Among U.S. adults, higher intake of processed meat, unprocessed red meat or poultry, but not fish, may be significantly associated with a small increased risk of incident cardiovascular disease, according to research published Feb. 3 in JAMA Internal Medicine. In addition, higher intake of processed meat or unprocessed red meat, but not poultry or fish, be may significantly associated with a small increased risk of all-cause mortality.

Victor W. Zhong, PhD, et al., analyzed individual-level data of 29,682 adult participants in six prospective cohort studies in the U.S. Among the participants, 6,963 incident cardiovascular disease events and 8,875 all-cause deaths were adjudicated during a median follow-up of 19 years.

The authors discovered that intake of processed meat (adjusted hazard ratio [HR], 1.07; adjusted absolute risk difference [ARD], 1.74 percent), unprocessed red meat (adjusted HR, 1.03; adjusted ARD, 0.62 percent) and poultry (adjusted HR, 1.04; adjusted ARD, 1.03 percent) was significantly associated with incident cardiovascular disease, while fish intake was not significantly associated with incident cardiovascular disease (adjusted HR, 1.00; adjusted ARD, 0.12 percent).

Furthermore, the authors found that intake of processed meat (adjusted HR, 1.03; adjusted ARD, 0.90 percent) or unprocessed red was significantly associated with all-cause mortality (adjusted HR, 1.03; adjusted ARD, 0.76 percent), while intake of poultry (adjusted HR, 0.99; adjusted ARD, −0.28 percent) or fish (adjusted HR, 0.99; adjusted ARD, −0.34 percent) was not significantly associated with all-cause mortality.

The authors note several limitations in this study, including unavoidable measurement error for self-reported diet and other data, unavailable data on food preparation methods, only one dietary data measurement used, and more.

However, the authors conclude that "despite the small effect sizes, findings of this study have critical public health implications because dietary behaviors are modifiable, and most people consume these four food types on a daily or weekly basis."

Commenting on the article, Andrew M. Freeman, MD, FACC, co-chair of ACC's Prevention Nutrition and Lifestyle Work Group, notes that this study adds additional reinforcing information to the large database of existing work in this space. "In short, the evidence to date still suggests the best diet to reduce cardiovascular disease and cancer risk is a predominant – if not fully – plant-based, whole food, lower-fat diet," Freeman writes. "While this study may have a small effect size, others have had much larger effects, and the summed evidence to date is powerful: eating is something we do every day, but is often taken for granted and can have profound effects on health outcomes." He adds, "It behooves us a medical community to be ready to implement these lifestyle approaches because it is both cost effective and highly effective."

Clinical Topics: Prevention, Diet

Keywords: Poultry, Meat, Diet, Fishes

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