How to Keep the Balance between Red and Processed Meat Intake and Physical Activity Regarding Mortality: A Dose-Response Meta-Analysis.

BACKGROUND: Non-communicable diseases have become a major threat to public health, with cardiovascular diseases (CVDs) and cancer being the top two causes of death each year. OBJECTIVE: Our objective is to evaluate the balanced association between the effect of red and processed meat intake on the risk of death and the effect of physical activity on the risk of mortality, where the risk of death includes all causes, CVDs, and cancers. METHODS: We searched electronic databases, including PubMed, ISI Web of Science, Embase, and the Cochrane Library, for prospective studies reporting risk estimates for the association between the intake of red and processed meat, walking, and muscle-strengthening activity (MSA) and the risk of mortality from all causes, CVDs, and cancer. We extracted fully adjusted effect estimates from original studies and performed a summary analysis using the fixed and random-effect models. RESULTS: A conventional meta-analysis showed that red meat and processed meat were positively associated with the risk of mortality, and daily steps and MSA were negatively associated with the risk of death. Further analysis of the dose-response relationship showed that a risk reduction (20%) from 39.5 min/week of MSA or 4100 steps/d was equivalent to an increased risk of all-cause mortality from a daily intake of 103.4 g/d of red meat or 50 g/d of processed meat. The risk was further decreased as the number of steps per day increased, but the risk reversed when the MSA exceeded the threshold (39.5 min/week). CONCLUSIONS: Adherence to physical activity is an effective way to reduce the risk of mortality due to meat intake. However, the total intake of red meat and processed meat should be controlled, especially the latter. Walking is recommended as the main daily physical activity of choice, while MSAs are preferred when time is limited, but it should be noted that longer MSAs do not provide additional benefits.

The association between red, processed and white meat consumption and risk of pancreatic cancer: a meta-analysis of prospective cohort studies.

PURPOSE: The association between meat consumption and the risk of pancreatic cancer has not been comprehensively investigated by different types of meat. The current study was conducted to evaluate this association. METHODS: PubMed and Web of Science databases were used to search for prospective cohort studies on meat consumption and pancreatic cancer risk through May 2022. A meta-analysis was performed using random-effects models to combine study-specific relative risks (RR). The quality of the included studies was evaluated using the Newcastle-Ottawa quality assessment scale. RESULTS: Twenty prospective cohort studies including 3,934,909 participants and 11,315 pancreatic cancer cases were identified. The pooled RR of pancreatic cancer for the highest versus lowest white meat intake category was 1.14 (95% CI: 1.03-1.27). There was no significant association between consumption of red meat and processed meat and pancreatic cancer risk in the highest versus lowest analysis. In dose-response analyses, pooled RRs were 1.14 (95% CI: 1.01-1.28) for an increase in red meat consumption of 120 g per day and 1.26 (95% CI: 1.08-1.47) for an increase in white meat consumption of 100 g per day, respectively. Processed meat consumption showed neither a linear nor a non-linear association with pancreatic cancer risk. CONCLUSION: Findings from this meta-analysis suggested that high consumption of red meat and white meat is associated with an increased risk of pancreatic cancer. Future prospective studies are warranted to confirm the association between meat consumption and the risk of pancreatic cancer.

Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the dose-response relationship: A systematic review and meta-analysis of cohort studies.

OBJECTIVES: The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CVD) incidence and mortality, and the dose-response relationship. METHODS: Published literature was retrieved through a structured search of 10 electronic databases: MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO and Embase, without language or year of publication restrictions. In addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes: The PRISMA Statement. RESULTS: Twenty-one prospective cohort studies were included in the systematic review. The CVDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CVD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; CI 1.01 to 1.19; p = 0.02). There was no association with Ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; CI 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CVD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; CI 1.08 to 1.26; p < 0.0001). There was no association with Ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CVD. CONCLUSION: According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CVD. This systematic review and meta-analysis protocol was registered on the PROSPERO (number: CRD42019100914).

Red/processed meat consumption and non-cancer-related outcomes in humans: umbrella review.

The associations of red/processed meat consumption and cancer-related health outcomes have been well discussed. The umbrella review aimed to summarise the associations of red/processed meat consumption and various non-cancer-related outcomes in humans. We systematically searched the systematic reviews and meta-analyses of associations between red/processed meat intake and health outcomes from PubMed, Embase, Web of Science and the Cochrane Library databases. The umbrella review has been registered in PROSPERO (CRD 42021218568). A total of 40 meta-analyses were included. High consumption of red meat, particularly processed meat, was associated with a higher risk of all-cause mortality, CVD and metabolic outcomes. Dose-response analysis revealed that an additional 100 g/d red meat intake was positively associated with a 17 % increased risk of type 2 diabetes mellitus (T2DM), 15 % increased risk of CHD, 14 % of hypertension and 12 % of stroke. The highest dose-response/50 g increase in processed meat consumption at 95 % confident levels was 1·37, 95 % CI (1·22, 1·55) for T2DM, 1·27, 95 % CI (1·09, 1·49) for CHD, 1·17, 95 % CI (1·02, 1·34) for stroke, 1·15, 95 % CI (1·11, 1·19) for all-cause mortality and 1·08, 95 % CI (1·02, 1·14) for heart failure. In addition, red/processed meat intake was associated with several other health-related outcomes. Red and processed meat consumption seems to be more harmful than beneficial to human health in this umbrella review. It is necessary to take the impacts of red/processed meat consumption on non-cancer-related outcomes into consideration when developing new dietary guidelines, which will be of great public health importance. However, more additional randomised controlled trials are warranted to clarify the causality.

Heterocyclic amines in cooked meat products, shortcomings during evaluation, factors influencing formation, risk assessment and mitigation strategies.

At this point in time, the evidence of a link between well-done meat intake and the incidence of cancer is stronger than it was 20 years ago. Several cohort and case-control studies have confirmed this evidence, and have shown a higher odd ratio and increased exposure to heterocyclic amines (HCAs) among those who frequently consume red meat. However, in most epidemiological studies, dietary assessment, combined with analytical data, is used to estimate the intake of HCAs, which has many inconsistencies. In addition, there is a lack of findings indicating a substantial correlation between various factors, like types of raw meat, types of meat products, and cooking methods that directly or indirectly influence the occurrence of cancer. Although numerous mitigation strategies have been developed to reduce HCAs levels in meat, there is still a high prevalence of carcinogenesis caused by HCAs in humans. The aim of this review is to summarise conflicting reports, address shortcomings and identify emerging trends of cutting-edge research related to HCAs.

Processed Meat Consumption and the Risk of Cancer: A Critical Evaluation of the Constraints of Current Evidence from Epidemiological Studies.

Based on a large volume of observational scientific studies and many summary papers, a high consumption of meat and processed meat products has been suggested to have a harmful effect on human health. These results have led guideline panels worldwide to recommend to the general population a reduced consumption of processed meat and meat products, with the overarching aim of lowering disease risk, especially of cancer. We revisited and updated the evidence base, evaluating the methodological quality and the certainty of estimates in the published systematic reviews and meta-analyses that examined the association between processed meat consumption and the risk of cancer at different sites across the body, as well as the overall risk of cancer mortality. We further explored if discrepancies in study designs and risks of bias could explain the heterogeneity observed in meta-analyses. In summary, there are severe methodological limitations to the majority of the previously published systematic reviews and meta-analyses that examined the consumption of processed meat and the risk of cancer. Many lacked the proper assessment of the methodological quality of the primary studies they included, or the literature searches did not fulfill the methodological standards needed in order to be systematic and transparent. The primary studies included in the reviews had a potential risk for the misclassification of exposure, a serious risk of bias due to confounding, a moderate to serious risk of bias due to missing data, and/or a moderate to serious risk of selection of the reported results. All these factors may have potentially led to the overestimation of the risk related to processed meat intake across all cancer outcomes. Thus, with the aim of lowering the risk of cancer, the recommendation to reduce the consumption of processed meat and meat products in the general population seems to be based on evidence that is not methodologically strong.

Consumo de embutidos en mujeres costarricenses: efecto del nivel socioeconómico / Intake of processed meats by Costa Rican women: effect of socioeconomic status

Resumen Introducción: El consumo de embutidos se ha asociado con serios problemas de salud que son comunes entre la población femenina. En el 2015 la Agencia Internacional para la Investigación en Cáncer clasificó los embutidos, como carcinógenos para los seres humanos ya que su ingesta está relacionada con el cáncer colorrectal. El aumento en el consumo de embutidos, los cuales son un alimento fuente de proteína de bajo costo, es diferencial según nivel socioeconómico y puede tener un impacto en la incidencia de enfermedades crónicas en la población. Objetivo: Examinar la asociación entre el consumo de embutidos y (a) la ingesta total de proteína, (b) la ingesta inadecuada de proteína, según NSE. Métodos: Se seleccionó una muestra (N = 135) de mujeres de 25 a 45 años, con 1 a 4 hijos, pertenecientes a tres diferentes niveles socioeconómicos, residentes de dos cantones del Gran Área Metropolitana de San José, Costa Rica, entre junio 2014 y marzo 2015. Mediante el uso de fotografías se indagó la percepción de las mujeres en cuanto al costo y su preferencia de consumo de 12 distintos alimentos, entre los cuales se incluyó los embutidos. Por medio de recordatorios alimentarios de 24 horas recolectados en tres visitas diferentes, y el uso de la base de datos de composición de alimentos ValorNut, se midió el consumo de proteína total en gramos y se determinó la cantidad promedio de veces por día que las mujeres consumen embutidos. A partir del peso de cada participante se determinó su requerimiento de proteína. La ingesta inadecuada de proteína se estimó como la diferencia entre el requerimiento y la ingesta observada. Mediante un modelo de regresión lineal se determinó la asociación entre el consumo total de proteína medido en gramos y la cantidad de veces por día que se ingiere embutidos. Mediante un modelo de regresión logística se estimó la asociación entre la ingesta inadecuada de proteína y la cantidad de veces por día que se ingiere embutidos. Resultados: Los embutidos son percibidos como la fuente de proteína menos apetecible, sin embargo, fue la tercera fuente de proteína más consumida. El consumo de embutidos difiere según NSE (P < 0.01), en el alto NSE es donde se consumen con menor frecuencia. Los embutidos más comúnmente consumidos fueron mortadela (bajo NSE), salchichón (NSE medio), y jamón de pavo (alto NSE). El consumo de embutidos se asocia significativamente con un incremento en la ingesta de proteína. Se encontró una asociación inversa entre el NSE y la ingesta inadecuada de proteína. Conclusiones: El consumo de embutidos está asociado con el nivel socioeconómico. Es probable que las mujeres consuman embutidos porque los perciben como un alimento fuente de proteína de bajo costo. Se requiere establecer estrategias educativas que ayuden a las mujeres a identificar sus necesidades alimentarias de proteína y a conciliar estas necesidades con la adquisición de alimentos saludables a un costo aceptable.

Abstract Introduction: Intake of processed meats has been associated with serious health problems that are common among women. In 2015, the International Agency for Research on Cancer classified processed meats as human carcinogens, associated specifically with colon cancer. The increase in intake of processed meats, which are a low-cost source of dietary protein, varies by socioeconomic status (SES) and can impact chronic disease incidence. Objective: Examine the association between processed meats intake and (a) total protein intake, (b) inadequate protein intake, by SES. Methods: This study included a representative sample (N = 135) of women age 25 to 45 years, with one to four children, from three different socioeconomic groups who were residents of two counties from the Greater Metropolitan Area of San José, Costa Rica between June 2014 and March 2015. Using photographs, we examined women's perceptions of the cost and perceived desirability of 12 different foods, including processed meats. Using 24-hour dietary recalls collected on three different days, and the ValorNut food composition database, we estimated total protein intake, in grams, and determined the intake frequency (times/day) of processed meat. Each women's dietary protein requirement was estimated based on her bodyweight. Inadequate protein intake was calculated as the difference between protein requirement and actual intake. A linear regression model was used to determine the association between total protein intake in grams and intake frequency (times/day) of processed meat. A logistic regression model was used to estimate the association between low protein intake and intake frequency (times/day) of processed meat. Results: Processed meats were perceived as the least preferred protein source but were the third most commonly consumed protein source. Consumption of processed meats differed by SES and was lower in the higher SES group (P < 0.01). The most commonly consumed processed meats by SES were "mortadella" (low-SES), sausages (middle-SES), and sliced turkey/ham (high-SES). Processed meat intake was significantly associated with an increase in protein intake. There was an inverse association between SES and inadequate protein intake. Conclusions: Processed meat intake is associated with SES. Women may consume processed meats because they are perceived to be a low-cost protein source. Educational strategies are needed to help women identify their protein needs and meet those needs with healthier and affordable dietary alternatives.

Red meat and processed meat consumption and the risk of dyslipidemia in Korean adults: A prospective cohort study based on the Health Examinees (HEXA) study.

BACKGROUND AND AIMS: There has been conflicting results on the effect of red meat and processed meat intake on the dyslipidemia risk. Moreover, studies in Asian population with lower meat intake than the Western population are lacking. In this study, we aimed to investigate the association between red and processed meat consumption and the dyslipidemia risk by sex among Koreans. METHODS AND RESULTS: A total of 20,407 participants from a prospective cohort were divided into quintiles according to their red meat consumption and tertiles according to their processed meat consumption based on the validated semi-quantitative food frequency questionnaire. The Cox proportional hazards regression analysis was used to estimate the relative risk and 95% confidence interval of dyslipidemia according to red and processed meat consumption. Higher red meat consumption was associated with a 34% and 10% increased risk of hypercholesterolemia in both men and women, and further, a 58% and 17% increased risk of hyper-low-density lipoprotein cholesterolemia and dyslipidemia, in men, compared to the lowest consumption group. Higher processed meat consumption was associated with a 38% and 9% increased risk of hypercholesterolemia, 29% and 18% increased risk of hypertriglyceridemia, and 32% and 10% increased risk of dyslipidemia in both men and women, respectively, compared to the lowest consumption group. CONCLUSION: The results of the present study can provide compelling evidence on Asian population that red and processed meat consumption can lead to a higher risk of dyslipidemia.

Red and processed meat consumption and cancer outcomes: Umbrella review.

The purpose of this umbrella review was to evaluate the quality of evidence, validity and biases of the associations between red and processed meat consumption and multiple cancer outcomes according to existing systematic reviews and meta-analyses. The umbrella review identified 72 meta-analyses with 20 unique outcomes for red meat and 19 unique outcomes for processed meat. Red meat consumption was associated with increased risk of overall cancer mortality, non-Hodgkin lymphoma (NHL), bladder, breast, colorectal, endometrial, esophageal, gastric, lung and nasopharyngeal cancer. Processed meat consumption might increase the risk of overall cancer mortality, NHL, bladder, breast, colorectal, esophageal, gastric, nasopharyngeal, oral cavity and oropharynx and prostate cancer. Dose-response analyses revealed that 100 g/d increment of red meat and 50 g/d increment of processed meat consumption were associated with 11%-51% and 8%-72% higher risk of multiple cancer outcomes, respectively, and seemed to be not correlated with any benefit.

Habitual fish intake negatively correlates with prevalence of frailty among patients with rheumatoid arthritis.

Frailty is a geriatric syndrome characterized by anabolic-catabolic imbalance and multisystem dysregulation resulting in increased adverse health outcomes, and is closely related with dietary habits in the general population. Although chronic inflammatory diseases are thought to accelerate development of frailty, correlations between rheumatoid arthritis (RA), frailty and dietary habits have not been examined. We performed a cross-sectional study using our cohort database (KURAMA cohort), and classified 306 participants into three groups (robust, prefrail and frail) according to the Study of Osteoporotic Fracture (SOF) criteria. Multivariate logistic analysis revealed that the presence of frailty/prefrailty was significantly correlated with the disease activity score (DAS28-ESR) (OR 1.70 (1.30-2.22), p < 0.0001). Additional analyses of frailty and food intake showed that 5 foods (fish, meat, milk, vegetables and fruits) of 20 groups on the questionnaire were inversely associated with the prevalence of frail/prefrail categories. In multivariate analysis with the five nutrients, fish intake (> two times a week) was an independent covariate negatively correlated with frailty/prefrailty (OR 0.35 (0.19-0.63), p = 0.00060). In conclusion, habitual fish intake may play a key role in nutritional intervention to prevent progression of frailty and RA.

Reducción de carnes rojas y procesadas en la población española: ¿cuál es su impacto sobre la mortalidad cardiovascular? / Reduction of red and processed meats in the Spanish population: What is its impact on total and cardiovascular mortality?

OBJETIVO: Cuantificar el impacto de reducir el consumo de carnes rojas y procesadas sobre la mortalidad cardiovascular y la mortalidad total de la población adulta española, basado en 5 revisiones publicadas. Participantes y mediciones principales: Se define la exposición como el consumo de ≥ 3 raciones/semana de carnes rojas o procesadas, y se consideran cuatro escenarios de población expuesta (30-60%). Con datos del Instituto Nacional de Estadística, se calcula la mortalidad ponderada en población española de 40-80 años y, utilizando los riesgos relativos (RR) y los intervalos de confianza (IC) al 95% publicados en 5 revisiones (RR = 0,88; IC95%: 0,84-0,93 para mortalidad por todas las causas y RR = 0,92; IC95%: 0,90-0,93 para la mortalidad cardiovascular), se calculó la tasa de mortalidad en expuestos y no expuestos. Multiplicando esas tasas por el número de expuestos, se obtuvo el número de muertes atribuibles. RESULTADOS: Asumiendo un 60% de población española de 40-80años expuesta, el número de muertes anuales de causa cardiovascular que se podrían evitar consumiendo < 3 raciones/semana de carnes rojas o procesadas con un IC95% está entre 2.112 y 3.055. Si la población expuesta fuese un 30% se podrían evitar entre 1.079 y 1.577 muertes. CONCLUSIONES: Incluso bajo el supuesto más conservador, el beneficio poblacional de reducir el consumo de carnes rojas o procesadas sobre la mortalidad cardiovascular y total sería muy importante. Las conclusiones de las revisiones mencionadas contradicen sus propios resultados y contribuyen a un estado de confusión que representa un daño a la salud pública

OBJECTIVE: Quantify the impact of reducing the consumption of red/processed meats on cardiovascular mortality and all-cause mortality of the Spanish adult population based in 5 revisions published. Participants and main measurements: We defined exposure as consumption of ≥ 3 servings/week of red or processed meats and considered four possible scenarios of exposed population (30%-60%). Based on data from the Spanish National Statistics Institute, we calculated the weighted mortality between 40 and 80years. Using the relative risks (RR) and 95% confidence intervals (CI) published by the referred revisions (RR = 0.88; IC95%: 0.84-0.93 for all-cause mortality and RR = 0.92; IC95%: 0.90-0.93 for cardiovascular mortality), we calculated the expected mortality rate in both exposed and unexposed categories. By multiplying these rates by the number of exposed individuals, we estimated the attributable number of yearly deaths. RESULTS: If 60% of the population was exposed, with a 95% CI, the number of cardiovascular deaths that could be averted each year if population consumed < 3 servings/week of red or processed meats was between 2.112 and 3.055. If was exposed that 30%, the difference in the yearly number of potentially averted deaths was between 1.079 and 1.577. CONCLUSIONS: Even under the most conservative assumption, the benefit, at the population level, of reducing red or processed meats consumption < 3 servings/week on cardiovascular mortality is important. The conclusions of the recently published reviews contradicted their own results and contributed to a state of confusion that can create substantial harm for public health

Meat lipids, NaCl and carnitine: Do they unveil the conundrum of the association between red and processed meat intake and cardiovascular diseases?_Invited Review.

The assessment of the actual contribution of red or processed meat to increasing the risk of suffering cardiovascular diseases (CVD) requires identification of specific harmful components and their underlying pathological mechanisms. In regards to CVD, meat lipids and their oxidation products have been recurrently studied due to their implications on lipid metabolism, hypercholesterolemia, obesity, and risk of suffering vascular events such as stroke. The impact of excess NaCl intake on increasing blood pressure is well-established and processed meat products have been recognized as a major contributor to dietary sodium in developed countries. Recent evidence has also suggested carnitine from red meat, as a precursor for trimethylamine-N-oxide, which has been shown to cause atherosclerosis, may increase the risk of suffering CVD in experimental animals. The present review aims to provide an updated overview, including evidence, controversies and unresolved questions on both the epidemiology and mechanisms relating red and processed meat consumption to CVD.

Negligible Oleandrin Content of Hot Dogs Cooked on Nerium oleander Skewers.

INTRODUCTION: The Nerium oleander plant contains cardenolides that may cause human poisoning when ingested. A long-standing belief holds that it is possible to be poisoned by eating hot dogs or other foods cooked on Nerium oleander branch skewers. Oleandrin levels in frankfurters cooked on fresh and dry Nerium oleander skewers were measured. METHODS: Hot dogs were cooked separately on either dried or fresh oleander branch skewers using a disposable charcoal grill. The hot dogs were then frozen and transported to an analytical laboratory where oleandrin content was measured via liquid chromatography/mass spectroscopy (LC/MS). RESULTS: The oleandrin content of hot dogs cooked on dried and fresh skewers did not exceed 343 ng and 701 ng, respectively. CONCLUSION: Hot dogs cooked on Nerium oleander skewers contain a negligible amount of oleandrin with respect to that sufficient to cause human poisoning. Reports of poisonings occurring in this manner are most likely the result of an urban myth.

Dietary Intake of Red Meat, Processed Meat, and Poultry and Risk of Colorectal Cancer and All-Cause Mortality in the Context of Dietary Guideline Compliance.

Meat intake has been linked to increased risk of colorectal cancer (CRC) and mortality. However, diet composition may affect the risks. We aimed to estimate associations between red and processed meat and poultry intake and risk of CRC and all-cause mortality and if they are modified by dietary quality using Cox regression analyses. Baseline dietary data were obtained from three survey rounds of the Danish National Survey on Diet and Physical Activity. Data on CRC and all-cause mortality were extracted from national registers. The cohort was followed from date of survey interview-or for CRC, from age 50 years, whichever came last, until 31 December 2017. Meat intake was analysed categorically and continuously, and stratified by dietary quality for 15-75-year-old Danes at baseline, n 6282 for CRC and n 9848 for mortality analyses. We found no significant association between red and processed meat intake and CRC risk. For poultry, increased CRC risk for high versus low intake (HR 1.62; 95%CI 1.13-2.31) was found, but not when examining risk change per 100 g increased intake. We showed no association between meat intake and all-cause mortality. The association between meat intake and CRC or mortality risk was not modified by dietary quality.

Association between meat intake and mortality due to all-cause and major causes of death in a Japanese population.

PURPOSE: We examined the association between meat intake and mortality due to all-cause and major causes of death using a population-based cohort study in Japan. METHODS: 87,507 Japanese aged between 45 and 74 years old at 5-year follow-up study were followed for 14.0 years on average. Associations between meat intake and mortality risk were assessed using a Cox proportional hazards model. RESULTS: A heavy intake of total meat was associated with a higher risk of all-cause mortality relative to the lowest quartile intake in men (Q4: HR,1.18; 95%CIs, 1.06-1.31). A higher intake of total meat was associated with a lower risk of stroke mortality in women (Q2: HR, 0.70; 95%CIs, 0.51-0.94, Q3: HR, 0.68; 95%CIs, 0.50-0.95, Q4: HR, 0.66; 95%CIs, 0.44-0.99). A heavy intake of red meat was also associated with all-cause mortality (Q4: HR, 1.13; 95%CIs, 1.02-1.26) and heart disease mortality (Q4: HR, 1.51; 95%CIs, 1.11-2.06) in men but not in women. Heavy intake of chicken was inversely associated with cancer mortality in men. CONCLUSIONS: Heavy intakes of total and red meat were associated with an increase in all-cause and heart disease mortality in men, while total meat intake was associated with a lower risk of stroke mortality in women.

Recent advances in heterocyclic aromatic amines: An update on food safety and hazardous control from food processing to dietary intake.

Heterocyclic aromatic amines (HAAs) as probable carcinogenic substances are mainly generated in meat products during thermal processing. Numerous studies have contributed to the analysis, formation, and mitigation of HAAs during food processing. However, few articles have comprehensively reviewed food safety aspects from both food processing and dietary intake regarding the formation, mitigation, metabolism, biomarkers for exposure, hazard control, and risk assessment of HAAs, and related food safety researches. Several factors may influence the generation of HAAs, including processing temperature, processing time, and chemical composition of the meat. Nonetheless, these mutagenic compounds are attenuated to different levels by the addition of natural or synthetic flavorings and antioxidant-rich marinades, as well as pretreatments using technique such as microwave heating. After dietary intake, different types of HAAs are metabolized in humans by several enzymes, including cytochrome P450s, peroxidases, N-acetyltransferases, sulfotransferases, uridine diphosphate-glucuronosyltransferases, and glutathione S-transferases. Their primary metabolites are further conjugated with DNA or ultimately excreted in urine and feces. The 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine in hair as well as DNA, hemoglobin, and serum albumin adducts has been considered as biomarkers for exposure assessment. Dietary intake information obtained from questionnaires and the results of epidemiological investigations have shown a positive relationship between the intakes of red meat and processed meat and high risk of cancer incidence. As several cancers have been reported to be associated with HAAs, HAAs should be both effectively reduced during food processing and controlled from dietary intake to facilitate human health.

Co-consumption of Vegetables and Fruit, Whole Grains, and Fiber Reduces the Cancer Risk of Red and Processed Meat in a Large Prospective Cohort of Adults from Alberta's Tomorrow Project.

We examined whether co-consumption of red and processed meat with key foods items and food constituents recommended for cancer prevention (vegetables and fruit, whole grains, and fiber) mitigates cancer incidence. In a prospective cohort of 26,218 adults aged 35-69 years at baseline, dietary intake was collected through 124-item past-year food frequency questionnaire. Incidence of all-cause and 15 cancers previously linked to red and processed meat intake was obtained through data linkage with a cancer registry (average follow-up 13.5 years). Competing risk Cox Proportional Hazard models estimated cancer risk and Accelerated Failure Time models estimated time-to-cancer occurrence for different combinations of intake levels while considering mortality from vital statistics and established confounders. Co-consumption of low vegetables and fruit intake with high processed meat was associated with higher incidence of all-cause and 15 cancers (men: HR = 1.85, 1.91; women: HR = 1.44, 1.49) and accelerated time-to-cancer occurrence (men: 6.5 and 7.1 years and women: 5.6 and 6.3 years, respectively), compared to high vegetables and fruit with low processed meat intake. Less pronounced and less consistent associations were observed for whole grains and fiber and for red meat. The findings provide initial evidence toward refining existing cancer prevention recommendations to optimize the intake and combination of foods in the general adult population.

Outbreak of Listeriosis in South Africa Associated with Processed Meat.

BACKGROUND: An outbreak of listeriosis was identified in South Africa in 2017. The source was unknown. METHODS: We conducted epidemiologic, trace-back, and environmental investigations and used whole-genome sequencing to type Listeria monocytogenes isolates. A case was defined as laboratory-confirmed L. monocytogenes infection during the period from June 11, 2017, to April 7, 2018. RESULTS: A total of 937 cases were identified, of which 465 (50%) were associated with pregnancy; 406 of the pregnancy-associated cases (87%) occurred in neonates. Of the 937 cases, 229 (24%) occurred in patients 15 to 49 years of age (excluding those who were pregnant). Among the patients in whom human immunodeficiency virus (HIV) status was known, 38% of those with pregnancy-associated cases (77 of 204) and 46% of the remaining patients (97 of 211) were infected with HIV. Among 728 patients with a known outcome, 193 (27%) died. Clinical isolates from 609 patients were sequenced, and 567 (93%) were identified as sequence type 6 (ST6). In a case-control analysis, patients with ST6 infections were more likely to have eaten polony (a ready-to-eat processed meat) than those with non-ST6 infections (odds ratio, 8.55; 95% confidence interval, 1.66 to 43.35). Polony and environmental samples also yielded ST6 isolates, which, together with the isolates from the patients, belonged to the same core-genome multilocus sequence typing cluster with no more than 4 allelic differences; these findings showed that polony produced at a single facility was the outbreak source. A recall of ready-to-eat processed meat products from this facility was associated with a rapid decline in the incidence of L. monocytogenes ST6 infections. CONCLUSIONS: This investigation showed that in a middle-income country with a high prevalence of HIV infection, L. monocytogenes caused disproportionate illness among pregnant girls and women and HIV-infected persons. Whole-genome sequencing facilitated the detection of the outbreak and guided the trace-back investigations that led to the identification of the source.

Síndrome urémico hemolítico y yogur: entre la creencia popular y la evidencia científica / Hemolytic uremic syndrome and yoghurt: popular belief and scientific evidence

Algunos profesionales de la salud desaconsejan el consumo del yogur por el riesgo de provocar Síndrome Urémico Hemolítico, una enfermedad grave causada por cepas de E. coli productor de toxina Shiga (STEC por sus siglas en inglés). Estas bacterias pueden pasar del intestino del ganado vacuno a la carne o a la leche en condiciones inadecuadas de trabajo en frigoríficos o establecimientos productores de leche, respectivamente, siendo las hamburguesas insuficientemente cocidas el principal vector de la enfermedad y la leche cruda sin pasteurizar o los productos lácteos elaborados con ésta, otro factor de riesgo. En la industria láctea, el yogur se elabora con leche que es sometida a un doble tratamiento térmico. En la bibliografía moderna reportes de la presencia de STEC en yogures industriales, y los trabajos de revisión y meta-análisis no incluyen al yogur, pero sí a la leche sin pasteurizar, como vectores de trasmisión de STEC. En este contexto, y dada la evidencia científica disponible actualmente en relación a E. coli productor de toxina Shiga, el SUH y el yogur, parecería que estamos ante la presencia de una correlación espuria, la asociación de dos hechos que no tienen relación causal entre sí, más que a un hecho científico del cual uno (el yogur) es el responsable del otro (SUH).

Some health professionals discourage yogurt because of the risk of Hemolytic Uremic Syndrome (HUS), a serious disease caused by strains of Shiga toxin-producing E. coli (STEC). These bacteria can pass from the intestine of cattle to meat or milk under inadequate working conditions in slaughterhouses or milking plants. Undercooked hamburgers the main is vector of disease and unpasteurized raw milk or dairy products made with it, are another risk factors. In the dairy industry, yoghurt is made from milk that undergoes a double heat treatment. There are no reports of the presence of STEC in industrial yogurts in the modern bibliography, and reviews and meta-analysis do not point to yogurt as a risk factor for STEC, but rather unpasteurized milk. In this context, and given the scientific evidence currently available regarding STEC, HUS and yogurt, it would seem that we are in the presence of a spurious correlation, the association between two facts that have no causal relationship between them, rather than a scientific fact for which one (yogurt) may be responsible for the other (HUS).