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Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0622. [Epub ahead of print]

Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials.

Author information

1
McMaster University, Hamilton, Ontario, Canada (D.Z., J.B., K.C., K.M., B.S., Y.L., G.H.G.).
2
Dalhousie University, Halifax, Nova Scotia, Canada (B.C.J.).
3
Jagiellonian University Medical College, Kraków, Poland (M.M.B.).
4
Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V., M.R., P.A.).
5
University of British Columbia, Vancouver, British Columbia, Canada (D.S.).
6
University of Toronto, Toronto, Ontario, Canada (A.A.).
7
Clinica Las Americas, Medellin, Colombia (A.M.Z.).
8
Chosun University, Gwangju, Republic of Korea (M.A.H.).
9
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands (R.W.V.).
10
Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil (R.E.).

Abstract

Background:

Few randomized trials have evaluated the effect of reducing red meat intake on clinically important outcomes.

Purpose:

To summarize the effect of lower versus higher red meat intake on the incidence of cardiometabolic and cancer outcomes in adults.

Data Sources:

EMBASE, CENTRAL, CINAHL, Web of Science, and ProQuest from inception to July 2018 and MEDLINE from inception to April 2019, without language restrictions.

Study Selection:

Randomized trials (published in any language) comparing diets lower in red meat with diets higher in red meat that differed by a gradient of at least 1 serving per week for 6 months or more.

Data Extraction:

Teams of 2 reviewers independently extracted data and assessed the risk of bias and the certainty of the evidence.

Data Synthesis:

Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio [HR], 0.99 [95% CI, 0.95 to 1.03], cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04]).

Limitations:

There were few trials, most addressing only surrogate outcomes, with heterogeneous comparators and small gradients in red meat consumption between lower versus higher intake groups.

Conclusion:

Low- to very-low-certainty evidence suggests that diets restricted in red meat may have little or no effect on major cardiometabolic outcomes and cancer mortality and incidence.

Primary Funding Source:

None (PROSPERO: CRD42017074074).

PMID:
31569236
DOI:
10.7326/M19-0622

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