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Sun L, Yuan JL, Chen QC, Xiao WK, Ma GP, Liang JH, Chen XK, Wang S, Zhou XX, Wu H, Hong CX. Red meat consumption and risk for dyslipidaemia and inflammation: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:996467. [PMID: 36247460 PMCID: PMC9563242 DOI: 10.3389/fcvm.2022.996467] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Aim The study (PROSPERO: CRD42021240905) aims to reveal the relationships among red meat, serum lipids and inflammatory biomarkers. Methods and results PubMed, EMBASE and the Cochrane databases were explored through December 2021 to identify 574 studies about red meat and serum lipids markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) or hypersensitive-CRP (hs-CRP). Finally, 20 randomized controlled trials (RCTs) involving 1001 people were included, red meat and serum lipid markers and their relevant information was extracted. The pooled standard mean difference (SMD) was obtained by applying a random-effects model, and subgroup analyses and meta-regression were employed to explain the heterogeneity. Compared with white meat or grain diets, the gross results showed that the consumption of red meat increased serum lipid concentrations like TG (0.29 mmol/L, 95% CI 0.14, 0.44,P<0.001), but did not significantly influence the TC (0.13 mmol/L, 95% CI −0.07, 0.33, P = 0.21), LDL-C (0.11 mmol/L, 95% CI −0.23, 0.45, P = 0.53), HDL-C (−0.07 mmol/L, 95% CI −0.31, 0.17, P = 0.57),CRP or hs-CRP (0.13 mmol/L, 95% CI −0.10, 0.37,P = 0.273). Conclusion Our study provided evidence to the fact that red meat consumption affected serum lipids levels like TG, but almost had no effect on TC, LDL-C, HDL-C and CRP or hs-CRP. Such diets with red meat should be taken seriously to avoid the problem of high lipid profiles. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021240905].
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Affiliation(s)
- Le Sun
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jia-Lin Yuan
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiu-Cen Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-Kang Xiao
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gui-Ping Ma
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jia-Hua Liang
- The Department of Cardiovascular Disease, Meizhou Hospital of Traditional Chinese Medicine, Meizhou, China
| | - Xiao-Kun Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Song Wang
- The Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Xiong Zhou
- The Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Wu
- The Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Hui Wu,
| | - Chuang-Xiong Hong
- The Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Chuang-Xiong Hong,
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Guasch-Ferré M, Satija A, Blondin SA, Janiszewski M, Emlen E, O’Connor LE, Campbell WW, Hu FB, Willett WC, Stampfer MJ. Meta-Analysis of Randomized Controlled Trials of Red Meat Consumption in Comparison With Various Comparison Diets on Cardiovascular Risk Factors. Circulation 2019; 139:1828-1845. [DOI: 10.1161/circulationaha.118.035225] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Marta Guasch-Ferré
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
| | - Ambika Satija
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Stacy A. Blondin
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Marie Janiszewski
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
| | - Ester Emlen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
| | - Lauren E. O’Connor
- Department of Nutrition Science, Purdue University, West Lafayette, IN (L.W.O., W.W.C.)
| | - Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN (L.W.O., W.W.C.)
| | - Frank B. Hu
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology (F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
| | - Walter C. Willett
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology (F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
| | - Meir J. Stampfer
- Department of Nutrition (M.G.-F., A.S., S.A.B., F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology (F.B.H., W.C.W., M.J.S.), Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (M.G.-F., M.J., E.E., F.B.H., W.C.W., M.J.S.)
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Abstract
We provide an overview of studies on seafood intake in relation to obesity, insulin resistance and type 2 diabetes. Overweight and obesity development is for most individuals the result of years of positive energy balance. Evidence from intervention trials and animal studies suggests that frequent intake of lean seafood, as compared with intake of terrestrial meats, reduces energy intake by 4–9 %, sufficient to prevent a positive energy balance and obesity. At equal energy intake, lean seafood reduces fasting and postprandial risk markers of insulin resistance, and improves insulin sensitivity in insulin-resistant adults. Energy restriction combined with intake of lean and fatty seafood seems to increase weight loss. Marine n-3 PUFA are probably of importance through n-3 PUFA-derived lipid mediators such as endocannabinoids and oxylipins, but other constituents of seafood such as the fish protein per se, trace elements or vitamins also seem to play a largely neglected role. A high intake of fatty seafood increases circulating levels of the insulin-sensitising hormone adiponectin. As compared with a high meat intake, high intake of seafood has been reported to reduce plasma levels of the hepatic acute-phase protein C-reactive protein level in some, but not all studies. More studies are needed to confirm the dietary effects on energy intake, obesity and insulin resistance. Future studies should be designed to elucidate the potential contribution of trace elements, vitamins and undesirables present in seafood, and we argue that stratification into responders and non-responders in randomised controlled trials may improve the understanding of health effects from intake of seafood.
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O'Connor LE, Kim JE, Campbell WW. Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials. Am J Clin Nutr 2017; 105:57-69. [PMID: 27881394 PMCID: PMC5183733 DOI: 10.3945/ajcn.116.142521] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/17/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Observational associations between red meat intake and cardiovascular disease (CVD) are inconsistent. There are limited comprehensive analyses of randomized controlled trials (RCTs) that investigate the effects of red meat consumption on CVD risk factors. OBJECTIVE The purpose of this systematically searched meta-analysis was to assess the effects of consuming ≥0.5 or <0.5 servings of total red meat/d on CVD risk factors [blood total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides, ratio of TC to HDL cholesterol (TC:HDL), and systolic and diastolic blood pressures (SBP and DBP, respectively)]. We hypothesized that the consumption of ≥0.5 servings of total red meat/d would have a negative effect on these CVD risk factors. DESIGN Two researchers independently screened 945 studies from PubMed, Cochrane Library, and Scopus databases and extracted data from 24 qualified RCTs. Inclusion criteria were 1) RCT, 2) subjects aged ≥19 y, 3) consumption of ≥0.5 or <0.5 total red meat servings/d [35 g (1.25 ounces)], and 4) reporting ≥1 CVD risk factor. We performed an adjusted 2-factor nested ANOVA mixed-effects model procedure on the postintervention values of TC, LDL cholesterol, HDL cholesterol, TC:HDL cholesterol, triglycerides, SBP, and DBP; calculated overall effect sizes of change values; and used a repeated-measures ANOVA to assess pre- to postintervention changes. RESULTS Red meat intake did not affect lipid-lipoprotein profiles or blood pressure values postintervention (P > 0.05) or changes over time [weighted mean difference (95% CI): -0.01 mmol/L (-0.08, 0.06 mmol/L), 0.02 mmol/L (-0.05, 0.08 mmol/L), 0.03 mmol/L (-0.01, 0.07 mmol/L), and 0.04 mmol/L (-0.02, 0.10 mmol/L); -0.08 mm Hg (-0.26, 0.11 mm Hg); and -1.0 mm Hg (-2.4, 0.78 mm Hg) and 0.1 mm Hg (-1.2, 1.5 mm Hg) for TC, LDL cholesterol, HDL cholesterol, triglycerides, TC:HDL cholesterol, SBP, and DBP, respectively]. Among all subjects, TC, LDL cholesterol, HDL cholesterol, TC:HDL cholesterol, triglycerides, and DBP, but not SBP, decreased over time (P < 0.05). CONCLUSIONS The results from this systematically searched meta-analysis of RCTs support the idea that the consumption of ≥0.5 servings of total red meat/d does not influence blood lipids and lipoproteins or blood pressures.
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Affiliation(s)
- Lauren E O'Connor
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Jung Eun Kim
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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5
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Howes NL, Bekhit AEDA, Burritt DJ, Campbell AW. Opportunities and Implications of Pasture-Based Lamb Fattening to Enhance the Long-Chain Fatty Acid Composition in Meat. Compr Rev Food Sci Food Saf 2014; 14:22-36. [DOI: 10.1111/1541-4337.12118] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 09/04/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Natalie L. Howes
- AbacusBio Limited; Dunedin New Zealand
- Dept. of Food Science; Univ. of Otago; Dunedin New Zealand
- Dept. of Botany; Univ. of Otago; Dunedin New Zealand
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6
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McNeill SH. Inclusion of red meat in healthful dietary patterns. Meat Sci 2014; 98:452-60. [PMID: 25034452 DOI: 10.1016/j.meatsci.2014.06.028] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/19/2014] [Accepted: 06/20/2014] [Indexed: 02/07/2023]
Abstract
Dietary patterns are an important concept in dietary recommendations. The Western pattern is most commonly defined as a diet characterized by high intakes of refined grains, sugar and red meat, and has been shown to be associated with increased risks for certain types of cancer, coronary heart disease, diabetes, and obesity. However, isolating the independent effects of individual foods on health outcomes is central to helping individuals choose foods to build healthier dietary patterns to which they can adhere. Red meat is a popular source of high quality protein and provides a variety of essential nutrients that improve overall diet quality. It is also a source of saturated fatty acids, which observational evidence suggests are associated with heart disease, although recent data challenge this. Several studies have shown that lean red meat can be successfully included in recommended heart-healthy dietary patterns without detriment to blood lipids. Furthermore, increased dietary protein has been shown to promote healthy body weight and composition, in part by increasing satiety, and to improve vitality and stamina.
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Affiliation(s)
- Shalene H McNeill
- Human Nutrition Research, National Cattlemen's Beef Association, a contractor to the Beef Checkoff Program, 9110 East Nichols Ave., #300, Centennial, CO 80112, United States.
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7
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McDaniel J, Askew W, Bennett D, Mihalopoulos J, Anantharaman S, Fjeldstad AS, Rule DC, Nanjee NM, Harris RA, Richardson RS. Bison meat has a lower atherogenic risk than beef in healthy men. Nutr Res 2013; 33:293-302. [PMID: 23602247 PMCID: PMC5858688 DOI: 10.1016/j.nutres.2013.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 01/22/2013] [Accepted: 01/28/2013] [Indexed: 11/27/2022]
Abstract
The rearing method of bison and the nutrient content of the meat may make bison a healthier alternative to beef. We hypothesized that the acute and chronic effects of bison consumption, in comparison to beef, will result in a less perturbed blood lipid panel and a reduced inflammatory and oxidative stress response which will minimize the detrimental effect on vascular function. A double-blind, cross-over randomized trial was employed to examine the consequence of a single 12 oz serving (n = 14) and 7 weeks of chronic consumption (n = 10) (12 oz/d, 6 d/wk) of each meat. Measurements included blood lipids, interleukin-6, plasminogen activator inhibitor 1, C-reactive protein, oxidized low-density lipoprotein, protein carbonyl, hydroperoxides, flow-mediated dilation (FMD) and FMD/shear rate. Following a single beef meal, triglycerides and oxidized low-density lipoprotein were elevated (67% ± 45% and 18% ± 17% respectively); there was a tendency for hydroperoxides to be elevated (24% ± 37%); and FMD/shear rate was reduced significantly (30% ± 38%). Following a single meal of bison: there was a smaller increase in triglycerides (30% ± 27%), and markers of inflammation and oxidative stress and FMD/shear rate were unchanged. Chronic consumption of either meat did not influence body weight, % body fat, or blood lipids. Protein carbonyl (24% ± 45%), plasminogen activator inhibitor 1 (78% ± 126%), interleukin-6 (59% ± 76%) and C-reactive protein (72% ± 57%) were significantly elevated and FMD/shear rate was significantly reduced (19% ± 28%) following 7 weeks of beef consumption, but not bison consumption. Based on our findings, the data suggest that bison consumption results in a reduced atherogenic risk compared to beef.
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Affiliation(s)
- John McDaniel
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA.
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8
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Contribution of beef consumption to nutrient intake, diet quality, and food patterns in the diets of the US population. Meat Sci 2012; 90:152-8. [DOI: 10.1016/j.meatsci.2011.06.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/25/2011] [Accepted: 06/16/2011] [Indexed: 11/23/2022]
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9
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Zanovec M, O'Neil CE, Keast DR, Fulgoni VL, Nicklas TA. Lean beef contributes significant amounts of key nutrients to the diets of US adults: National Health and Nutrition Examination Survey 1999-2004. Nutr Res 2010; 30:375-81. [PMID: 20650344 DOI: 10.1016/j.nutres.2010.06.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 06/02/2010] [Accepted: 06/03/2010] [Indexed: 10/19/2022]
Abstract
Consumption of lean meat is a valuable addition to a healthy diet because it provides complete protein and is a rich source of vitamin B(12), iron, and zinc. The objective of this study was to examine the nutritional contribution of total beef and lean beef (LB) to the American diet using the USDA definition of LB as defined in MyPyramid. Twenty-four-hour dietary recall data from adults 19 to 50 years of age (n = 7049) and 51+ years (n = 6243) participating in the National Health and Nutrition Examination Survey 1999-2004 were assessed. Lean beef was defined as beef with <9.28 g fat per 100 g (excess was discretionary fat). Fifty percent of adults 19 to 50 years and 41% of adults 51+ years consumed beef on the day of the dietary recall. Total beef consumed among adults 19 to 50 and 51+ years was 49.3 +/- 1.4 g (1.74 oz/d) and 37.1 +/- 1.2 g (1.31 oz/d), respectively. In adults 19 to 50 and 51+ years, LB contributed 3.9% and 3.7% to total energy; 4.5% and 4.1% to total fat, 3.8% and 3.6% to saturated fatty acids; 13% and 11% to cholesterol intake; 15% and 14% to protein; 25% and 20% to vitamin B(12); 23% and 20% to zinc; and 8% and 7% to iron, respectively. Beef was also an important food source of many other nutrients, including niacin, vitamin B(6), phosphorus, and potassium. In addition, beef provided only 1% of total sodium intake. Consumption of beef contributed significantly to intake of protein and other key nutrients by US adults.
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Affiliation(s)
- Michael Zanovec
- School of Human Ecology, Louisiana State University Agricultural Center, Baton Rouge, LA 70803, USA
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O'Neil CE, Zanovec M, Keast DR, Fulgoni VL, Nicklas TA. Nutrient contribution of total and lean beef in diets of US children and adolescents: National Health and Nutrition Examination Survey 1999-2004. Meat Sci 2010; 87:250-6. [PMID: 21093990 DOI: 10.1016/j.meatsci.2010.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 10/21/2010] [Accepted: 10/26/2010] [Indexed: 11/28/2022]
Abstract
This study examined the nutritional contribution of total beef and lean beef (LB) to the diet of US children and adolescents using the US Department of Agriculture definition of LB as defined in MyPyramid. Twenty-four hour dietary recall data from children 4-8 years of age [y] (n=2474), 9-13 y (n=3273), and adolescents 14-18 y (n=4044) participating in the NHANES 1999-2004 were assessed. LB was defined as beef with ≤9.28 grams [g] fat/100 g (excess was discretionary fat). Means and standard errors were determined using appropriate sample weights. Consumption of LB contributed significantly to intake of protein and many key nutrients such as vitamins B6 and B12, zinc, iron, niacin, phosphorus, and potassium by US children and adolescents without providing significantly to intakes of total fat, saturated fatty acids, or sodium.
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Affiliation(s)
- Carol E O'Neil
- School of Human Ecology, Louisiana State University Agricultural Center, 261 Knapp Hall, Baton Rouge, LA 70803, USA.
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McAfee AJ, McSorley EM, Cuskelly GJ, Moss BW, Wallace JM, Bonham MP, Fearon AM. Red meat consumption: An overview of the risks and benefits. Meat Sci 2010; 84:1-13. [DOI: 10.1016/j.meatsci.2009.08.029] [Citation(s) in RCA: 444] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 08/07/2009] [Accepted: 08/10/2009] [Indexed: 11/29/2022]
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12
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Schönfeldt H, Gibson N. Changes in the nutrient quality of meat in an obesity context. Meat Sci 2008; 80:20-7. [DOI: 10.1016/j.meatsci.2008.05.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 05/20/2008] [Accepted: 05/21/2008] [Indexed: 10/22/2022]
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13
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Hooper L, Thompson RL, Harrison RA, Summerbell CD, Moore H, Worthington HV, Durrington PN, Ness AR, Capps NE, Davey Smith G, Riemersma RA, Ebrahim SBJ. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev 2004:CD003177. [PMID: 15495044 PMCID: PMC4170890 DOI: 10.1002/14651858.cd003177.pub2] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND It has been suggested that omega 3 (W3, n-3 or omega-3) fats from oily fish and plants are beneficial to health. OBJECTIVES To assess whether dietary or supplemental omega 3 fatty acids alter total mortality, cardiovascular events or cancers using both RCT and cohort studies. SEARCH STRATEGY Five databases including CENTRAL, MEDLINE and EMBASE were searched to February 2002. No language restrictions were applied. Bibliographies were checked and authors contacted. SELECTION CRITERIA RCTs were included where omega 3 intake or advice was randomly allocated and unconfounded, and study duration was at least six months. Cohorts were included where a cohort was followed up for at least six months and omega 3 intake estimated. DATA COLLECTION AND ANALYSIS Studies were assessed for inclusion, data extracted and quality assessed independently in duplicate. Random effects meta-analysis was performed separately for RCT and cohort data. MAIN RESULTS Forty eight randomised controlled trials (36,913 participants) and 41 cohort analyses were included. Pooled trial results did not show a reduction in the risk of total mortality or combined cardiovascular events in those taking additional omega 3 fats (with significant statistical heterogeneity). Sensitivity analysis, retaining only studies at low risk of bias, reduced heterogeneity and again suggested no significant effect of omega 3 fats. Restricting analysis to trials increasing fish-based omega 3 fats, or those increasing short chain omega 3s, did not suggest significant effects on mortality or cardiovascular events in either group. Subgroup analysis by dietary advice or supplementation, baseline risk of CVD or omega 3 dose suggested no clear effects of these factors on primary outcomes. Neither RCTs nor cohorts suggested increased relative risk of cancers with higher omega 3 intake but estimates were imprecise so a clinically important effect could not be excluded. REVIEWERS' CONCLUSIONS It is not clear that dietary or supplemental omega 3 fats alter total mortality, combined cardiovascular events or cancers in people with, or at high risk of, cardiovascular disease or in the general population. There is no evidence we should advise people to stop taking rich sources of omega 3 fats, but further high quality trials are needed to confirm suggestions of a protective effect of omega 3 fats on cardiovascular health. There is no clear evidence that omega 3 fats differ in effectiveness according to fish or plant sources, dietary or supplemental sources, dose or presence of placebo.
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Affiliation(s)
- L Hooper
- MANDEC, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.
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