University of Leicester
Browse
CIRCULATIONAHA.118.038813.pdf (1.46 MB)

Consumption of Meat, Fish, Dairy Products, Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409,885 Participants in the Pan-European EPIC Cohort.

Download (1.46 MB)
journal contribution
posted on 2019-06-24, 10:35 authored by TJ Key, PN Appleby, KE Bradbury, M Sweeting, A Wood, I Johansson, T Kühn, M Steur, E Weiderpass, M Wennberg, AML Würtz, A Agudo, J Andersson, L Arriola, H Boeing, JMA Boer, F Bonnet, M-C Boutron-Ruault, AJ Cross, U Ericson, G Fagherazzi, P Ferrari, M Gunter, JM Huerta, V Katzke, K-T Khaw, V Krogh, C La Vecchia, G Matullo, C Moreno-Iribas, A Naska, LM Nilsson, A Olsen, K Overvad, D Palli, S Panico, E Molina-Portillo, JR Quirós, G Skeie, I Sluijs, E Sonestedt, M Stepien, A Tjønneland, A Trichopoulou, R Tumino, I Tzoulaki, YT van der Schouw, WMM Verschuren, E Di Angelantonio, C Langenberg, N Forouhi, N Wareham, A Butterworth, E Riboli, J Danesh
BACKGROUND: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort. METHODS: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated using 24-hour recalls. Lipids and blood pressure were measured in a subsample. During 12.6 years mean follow up, 7198 participants had a myocardial infarction or died from IHD. The relationships of animal foods with risk were examined using Cox regression with adjustment for other animal foods and relevant covariates. RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI 1.06-1.33) for a 100 g/d increment in intake of red and processed meat, and this remained significant after excluding the first 4 years of follow-up (HR 1.25 [1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR 0.93 [0.89-0.98] per 100 g/d increment), cheese (HR 0.92 [0.86-0.98] per 30 g/d increment) and eggs (HR 0.93 [0.88-0.99] per 20 g/d increment); the associations with yogurt and eggs were attenuated and non-significant after excluding the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish or milk. In analyses modelling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese or eggs was associated with approximately 20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-HDL cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-HDL cholesterol. CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat, and inversely associated with consumption of yogurt, cheese and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-HDL cholesterol, and for red and processed meat with systolic blood pressure, which could mediate such effects.

Funding

Analyses were supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491), and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). The project (EPIC-CVD) has been supported by the European Union Framework 7 (HEALTH-F2-2012–279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002, RG/08/014, and RG13/13/30194), and the UK National Institute of Health Research. The coordination of EPIC is financially supported by the European Commission and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research, Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Italian Association for Research on Cancer, National Research Council (Italy) and Ministero dell’Istruzione dell’Università e della Ricerca “Dipartimenti di Eccellenza” (Project D15D18000410001) to the Department of Medical Sciences (Italy); Dutch Ministry of Public Health, Welfare and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch Zorg Onderzoek Nederland, World Cancer Research Fund; Health Research Fund, PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, regional governments of Andalucía, Asturias, Basque Country, Murcia (No. 6236), and Navarra, Instituto de Salud Carlos III (ISCIII RETIC RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16

History

Citation

Circulation. 2019;139:2835–2845

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

  • VoR (Version of Record)

Published in

Circulation. 2019;139:2835–2845

eissn

1524-4539

Acceptance date

2019-02-23

Copyright date

2019

Available date

2019-06-24

Publisher version

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038813

Notes

The online-only Data Supplement is available with this article at https://www.ahajournals.org/doi/suppl/10.1161/circulationaha.118.038813.

Language

en

Usage metrics

    University of Leicester Publications

    Categories

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC