Research article
Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition
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
BMC Medicine 2013, 11:63 doi:10.1186/1741-7015-11-63
Published: 7 March 2013Abstract
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.
