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Open Access Highly Accessed Research article

Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

Sabine Rohrmann12*, Kim Overvad3, H Bas Bueno-de-Mesquita45, Marianne U Jakobsen3, Rikke Egeberg6, Anne Tjønneland6, Laura Nailler78, Marie-Christine Boutron-Ruault78, Françoise Clavel-Chapelon78, Vittorio Krogh9, Domenico Palli10, Salvatore Panico11, Rosario Tumino12, Fulvio Ricceri13, Manuela M Bergmann14, Heiner Boeing14, Kuanrong Li2, Rudolf Kaaks2, Kay-Tee Khaw15, Nicholas J Wareham16, Francesca L Crowe17, Timothy J Key17, Androniki Naska18, Antonia Trichopoulou1819, Dimitirios Trichopoulos192021, Max Leenders5, Petra HM Peeters2223, Dagrun Engeset24, Christine L Parr25, Guri Skeie24, Paula Jakszyn26, María-José Sánchez2728, José M Huerta2729, M Luisa Redondo30, Aurelio Barricarte2831, Pilar Amiano2832, Isabel Drake33, Emily Sonestedt33, Göran Hallmans34, Ingegerd Johansson35, Veronika Fedirko36, Isabelle Romieux36, Pietro Ferrari36, Teresa Norat23, Anne C Vergnaud23, Elio Riboli23 and Jakob Linseisen237

Author Affiliations

1 Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, 8001 Zurich, Switzerland

2 Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, 69221 Heidelberg, Germany

3 Section of Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark

4 National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands

5 Department of Gastroenterology and Hepatology, University Medical Centre, 3508 Utrecht, The Netherlands

6 Danish Cancer Society Research Center, 2100 Copenhagen, Denmark

7 Inserm, Centre for Research in Epidemiology and Population Health, U1018, Institut Gustave Roussy, 94805 Villejuif, France

8 Paris South University, UMRS 1018, 94805 Villejuif, France

9 Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy

10 Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), 50139 Florence, Italy

11 Department of Clinical and Experimental Medicine, Federico II University, 80131 Naples, Italy

12 Cancer Registry and Histopathology Unit, "Civile - M.P.Arezzo" Hospital, 97100 Ragusa, Italy

13 HuGeF - Human Genetics Foundation - Torino, 10126 Torino, Italy

14 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany

15 Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 2QQ, UK

16 Medical Research Council (MRC) Epidemiology Unit, Cambridge CB2 0QQ, UK

17 Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LF, UK

18 WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 11527 Athens, Greece

19 Hellenic Health Foundation, 11527 Athens, Greece

20 Department of Epidemiology, Harvard School of Public Health, Boston MA 02115, USA

21 Bureau of Epidemiologic Research, Academy of Athens, 11527 Athens, Greece

22 Julius Center, University Medical Center Utrecht, 3508 Utrecht, The Netherlands

23 School of Public Health, Imperial College, London SW7 2AZ, UK

24 Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway

25 Department of Biostatistics, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway

26 Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), 08907 Barcelona, Spain

27 Andalusian School of Public Health, 18080 Granada, Spain

28 Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain

29 Department of Epidemiology, Murcia Regional Health Council, 30008 Murcia, Spain

30 Public Health Directorate Asturias, 33006 Oviedo, Spain

31 Navarre Public Health Institute, 31003 Pamplona, Spain

32 Public Health Division of Gipuzkoa, BIODonostia Research Institute, Department of Health of the Regional Government of the Basque Country, San Sebastian, Spain

33 Department of Clinical Sciences, Lund University, 20502 Malmö, Sweden

34 Department of Public Health and Clinical Medicine, Nutrition Research, 90185 Umeå University, Umeå, Sweden

35 Department of Odontology, Cariology, Umeå University, 90185 Umeå, Sweden

36 International Agency for Research on Cancer (IARC), 69008 Lyon, France

37 Institute of Epidemiology, Helmholtz Centre Munich, 85764 Neuherberg, Germany

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BMC Medicine 2013, 11:63  doi:10.1186/1741-7015-11-63

Published: 7 March 2013

Abstract

Background

Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Methods

Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality.

Results

As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality.

Conclusions

The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.

Keywords:
diet; meat; mortality; cohort; Europe; cardiovascular; cancer