Sinha Rashmi, Cross Amanda J, Graubard Barry I, Leitzmann Michael F, Schatzkin Arthur
Division of Cancer Epidemiology and Genetics, National Cancer Institute-Nutritional Epidemiology Branch, Rockville, MD 20852, USA.
Arch Intern Med. 2009 Mar 23;169(6):562-71. doi: 10.1001/archinternmed.2009.6.
High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.
The study population included the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire administered at baseline. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of meat intake. The covariates included in the models were age, education, marital status, family history of cancer (yes/no) (cancer mortality only), race, body mass index, 31-level smoking history, physical activity, energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption, and menopausal hormone therapy among women. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.
There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up. Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality. Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes. Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes. When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.
Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.
大量摄入红肉或加工肉类可能会增加死亡风险。我们的目标是确定红肉、白肉和加工肉类的摄入量与全因死亡率和特定病因死亡率风险之间的关系。
研究人群包括美国国立卫生研究院-美国退休人员协会(原美国退休人员协会)饮食与健康研究队列中50万年龄在50至71岁之间的基线人群。肉类摄入量通过基线时发放的食物频率问卷进行估算。Cox比例风险回归模型估计了肉类摄入量五分位数内的风险比(HRs)和95%置信区间(CIs)。模型中纳入的协变量包括年龄、教育程度、婚姻状况、癌症家族史(是/否)(仅用于癌症死亡率分析)、种族、体重指数、31级吸烟史、身体活动、能量摄入、酒精摄入、维生素补充剂使用情况、水果消费、蔬菜消费以及女性的绝经后激素治疗情况。主要结局指标包括全因死亡率以及癌症、心血管疾病、伤害和猝死以及所有其他原因导致的死亡。
在10年的随访期间,有47976例男性死亡和23276例女性死亡。红肉(HR分别为1.31[95%CI,1.27 - 1.35]和HR为1.36[95%CI,1.30 - 1.43])和加工肉类(HR分别为1.16[95%CI,1.12 - 1.20]和HR为1.25[95%CI,1.20 - 1.31])摄入量处于最高五分位数与最低五分位数的男性和女性,其全因死亡风险均有所升高。关于特定病因死亡率,红肉(HR分别为1.22[95%CI,1.16 - 1.29]和HR为1.20[95%CI,1.12 - 1.30])和加工肉类(HR分别为1.12[95%CI,1.06 - 1.19]和HR为1.11[95%CI 1.04 - 1.19])摄入量处于最高五分位数与最低五分位数的男性和女性,其癌症死亡风险均有所升高。此外,红肉(HR分别为1.27[95%CI,1.20 - 1.35]和HR为1.50[95%CI,1.37 - 1.65])和加工肉类(HR分别为1.09[95%CI,1.03 - 1.15]和HR为1.38[95%CI,1.26 - 1.51])摄入量处于最高五分位数的男性和女性,其心血管疾病风险升高。当比较白肉摄入量最高与最低五分位数时,男性和女性在全因死亡率、癌症死亡率以及所有其他死因方面均呈现负相关。
红肉和加工肉类的摄入量与全因死亡率、癌症死亡率和心血管疾病死亡率的适度增加有关。