Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials.

Cardiovascular Diseases / epidemiology Diet / adverse effects Humans Neoplasms / epidemiology Randomized Controlled Trials as Topic Red Meat / adverse effects

Journal

Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351

Informations de publication

Date de publication:
19 11 2019
Historique:
pubmed: 1 10 2019
medline: 17 6 2020
entrez: 1 10 2019
Statut: ppublish

Résumé

This article has been corrected. The original version (PDF) is appended to this article as a Supplement. Few randomized trials have evaluated the effect of reducing red meat intake on clinically important outcomes. To summarize the effect of lower versus higher red meat intake on the incidence of cardiometabolic and cancer outcomes in adults. EMBASE, CENTRAL, CINAHL, Web of Science, and ProQuest from inception to July 2018 and MEDLINE from inception to April 2019, without language restrictions. Randomized trials (published in any language) comparing diets lower in red meat with diets higher in red meat that differed by a gradient of at least 1 serving per week for 6 months or more. Teams of 2 reviewers independently extracted data and assessed the risk of bias and the certainty of the evidence. Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio [HR], 0.99 [95% CI, 0.95 to 1.03]), cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04]). There were few trials, most addressing only surrogate outcomes, with heterogeneous comparators and small gradients in red meat consumption between lower versus higher intake groups. Low- to very-low-certainty evidence suggests that diets restricted in red meat may have little or no effect on major cardiometabolic outcomes and cancer mortality and incidence. None (PROSPERO: CRD42017074074).

Sections du résumé

This article has been corrected. The original version (PDF) is appended to this article as a Supplement.
Background
Few randomized trials have evaluated the effect of reducing red meat intake on clinically important outcomes.
Purpose
To summarize the effect of lower versus higher red meat intake on the incidence of cardiometabolic and cancer outcomes in adults.
Data Sources
EMBASE, CENTRAL, CINAHL, Web of Science, and ProQuest from inception to July 2018 and MEDLINE from inception to April 2019, without language restrictions.
Study Selection
Randomized trials (published in any language) comparing diets lower in red meat with diets higher in red meat that differed by a gradient of at least 1 serving per week for 6 months or more.
Data Extraction
Teams of 2 reviewers independently extracted data and assessed the risk of bias and the certainty of the evidence.
Data Synthesis
Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio [HR], 0.99 [95% CI, 0.95 to 1.03]), cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04]).
Limitations
There were few trials, most addressing only surrogate outcomes, with heterogeneous comparators and small gradients in red meat consumption between lower versus higher intake groups.
Conclusion
Low- to very-low-certainty evidence suggests that diets restricted in red meat may have little or no effect on major cardiometabolic outcomes and cancer mortality and incidence.
Primary Funding Source
None (PROSPERO: CRD42017074074).

Identifiants

DOI: 10.7326/M19-0622 PMID: 31569236
pubmed: 31569236
pii: 2752326
doi: 10.7326/M19-0622
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

721-731

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Auteurs

Dena Zeraatkar (D)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Bradley C Johnston (BC)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Jessica Bartoszko (J)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Kevin Cheung (K)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Malgorzata M Bala (MM)

Jagiellonian University Medical College, Kraków, Poland (M.M.B.).

Claudia Valli (C)

Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V., M.R., P.A.).

Montserrat Rabassa (M)

Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V., M.R., P.A.).

Daegen Sit (D)

University of British Columbia, Vancouver, British Columbia, Canada (D.S.).

Kirolos Milio (K)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Behnam Sadeghirad (B)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Arnav Agarwal (A)

University of Toronto, Toronto, Ontario, Canada (A.A.).

Adriana M Zea (AM)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Yung Lee (Y)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Mi Ah Han (MA)

Chosun University, Gwangju, Republic of Korea (M.A.H.).

Robin W M Vernooij (RWM)

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands (R.W.V.).

Pablo Alonso-Coello (P)

Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V., M.R., P.A.).

Gordon H Guyatt (GH)

McMaster University, Hamilton, Ontario, Canada (D.Z., B.C.J., J.B., K.C., K.M., B.S., A.M.Z., Y.L., G.H.G.).

Regina El Dib (R)

Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil (R.E.).

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Classifications MeSH

questionsmedicales.fr › Maladies cardiovasculaires › Effect of Lower Versus Higher Red Meat Intake...
questionsmedicales.fr › Phénomènes physiologiques › Alimentation et nutrition › Phénomènes physiologiques nutritionnels › Régime alimentaire › Effect of Lower Versus Higher Red Meat Intake...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Effect of Lower Versus Higher Red Meat Intake...
questionsmedicales.fr › Tumeurs › Effect of Lower Versus Higher Red Meat Intake...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Effect of Lower Versus Higher Red Meat Intake...
questionsmedicales.fr › Aliments et boissons › Aliments › Viande › Viande rouge › Effect of Lower Versus Higher Red Meat Intake...