A US study has found that increased intake of processed meat and unprocessed red meat is associated with a slightly increased risk for incident cardiovascular disease (CVD) and all-cause mortality in adults, once again confirming the implication of meat consumption in heart disease and death. The study, published in JAMA Internal Medicine, also suggested that higher poultry intake may increase the risk for CVD but not all-cause mortality.

The study included 29,682 patients from 6 US prospective cohort studies (mean age, 53.7 years) part of the Lifetime Risk Pooling Project. In each cohort, baseline diet data were collected between the years 1985 and 2002 and patients were followed until August 31, 2016. Using a validated food frequency questionnaire and diet history assessment, the investigators collected information on patients’ intake of processed meat, unprocessed red meat, poultry, or fish. Outcomes included incident CVD and all-cause mortality, with incident CVD representing a composite endpoint of fatal and nonfatal coronary heart disease, fatal and nonfatal stroke, fatal and nonfatal heart failure, and other CVD deaths.

During a median follow-up of 19 years, there were 6963 incident CVD events and 8875 all-cause deaths. Incident CVD was associated with the intake of processed meat (adjusted hazard ratio [aHR], 1.07 [95% CI, 1.04-1.11]; adjusted absolute risk difference [aARD], 1.74% [95% CI, 0.85%-2.63%]), unprocessed red meat (aHR, 1.03 [95% CI, 1.01-1.06]; aARD, 0.62% [95% CI, 0.07%-1.16%]), or poultry (aHR, 1.04 [95% CI, 1.01-1.06]; aARD, 1.03% [95% CI, 0.36%-1.70%]). There was no association between incident CVD and fish intake (aHR, 1.00 [95% CI, 0.98-1.02]; aARD, 0.12% [95% CI, −0.40% to 0.65%]).

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A higher risk for all-cause mortality was associated with the intake of processed meat (aHR, 1.03 [95% CI, 1.02-1.05]; aARD, 0.90% [95% CI, 0.43%-1.38%]) and unprocessed red meat (aHR, 1.03 [95% CI, 1.01-1.05]; aARD, 0.76% [95% CI, 0.19%-1.33%]). No association was found between all-cause mortality and poultry (aHR, 0.99 [95% CI, 0.97-1.02]; aARD, −0.28% [95% CI, −1.00% to 0.44%]) or fish (aHR, 0.99 [95% CI, 0.97-1.01]; aARD, −0.34% [95% CI, −0.88% to 0.20%]) intake.

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Study limitations included the reliance on self-reported dietary intake data and the lack of information on food preparation methods.

According to the study investigators, “The findings of this study appear to have critical public health implications given that dietary behaviors are modifiable and most people consume these 4 food types on a daily or weekly basis.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Zhong VW, Van Horn L, Greenland P, et al. Associations of processed meat, unprocessed red meat, poultry, or fish intake with incident cardiovascular disease and all-cause mortality [published online February 3, 2020]. JAMA Intern Med. doi:10.1001/jamainternmed.2019.6969