Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies
Hidayat K, Chen JS, Wang HP, Wang TC, Liu YJ, Zhang XY, Rao CP, Zhang JW, Qin LQ
Nutrition reviews · 21 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- Government
- National Natural Science Foundation of China
- University or hospital
- State Key Laboratory Open Project of Radiation Medicine and Protection
- Grants
- National Natural Science Foundation of China (82173502); National Natural Science Foundation of China (82150410453)
Based on 2 listed funder(s).
Publication
- Published
- 2022-02-13 · Nutr Rev · vol. 80 · issue 9 · pp. 1959–1973
- Publisher
- Oxford University Press
- Cited
- 36 citations · more than 82% of similar papers · 1.7× the field average
- References
- 59 works
- Access
- Paywalled
- Research areas
- Nutritional Studies and Diet · Agriculture Sustainability and Environmental Impact · Meat and Animal Product Quality
- Keywords
- Red meat, Relative risk, Medicine, Meta-analysis, Observational study, Prospective cohort study, Lower risk, Confidence interval, Internal medicine, Pathology
- MeSH
- animals, humans, vegetables, coronary disease, diet, risk factors, prospective studies, observational studies as topic, red meat
9 authors
From CN
- Khemayanto Hidayat · correspondingSoochow University
- Jingsi ChenSoochow University
- Haipeng WangSoochow University; First Affiliated Hospital of Soochow University
- Tianci WangSoochow University
- Yujie LiuSoochow University
- Xueying ZhangSuzhou Vocational Health College
Abstract
Context
A high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat.
Objective
A PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes.
Data sources
The PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021.
Data extraction
The prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest.
Data analysis
Thirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82-0.96; I2 = 0%), dairy (RR, 0.90, 95%CI, 0.88-0.92; I2 = 0%), eggs (RR, 0.86, 95%CI, 0.79-0.94; I2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74-0.95; I2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74-0.95; I2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79-1.04; I2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89-0.96; I2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90-0.95; I2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87-0.95; I2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87-0.97; I2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93-1.01; I2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93-1.01; I2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d.
Conclusion
Keeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death.
Systematic review registration
PROSPERO registration no. CRD42021259446.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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