Physicians' Academy for Cardiovascular Education

Eating more processed meat, unprocessed red meat or poultry associated with incident CVD

Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality

Literature - Zhong VW, Van Horn L, Greenland P et al., - JAMA Intern Med. 2020. doi: 10.1001/jamainternmed.2019.6969.

Introduction and methods

Processed meat intake is associated with CVD and all-cause mortality [1-8]. However, it remains uncertain whether consumption of unprocessed read meat, poultry or fish are associated with CVD and mortality. This data analysis of pooled individual-level data from 6 prospective cohort studies that were part of the Lifetime Risk Pooling Project (ARIC (Atherosclerosis Risk in Communities) study, CARDIA (Coronary Artery Risk Development in Young Adults) study, CHS (Cardiovascular Health Study), FHS (Framingham Heart Study), FOS (Framingham Offspring Study), and MESA (Multi-Ethnic Study of Atherosclerosis) [9] investigated the associations of processed meat, unprocessed read meat, poultry, or fish intake with incident CVD and all-cause mortality.

Data from 29,682 US adults were analyzed. The mean (SD) age was 53.7 (15.7) years at baseline, 44.4% were male. Baseline diet data from 1985 to 2002 were collected using a validated food frequency questionnaire or diet history. Participants were free of CVD at baseline. The median (IQR) follow-up duration was 19.0 (14.1-23.7) years. One serving was defined as 4 oz of unprocessed red meat or poultry or 3 oz of fish. For processed meat, 1 serving consisted of 2 slices of bacon, 2 small sausages, or 1 hot dog.

The two primary outcomes were incident CVD (defined as a composite of fatal and nonfatal coronary heart disease, fatal and nonfatal stroke, fatal and nonfatal heart failure, and other CVD deaths), and all-cause mortality.

Main results

incident CVD

All-cause mortality


Higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with incident CVD. Higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with all-cause mortality. The effect sizes of the associations were small (ranging from approximately 3% to 7%). The increased 30-year absolute risks were less than 2%.


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Find this article online at JAMA Intern Med.

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