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

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RESEARCH ARTICLE

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Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition Sabine Rohrmann1,2*, Kim Overvad3, H Bas Bueno-de-Mesquita4,5, Marianne U Jakobsen3, Rikke Egeberg6, Anne Tjønneland6, Laura Nailler7,8, Marie-Christine Boutron-Ruault7,8, Françoise Clavel-Chapelon7,8, 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 Trichopoulou18,19, Dimitirios Trichopoulos19,20,21, Max Leenders5, Petra HM Peeters22,23, Dagrun Engeset24, Christine L Parr25, Guri Skeie24, Paula Jakszyn26, María-José Sánchez27,28, José M Huerta27,29, M Luisa Redondo30, Aurelio Barricarte28,31, Pilar Amiano28,32, Isabel Drake33, Emily Sonestedt33, Göran Hallmans34, Ingegerd Johansson35, Veronika Fedirko36, Isabelle Romieux36, Pietro Ferrari36, Teresa Norat23, Anne C Vergnaud23, Elio Riboli23 and and Jakob Linseisen2,37

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

* Correspondence: sabine.ro