Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis.
Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis.
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DOI：
10.1161/circulationaha.109.924977
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发表时间：
2010-06-01
期刊：
影响因子：
37.8
通讯作者：
Mozaffarian D
中科院分区：
文献类型：
--
作者：
Micha R;Wallace SK;Mozaffarian D
肉类消费与冠心病（CHD），中风和糖尿病的发展不一致，限制了消费水平的定量建议。肉类摄入量对这些不同结果的影响，以及红肉与加工肉类的影响也可能不同。我们对红肉、加工肉制品和肉类总消费量与冠心病、中风和糖尿病发病率之间关系的证据进行了系统回顾和荟萃分析。我们检索了任何队列、病例对照研究或随机试验，这些研究评估了一般健康成人的这些暴露和结局。在1，598篇识别的摘要中，20项研究符合纳入标准，包括17项前瞻性队列研究和3项病例对照研究。所有数据均独立提取，一式两份。使用趋势估计的随机效应广义最小二乘模型推导汇总剂量反应估计值。这20项研究包括1，218，380例患者和23，889例CHD，2，280例中风和10，797例糖尿病病例。红肉摄入量与冠心病（n=4项研究，每100克/天的RR =1.00，95%CI=0.81- 1.23，p异质性=0.36）或糖尿病（n=5，RR=1.16，95%CI=0.92- 1.46，p =0.25）无关。相反，加工肉类摄入量与冠心病风险增加42%（n=5，每50克/天的RR =1.42，95%CI=1.07- 1.89，p =0.04）和糖尿病风险增加19%（n=7，RR=1.19，95%CI=1.11- 1.27，p <0.001）相关。协会是中间的总肉类摄入量。红肉和加工肉类的消费与中风无关，但只有3项研究评估了这些关系。食用加工肉类，而不是红肉，与冠心病和糖尿病的发病率较高有关。这些结果强调了需要更好地了解潜在的影响机制，并特别关注加工肉类的饮食和政策建议。
Meat consumption is inconsistently associated with development of coronary heart disease (CHD), stroke, and diabetes, limiting quantitative recommendations for consumption levels. Effects of meat intake on these different outcomes, and of red vs. processed meat, may also vary. We performed a systematic review and meta-analysis of evidence for relationships of red, processed, and total meat consumption with incident CHD, stroke, and diabetes. We searched for any cohort, case-control study or randomized trial that assessed these exposures and outcomes in generally healthy adults. Of 1,598 identified abstracts, 20 studies met inclusion criteria, including 17 prospective cohorts and 3 case-control studies. All data were abstracted independently in duplicate. Random-effects generalized least squares models for trend estimation were used to derive pooled dose-response estimates. The 20 studies included 1,218,380 individuals and 23,889 CHD, 2,280 stroke, and 10,797 diabetes cases. Red meat intake was not associated with CHD (n=4 studies, RR per 100g serving/day=1.00, 95%CI=0.81–1.23,p-for-heterogeneity=0.36) or diabetes (n=5, RR=1.16, 95%CI=0.92–1.46,p=0.25). Conversely, processed meat intake was associated with 42% higher risk of CHD (n=5, RR per 50g serving/day=1.42, 95%CI=1.07–1.89,p=0.04) and 19% higher risk of diabetes (n=7, RR=1.19, 95%CI=1.11–1.27,p<0.001). Associations were intermediate for total meat intake. Red and processed meat consumption were not associated with stroke, but only 3 studies evaluated these relationships. Consumption of processed meats, but not red meats, is associated with higher incidence of CHD and diabetes. These results highlight the need for better understanding of potential mechanisms of effects, and for particular focus on processed meats for dietary and policy recommendations.