Monday, January 13, 2014

Daging meningkatkan risiko jantung dan kanker

JAMA http://archinte.jamanetwork.com/issue.aspx?journalid=71&issueid=23009

Red Meat Consumption and Mortality
Results From 2 Prospective Cohort Studies

An Pan, PhD; Qi Sun, MD, ScD; Adam M. Bernstein, MD, ScD; Matthias B. Schulze, DrPH; JoAnn E. Manson, MD, DrPH; Meir J. Stampfer, MD, DrPH; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD


Background
 Red meat consumption has been associated with an increased risk of chronic diseases. However, its relationship with mortality remains uncertain.

Methods We prospectively observed 37 698 men from the Health Professionals Follow-up Study (1986-2008) and 83 644 women from the Nurses' Health Study (1980-2008) who were free of cardiovascular disease (CVD) and cancer at baseline. Diet was assessed by validated food frequency questionnaires and updated every 4 years.

Results We documented 23 926 deaths (including 5910 CVD and 9464 cancer deaths) during 2.96 million person-years of follow-up. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) (95% CI) of total mortality for a 1-serving-per-day increase was 1.13 (1.07-1.20) for unprocessed red meat and 1.20 (1.15-1.24) for processed red meat. The corresponding HRs (95% CIs) were 1.18 (1.13-1.23) and 1.21 (1.13-1.31) for CVD mortality and 1.10 (1.06-1.14) and 1.16 (1.09-1.23) for cancer mortality. We estimated that substitutions of 1 serving per day of other foods (including fish, poultry, nuts, legumes, low-fat dairy, and whole grains) for 1 serving per day of red meat were associated with a 7% to 19% lower mortality risk. We also estimated that 9.3% of deaths in men and 7.6% in women in these cohorts could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings per day (approximately 42 g/d) of red meat.

Conclusions Red meat consumption is associated with an increased risk of total, CVD, and cancer mortality. Substitution of other healthy protein sources for red meat is associated with a lower mortality risk.

Meat is a major source of protein and fat in most diets. Substantial evidence from epidemiological studies shows that consumption of meat, particularly red meat, is associated with increased risks of diabetes,1 cardiovascular disease (CVD),2 and certain cancers.3 Several studies also suggest an elevated risk of mortality associated with red meat intake. However, most of these studies have been performed in populations with a particularly high proportion of vegetarians (such as Seventh-Day Adventists in the United States4 and several studies in Europe5). A recent large cohort study6 with 10 years of follow-up found that a higher intake of total red meat and total processed meat was associated with an increased risk of mortality. However, this study did not differentiate unprocessed from processed red meat, and diet and other covariates were assessed at baseline only. Furthermore, to our knowledge, no study has examined whether substitution of other dietary components for red meat is associated with a reduced mortality risk.

Therefore, we investigated the association between red meat intake and cause-specific and total mortality in 2 large cohorts with repeated measures of diet and up to 28 years of follow-up: the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). We also estimated the associations of substituting other healthy protein sources for red meat with total and cause-specific mortality.