Long-term processed and unprocessed red meat consumption and risk of heart failure: A prospective cohort study of women

Consumption of processed meat but not red meat is associated with the incidence of hypertension: ELSA-Brasil cohort

OBJECTIVES

To verify the association between the consumption of red and processed meats and the incidence of hypertension in participants of the Longitudinal Study of Adult Health.

METHODS

This was a cohort with data from the baseline (2008-2010) and second wave (2012-2014) with 8,089 public workers of both sexes and different racial groups, with mean age of 49 ± 8 years (35-74 years old). Meat consumption (g/d) was estimated using a food frequency questionnaire and was divided into consumption tertiles. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic ≥90 mm Hg and/or antihypertensive medication. Cox proportional hazards models were used to estimate adjusted Hazard Ration (HRs) and 95% confidence interval (CI) for incident hypertension.

RESULTS

A total of 1186 incident cases of hypertension were identified. Even adjusting for confounders, such as urinary Na/K (sodium/potassium) ratio and BMI (body mass index), participants in the second (HR:1.19; 95% CI 1.03-1.30) and third (HR:1.30; 95% CI:1.11-1.53) tertile of processed meat consumption had a higher risk of developing hypertension than those in the first tertile. We did not find a significant association between red meat consumption and hypertension.

CONCLUSIONS

The increased risk of developing hypertension is associated with moderate and high consumption of processed meats but not with consumption of red meat.

Red and processed meat intake and risk of cardiovascular disease: A two-sample Mendelian randomization study

BACKGROUND & AIMS

Previous observational studies have yielded inconsistent findings regarding associations between red/processed meat intake and the risk of cardiovascular disease (CVD). Some studies have suggested positive relationships, while others have demonstrated no significant associations. However, causal effects remain uncertain. This 2023 Mendelianrandomization (MR) study investigated the causal relationship between red and processed meat (porkmeat, mutton meat, beef meat)intake and CVD risk by analyzing summary data from the UK Biobank (exposure), CARDIoGRAMplusC4D (coronary artery disease [CAD]), MEGASTROKE (stroke), Nielsen et al. (atrial fibrillation [AF]), HERMES (heart failure [HF]), and FinnGen (cardiovascular outcomes) public databases.

METHODS

Genome-wide association studies (GWAS) of red meat (pork, beef, and mutton) and processed meat were sourced from the United Kingdom (UK) Biobank. GWAS data on CVD for this study were obtained from the Gene and FinnGen consortia. The primary method employed for the two-sample MR analysis was inverse variance weighting (IVW). Sensitivity analysis was performed to assess the reliability and consistency of the results.

RESULTS

Genetically predicted red and processed meat consumption did not demonstrate a causal association with any CVD outcomes when employing the IVW method. For processed meat intake, the odds ratios (ORs) (95% confidence intervals CIs) in large consortia were as follows: 0.88 (0.56-1.39) for CAD, 0.91 (0.65-1.27) for AF, 0.84 (0.58-1.21) for HF, and 1.00 (0.75-1.05) for stroke. In FinnGen, the ORs were as follows: 1.15 (0.83-1.59) for CAD, 1.25 (0.75-2.07) for AF, 1.09 (0.73-1.64) for HF, and 1.27 (0.85-1.91) for stroke. For beef intake, the ORs (95% CIs) in large consortia were as follows: 0.70 (0.28-1.73) for CAD, 0.85 (0.49-1.49) for AF, 0.80 (0.35-1.83) for HF, and 1.29 (0.85-1.95) for stroke. In FinnGen, the ORs were as follows: 2.01 (0.75-5.39) for CAD, 1.83 (0.60-5.56) for AF, 0.80 (0.30-2.13) for HF, and 1.30 (0.62-2.73) for stroke. For pork intake, the ORs (95% CIs) in large consortia were as follows: 1.25 (0.37-4.22) for CAD, 1.26 (0.73-2.15) for AF, 1.71 (0.86-3.39) for HF, and 1.15 (0.63-2.11) for stroke. In FinnGen, the ORs were as follows: 1.12 (0.43-2.88) for CAD, 0.39 (0.08-1.83) for AF, 0.62 (0.20-1.88) for HF, and 0.60 (0.21-1.65) for stroke. For mutton intake, the ORs (95% CIs) in large consortia were as follows: 0.84 (0.48-1.44) for CAD, 0.84 (0.56-1.26) for AF, 1.04 (0.65-1.67) for HF, and 1.06 (0.77-1.45) for stroke. In FinnGen, the ORs were as follows: 1.20 (0.65-2.21) for CAD, 0.92 (0.44-1.92) for AF, 0.74 (0.34-1.58) for HF, and 0.75 (0.45-1.24) for stroke. The results remained robust and consistent in both the meta-analysis and supplementary MR analysis.

CONCLUSIONS

This MR study demonstrated no significant causal relationships between red/processed meat intake and the risk of the four CVD outcomes examined. Further investigation is warranted to confirm these findings.

Red meat consumption, cardiovascular diseases, and diabetes: a systematic review and meta-analysis

AIMS

Observational studies show inconsistent associations of red meat consumption with cardiovascular disease (CVD) and diabetes. Moreover, red meat consumption varies by sex and setting, however, whether the associations vary by sex and setting remains unclear.

METHODS AND RESULTS

This systematic review and meta-analysis was conducted to summarize the evidence concerning the associations of unprocessed and processed red meat consumption with CVD and its subtypes [coronary heart disease (CHD), stroke, and heart failure], type two diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM) and to assess differences by sex and setting (western vs. eastern, categorized based on dietary pattern and geographic region). Two researchers independently screened studies from PubMed, Web of Science, Embase, and the Cochrane Library for observational studies and randomized controlled trials (RCTs) published by 30 June 2022. Forty-three observational studies (N = 4 462 810, 61.7% women) for CVD and 27 observational studies (N = 1 760 774, 64.4% women) for diabetes were included. Red meat consumption was positively associated with CVD [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.05 to 1.16 for unprocessed red meat (per 100 g/day increment); 1.26, 95% CI 1.18 to 1.35 for processed red meat (per 50 g/day increment)], CVD subtypes, T2DM, and GDM. The associations with stroke and T2DM were higher in western settings, with no difference by sex.

CONCLUSION

Unprocessed and processed red meat consumption are both associated with higher risk of CVD, CVD subtypes, and diabetes, with a stronger association in western settings but no sex difference. Better understanding of the mechanisms is needed to facilitate improving cardiometabolic and planetary health.

Nuclear ATR lysine-tyrosylation protects against heart failure by activating DNA damage response

Dysregulated amino acid increases the risk for heart failure (HF) via unclear mechanisms. Here, we find that increased plasma tyrosine and phenylalanine levels are associated with HF. Increasing tyrosine or phenylalanine by high-tyrosine or high-phenylalanine chow feeding exacerbates HF phenotypes in transverse aortic constriction and isoproterenol infusion mice models. Knocking down phenylalanine dehydrogenase abolishes the effect of phenylalanine, indicating that phenylalanine functions by converting to tyrosine. Mechanistically, tyrosyl-tRNA synthetase (YARS) binds to ataxia telangiectasia and Rad3-related gene (ATR), catalyzes lysine tyrosylation (K-Tyr) of ATR, and activates the DNA damage response (DDR) in the nucleus. Increased tyrosine inhibits the nuclear localization of YARS, inhibits the ATR-mediated DDR, accumulates DNA damage, and elevates cardiomyocyte apoptosis. Enhancing ATR K-Tyr by overexpressing YARS, restricting tyrosine, or supplementing tyrosinol, a structural analog of tyrosine, promotes YARS nuclear localization and alleviates HF in mice. Our findings implicate facilitating YARS nuclear translocation as a potential preventive and/or interfering measure against HF.

State-of-the-Art Review: Evidence on Red Meat Consumption and Hypertension Outcomes

Hypertension (HTN) is a well-established risk factor for cardiovascular diseases (CVDs), including ischemic heart disease, stroke, heart failure, and atrial fibrillation. The prevalence of HTN, as well as mortality rates attributable to HTN, continue to increase, particularly in the United States and among Black populations. The risk of HTN involves a complex interaction of genetics and modifiable risk factors, including dietary patterns. In this regard, there is accumulating evidence that links dietary intake of red meat with a higher risk of poorly controlled blood pressure and HTN. However, research on this topic contains significant methodological limitations, which are described in the review. The report provided below also summarizes the available research reports, with an emphasis on processed red meat consumption and how different dietary patterns among certain populations may contribute to HTN-related health disparities. Finally, this review outlines potential mechanisms and provides recommendations for providers to counsel patients with evidence-based nutritional approaches regarding red meat and the risk of HTN, as well as CVD morbidity and mortality.

High Exogenous Antioxidant, Restorative Treatment (Heart) for Prevention of the Six Stages of Heart Failure: The Heart Diet

The exact pathophysiology of heart failure (HF) is not yet known. Western diet, characterized by highly sweetened foods, as well as being rich in fat, fried foods, red meat and processed meat, eggs, and sweet beverages, may cause inflammation, leading to oxidative dysfunction in the cardiac ultra-structure. Oxidative function of the myocardium and how oxidative dysfunction causes physio-pathological remodeling, leading to HF, is not well known. Antioxidants, such as polyphenolics and flavonoids, omega-3 fatty acids, and other micronutrients that are rich in Indo-Mediterranean-type diets, could be protective in sustaining the oxidative functions of the heart. The cardiomyocytes use glucose and fatty acids for the physiological functions depending upon the metabolic requirements of the heart. Apart from toxicity due to glucose, lipotoxicity also adversely affects the cardiomyocytes, which worsen in the presence of deficiency of endogenous antioxidants and deficiency of exogenous antioxidant nutrients in the diet. The high-sugar-and-high-fat-induced production of ceramide, advanced glycation end products (AGE) and triamino-methyl-N-oxide (TMAO) can predispose individuals to oxidative dysfunction and Ca-overloading. The alteration in the biology may start with normal cardiac cell remodeling to biological remodeling due to inflammation. An increase in the fat content of a diet in combination with inducible nitric oxide synthase (NOSi) via N-arginine methyl ester has been found to preserve the ejection fraction in HF. It is proposed that a greater intake of high exogenous antioxidant restorative treatment (HEART) diet, polyphenolics and flavonoids, as well as cessation of red meat intake and egg, can cause improvement in the oxidative function of the heart, by inhibiting oxidative damage to lipids, proteins and DNA in the cell, resulting in beneficial effects in the early stage of the Six Stages of HF. There is an unmet need to conduct cohort studies and randomized, controlled studies to demonstrate the role of the HEART diet in the treatment of HF.

Red meat consumption, incident CVD and the influence of dietary quality in the Jackson Heart Study

OBJECTIVES

We investigated the prospective associations between meat consumption and CVD and whether these relationships differ by dietary quality among African American (AA) adults.

DESIGN

Baseline diet was assessed with a regionally specific FFQ. Unprocessed red meat included beef and pork (120 g/serving); processed meat included sausage, luncheon meats and cured meat products (50 g/serving). Incident total CVD, CHD, stroke and heart failure were assessed annually over 9·8 years of follow-up. We characterised dietary quality using a modified Healthy Eating Index-2010 score (m-HEI), excluding meat contributions.

SETTING

Jackson, MS, USA.

PARTICIPANTS

AA adults (n 3242, aged 55 y, 66 % female).

RESULTS

Mean total, unprocessed red and processed meat intakes were 5·7 ± 3·5, 2·3 ± 1·8 and 3·3 ± 2·7 servings/week, respectively. Mostly, null associations were observed between meat categories and CVD or subtypes. However, greater intake of unprocessed red meat (three servings/week) was associated with significantly elevated risk of stroke (hazard ratio = 1·43 (CI: 1·07,1·90)). With the exception of a more positive association between unprocessed meat consumption and stroke among individuals in m-HEI Tertile 2, the strength of associations between meat consumption categories and CVD outcomes did not differ by m-HEI tertile. In formal tests, m-HEI did not significantly modify meat-CVD associations.

CONCLUSIONS

In this cohort of AA adults, total and processed meat were not associated with CVD outcomes, with the exception that unprocessed red meat was related to greater stroke risk. Dietary quality did not modfiy these associations. Research is needed in similar cohorts with longer follow-up and greater meat consumption to replicate these findings.

Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the dose-response relationship: A systematic review and meta-analysis of cohort studies

OBJECTIVES

The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CVD) incidence and mortality, and the dose-response relationship.

METHODS

Published literature was retrieved through a structured search of 10 electronic databases: MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO and Embase, without language or year of publication restrictions. In addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes: The PRISMA Statement.

RESULTS

Twenty-one prospective cohort studies were included in the systematic review. The CVDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CVD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; CI 1.01 to 1.19; p = 0.02). There was no association with Ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; CI 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CVD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; CI 1.08 to 1.26; p < 0.0001). There was no association with Ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CVD.

CONCLUSION

According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CVD. This systematic review and meta-analysis protocol was registered on the PROSPERO (number: CRD42019100914).

The Dietary Approach to Stop Hypertension (DASH) diet is associated with a lower risk of heart failure: A cohort study

AIMS

Trials demonstrate that following the DASH diet lowers blood pressure, which may prevent development of heart failure (HF). We investigated the association between long-term adherence to the DASH diet and food substitutions within the DASH diet on the risk of HF.

METHODS

Men and women aged 45-83 years without previous HF, ischemic heart disease or cancer at baseline in 1998 from the Cohort of Swedish Men (n = 41,118) and the Swedish Mammography Cohort (n = 35,004) were studied. The DASH diet emphasizes intake of fruit, vegetables, whole grains, nuts and legumes and low-fat dairy and deemphasizes red and processed meat, sugar-sweetened beverages and sodium. DASH diet scores were calculated based on diet assessed by food frequency questionnaires in late 1997 and 2009. Incidence of HF was ascertained using the Swedish Patient Register. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI).

RESULTS

During the median 22 years of follow-up (1998-2019) 12,164 participants developed HF. Those with the greatest adherence to the DASH diet had a lower risk of HF compared to those with the lowest adherence (HR 0.85, 95% CI 0.80, 0.91 for baseline diet and HR 0.83, 95% CI 0.78, 0.89 for long-term diet, comparing quintiles). Replacing 1 serving/day of red and processed meat with emphasized DASH diet foods was associated with an 8-12% lower risk of HF.

CONCLUSION

Long-term adherence to the DASH diet and relevant food substitutions within the DASH diet were associated with a lower risk of HF.

Contrasting prenatal nutrition and environmental exposures in association with birth weight and cognitive function in children at 7 years

Background

Good nutrition is essential for individual health, a notion that is particularly true during pregnancy. We have used a nutrition index that measures the adequacy of one’s diet relative to the unique nutritional needs of individuals due to, for example, their activity level, dietary restrictions, lifestyle and body size. The use of this personalised metric of dietary nutritiousness in the analysis of prenatal environmental exposures and developmental outcomes permits testing for potential mitigating effects of good nutrition. We also provide an analysis strategy for investigating the balance in beneficial food sources which are also the source of environmental toxicants.

Methods

A holistic measure of nutrition, My Nutrition Index (MNI), measures the nutrient quality (ie, ‘nutritiousness’) of a specified daily diet. MNI is calculated based on quantification of dozens of macronutrients and micronutrients that are specific to an individual’s nutritional needs by incorporating dietary restrictions, subject characteristics, activity level and health behaviours. The Swedish Environmental, Longitudinal, Mother and child, Asthma and allergy Study is a Swedish pregnancy cohort, with prenatal endocrine disrupting chemicals (EDCs) exposure and dietary data available. This makes it possible to test for the potential mitigating effects of good nutrition on health and development effects in offspring from EDCs.

Results

Using prenatal Food Frequency Questionnaire data to construct an individual’s MNI, the index was significantly and positively associated with important metabolic outcome (as measured by birth weight) and cognitive function at age 7 years (as measured by WISC IQ) in children when adjusted for covariates and prenatal concentrations of an EDC. In a stratified analysis of ‘low’ and ‘high’ fish consumption, a potential source of perfluoro-octanesulfonic acid (PFOS), the association between PFOS and birth weight was diminished in the high consumption group compared with the low consumption group.

Conclusions

Thus, MNI is evidently a metric of the general nutritiousness of daily diets and is useful in environmental health studies in representing the impact of good nutrition, even during pregnancy.

Intake of Animal Source Foods in Relation to Risk of Metabolic Syndrome

Metabolic syndrome (MetS) is a prevalent disorder associated with diabetes and cardiovascular diseases. Lifestyle and occupation can increase the risk of developing MetS. Since dietary pattern is a major component of lifestyle, this study aimed to determine the relationship between consumption of animal source foods (ASFs) and MetS among food suppliers. This cross-sectional study was conducted on 112 male food suppliers. We measured anthropometric indices, body composition, and blood pressure of the participants. Blood biochemistry was determined using 5 mL fasting blood samples. MetS was defined based on the guidelines described by the International Diabetes Federation (IDF). ASF intake, including dairy products, eggs, red meat, poultry, and fish, was assessed using food frequency questionnaires. Overall, 46.4% of participants had MetS. Participants who consumed dairy 3∼5 times/d and more than 5 times/d had lower risk of MetS [odds ratios (OR): 0.18 (confidence interval (CI) 95%: 0.05∼0.62) and OR: 0.20 (CI 95%: 0.06∼0.67), respectively] compared with participants in the lowest tertile. The risk of hypertension was significantly decreased in participants who consumed dairy products >5 times/d [OR: 0.22 (CI 95%: 0.07∼0.67)]. Other ASFs were not associated against the risk of MetS in crude and adjusted models. Our findings indicated that adhering to dairy products can decrease the risk of MetS. Higher adherence to dairy products was also protective against hypertension in these participants.

Race, Gender, Family Structure, Socioeconomic Status, Dietary Patterns, and Cardiovascular Health in Adolescents

BACKGROUND

Dietary patterns represent a broad picture of food and nutrient consumption and may be more predictive of health outcomes than individual foods and nutrients.

OBJECTIVE

We investigated the relations among race, gender, family structure, parental socioeconomic status (SES), dietary patterns, and cardiovascular disease (CVD) profiles among adolescents in the southeastern region of the United States.

METHODS

A total of 743 adolescents from a cross-sectional study were divided into 4 dietary pattern groups by K-means cluster analysis. Multinomial logistic regression was performed to determine the relations among the parental SES, family structures, and dietary patterns of the adolescents. Associations between dietary patterns and CVD profiles were analyzed by multiple linear regression.

RESULTS

Four dietary patterns were derived: "healthy" (17%), "snacks and sweets" (26%), "processed meat" (20%), and "sugar-sweetened beverage (SSB) and fried food" (37%). Whites and females were more likely to have a "healthy" dietary pattern (Ps < 0.001). There were significant race/ethnicity differences in family structures, SES, and dietary patterns (Ps < 0.05). In whites, higher mother's education and father's education and occupation were associated with greater likelihood of a "healthy" dietary pattern (Ps < 0.05). Stay-at-home mother was associated with less likelihood of an "SSB and fried food" pattern (P = 0.023). In blacks, higher mother's occupation, father's education, and living with both parents were associated with more likelihood of a "healthy" dietary pattern (Ps < 0.05). Stay-at-home father was associated with less likelihood of the "snacks and sweets" (P = 0.025) and "SSB and fried food" dietary patterns (P = 0.044). Overall, adolescents with poor dietary patterns exhibited higher percentage body fat, waist circumference, systolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance, C-reactive protein, and total triglyceride (Ps < 0.05).

CONCLUSIONS

Our data suggest that family structure, parental working status, and SES are associated with the diet quality in adolescents. Moreover, "snacks and sweets," "processed meat," and "SSB and fried food" dietary patterns are all associated with worse CVD risk profiles.

Factors Associated with Meat Consumption in Students of Spanish Universities: UniHcos Project

The level of meat consumption is one of the main deviations from the Mediterranean diet pattern in Spanish university students. The objective of this cross-sectional descriptive study is to analyze the association between sociodemographic factors and the consumption of fresh and processed meat in Spanish university students. This study is part of a cohort of 11 Spanish universities with 9862 university students (UniHcos Project). A descriptive analysis and a chi2 test were carried out to assess differences between personal and sociodemographic variables and meat consumption, and binary logistic regression analysis to assess factors associated with consumption; 19.9% and 73.5% met the recommendations for meat-fresh and meat-processed consumption, respectively. Only 3.8% of students meet the recommendations for both fresh and processed meat. Statistically significant differences were found between sex, BMI, employment, housing, and coexistence regarding compliance with recommendations. Female employed students living in rental accommodations with a partner are more likely to meet the recommendations for fresh meats while male, normal weight, employed students living in rental accommodations with a partner are more likely to meet the recommendations for processed meats. There is a lack of compliance with the recommendations for consumption of fresh meat in Spanish university students, differences in compliance among students of differing regions and an association with sex, employment, housing, and coexistence regarding compliance.

Intake of Different Dietary Proteins and Risk of Heart Failure in Men: The Kuopio Ischaemic Heart Disease Risk Factor Study

Supplemental Digital Content is available in the text.

Background:

Animal and plant protein intakes have indicated opposite associations with cardiovascular mortality risk. Whether dietary proteins are associated with risk of heart failure (HF) is unclear. Thus, we examined the associations of proteins from different food sources with risk of HF.

Methods and Results:

The study included 2441 men aged 42 to 60 years at the baseline examinations in 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Protein intakes at baseline were assessed with 4-day dietary records. Data on incident HF cases were obtained from national registers. HF risk according to protein intake was estimated by Cox proportional hazard ratios. During the mean follow-up of 22.2 years, 334 incident HF cases occurred. Higher intake of total protein indicated a trend toward increased risk of HF (multivariable-adjusted hazard ratio in the highest versus lowest quartile=1.33; 95% confidence interval: 0.95–1.85; P-trend=0.05). The associations between specific types and sources of protein with incident HF were consistent with this overall finding although not all associations reached statistical significance. For example, the hazard ratio in the highest versus lowest quartile was 1.43 (95% confidence interval: 1.00–2.03; P-trend=0.07) for total animal protein and 1.17 (95% confidence interval: 0.72–1.91; P-trend=0.35) for total plant protein.

Conclusions:

In middle-aged men, higher protein intake was marginally associated with increased risk of HF.

CLINICAL TRIAL REGISTRATION:

URL: https://www.clinicaltrials.gov. Unique identifier: NCT03221127

Estimation of the burden of disease attributable to red meat consumption in France: Influence on colorectal cancer and cardiovascular diseases

The consumption of red meat has been associated with colorectal cancer (CRC) and cardiovascular disease (CVD) worldwide. The objective of this study was to assess quantitatively the burden of disease of CRC and CVD due to the consumption of red meat in France. A probabilistic risk assessment model quantifying the risk, deaths and disability adjusted life years (DALY) of both outcomes was built. In the model, uncertainty and variability were propagated separately. The model used data on current CRC and CVD incidence and red meat consumption in France, as well as dose-response from epidemiological studies. Results were given by age class and gender. A total of 19 [95% CI = 8-33] DALY per 100,000 people per year for CRC associated with red meat consumption was estimated. For CVD, 21 [95% CI = 12-32] DALY per 100,000 people per year was estimated. The uncertainty was mainly due to the dose-response, as revealed by a sensitivity analysis. A scenario analysis, performed on red meat intake, highlighted that consumption of less than 65 g per day could limit the risk of CRC and CVD in the most affected sub-populations.

Association between intake of red and processed meat and the risk of heart failure: a meta-analysis

Background

Many studies have assessed the association between consumption of red and processed meat and the risk of heart failure, but the results are not consistent. This meta-analysis aimed to comprehensively evaluate the relationship between intake of red and processed meat and the risk of heart failure.

Methods

Databases of Web of Knowledge, PubMed, and Wan Fang Med Online were retrieved up to date of August 31st, 2017. Suitable publications were identified through using the defined inclusion criteria. The summarized relative risk (RR) with the corresponding 95% confidence interval (CI) was calculated.

Results

Six scientific literatures were included in this study. In comparison with the lowest category, the summarized RR and 95% CI of the highest category of processed meat intake for heart failure risk was 1.23 (95% CI = 1.07–1.41, I² = 58.9%, P = 0.045). A significant connection between processed meat intake and heart failure was identified among the Europeans (RR = 1.33, 95% CI = 1.15–1.54), but not the Americans. Yet few of essential association was found between heart failure risk and red meat intake (RR = 1.04, 95% CI = 0.96–1.12).

Conclusions

Findings of this meta-analysis indicated that the highest category of processed meat intake, other than red meat intake, correlated with an increased risk of heart failure.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6653-0) contains supplementary material, which is available to authorized users.

Intake of protein-rich foods in relation to outcomes of infertility treatment with assisted reproductive technologies

Background

Some dietary factors have been linked to outcomes of infertility treatment with assisted reproductive technology (ART), but the role of intake of meats and other protein-rich foods remains unclear.

Objective

The aim of this manuscript was to study the relation between preconception intake of meat and other protein-rich foods and outcomes of infertility treatment with ART.

Design

A total of 351 women enrolled in a prospective cohort at the Massachusetts General Hospital Fertility Center and underwent 598 ART cycles for infertility treatment. Meat intake was assessed with a validated food-frequency questionnaire, and ART outcomes were abstracted from electronic medical records. We estimated the associations between intake of protein-rich foods (meats, eggs, beans, nuts, and soy) and the outcome of live birth per initiated cycle using generalized linear mixed models.

Results

The average total meat intake was 1.2 servings/d, with most coming from poultry (35%), fish (25%), processed meat (22%), and red meat (17%). Fish intake was positively related to the proportion of cycles resulting in live birth. The multivariable-adjusted probabilities of live birth for women in increasing quartiles of fish intake were 34.2% (95% CI: 26.5%, 42.9%), 38.4% (95% CI: 30.3%, 47.3%), 44.7% (95% CI: 36.3%, 53.4%), and 47.7% (95% CI: 38.3%, 57.3%), respectively (P-trend = 0.04). In the estimated substitution analyses, the ORs of live birth associated with increasing fish intake by 2 servings/wk were 1.54 (95% CI: 1.14, 2.07) when fish replaced any other meat, 1.50 (95% CI: 1.13, 1.98) when fish replaced any other protein-rich food, and 1.64 (95% CI: 1.14, 2.35) when fish replaced processed meat.

Conclusions

Fish consumption is related to a higher probability of live birth following infertility treatment with ART. This trial was registered at clinicaltrials.gov as NCT00011713.

Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies

Growing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.

A Review of Plant-based Diets to Prevent and Treat Heart Failure

Evidence supporting the role of nutrition in heart failure (HF) incidence and severity is growing. A comprehensive search of online databases was conducted using relevant keywords to identify human studies including diet and HF. Several plant-based diets have consistently been associated with decreased HF incidence and severity, notably the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets. Several other plant-based dietary patterns, including low-fat diets and the rice diet, also show promise. Higher dietary quality, as assessed using different scores, seems to provide protective qualities. Fruit, vegetables, legumes and wholegrains appear to be beneficial, whereas red/processed meats, eggs and refined carbohydrates appear harmful. Some evidence suggests detrimental effects of dairy products and poultry, but more research is needed. There is observational and interventional evidence that a plant-based diet high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans fats may decrease the incidence and severity of HF. Potential mechanisms for this include decreased oxidative stress, homocysteine and inflammation levels, as well as higher antioxidant defence and nitric oxide bioavailability with gut microbiome modulation. Well-designed randomised, controlled nutrition intervention trials specific to HF are urgently required.

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

BACKGROUND

Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).

METHODS

We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.

RESULTS

Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RRCHD: 0.95 (95% CI: 0.92-0.98), RRHF: 0.96 (0.95-0.97)), vegetables and fruits (RRCHD: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RRstroke: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RRCHD: 0.67 (0.43-1.05)), and fish consumption (RRCHD: 0.88 (0.79-0.99), RRstroke: 0.86 (0.75-0.99), and RRHF: 0.80 (0.67-0.95)), while a positive association was present for egg (RRHF: 1.16 (1.03-1.31)), red meat (RRCHD: 1.15 (1.08-1.23), RRstroke: 1.12 (1.06-1.17), RRHF: 1.08 (1.02-1.14)), processed meat (RRCHD: 1.27 (1.09-1.49), RRstroke: 1.17 (1.02-1.34), RRHF: 1.12 (1.05-1.19)), and SSB consumption (RRCHD: 1.17 (1.11-1.23), RRstroke: 1.07 (1.02-1.12), RRHF: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.

CONCLUSION

An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.

Processed red meat contribution to dietary patterns and the associated cardio-metabolic outcomes

Evidence suggests that processed red meat consumption is a risk factor for CVD and type 2 diabetes (T2D). This analysis investigates the association between dietary patterns, their processed red meat contributions, and association with blood biomarkers of CVD and T2D, in 786 Irish adults (18–90 years) using cross-sectional data from a 2011 national food consumption survey. All meat-containing foods consumed were assigned to four food groups (n 502) on the basis of whether they contained red or white meat and whether they were processed or unprocessed. The remaining foods (n 2050) were assigned to twenty-nine food groups. Two-step and k-means cluster analyses were applied to derive dietary patterns. Nutrient intakes, plasma fatty acids and biomarkers of CVD and T2D were assessed. A total of four dietary patterns were derived. In comparison with the pattern with lower contributions from processed red meat, the dietary pattern with greater processed red meat intakes presented a poorer Alternate Healthy Eating Index (21·2 (sd 7·7)), a greater proportion of smokers (29 %) and lower plasma EPA (1·34 (sd 0·72) %) and DHA (2·21 (sd 0·84) %) levels (P<0·001). There were no differences in classical biomarkers of CVD and T2D, including serum cholesterol and insulin, across dietary patterns. This suggests that the consideration of processed red meat consumption as a risk factor for CVD and T2D may need to be re-assessed.

Potential health hazards of eating red meat

Red meat (beef, veal, pork, lamb and mutton) consumption contributes several important nutrients to the diet, for example essential amino acids, vitamins (including B12) and minerals (including iron and zinc). Processed red meat (ham, sausages, bacon, frankfurters, salami, etc.) undergoes treatment (curing, smoking, salting or the use of chemical preservatives and additives) to improve its shelf life and/or taste. During recent decades, consumption of red meat has been increasing globally, especially in developing countries. At the same time, there has been growing evidence that high consumption of red meat, especially of processed meat, may be associated with an increased risk of several major chronic diseases. Here, a comprehensive summary is provided of the accumulated evidence based on prospective cohort studies regarding the potential adverse health effects of red meat consumption on major chronic diseases, such as diabetes, coronary heart disease, heart failure, stroke and cancer at several sites, and mortality. Risk estimates from pooled analyses and meta-analyses are presented together with recently published findings. Based on at least six cohorts, summary results for the consumption of unprocessed red meat of 100 g day^-1 varied from nonsignificant to statistically significantly increased risk (11% for stroke and for breast cancer, 15% for cardiovascular mortality, 17% for colorectal and 19% for advanced prostate cancer); for the consumption of 50 g day^-1 processed meat, the risks were statistically significantly increased for most of the studied diseases (4% for total prostate cancer, 8% for cancer mortality, 9% for breast, 18% for colorectal and 19% for pancreatic cancer, 13% for stroke, 22% for total and 24% for cardiovascular mortality and 32% for diabetes). Potential biological mechanisms underlying the observed risks and the environmental impact of red meat production are also discussed. The evidence-based integrated message is that it is plausible to conclude that high consumption of red meat, and especially processed meat, is associated with an increased risk of several major chronic diseases and preterm mortality. Production of red meat involves an environmental burden. Therefore, some European countries have already integrated these two issues, human health and the 'health of the planet', into new dietary guidelines and recommended limiting consumption of red meat.

Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts

BACKGROUND

Some studies have found that egg consumption is associated with a higher risk of ischemic heart disease in patients with diabetes. Epidemiologic studies of egg consumption in relation to risk of heart failure (HF) and stroke types are scarce.

OBJECTIVE

The aim of this study was to examine whether egg consumption is associated with incidence of HF, myocardial infarction (MI), or stroke types.

DESIGN

In prospective cohorts of 37,766 men (Cohort of Swedish Men) and 32,805 women (Swedish Mammography Cohort) who were free of cardiovascular disease (CVD), egg consumption was assessed at baseline with a food-frequency questionnaire. Incident CVD cases were identified through linkage with the Swedish National Patient and Cause of Death Registers. The data were analyzed with the use of a Cox proportional hazards regression model.

RESULTS

During 13 y of follow-up, we ascertained 1628 HFs, 3262 MIs, 2039 ischemic strokes, and 405 hemorrhagic strokes in men and 1207 HFs, 1504 MIs, 1561 ischemic strokes, and 294 hemorrhagic strokes in women. There was no statistically significant association between egg consumption and risk of MI or any stroke type in either men or women or HF in women. In men, consumption of ≤6 eggs/wk was not associated with HF risk; however, daily egg consumption (≥1/d) was associated with a 30% higher risk of HF (RR: 1.30; 95% CI: 1.01, 1.67). Egg consumption was not associated with any CVD outcome in individuals with diabetes.

CONCLUSIONS

Daily egg consumption was not associated with risk of MI or any stroke type in either men or women or with HF in women. Consumption of eggs ≥1 time/d, but not less frequent consumption, was associated with an elevated risk of HF in men.