Abstract
Background:
Red meat consumption was associated with increased risk of cardiovascular disease (CVD) in prospective cohort studies and a profile of biomarkers favoring high cardiovascular risk in short-term controlled trials. However, several recent systematic reviews and meta-analyses concluded with no or weak evidence for limiting red meat intake.
Objective:
To prospectively examine the associations between red meat intake and incident CVD in an ongoing cohort study with diverse socioeconomic and racial/ethnic backgrounds.
Method:
Our study included 148,506 participants (17,804 female (12.0%)) who were free of cancer, diabetes, and CVD at baseline from the Million Veteran Program. Red meat intakes were measured by a food frequency questionnaire at baseline. Non-fatal myocardial infarction and acute ischemic stroke were identified through a high-throughput phenotyping algorithm, and fatal CVD events were identified by searching the National Death Index.
Results:
Comparing the extreme categories of intake, the multivariate-adjusted relative risks of CVD was 1.18 (95% CI: 1.01-1.38; Ptrend < 0.0001) for total red meat, 1.14 (95% CI: 0.96-1.36; Ptrend=0.01) for unprocessed red meat and 1.29 (95% CI: 1.04-1.60; Ptrend =0.003) for processed red meat. We observed a more pronounced positive association between red meat intake and CVD in African-American participants than in white participants (Pinteraction =0.01). Replacing 0.5 servings/day of red meat with 0.5 servings/day of nuts, whole grains, and skimmed milk was associated with 14% (RR=0.86; 95% CI, 0.83-0.90), 7% (RR=0.93; 95% CI, 0.89-0.96), and 4% (RR=0.96; 95% CI, 0.94-0.99) lower risks of CVD, respectively.
Conclusions:
Red meat consumption is associated with an increased risk of CVD. Our findings support lowering red meat intake and replacing red meat with plant sources of protein or low-fat dairy foods as a key dietary recommendation for the prevention of CVD.
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