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Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409885 Participants in the Pan-European EPIC Cohort

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Title: Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409885 Participants in the Pan-European EPIC Cohort
Authors: Key, TJ
Appleby, PN
Bradbury, KE
Sweeting, M
Wood, A
Johansson, I
Kühn, T
Steur, M
Weiderpass, E
Wennberg, M
Würtz, AML
Agudo, A
Andersson, J
Arriola, L
Boeing, H
Boer, JMA
Bonnet, F
Boutron-Ruault, M-C
Cross, AJ
Ericson, U
Fagherazzi, G
Ferrari, P
Gunter, M
Huerta, JM
Katzke, V
Khaw, K-T
Krogh, V
La Vecchia, C
Matullo, G
Moreno-Iribas, C
Naska, A
Nilsson, LM
Olsen, A
Overvad, K
Palli, D
Panico, S
Molina-Portillo, E
Quirós, JR
Skeie, G
Sluijs, I
Sonestedt, E
Stepien, M
Tjønneland, A
Trichopoulou, A
Tumino, R
Tzoulaki, I
Van der Schouw, YT
Verschuren, WMM
Di Angelantonio, E
Langenberg, C
Forouhi, N
Wareham, N
Butterworth, A
Riboli, E
Danesh, J
Item Type: Journal Article
Abstract: 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.
Issue Date: 18-Jun-2019
Date of Acceptance: 23-Feb-2019
URI: http://hdl.handle.net/10044/1/70030
DOI: 10.1161/CIRCULATIONAHA.118.038813
ISSN: 0009-7322
Publisher: American Heart Association
Start Page: 2835
End Page: 2845
Journal / Book Title: Circulation
Volume: 139
Issue: 25
Copyright Statement: © 2019 The Authors. Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
Sponsor/Funder: Commission of the European Communities
Funder's Grant Number: 279233
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Cardiovascular System & Cardiology
dairy products
heart diseases
dairy products
heart diseases
dairy products
Cardiovascular System & Hematology
1103 Clinical Sciences
1102 Cardiorespiratory Medicine and Haematology
1117 Public Health and Health Services
Publication Status: Published
Conference Place: United States
Open Access location: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038813
Online Publication Date: 2019-04-22
Appears in Collections:School of Public Health