BackgroundRecently, 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).MethodsIncluded 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.ResultsAs 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.ConclusionsThe 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.
Health-promoting effects of the Mediterranean diet have been in focus for decades, whereas less interest has been given to existing healthy dietary habits within other Western cultures. The aim of the study was to develop a food index based on traditional Nordic food items with expected health-promoting effects and relate this to all-cause mortality in a cohort of Danes. Detailed information about diet, lifestyle, and anthropometry was provided by 57,053 Danes aged 50-64 y. During 12 y of follow-up, 4126 of the cohort participants died. A healthy Nordic food index, consisting of traditional Nordic food items with expected health-promoting effects (fish, cabbages, rye bread, oatmeal, apples and pears, and root vegetables), was extracted and associated with mortality by Cox proportional hazard models. Mortality rate ratios (MRR) with 95% CI were used to associate the index to mortality. In an adjusted model, a 1-point higher index score was associated with a significantly lower MRR for both men [0.96 (0.92-0.99)] and women [0.96 (0.92-1.00)] (P = 0.03). When the index components were evaluated separately, whole grain rye bread intake was the factor most consistently associated with lower mortality in men. In conclusion, an index based on traditional healthy Nordic foods was found to be related to lower mortality among middle-aged Danes, in particular among men. This study indicates that traditional, healthy food items should be considered before public recommendations for major dietary changes are made.
Heavy (but not light or moderate) consumption of alcohol at baseline (mainly from beer) is associated with intestinal-type noncardia GC risk in men from the EPIC cohort.
Individual lifestyle factors have been associated with lifestyle diseases and premature mortality by an accumulating body of evidence. The impact of a combination of lifestyle factors on mortality has been investigated in several studies, but few have applied a simple index taking national guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international and national health recommendations. A Cox proportional hazards model was used to estimate hazard ratios (HR) with 95 % CI. During a median follow-up of 14 years, 3941 men and 2827 women died. Among men, adherence to one additional health recommendation was associated with an adjusted HR of 0·73 (95 % CI 0·71, 0·75) for all-cause mortality, 0·74 (95 % CI 0·71, 0·78) for cancer mortality and 0·70 (95 % CI 0·65, 0·75) for cardiovascular mortality. Among women, the corresponding HR was 0·72 (95 % CI 0·70, 0·75) for all-cause mortality, 0·76 (95 % CI 0·73, 0·80) for cancer mortality and 0·63 (95 % CI 0·57, 0·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population. Key words: Lifestyle factors: Mortality: Public health: RecommendationsTo improve public health and implement targeted efforts, it is necessary to acquire knowledge about health risk factors and quantify their influence on public health. The simplest and most objective measure of a population's health status is overall mortality. Tobacco smoking (1 -3) , alcohol consumption (4,5) , physical inactivity (6 -8) , adiposity (9,10) and an unhealthy diet (11 -17) are all modifiable lifestyle factors that by an accumulating body of evidence have been associated with a higher risk of developing lifestyle diseases and premature mortality. Among the leading causes of death worldwide are cancers and CVD (18) . Although these diseases are highly preventable, approximately 60 % of all deaths are attributed to cancers and CVD in Denmark (19) . Multiple lifestyle behaviours coexist and may interact, and the underlying causes of death are probably multicausal of nature. Thus, studying the combined impact of lifestyle factors instead of their individual impact on health outcomes is highly relevant. Public health recommendations for the most important risk factors have been developed by many organisations and countries (20 -22) . Applying a simple lifestyle index based on international and national lifestyle recommendations is useful for decision-makers and political governments and for counselling purposes, and may motivate subjects to change their lifestyle in a healthier direction -particularly if the message is simple.Recently, the combined impact of healthy lifestyle behaviours on all-cau...
Aims/hypothesis A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption. Results Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants. Conclusions/interpretation This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.
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