Abstract P512: Red Meat Intake and Risk of Coronary Heart Disease Among US Men

Background: The relation of red meat to risk of coronary heart disease (CHD) is of great interest, but this is likely to depend on the foods to which red meat is compared. Objective: We investigated the associations between total, processed and unprocessed red meat consumption and CHD risk and also estimated the effects of substituting other protein sources for red meat. Methods: We prospectively followed 43,259 men in the Health Professionals Follow up Study (1986-2012) who had no known history of cancer or cardiovascular disease. Diet was assessed by a standardized and validated food frequency questionnaire that was updated every 4 years. Multivariate Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of CHD risk across categories of red meat consumption. Substitution analyses were done by comparing coefficients in models including alternative foods as continuous variables. Results: During 932,968 person-years of follow-up, we documented 4,148 incident CHD cases of which 1,680 were fatal CHD cases. After multivariate adjustment for dietary and nondietary risk factors, both total and processed red meat intake were associated with a modestly higher risk of CHD (HR for a one serving/day increment: 1.08; 95% CI, 1.01-1.14 for total and HR=1.13; 95% CI, 1.03-1.22 for processed red meat). Substitutions of 1-serving per day of other foods (including nuts, legumes, soy, whole grains, low- and high-fat dairy) for 1-serving per day of total red meat were associated with a 10%-47% lower CHD risk. Stronger inverse associations were observed between some of these substitutions for red meat and risk of fatal CHD [substituting nuts (-17%, -27% to -6%) or whole grains (-48%, -60% to -32%), and were more pronounced when replacing processed red meat. Conclusions: Our results suggest that red meat consumption, particularly processed red meat, is associated with higher risk of CHD. Substituting high-quality plant foods such as legumes, nuts, soy, and whole grains for red meat may substantially lower CHD risk.