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Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1583. [Epub ahead of print]

Patterns of Red and Processed Meat Consumption and Risk for Cardiometabolic and Cancer Outcomes: A Systematic Review and Meta-analysis of Cohort Studies.

Author information

Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands, and Dalhousie University, Halifax, Nova Scotia, Canada (R.W.V.).
McMaster University, Hamilton, Ontario, Canada (D.Z., M.Z., K.M., Y.L., Y.C., S.E.H., R.D., G.H.G.).
Chosun University, Gwangju, Republic of Korea (M.A.H.).
Dalhousie University, Halifax, Nova Scotia, Canada, and Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil (R.E.).
University of British Columbia, Vancouver, British Columbia, Canada (D.S.).
Alexandria University, Alexandria, Egypt, and Tanta Chest Hospital, Ministry of Health, Tanta, Egypt (H.G.).
Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V.).
Jagiellonian University Medical College, Krakow, Poland (M.J.S., M.M.B.).
University of Guelph, Guelph, Ontario, Canada (P.M.B.).
University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada (J.S.).
Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB San Pau), and CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (P.A.).
Dalhousie University, Halifax, Nova Scotia, Texas A&M University, College Station, Texas, and McMaster University, Hamilton, Ontario, Canada (B.C.J.).



Studying dietary patterns may provide insights into the potential effects of red and processed meat on health outcomes.


To evaluate the effect of dietary patterns, including different amounts of red or processed meat, on all-cause mortality, cardiometabolic outcomes, and cancer incidence and mortality.

Data Sources:

Systematic search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and ProQuest Dissertations & Theses Global from inception to April 2019 with no restrictions on year or language.

Study Selection:

Teams of 2 reviewers independently screened search results and included prospective cohort studies with 1000 or more participants that reported on the association between dietary patterns and health outcomes.

Data Extraction:

Two reviewers independently extracted data, assessed risk of bias, and evaluated the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.

Data Synthesis:

Eligible studies that followed patients for 2 to 34 years revealed low- to very-low-certainty evidence that dietary patterns lower in red and processed meat intake result in very small or possibly small decreases in all-cause mortality, cancer mortality and incidence, cardiovascular mortality, nonfatal coronary heart disease, fatal and nonfatal myocardial infarction, and type 2 diabetes. For all-cause, cancer, and cardiovascular mortality and incidence of some types of cancer, the total sample included more than 400 000 patients; for other outcomes, total samples included 4000 to more than 300 000 patients.


Observational studies are prone to residual confounding, and these studies provide low- or very-low-certainty evidence according to the GRADE criteria.


Low- or very-low-certainty evidence suggests that dietary patterns with less red and processed meat intake may result in very small reductions in adverse cardiometabolic and cancer outcomes.

Primary Funding Source:

None. (PROSPERO: CRD42017074074).


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