Nutritional epidemiology

Abstract

Objectives: Red and processed meat consumption is adversely related to cardiometabolic risk, but the impact of overall dietary quality on this association has not been systematically investigated. We examined the influence of dietary quality on associations of meat intake with biomarkers of cardiometabolic risk. Methods:Data are from the JacksonHeart Study, a cohort of African Americans (baseline age 55 y, 66% female, 20% diabetes, 9% CVD). We analyzed those with biomarker data available at Visit 1 (2000– 04) and at Visit 2 (2005–09) or 3 (2009–13). Diet was assessed by food frequency questionnaire (Visit 1). Total observations used were: Visit 1 (n = 3725), Visit 2 (n = 2736), and Visit 3 (n = 3319). Unprocessed red meat included beef and pork, and processed meat included sausage, lunch, and cured meats. Diet quality was measured by a modified Healthy Eating Index 2010 score (m-HEI) that excluded meat contributions. Modified HEI stratified and unstratified analyses were conducted using linear mixed modeling. Fasting HbA1c and CRP values were log transformed. Results: Meat consumption was not associated with HbA1c in mHEI stratified or unstratified analyses. A 1 oz/1000 kcal/wk increase in unprocessed red and total meat was associated with a 1.3% ± 0.5% (P = 0.02) and 1.1% ± 0.3% (P = 0.005) higher CRP in unstratified analyses, respectively. Unprocessed red meat was positively associated with CRP in m-HEI tertiles 1 (2.0% ± 0.8%, P = 0.01) and 3 (2.2%± 0.8%,P= 0.008). Totalmeatwas associatedwithCRP inm-HEI tertile 1 (2.0%± 0.6%, P= 0.001) and trended in tertile 3 (1.1%± 0.6%, P= 0.09); processedmeat also approached significance inm-HEI tertile 1 (2.1%± 1.2%, P= 0.08). There was evidence thatm-HEImodified the associations between processed meat and CRP (P-interaction = 0.04), but not for other associations. Excluding those with diabetes or CVD did not alter these results. Conclusions: Our results do not support that meat intake is associated with HbA1c, or that overall dietary quality modifies these associations. Unprocessed red and total meat intakes were associated with greater CRP in unstratified and subsets of stratified analyses. Associations of processed meat with CRP appeared stronger among those with the poorest diet quality. These data suggest that reduction in red meat intake could benefit inflammation among African American adults. Funding Sources: The Beef Checkoff.