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Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.

ABSTRACT: Previous studies have shown inconsistent associations between red and processed meat intake and breast cancer risk. N-nitroso compounds and heme iron have been hypothesized as contributing factors. We followed 193,742 postmenopausal women in the NIH-AARP Diet and Health Study and identified 9,305 incident breast cancers (1995-2006). Dietary intake was assessed using a food frequency questionnaire at baseline. We adjusted daily intakes of meat, nitrite and heme iron for energy intake using the nutrient density method. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) by quintiles of dietary exposures for all breast cancer, by stage (in-situ, localized, regional/distant) and by estrogen/progesterone receptor (ER/PR) status using Cox proportional hazards regression. Total red meat intake was positively associated with risk of regional/distant cancer (p-trend?=?0.02). The risk was 25% higher in the highest vs. lowest intake quintile (95% CI?=?1.03-1.52). Higher processed red meat intake (Q5 vs. Q1) was associated with 27% higher risk of localized breast cancer (95% CI?=?1.01-1.27, p-trend?=?0.03) and a 19% higher risk of regional/distant cancer (95% CI?=?0.98-1.44, p-trend?=?0.10). In addition, higher nitrite intake from processed red meat was positively associated with localized cancer (HR for Q5 vs. Q1?=?1.23, 95% CI?=?1.09-1.39, p-trend?

SUBMITTER: Inoue-Choi M

PROVIDER: S-EPMC4724256 | biostudies-other | 2016 Apr

REPOSITORIES: biostudies-other

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Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.

Inoue-Choi Maki M Sinha Rashmi R Gierach Gretchen L GL Ward Mary H MH

International journal of cancer 20151120 7

Previous studies have shown inconsistent associations between red and processed meat intake and breast cancer risk. N-nitroso compounds and heme iron have been hypothesized as contributing factors. We followed 193,742 postmenopausal women in the NIH-AARP Diet and Health Study and identified 9,305 incident breast cancers (1995-2006). Dietary intake was assessed using a food frequency questionnaire at baseline. We adjusted daily intakes of meat, nitrite and heme iron for energy intake using the nu ...[more]

PMID: 26505173

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Project description:BackgroundThe associations of red and processed meat with chronic disease risk remain to be clarified, in part because of measurement error in self-reported diet.ObjectivesWe sought to develop metabolomics-based biomarkers for red and processed meat, and to evaluate associations of biomarker-calibrated meat intake with chronic disease risk among postmenopausal women.MethodsStudy participants were women who were members of the Women's Health Initiative (WHI) study cohorts. These participants were postmenopausal women aged 50-79 y when enrolled during 1993-1998 at 40 US clinical centers with embedded human feeding and nutrition biomarker studies. Literature reports of metabolomics correlates of meat consumption were used to develop meat intake biomarkers from serum and 24-h urine metabolites in a 153-participant feeding study (2010-2014). Resulting biomarkers were used in a 450-participant biomarker study (2007-2009) to develop linear regression calibration equations that adjust FFQ intakes for random and systematic measurement error. Biomarker-calibrated meat intakes were associated with cardiovascular disease, cancer, and diabetes incidence among 81,954 WHI participants (1993-2020).ResultsBiomarkers and calibration equations meeting prespecified criteria were developed for consumption of red meat and red plus processed meat combined, but not for processed meat consumption. Following control for nondietary confounding factors, hazard ratios were calculated for a 40% increment above the red meat median intake for coronary artery disease (HR: 1.10; 95% CI: 1.07, 1.14), heart failure (HR: 1.26; 95% CI: 1.20, 1.33), breast cancer (HR: 1.10; 95% CI: 1.07, 1.13) for, total invasive cancer (HR: 1.07; 95% CI: 1.05, 1.09), and diabetes (HR: 1.37; 95% CI: 1.34, 1.39). HRs for red plus processed meat intake were similar. HRs were close to the null, and mostly nonsignificant following additional control for dietary potential confounding factors, including calibrated total energy consumption.ConclusionsA relatively high-meat dietary pattern is associated with somewhat higher chronic disease risks. These elevations appear to be largely attributable to the dietary pattern, rather than to consumption of red or processed meat per se.

Project description:Objective To determine the association of different types of meat intake and meat associated compounds with overall and cause specific mortality.Design Population based cohort study.Setting Baseline dietary data of the NIH-AARP Diet and Health Study (prospective cohort of the general population from six states and two metropolitan areas in the US) and 16 year follow-up data until 31 December 2011.Participants 536 969 AARP members aged 50-71 at baseline.Exposures Intake of total meat, processed and unprocessed red meat (beef, lamb, and pork) and white meat (poultry and fish), heme iron, and nitrate/nitrite from processed meat based on dietary questionnaire. Adjusted Cox proportional hazards regression models were used with the lowest fifth of calorie adjusted intakes as reference categories.Main outcome measure Mortality from any cause during follow-up.Results An increased risk of all cause mortality (hazard ratio for highest versus lowest fifth 1.26, 95% confidence interval 1.23 to 1.29) and death due to nine different causes associated with red meat intake was observed. Both processed and unprocessed red meat intakes were associated with all cause and cause specific mortality. Heme iron and processed meat nitrate/nitrite were independently associated with increased risk of all cause and cause specific mortality. Mediation models estimated that the increased mortality associated with processed red meat was influenced by nitrate intake (37.0-72.0%) and to a lesser degree by heme iron (20.9-24.1%). When the total meat intake was constant, the highest fifth of white meat intake was associated with a 25% reduction in risk of all cause mortality compared with the lowest intake level. Almost all causes of death showed an inverse association with white meat intake.Conclusions The results show increased risks of all cause mortality and death due to nine different causes associated with both processed and unprocessed red meat, accounted for, in part, by heme iron and nitrate/nitrite from processed meat. They also show reduced risks associated with substituting white meat, particularly unprocessed white meat.

Project description:PurposeTo determine the association between red meat (RM), processed red meat (PRM) and total red and processed red meat (TRPRM) consumption on nutritional adequacy and markers of health and cardio-metabolic diseases in British adults.MethodsIn this cross-sectional study of adults (19-64 y) from the National Diet and Nutrition Survey (NDNS) (n = 1758), RM and PRM consumption were assessed from 4 day estimated food diaries. Anthropometric measures, blood pressure (BP), pulse pressure (PP), plasma glucose, HbA1c, C-reactive protein, TAG, TC, LDL-C and HDL-C from the NDNS were used.Results43% of adults (men 57% and women 31%) consumed more than the 70 g/d TRPRM guidelines. Fewer adults in the highest tertile of TRPRM intake were below lower reference nutrient intakes (LRNIs), particularly for zinc and iron, respectively. In model 3 (controlled for age, energy intake, socioeconomic classification, number of daily cigarettes, BMI, dietary factors), higher RM consumption was associated with being significantly taller (model 3: P-ANCOVA = 0.006; P-T3/T1 = 0.0004) in men and lower diastolic BP (model 3: P-ANCOVA = 0.004; P-T3/T2 = 0.002) in women. Higher PRM in men was associated with significantly higher plasma ferritin concentration (model 3: P-ANCOVA = 0.0001; P-T2/T1 = 0.0001), being taller (P-ANCOVA = 0.019; P-T1/T2 = 0.047, T1/T3 = 0.044), increased body weight (model 3: P-ANCOVA = 0.001; P-T1/T3 = 0.0001), BMI (model 3: P-ANCOVA = 0.007; P-T1/T3 = 0.006) and smaller hip circumference (model 3: P-ANCOVA = 0.006; P-T3/T1 = 0.024; P-T2/T1 = 0.013) and in women significantly higher TC (model 3: P-ANCOVA = 0.020; P-T3/T2 = 0.016), LDL-C (P-ANCOVA = 0.030; P-T3/T2 = 0.025), HbA1c (model 3: P-ANCOVA = 0.0001; P-T2/T1 = 0.001; P-T3/T2 = 0.001) and higher PP (model 3: P-ANCOVA = 0.022; P-T3/T1 = 0.021). Higher PRM consumption was associated with significantly higher BMI and hip circumference in men, and higher TC, LDL-C, HbA1c and PP in women, which was not observed for RM consumption.

Dataset Information

Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.

Publications

Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.

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