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Meat Intake and Mortality: A Prospective Study of Over Half a Million People

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Sinha, Rashmi, Cross, Amanda J., Graubard, Barry I., Leitzmann, Michael F., Schatzkin, Arthur·2009·Archives of Internal Medicine
DOI 10.1001/archinternmed.2009.6PMC PMC2803089
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Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

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  • While a minority of individual studies suggest similar cardiovascular risk for unprocessed red meat vs. processed meats, many other individual studies and meta-analyses support much stronger effects of processed meats, including low-fat deli meats, on CVD.

    “Consistent with this, while a minority of individual studies suggest similar cardiovascular risk for unprocessed red meat vs. processed meats,170, 171 many other individual studies and meta-analyses support much stronger effects of processed meats, including low-fat deli meats, on CVD (Figure 6).172-174”

    From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [170]

  • At very low levels of intake animal food consumption may not induce harm, providing high quality protein and iron, whereas excess animal food intake in HIC may be linked to adverse health outcomes, particularly from processed meats.

    “At very low levels of intake animal food consumption may not induce harm, providing high quality protein and iron, whereas excess animal food intake in HIC may be linked to adverse health outcomes, particularly from processed meats (70).”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [70]

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  1. [7]Fraser GE Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists Am J Clin Nutr 1999 70 532S 538S 10479227
  2. [8]Kahn HA Phillips RL Snowdon DA Choi W Association between reported diet and all-cause mortality. Twenty-one-year follow-up on 27,530 adult Seventh-Day Adventists Am J Epidemiol 1984 119 775 787 6720674
  3. [9]Appleby PN Key TJ Thorogood M Burr ML Mann J Mortality in British vegetarians Public Health Nutr 2002 5 29 36 12001975
  4. [10]Key TJ Fraser GE Thorogood M Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies Public Health Nutr 1998 1 33 41 10555529
  5. [11]Key TJ Fraser GE Thorogood M Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies Am J Clin Nutr 1999 70 516S 524S 10479225
  6. [12]Thorogood M Mann J Appleby P McPherson K Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters BMJ 1994 308 1667 1670 8025458 PMC2540657
  7. [15]Fraser GE Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists Am J Clin Nutr 1999 70 532S 538S 10479227
  8. [17]Kahn HA Phillips RL Snowdon DA Choi W Association between reported diet and all-cause mortality. Twenty-one-year follow-up on 27,530 adult Seventh-Day Adventists Am J Epidemiol 1984 119 775 787 6720674
  9. [19]Appleby PN Key TJ Thorogood M Burr ML Mann J Mortality in British vegetarians Public Health Nutr 2002 5 29 36 12001975
  10. [20]Key TJ Fraser GE Thorogood M Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies Public Health Nutr 1998 1 33 41 10555529
  11. [22]Key TJ Fraser GE Thorogood M Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies Am J Clin Nutr 1999 70 516S 524S 10479225
  12. [25]Thorogood M Mann J Appleby P McPherson K Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters BMJ 1994 308 1667 1670 8025458 PMC2540657
  13. [27]Schatzkin A Subar AF Thompson FE Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health-American Association of Retired Persons Diet and Health Study Am J Epidemiol 2001 154 1119 1125 11744517
  14. [49]Wolmarans P Benade AJ Kotze TJ Daubitzer AK Marais MP Laubscher R Plasma lipoprotein response to substituting fish for red meat in the diet Am J Clin Nutr 1991 53 1171 1176 2021128

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Authors
Sinha, R., Cross, A. J., Graubard, B. I., Leitzmann, M. F., & Schatzkin, A.
Affiliations
  • Division of Cancer Epidemiology and Genetics (US)
  • United States Department of Health and Human Services (US)
ORCID
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2009-03-23
Volume
169
Issue
6
Pages
562
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinternmed.2009.6
PMC
PMC2803089
OpenAlex
W2159002413
Cited by
543
References
36
Citations by year
2026: 11 · 2025: 27 · 2024: 16 · 2023: 26 · 2022: 25 · 2021: 37 · 2020: 33 · 2019: 46 · 2018: 28 · 2017: 42 · 2016: 29 · 2015: 34 · 2014: 25 · 2013: 47 · 2012: 40
FWCI
39.14
Type
journal article
Language
en
Open access
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (Z99 CA999999)
  • National Cancer Institute (Z01CP010127)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Meat and Animal Product Quality
  • Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
Keywords
red meat consumption, processed meat intake, meat consumption, mortality, cancer mortality, cardiovascular mortality, cause-specific mortality, AARP Diet and Health Study, older adults, dietary risk factors, fruit and vegetable intake, alcohol consumption, smoking, physical activity, hormone replacement therapy, body mass index, vitamin supplements
MeSH terms
Aged, Cardiovascular Diseases, Diet, Eating, Female, Humans, Male, Meat, Middle Aged, Neoplasms, Prospective Studies, United States

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