet (PI13/01162); Instituto de Salud Carlos III (01162); Bundesministerium für Bildung und Forschung (C570/A16491); Vetenskapsrådet (C8221/A19170); Hellenic Health Foundation (MR/M012190/1); National Institute for Health and Care Research (NF-SI-0617-10149); Hellenic Health Foundation (RD06/0020); Deutsches Krebsforschungszentrum (PI13/00061); Vetenskapsrådet (C570/A16491); European Commission (37197); Vetenskapsrådet (MR/M012190/1); Medical Research Council (MR/L003120/1)

Based on 25 listed funder(s) and full-text disclosure statement.

Publication

Published: 2019-04-22 · Circulation · vol. 139 · issue 25 · pp. 2835–2845
Publisher: Lippincott Williams & Wilkins
Cited: 153 citations · more than 100% of similar papers · 17.4× the field average
Impact: Top 10% most cited in its field
References: 33 works
Access: Open access (hybrid journal) · CC-BY
Research areas: Nutritional Studies and Diet · Fatty Acid Research and Health · Meat and Animal Product Quality
Keywords: Medicine, Fish <Actinopterygii>, Disease, Consumption (sociology), Food science, Fishery, Internal medicine, Biology
MeSH: humans, myocardial ischemia, diet surveys, risk assessment, risk factors, prospective studies, cross-sectional studies, risk reduction behavior, nutritive value, blood pressure, time factors, dairy products, eggs, meat, seafood, adult, aged, middle aged, europe, female, male, cholesterol, hdl, recommended dietary allowances, protective factors, biomarkers, diet, healthy

DOI ↗PubMed Central ↗OpenAlex ↗

55 authors

From GB, NZ, SE, DE, NO, FI, DK, ES, US, NL, FR, IT, GR, BY

Timothy J. KeyNuffield Health
Paul N. ApplebyUniversity of Oxford; Nuffield Health
Kathryn Erica BradburyUniversity of Auckland; Nuffield Health
Michael J. SweetingUniversity of Cambridge; British Heart Foundation
ANGELA M. WOODUniversity of Cambridge; British Heart Foundation
Ingegerd JohanssonUmeå University

Abstract

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.

Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).

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