Most studies reported the RR of ischemic stroke incidence (n=6). http://vizhub.healthdata.org/burden-of-proof/, https://www.jstatsoft.org/article/view/v036i03, https://www.jstatsoft.org/article/view/v072c01, https://vizhub.healthdata.org/burden-of-proof/, https://github.com/ihmeuw-msca/burden-of-proof, https://www.iarc.who.int/wp-content/uploads/2018/07/pr240_E.pdf, http://health.gov/dietaryguidelines/2015/guidelines/, https://doi.org/10.1080/10618600.2020.1868303, https://www.wcrf.org/wp-content/uploads/2021/02/Colorectal-cancer-report.pdf. J. Biomark. Several meta-analyses examining the association between red meat consumption and type 2 diabetes identified associations of similar magnitude to our findings, though our UIs are wider; in 2017, Schwingshackl et al. Red Meat and Cancer: What's the Connection? - Verywell Health Crit. The researchers defined unprocessed red meat as any unprocessed meat from beef, lamb or pork, excluding poultry. Papier, K. et al. 3, 152159 (2006). Biaek-Dratwa A, Kokot T, Czech E, Cayniuk B, Kiciak A, Stakiewicz W, Stanjek-Cichoracka A, Soma-Krzelak M, Sobek O, Kujawiska M, Grot M, Szczepaska E, Muc-Wierzgo M. Front Nutr. As noted, we further divided the positive ROSs into ranges of at least a 015% increase (for harmful risks) or 013% decrease (for protective risks) in risk with average exposure (two stars), >1550% increase or >1334% decrease (three stars), >5085% increase or >3446% decrease (four stars) and greater than 85% increase or greater than 46% decrease (five stars). 32, 363375 (2017). Unprocessed red meat, processed meat intake not linked to colon cancer had primary responsibility for applying analytical methods to produce estimates. Lancet 396, 12231249 (2020). Dong X, Zhuang Z, Zhao Y, Song Z, Xiao W, Wang W, Li Y, Huang N, Jia J, Liu Z, Qi L, Huang T. J Am Heart Assoc. Unprocessed Red Meat Intake (g/day) 2: Zero Intake: Quartiles of Intake 3: p-trend: 90th vs. 0 4: 90th vs. 0 4: 0: Q1: Q2: Q3: Q4: Uncalibrated: Calibrated: No. Recommendations and public health and policy implications. Food groups and risk of coronary heart disease, stroke and heart failure: a systematic review and doseresponse meta-analysis of prospective studies. No statistical method was used to predetermine sample size. Processed meat causes cancer, says WHO - CNN Business For reports that gave mean consumption rather than intake range, we calculated the range by using the midpoint between means to provide a cutoff for intake intervals. English, D. R. et al. Tobacco smoking and asbestos are also both classified as carcinogenic to humans (Group 1). Moreover, we found no evidence of an association between unprocessed red meat and ischemic stroke or hemorrhagic stroke. Am. J. The corresponding ROS of 0.13 resulted in a one-star rating, consistent with no evidence of an association between consumption of unprocessed red meat and decreased risk of hemorrhagic stroke. In conclusion, we applied the BPRF framework of Zheng et al.20 to present a systematic meta-analysis of red meat consumption on six important health outcomes. and A.L.S. 70, 532s538s (1999). Provided by the Springer Nature SharedIt content-sharing initiative, Nature Medicine (Nat Med) Softw. It's a correlation or "link" backed by statistical evidence. Takata, Y. et al. Eur. For example, a mean log BPRF of 0.4 for a harmful risk (where null=0 for log RR) and a mean log BPRF of 0.4 for a protective risk would both have an ROS of 0.4 because the magnitude of the log RR is the same. CAS Br. 2 Red meat consumption and type 2 diabetes. These outcomes were selected using the WCRF criteria for convincing or probable evidence7. This value can be interpreted such that even accounting for between-study heterogeneity and its uncertainty, we are confident that the log RR across the studied unprocessed meat consumption range is at least as high as the BPRF (or at least as low as the BPRF for a protective risk). The exposure-averaged BPRF value for hemorrhagic stroke was 1.14 (Table 2 and Extended Data Fig. For outcomes in which the curve decreased then increased and was minimized at a non-zero value, we did not apply a monotonicity constraint but instead implemented a linear-tail constraint (sometimes referred to as natural splines in curve-fitting literature) on the left side of the domain to ensure more plausible risk curve behavior at low exposure levels. doi: 10.1080/10408398.2013.873886. 104). H.L., A.A., C.B., M.B., S.I.H., S.A.M., M.C.P., R.J.D.S., A.Y.A., P.Z. 1), where the UIs account for between-study heterogeneity and other forms of uncertainty. Non-communicable disease risk associated with red and processed meat consumption-magnitude, certainty, and contextuality of risk? That's because it would be logistically challenging, and possibly unethical, to assign two separate groups to a dietary plan at random and get them to adhere to it for a long period of time to see whether one group ended up with more cases of cancer. Cancer 90, 7382 (2018). Cancer Causes Control 24, 675684 (2013). Nutr. For log-linear relationships, our approach and the metafor package showed similarly superior performance over the one- and two-stage approaches, whereas for non-log-linear relationships, our approach produced uniformly better performance across all scenarios compared to the other approaches. Dietary iron modulates gut microbiota and induces SLPI secretion to promote colorectal tumorigenesis. Red and processed meat intake and cancer risk: results from the prospective NutriNet-Sant cohort study. Crit. Cancer 113, 829834 (2005). J. Nutr. J. Nutr. Red meat is associated with an increased risk of colon and rectum cancer, and evidence also suggests it is associated with some other cancers, such as prostate and pancreatic cancer. The .gov means its official. As detailed by Murray et al.5, riskoutcome pairs were initially selected using the WCRF criteria for convincing or probable evidence. If you've been paying attention to mainstream nutritional dogma over the last half century, you probably think it does. Authors reply. & Hsieh, C.-C. A two-stage hierarchical regression model for meta-analysis of epidemiologic nonlinear doseresponse data. Eight cohorts were from Europe, six from North America and three from Asia. The estimates for our primary indicators from this workRRs across a range of exposures, BPRFs, ROSs and star ratings for each riskoutcome pairare not specific to, or disaggregated by, specific populations (we did not estimate by location, sex or age group; though this analysis evaluated the effects of unprocessed red meat consumption on selected chronic disease end points in adults 25 years and older only and breast cancer is only applicable to females). Associations between red meat and risks for colon and rectal cancer depend on the type of red meat consumed. Epub 2021 Jul 20. Med. Meat consumption and risk of 25 common conditions: outcome-wide analyses in 475,000 men and women in the UK Biobank study. Eur. the UK dietary guidelines []) have in recent years recommended a reduction of red and processed meat consumption, based on consistent evidence linking high processed meat, and probably red meat consumption, with colorectal cancer risk [].While the association between meat intake and cancer risk has been . Meat intake, cooking methods and risk of proximal colon, distal colon and rectal cancer: the Norwegian Women and Cancer (NOWAC) cohort study. A key finding of our analysis is that there is substantial between-study heterogeneity and uncertainty for all six riskoutcome pairs included. of . While there is some evidence that eating unprocessed red meat is associated with increased risk of disease incidence and mortality, it is weak and insufficient to make stronger or more conclusive recommendations. 20152020 dietary guidelines for Americans. Crit. are difficult to evaluate within our methodological framework. 2023 Jan-Dec;15(1):2221978. doi: 10.1080/19490976.2023.2221978. 2016;56:27472766. To safeguard against underestimating the between-study heterogeneity when too few studies were available, we used the Fisher information matrix108 to estimate the variance of the between-study heterogeneity, Zheng et al.20 provides more details. Unprocessed red meat consumption and breast cancer. Prospective association between red and processed meat intakes and breast cancer risk: modulation by an antioxidant supplementation in the SU.VI.MAX randomized controlled trial. & Wolk, A. This study complies with the Guidelines on Accurate and Transparent Health Estimate Reporting recommendations92 (Supplementary Table 5). Stay up to date with what you want to know. These included 18 cohorts and one nested casecontrol from Europe, 13 cohorts from North America, five cohorts from Asia and one from Australia. Eur. Zheng, P. et al. Circulation 122, 876883 (2010). The corresponding ROS of 0.02 resulted in a one-star rating, consistent with no evidence of an association between consumption of unprocessed red meat and increased risk of ischemic stroke. Adding to this ambiguity, several studies have found no significant relationship between red meat consumption and risk of death11,12, which has led to further questioning of the strength of evidence in these risk pair associations13,14. When significant bias was detected, we adjusted for it using an appropriate modification of the trim-and-fill algorithm110. 2023;63(3):426-437. doi: 10.1080/10408398.2021.1949575. The controversy stems from the type of evidence used in evaluating diet and disease risks. We also found that while risk for the six outcomes in our analysis combined was minimized at 0 g unprocessed red meat intake per day, the 95% uncertainty interval that incorporated between-study heterogeneity was very wide: from 0-200 g d-1. The measures of risk can be considered current until subsequent analyses are made based on newly available data. The funders of the study had no role in study design, data collection, data analysis, data interpretation, writing of the final report or the decision to publish. 8th edn. For undefined lower bounds, we assumed a consumption level of 0gd1. 3 Based on the findings from the present study and current red and processed meat intakes in the UK, 4 if all these 100 people reduced their unprocessed red meat intake by three-quarters (for example from four times a week to one time a . Wei, E. K. et al. Circulation. J. Comput. Processed meats are meats that have been preserved by smoking or salting, curing or adding chemical preservatives. Mehta, S. S. et al. Overall, a larger positive ROS indicates more consistency in evidence and a higher average effect size across the continuum of the risk. Am. Evidence has linked red and processed meat to higher risk of many types of cancer as well as a higher chance of dying from cancer. 3), which put it opposite null from the mean RR of 1.15 (95% UI inclusive of between-study heterogeneity of 0.931.40) at 100gd1. Reports involving processed meat were excluded because we aimed to distinguish the health effects of red meat intake per se from the health effects of meat preservatives or preservation byproducts. Scand. J. Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease 4). To assess potential publication or reporting bias, we used a data-driven approach known as Eggers regression109 to test for significant correlation between the residuals of the risk function and their s.d. There were no bias covariates identified by our algorithm as statistically relevant for inclusion in the model. We found weak evidence of a harmful association between unprocessed red meat intake and risk of breast cancer. Brit. Zheng, P. limetr: linear mixed effects model with trimming. Red meat consumption. Papier, K., Knuppel, A., Syam, N., Jebb, S. A. 2022 Oct;28(10):2001-2002. doi: 10.1038/s41591-022-02006-8. In 2015, based on data from 800 studies, IARC classified processed meat as a human carcinogen (Group 1), meaning that there is enough evidence to conclude that it can cause cancer in humans. Dietary protein sources and the risk of stroke in men and women. For processed meat, average RR was 1.31 (95% CI: 1.13-1.51). A. et al. Large-scale. Kurotani, K. et al. J. -, Bellavia A, Stilling F, Wolk A. For many, a turkey sandwich is a lunchtime fixture . doi: 10.1161/JAHA.122.027934. Willett, W. et al. For undefined upper bounds when mean and s.d. Math. Nutr. Bechthold, A. et al. Supplementary Sections 17, Supplementary Tables 18 and Supplementary Figs. The Global Burden of Diseases, Injuries and Risk Factors study (GBD) 2019 estimated that 896,000 (95% uncertainty interval (UI) 536,0001,250,000) deaths and 23.9 million (15.632.0) disability-adjusted life years were attributable to unprocessed red meat consumption globally in 2019 (ref. A meta-analysis by Yang and colleagues reported a pooled RR of 0.88 (0.731.06) for each 100gd1 increase in intake of unprocessed red meat81. 0, 112 (2021). Vegetarianism, low meat consumption and the risk of lung, postmenopausal breast and prostate cancer in a population-based cohort study. The aggregated risk curve for the six outcomes in our analysis combined was minimized at a mean unprocessed red meat consumption level of 0gd1 (95% UI 0200) (Fig. H.L., C.A., G.F., V.I., M.C.P. In all cohorts but one, the RR was adjusted for BMI and in 15 cohorts, the RR was adjusted for dietary components. . Genkinger, J. M., Makambi, K. H., Palmer, J. R., Rosenberg, L. & Adams-Campbell, L. L. Consumption of dairy and meat in relation to breast cancer risk in the Black Womens Health Study. Br. Supplementary Information, section 5, contains a full list of inclusion and exclusion criteria. Zhang, R., Fu, J., Moore, J. Med. 56, 27472766 (2016). FOIA Epub 2016 Sep 6. Nature Medicine thanks Sabita Soedamah-Muthu and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. In contrast, for riskoutcome pairs with a BPRF opposite the null from the mean risk, ROS would be calculated as negative. Health 29, 317324 (2003). Nutr. Get what matters in cancer research, free to your inbox weekly. To validate key aspects of the meta-regression model used in this analysis, the following packages were used, as described by Zheng et al. 18, 44 (2018). PLoS ONE 6, e20456 (2011). Supplementary Information, section 3 provides more information on our risk of bias assessment. Zheng, P., Barber, R., Sorensen, R. J., Murray, C. J. Expert Is Eating More Red Meat After Looking at Cancer, Heart - Insider J. Clin. The approach accounts for exposure ranges reported in the data and different comparator groups21. values were not available, we applied the range from the cohorts most adjacent quartile or tertile to estimate the upper bound of consumption, specific to each study cohort. Aravkin, A. Google Scholar. Nutr. 4), which was opposite null from the mean RR of 0.87 (0.561.35) at 100gd1. Larsson, S. C., Virtamo, J. Lancet. Heart J. Am. https://doi.org/10.1038/s41591-022-01968-z, DOI: https://doi.org/10.1038/s41591-022-01968-z. You are using a browser version with limited support for CSS. Nutrients 8, 730 (2016). Similarly, for IHD, we excluded RRs from incidence or mortality of unspecified cardiovascular disease outcomes and limited our model to RRs specifically associated with IHD outcomes to most accurately assess the relationship with IHD. Chan, D. S. M. et al. Bernstein, A. M. et al. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. Cancer Epidemiol. BMJ 2021;372:n71. Because the current evidence for an association between unprocessed red meat and risk of these health outcomes is weak there is a critical need for better data from large-scale, high-quality studies in locations around the world. & Liu, Q.-F. Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. 25, 11771186 (2016). Circulation 121, 22712283 (2010). Materials and Methods. Food Sci. Cochrane Handbook for Systematic Reviews of Interventions (John Wiley & Sons, 2019). To explain some of the between-study heterogeneity, the approach uses bias covariates automatically selected from an expert-defined candidate set consistent with GRADE86, Cochrane87 and other evidence-grading criteria. Red meat consumption and mortality: results from 2 prospective cohort studies. Technically, meat consumption has been linked to cancer, especially colorectal cancer, for years. Circulation 139, 28352845 (2019). Extended Data Fig. 67, 598606 (2013). 186, 824833 (2017). Red meat consumption, cardiovascular diseases, and diabetes: a Rev. PRISMA flow diagram of unprocessed red meat data seeking approach. All code used for these analyses is publicly available online (https://github.com/ihmeuw-msca/burden-of-proof). Biomark. Full texts of potentially relevant articles were manually assessed for eligibility by two investigators. Currently in the UK, about 10 in 100 people would be expected to eventually die from coronary heart disease. The thresholds for each star rating were developed in consultation with collaborators, stakeholders and other audiences and can broadly be interpreted as indicating no evidence of association, weak evidence of association, moderate evidence of association, strong evidence of association and very strong evidence of association. The main findings and implications for policy of this work are summarized in Table 1.

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