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

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.

Healthy eating index-2015 and its association with the prevalence of stroke among US adults

This study aims to investigate the relationship between the healthy eating index (HEI) and the prevalence of stroke within a diverse United States population. Employing a cross-sectional design, we utilized data sourced from the National Health and Nutrition Examination Survey (NHANES). Dietary information was collected from participants and HEI scores were computed. NHANES employed stratified multistage probability sampling, with subsequent weighted analysis following NHANES analytical guidelines. Thorough comparisons were made regarding the baseline characteristics of individuals with and without stroke. Weighted multivariable logistic regression analysis and restricted cubic spline (RCS) methods were employed to ascertain the association between stroke risk and HEI, with LASSO regression utilized to identify dietary factors most closely linked to stroke risk. Additionally, we constructed a nomogram model incorporating key dietary factors and assessed its discriminatory capability using the receiver operating characteristic (ROC) curve. Our study encompassed 43,978 participants, representing an estimated 201 million U.S. residents. Participants with a history of stroke exhibited lower HEI scores than their non-stroke counterparts. Logistic regression analysis demonstrated a robust association between lower HEI scores and stroke, even after adjusting for confounding variables. RCS analysis indicated a nonlinear negative correlation between HEI and stroke risk. Furthermore, detailed subgroup analysis revealed a significant gender-based disparity in the impact of dietary quality on stroke risk, with females potentially benefiting more from dietary quality improvements. Sensitivity analysis using unweighted logistic regression yielded results consistent with our primary analysis. The nomogram model, based on key dietary factors identified through LASSO regression, demonstrated favorable discriminatory power, with an area under the curve (AUC) of 79.3% (95% CI 78.4-81.2%). Our findings suggest that higher HEI scores are inversely related to the risk of stroke, with potential greater benefits for women through dietary quality enhancement. These results underscore the importance of improving dietary quality for enhanced stroke prevention and treatment.

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.