Total meats and all-cause mortality or survival.
Background/use of data:
- 7 publications were found about The EPIC Study (16). These included data about the same subpopulation with different length of
follow-up (Trichopoulou A. 2003 vs Trichopoulou A. 2009, and Key TJ. 2003 vs Key TJ. 2009).
The EPIC-Elderly study provided data about 74,607 elderly (aged ≥ 60) subjects - with or whithout diabetes - from 9 countries (including Greece & UK), and including 4,047 deaths (Trichopoulou A. 2005). But 3 other publications provided information about subgroups of this cohort from which the data partly overlapped with data from The EPIC-Elderly Study:
a) Trichopoulou A (2006). 1,013 subjects from EPIC-Greece, and with diabetes, including 80 deaths.
b) Trichopoulou A (2009). 23,349 subjects aged 20-86 from EPIC-Greece, and without diabetes, including 1,075 deaths.
c) Key TJ (2009). 47,254 subjects aged 20-89 from EPIC-Oxford (UK), including 1,513 deaths.
Data form The EPIC-Elderly Study was included in the systematic review, excluding data from the previous 3 publications, because the Greek and UK subcohorts included less deaths than the EPIC-Elderly Study (2,668 vs 4,047). - Dr. Hirayama examined the effects of a small amount of food groups in relation to a large amount of mortality end points in a Japanese cohort of
very large size. An extended review of his work was published as a book in 1990 (Hirayama T [5]). Data about this cohort is seldom included in current
systematic reviews about the relations mentioned. Dr. Hirayama published a lot of articles stating that vegetables and meats were related to
several disease end points, adjusted for age and sex. However, the book included one page showing effects after multivariate analysis including
cigarette smoking, meat, green-yellow vegetables, and alcohol. And this analysis showed that a large amount of previously published effects completely
changed when these variables were taken into account.
Since a) Dr. Hirayama himself only published sex, and age-adjusted results in the English language, while results following multivariate analysis were completely different b) the results were published as a book and not in a peer-reviewed journal, and c) Dr. Hirayama was the only researcher examining this cohort, results from his cohort are debatable. Results will be presented including effects from his work, but his work will not be included in the evidence for a possible effect. - In 1999, Key TJ published a collaborative analysis of combined data from 4 cohort studies, including primarily vegetarian subjects, and including 8,330 deaths. Findings about 3 of these cohorts were published following this publication, including a longer follow-up period. Cohort-specific results were chosen to be included in the systematic review, instead of results from the collaborative analysis, because this allowed for a larger amount of deaths to be included in the analysis.
- In 2002, Appleby PN published results about "The Oxford Vegetarian Study". Results were published for a) vegetarians vs nonvegetarians, and b) meat eaters vs non-meat eaters. Though it seems obvious to include the results from the meat eaters vs non-meat eaters, the non-meat eating group in this analysis included both low consumers of meats, and fish eaters. Therefore, results for vegetarians vs nonvegetarians were included.
- In 1984, Kahn HA published results about "The Adventist Health Study". 3 different OR's were provided, following 3 different series of adjustments. The OR after adjustment for cigarettes was included in this systematic review, because cigarette smoking has been shown to influence mortality rates more convincingly than consumption of eggs/fish or eggs/salad.
Results: 37 articles providing information about 14 different cohorts were found, including a total of 72,642 cases. Survival was the end point in one
article (Nube M [2]), and mortality was the end point in all remaining articles.
A significantly increased risk was found in one cohort (Kahn HA [1]). But and a significant protective effect was found in one other cohort (Jamrozik K [12]),
and women had higher survival rates in another cohort (Nube M [2]). No other (non)significant associations were found. The average RR = 1.05 for total meats consumption,
including data from all 14 cohorts.
When one cohort with debatable results was excluded from the analysis (Hirayama T [4]), this left 17,142 cases, and the average RR became 1.12.
Effect modification: The significantly increased risk found by Kahn HA (1) was restricted to men. Another cohort showed a protective effect among women
only (Nube M [2]). No other effect modification was found by gender (Key TJ [9], Key TJ [16]).
Meat consumption significantly increased mortality among elderly subjects without chronic diseases, but this association was found in a cohort of very small size
(Fortes C [14]).
Meat fat: Data about meat fat was provided by 2 cohorts (Kahn HA [1], Jamrozik K [12]). No associations were found with mortality.
Conclusion: Few, and inconsistent effects were found. No evidence was found for an association between total meats consumption, or meat fats, and all-cause
mortality.
Limitations: Few results were published at different levels of consumption (Kahn HA [1], Nube M [2], Mann JI [6], Fortes C [14]).
Mostly, results were published for 2 units of consumption (e.g., vegetarians vs nonvegetarians), or as continuous data instead of categorized data. This makes
it impossible to link any possible effect to a given level of consumption. Also, hardly any data is available about effect modification.
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 19) González S (2008) | No cohort name defined | 83 | RR = 0.89 (0.69-1.16; P = 0.39). |
| 16) Trichopoulou A (2005) | The EPIC-Elderly Study (subjects without CHD) | 4,047 | MR = 1.03 (0.99-1.07). |
| 16) Trichopoulou A (2005) | The EPIC-Greece Study (subjects with CHD) | 131 | MR = 0.96 (0.79-1.17). |
| 14) Fortes C (2000) | No cohort name defined | 53 | RR = 1.82 (0.91-3.60). |
| 13) Lasheras C (2000) | No cohort name defined | 38 (< 80 y), and 58 (≥ 80 y) | < 80 y: RR = 1.06 (0.42-2.42; P = 0.98). ≥ 80 y: RR = 0.65 (0.30-1.40; P = 0.27). |
| 12) Jamrozik K (2000) | The Perth Community Study | 198 | HR = 0.69 (0.50-0.96). |
| 11) Kouris-Blazos A (1999) | No cohort name defined | 38 | RR = 0.97 (0.89-1.06). |
| 8) Knoops KT (2006) | The HALE | 1,384 | HR = 0.97 (0.87-1.09) for low vs high consumption. |
| 6) Appleby PN (2002) | The Health Food Shoppers Study | 2,346 | DRR = 1.03 (0.95-1.13) for vegetarianism vs nonvegetarianism. |
| 6) Appleby PN (2002) | The Oxford Vegetarian Study | 1,131 | DRR = 1.03 (0.91-1.16) for vegetarianism vs nonvegetarianism. |
| 5) Trichopoulou A (1995) | No cohort name defined | 53 | RR = 1.02 (0.93-1.12; P = 0.65). |
| 4) Hirayama T (1990) | No cohort name defined | 55,523 | RR = 1.03. |
| 3) Chang-Claude J (2005) | The German Vegetarian Study | 433 | RR = 1.08 (0.86-1.34) for low vs high consumption. |
| 2) Nube M (1987) | No cohort name defined | 742 men, and 448 women | Men: No significant association (survival rate = 47.3 vs 45.5). Women: A higher survival rate (73.4 vs 66.8). |
| 1) Kahn HA (1984) | The Adventist Health Study | 5,936 | A significantly increased risk: OR = 1.35. |
| Total number of cases: 72,642 | Average RR = 1.05 |
Total meats and all-cause mortality. Meat consumption vs vegetarianism.
Background: The previous analysis included data about both meat consumption and vegetarianism. But vegetarianism can modify a possibly effect of
meat consumption by other differences in diet and lifestyle behaviors in vegetarians. Therefore, a second analysis was made stratifying the previous
anlysis into data about total meats consumption vs vegetarianism.
Meat consumption: Data was provided about 12 cohorts, including 69,165 cases. Results were identical to the previous results including data about
vegetarianism. When one cohort with debatable results was excluded from the analysis (Hirayama T [4]), this left 13,642 cases, and the average RR became 1.15.
Vegetarianism: In 1999, Key TJ (9) published an analysis of 4 different cohort studies, including 8,330 deaths. One of these cohorts (The Adventist
Health Study [1]) was followed-up over 2 different time periods (see extended table). This analysis showed no effect of vegetarianism vs nonvegetarianism,
though the DRR was slightly below 1 (DRR = 0.95; 95% CI = 0.82-1.11). Findings about 3 of these cohorts (Chang-Claude J [3], Appleby PN [6]) were published
following this publication, including a longer follow-up period. RR's for vegetarians were > 1 in all 3 cohorts. The average RR = 1.04 for vegetarianism, when
data about the EPIC-Oxford Study is included (Key TJ [16]).
Veganism: In 1999, Key TJ (9) published an analysis of 4 different cohort studies (see extended table). Occasionial meat eaters, fish eaters, and
vegetarians all had lower mortality rates compared with regular meat eaters (≥ 1 time/wk), but mortality rates for vegans and regular meat eaters were
identical.
Conclusion: Few effects were found. No evidence was found for an association between total meats consumption - or vegetarianism - and all-cause mortality.
Perspective: Key TJ (9), found a DRR of 0.95 for vegetarianism analysing results from 4 cohorts, and the RR for meat consumption was > 1 in my
systematic review (RR = 1.15). Both effect sizes were driven by results from one cohort. Without results from "The Adventist Health Study", RR's would become 1.04, and 1.00
for vegetarianism, and meat consumption, respectively.
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 19) González S (2008) | No cohort name defined | 83 | RR = 0.89 (0.69-1.16; P = 0.39). |
| 16) Trichopoulou A (2005) | The EPIC-Elderly Study (subjects without CHD) | 4,047 | MR = 1.03 (0.99-1.07). |
| 16) Trichopoulou A (2005) | The EPIC-Greece Study (subjects with CHD) | 131 | MR = 0.96 (0.79-1.17). |
| 14) Fortes C (2000) | No cohort name defined | 53 | RR = 1.82 (0.91-3.60). |
| 13) Lasheras C (2000) | No cohort name defined | 38 (< 80 y), and 58 (≥ 80 y) | < 80 y: RR = 1.06 (0.42-2.42; P = 0.98). ≥ 80 y: RR = 0.65 (0.30-1.40; P = 0.27). |
| 12) Jamrozik K (2000) | The Perth Community Study | 198 | HR = 0.69 (0.50-0.96). |
| 11) Kouris-Blazos A (1999) | No cohort name defined | 38 | RR = 0.97 (0.89-1.06). |
| 8) Knoops KT (2006) | The HALE | 1,384 | HR = 0.97 (0.87-1.09) for low vs high consumption. |
| 5) Trichopoulou A (1995) | No cohort name defined | 53 | RR = 1.02 (0.93-1.12; P = 0.65). |
| 4) Hirayama T (1990) | No cohort name defined | 55,523 | RR = 1.03. |
| 3) Chang-Claude J (2005) | The German Vegetarian Study | 433 | RR = 1.08 (0.86-1.34) for low vs high consumption. |
| 2) Nube M (1987) | No cohort name defined | 742 men, and 448 women | Men: No significant association (survival rate = 47.3 vs 45.5). Women: A higher survival rate (73.4 vs 66.8). |
| 1) Kahn HA (1984) | The Adventist Health Study | 5,936 | A significantly increased risk: OR = 1.35. |
| Total number of cases: 69,165 | Average RR = 1.05 |
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 16) Key TJ (2009) | The EPIC-Oxford Study | 1,513 | DRR = 1.05 (0.93-1.19). |
| 6) Appleby PN (2002) | The Health Food Shoppers Study | 2,346 | DRR = 1.03 (0.95-1.13). |
| 6) Appleby PN (2002) | The Oxford Vegetarian Study | 1,131 | DRR = 1.03 (0.91-1.16). |
| 3) Chang-Claude J (2005) | The German Vegetarian Study | 433 | RR = 1.08 (0.86-1.34) for lacto-ovo vegetarians vs nonvegetarians. |
| Total number of cases: 5,423 | Average RR = 1.04 |
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 19) González S (2008) | Not defined | 288 elderly people aged 60-85 from nursing homes in Asturias (Northern Spain) | 6 (1999-2002 to 2007) | 83 | All-cause mortality | Meat and meat products (not defined) | RR = 0.892 (0.687-1.159; P = 0.394) per 1 SD increase. | Age, gender, BMI, energy intake, hyperglycemia, hypercholesterolemia, chewing ability, physical activity, smoking, self perceived health, education level and institution. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 16) Key TJ (2009) | The EPIC-Oxford Study | 47,254 participants aged 20-89 without MI, stroke, or malignant cancer (including surviving participants in the Oxford Vegetarian Study). (UK) | 1993-99 to 2007 | 1,513 | Death from all causes | Vegetarianism |
DRR = 1.05 (0.93-1.19) for vegetarian vs nonvegetarian.
No significant effect modification by sex was found (results not shown). Age, sex, smoking, and alcohol consumption. |
16) Trichopoulou A (2009) | The Greek segment of the EPIC Study | 23,349 men and women aged 20-86, and without cancer, CHD, or diabetes. | 8.5 | (1994-97 to 2008) 1,075? | All-cause mortality | Meat and meat products |
Mortality Ratio = 1.148 (0.992-1.329; P = 0.063) for ≥ vs < median consumption (121.11 g/day for men, and 89.88 g/day for women). | Sex, age, education, smoking status, waist:hip ratio, BMI, MET score, total energy, and consumption of vegetables, legumes, fruits and nuts, cereals, fish and seafood, monounsaturated/saturated lipids ratio, dairy products, ethanol. |
16) Trichopoulou A (2006) | The EPIC Study | 1,013 subjects taking drugs for diabetes mellitus at enrolment. | (Greece) 4.5 | 80? (46 cardiovascular, 19 cancer, 15 other) | Mortality | Meat and products (not defined) | HR = 1.16 (0.88-1.54; P = 0.29) per increment of 45 g/day. | Gender, age, education, smoking, waist-to-height, hip circumference, MET score, treatment with insulin, treatment for hypertension, treatment for hypercholesterolaemia, vegetables, legumes/potatoes, fruits/nuts, dairy, cereals, fish/seafood, eggs, sugar/confectionery, soft drinks/juices, tea/coffee, ethanol, and olive oil. |
16) Trichopoulou A (2005) | The EPIC-elderly Study | 74,607 men and women aged ≥ 60 without a history of CHD, stroke, or cancer, and from 9 European countries. | (Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, UK) Median 89 months. | (1992-2000 to 1999-2003) 4,047? | Overall mortality | Meat (not defined) | Mortality ratio: 1.03 (0.99-1.07; No P-value) for an increment of 55 g/day. | Stratified by country and adjusted for sex, age, diabetes mellitus at baseline, BMI, educational achievement, smoking status, physical activity at occupation, physical activity at leisure, alcohol intake, and total energy intake. |
16) Trichopoulou A (2005) | The Greek part of the EPIC Study | 1,302 men and women aged 20-86 with CHD (MI and/or angina pectoris), and with or without diabetes mellitus. | (Greece) 3.78 | (1994-97 to 2003) 131? | All-cause mortality | Meat and meat products (not defined) | MR = 0.96 (0.79-1.17) for an increment of 40 g/d. | Sex, age, previous treatment for hypercholesterolemia, diabetes mellitus at enrollment, years of schooling, smoking status, waist-to-hip ratio, metabolic equivalent score, BMI, and total energy |
16) Trichopoulou A (2003) | The Greek component of The EPIC Study | 22,043 adults aged 20-86. | (Greece) 3.7 | (1994-99 to 2002) 275? | All-cause mortality | Meat (not defined) | HR = 1.06 (0.93-1.22; No P-value) for an increment of 50 g/day. | Sex, age, waist-to-hip ratio, energy-expenditure score, education, smoking status and 5 categories of current smoker, BMI, and total energy. |
16) Key TJ (2003) | The EPIC-Oxford Study | 46,562 participants aged 20-89. | 5.9 | (1993-99 to 2002) 558 | Death from all causes | Vegetarian status (not defined) | DRR = 1.05 (0.86-1.27) for vegetarians vs nonvegetarians. | Age, sex, and smoking. |
15) McCullough ML (2000) | The Health Professionals Follow-up Study | 38,622 men aged 40-75. | (USA) 8 | (1986-1994) 3,119? | Risk of major chronic disease (defined as CVD, cancer, or death not resulting from trauma) | Meats (defined as meat, poultry, fish, dry beans, eggs, and nuts) | RR for a 5-point increase (representing more servings) = 1.00 (0.89-1.12). | Highest (10 points) vs lowest tertile (0 points) = 2.5-2.8 vs 0 servings/d respectively. Each component of the healthy food index was added individually into the multivariate model, adjusting for age, smoking, body mass index, alcohol intake, physical activity, diagnosis of hypertension or hypercholesterolemia at baseline, total energy intake, and time period. |
14) Fortes C (2000) | Cohort name not defined | 161 elderly (52 men, and 109 women) ≥ 65 years of which 93 without chronic diseases. (Mean age 80) in Rome. | (Italy) 5 | (1993-1998) 53? (21 men, and 32 women) | Overall mortality | Meat (white and red) |
RR = 1.82 (0.91-3.60; No P-value) for the highest vs lowest tertile of consumption. | Amount specific data (times/wk)): < 1: RR = 1. 1: RR = 1.13 (0.46-2.70). > 1: RR = 1.82 (0.91-3.60). Effect modification: Among subjects without chronic diseases, consumption of meat > once/wk was associated with higher risk of mortality: RR = 9.72 (2.68-35.1; No P-value). age, sex, education, BMI, smoking, cognitive function, and chronic diseases. |
13) Lascheras C (2000) | No cohort name | 161 nonsmoking elderly subjects aged 65-95 (74 aged < 80 y, and 87 aged ≥ 80) living in Asturias, Spain. | 9.5 | (1989-1998) 96? | (38 < 80 y, and 58 ≥ 80 y) All-cause mortality | Meat and meat products (not defined) |
|
RRs are for a 20 g change. Adjusted to 2500 kcal for men and 2000 kcal for women. Age, sex, BMI, albumin concentration, physical activity, self-assessment of health, and dieting for chronic conditions, monounsaturated fat, saturated fat. |
12) Jamrozik K (2000) | The Perth Community Stroke Study | 790 controls from a previous case-control analysis with or without a history of CVD. | (Australia) 4 | (1990-91 to 1994) 198? | Death from any cause | Meat (not defined) | HR = 0.69 (0.50-0.96) for eating meat > 4 vs ≤ 4 times/week. | Sex and age. |
12) Jamrozik K (2000) | The Perth Community Stroke Study | 790 controls from a previous case-control analysis with or without a history of CVD. | (Australia) 4 | (1990-91 to 1994) 198? | Death from any cause | Fat from meat (not defined) | No significant relationship was found with trimming fat from meat (no data shown). | Sex and age. |
11) Kouris-Blazos A (1999) | Not defined | 330 Anglo-Celts and Greek-Australians of both sexes aged ≥ 70 from Melbourne. | (Australia) 1990-92 to 1996 | 38? | All-cause mortality | Meat and meat products (not defined) | RR = 0.97 (0.89-1.06) for a daily consumption of 20 g (adjusted to 2500 kcal for men and 2000 kcal for women). | Age, sex, smoking status and ethnic origin. |
9) Key TJ (1999) | Collaborative analysis of 4 prospective studies over 5 follow-up periods | 76,172 men and women aged 16-89. | Median 10.6 | (5.6-18.4) 8,330 | Mortality from all causes | Vegetarianism |
INCLUDED STUDIES (Follow-up years/No. of cases). |
RESULTS:
Age, sex, and smoking status. |
8) Knoops KT (2006) | The HALE (Healthy Ageing: a Longitudinal study in Europe). | (Including subjects of the SENECA and FINE study) 2,044 men and, 1,049 women aged 70-90 from 10 European countries. | (The FINE Study included the survivors of 5 cohorts [from Finland, Italy, and The Netherlands] of The Seven Countries Study) 10 | (1988-2000) See variables | All-cause mortality | Meat and poultry (not defined) |
|
Age, gender, physical activity, smoking, alcohol use, education, BMI, chronic disease at baseline and study centre. |
8) Iestra J (2006) | The HALE | (Including the SENECA study, and the FINE study. The FINE study is an extension of "The Seven Countries Study" beyond the 25 years follow-up) 462 men and women age ≥ 70 with a history of MI | 10 | Not defined (53% died) | All-cause mortality | Meat, poultry and derived products (not defined) |
HR = 0.99 (0.76-1.29) for below vs above median consumption. |
Study, gender, age, years of education, BMI, history of diabetes or stroke, smoking, physical activity, alcohol |
8) Osler M (1997) | Part of the Euronut SENECA Study | 202 elderly subjects (101 men and 101 women) from the Danish Municipality Roskilde. | 6 | (1988-89 to 1995) 52? | Total mortality | Meat (not defined) | No significant association: RR = 0.99 (0.86-1.13; No P-value) for a 20 g change. | Adjusted for energy (to 10.5 MJ for men, and 8.4 MJ in women). Age, sex, and smoking status. |
16) Key TJ (2003) | The Health Food Shoppers Study | 10.736 subjects. | (UK) 1973-79 to 1997 | 2.346 | Death | Vegetarianism | DRR = 1.03 (0.95-1.13) for vegetarians vs nonvegetarians. | Age, sex, and smoking. |
6) Appleby PN (2002) | The Health Food Shoppers Study | 10,736 subjects aged 16-89. | (UK) 1973-79 to 1997 | 2,346 | Death from all causes | Vegetarianism (not defined) | DRR = 1.03 (0.95-1.13) for vegetarians vs nonvegetarians. | Age at entry, sex and smoking. |
7) Key TJ (1996) | The Health Food Shoppers Study | 10.771 (4.336 men and 6.435 women) aged > or = 16, recruited through health food shops, vegeterian societies, and magazines. | (UK) 16.8 | (1973-79 to 1995) 1.343? (666 men, 677 women) | all cause mortality | vegetarianism | RR = 1.04 (0.93-1.16; No P-value). | age, sex, and smoking |
16) Key TJ (2003) | The Oxford Vegetarian Study | 11,045 subjects. | (UK) 1980-84 to 2000 | 1,131 | Death | Vegetarianism | DRR = 1.01 (0.89-1.14) | Age, sex, and smoking. |
6) Appleby PN (2002) | The Oxford Vegetarian Study | 11,045 subjects aged 16-89. | (UK) 1980-84 to 2000 | 1,131 | All causes of death | Vegetarianism (not eating meat or fish) |
|
Age at entry, sex and smoking. |
6) Mann JI (1997) | The Oxford Vegetarian Study | 10,802 subjects (4102 men and 6700 women) aged 16-79. | (UK) 13.3 | (1980-84 to 1995) 392 | All-cause mortality | Vegetarianism |
Death rate ratio = 102 (82-127; P = Not Significant) for being vegetarian/vegan vs meat eater. | Specific data: Meat eater: DRR = 100. Semi-vegetarian: DRR = 102 (73-143). Vegetarian/vegan: DRR = 102 (82-127). Semi-vegetariansm was described as 1) eating meat occasionally but < once/week, or 2) eating fish, but not meat. Age, sex, smoking and social class. |
6) Mann JI (1997) | The Oxford Vegetarian Study | 10,802 subjects (4102 men and 6700 women) aged 16-79. | (UK) 13.3 | (1980-84 to 1995) 386 | All-cause mortality | Meat (not defined) |
Death rate ratio = 101 (79-130; P = Not Significant) for the highest vs lowest tertile of consumption. | Amount specific data: None eaten: DRR = 100. < Daily: DRR = 102 (79-133). Daily: DRR = 101 (79-130). Age, sex, smoking and social class. |
6) Thorogood M (1994) | The Oxford Vegetarian Study | 11,130 UK subjects | 12 | 404? | Death from all causes | Meat (not defined) |
|
BMI, smoking, and social class. |
5) Trichopoulou A (1995) | No cohort name | 182 elderly residents (91 men, and 91 women) aged > 70 from 3 Greek villages. | 1988-90 to 1993-94 | 53? | All-cause mortality | Meat (not defined) | RR = 1.02 (0.93-1.12; P = 0.65) for an increment of 20 g. | Adjusted to 2500 kcal for men, and 2000 kcal for women. Age, sex, and smoking status. |
4) Hirayama T (1990) | Not defined | 265,118 adults (122,261 men, 142,857 women) aged ≥ 40 from 6 prefectures in Japan. | 17 | (1966-1982) 55.523? (31.979 men, 23.544 women) | All cause mortality | Meat (beef, pork, chicken, ham/sausages, and other) |
|
RRs of meat, green-yellow vegetables, and alcohol are for consumption ≥ 4 times/wk. RR of smoking is for daily smoking. No reference groups are defined. Definitions: Green-yellow vegetables (containing ≥ 600 mcg carotene/100 g edible parts. Including carrots, spinach, green peppers, Italian broccoli, pumpkin, turnip leaves, green lettuce, chives leeks [green], asparagus, [green], chicory and parsley.), Alcohol (sake, shochu, beer, whiskey, and others). Not defined (possibly only age). |
3) Chang-Claude J (2005) | The German Vegetarian Study | 1,724 vegetarians and health conscious persons. | 21 | (1978-1999) 456 | All-cause mortality | Vegetarianism | RR = 1.10 (0.89-1.36) for vegetarianism vs nonvegetarianism. | Veganism: Being a vegan was associated with a higher mortality risk (1.59; 95% CI, 0.98-2.59) than being a lacto-ovo vegetarian (1.08; 95% CI, 0.86-1.34), when compared with nonvegetarians with moderate meat/fish consumption (based on 60 vegans, including 23 deaths). Age, gender, smoking, level of activity, alcohol consumption, BMI, and education. |
3) Chang-Claude J (1993) | No cohort name defined | 1904 subjects (858 men and 1046 women). | (Germany) 11 | (1978-1989) 225? | Total mortality | Vegetarianism (94% were lacto- or ovolacto vegetarians) |
|
Moderate vegetarianism = occasional consumption of fish or meat. Sex, physical activity, and BMI. |
3) Frentzel-Beyme R (1988) | No cohort name defined | 1,904 subjects (858 men, and 1,046 women) aged ≥ 10. | (Germany) 5 | (1978-1983) 45 men, and | 37 women Mortality from all causes | Vegetarianism |
|
Moderate vegetarianism = occasional consumption of fish or meat. Age-standardized. |
2) Nube M (1987) | No cohort name | 2,820 Dutch civil servants of Amsterdam and their spouses aged 40-64 (1,394 men, and 1,426). | 25 | (1953-54 to ?) 742? men, and | 448? women Survival | Meat (not defined) |
|
Age. |
1) Fraser GE (1997) | The Adventist Health Study | Non-Hispanic white Seventh Seventh Day Adventists aged ≥ 84. | At study baseline there were 603 subjects older than 84 years, and during a 12-year follow-up, these and intitially younger subjects contributed 11,828 person-years of observation in the oldest-old age range. (USA) 12 | (1976-88) 1,387? | (451 men, and 936 women) All-cause mortality | Meat, fish, and poultry (not defined) |
|
Age and sex. |
1) Fraser GE (1997) | The Adventist Health Study | 1.668 black California men and women aged ≥ 25. | 1976-1985 | See variables | All-cause mortality | Meat, fish, or poultry (beef steak, beef hamburger, other beef or veal, fish, chicken or turkey, pork products) |
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Age, smoking and exercise. |
1) Kahn HA (1984) | The Adventist Health Study | 27,530 California members of the Seventh-Day Adventist Church aged ≥ 30, including black, white and oriental subjects. | (USA) 21 | (1960-1980) 5,936 | All-cause mortality | Meat or poultry (not defined) |
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After additional adjustment for eggs and fish, the association remained significant (OR = 1.37). After additional adjustment for coffee and cigarettes the associaton remained significant (OR = 1.35). After additional adjustment for eggs and salad the association also remained significant (OR = 1.38). Age (15-year intervals for men & women combined, 10-year intervals for associations stratified by sex), sex, history of disease (heart disease, stroke, hypertension, diabetes, or cancer), age at initial exposure to the Adventist Church, and smoking history (never vs ever). |
1) Kahn HA (1984) | The Adventist Health Study | 27,530 California members of the Seventh-Day Adventist Church aged ≥ 30, including black, white and oriental subjects. | (USA) 21 | (1960-1980) 2,741 | All-cause mortality | Avoid fat on meat (not defined) |
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RRs are for not avoiding fat on meat vs avoiding fat on meat. Age (15-year intervals), sex, history of disease (heart disease, stroke, hypertension, diabetes, or cancer), age at initial exposure to the Adventist Church, and smoking history (never vs ever). |
1) Phillips RL (1983) | The Adventist Health Study | 23,000 white California adventists. | (USA) 20 | (1960-1979) 6,254 | Mortality from all causes | Meat (meat, poultry, and fish) | Mortality Ratio = 1.33 (P = ≤ 0.01) for the highest vs lowes tertile of contumption (Use of meat ≥ 4 days/wk vs lacto-ovo vegetarians). | Age and sex. |
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