Data_Sheet_2_The Association of Meat Intake With All-Cause Mortality and Acute Myocardial Infarction Is Age-Dependent in Patients With Stable Angina Pectoris.PDF

Background: Red and processed meat intake have been associated with increased risk of morbidity and mortality, and a restricted intake is encouraged in patients with cardiovascular disease. However, evidence on the association between total meat intake and clinical outcomes in this patient group is lacking.
Objectives: To investigate the association between total meat intake and risk of all-cause mortality, acute myocardial infarction, cancer, and gastrointestinal cancer in patients with stable angina pectoris. We also investigated whether age modified these associations.
Materials and Methods: This prospective cohort study consisted of 1,929 patients (80% male, mean age 62 years) with stable angina pectoris from the Western Norway B-Vitamin Intervention Trial. Dietary assessment was performed by the administration of a semi-quantitative food frequency questionnaire. Cox proportional hazards models were used to investigate the association between a relative increase in total meat intake and the outcomes of interest.
Results: The association per 50 g/1,000 kcal higher intake of total meat with morbidity and mortality were generally inconclusive but indicated an increased risk of acute myocardial infarction [HR: 1.26 (95% CI: 0.98, 1.61)] and gastrointestinal cancer [1.23 (0.70, 2.16)]. However, we observed a clear effect modification by age, where total meat intake was associated with an increased risk of mortality and acute myocardial infarction among younger individuals, but an attenuation, and even reversal of the risk association with increasing age.
Conclusion: Our findings support the current dietary guidelines emphasizing a restricted meat intake in cardiovascular disease patients but highlights the need for further research on the association between meat intake and health outcomes in elderly populations. Future studies should investigate different types of meat separately in other CVD-cohorts, in different age-groups, as well as in the general population.

背景：红肉与加工肉类的摄入已被证实与发病率及死亡率升高存在关联，临床指南建议心血管疾病患者限制此类食物的摄入。然而，目前针对该患者群体中总肉类摄入与临床结局之间的关联，仍缺乏足够的研究证据。
研究目标：本研究旨在探讨稳定性心绞痛患者的总肉类摄入与全因死亡率、急性心肌梗死、癌症及胃肠道癌症风险之间的关联，并分析年龄是否对上述关联存在修饰效应。
材料与方法：本前瞻性队列研究的数据源自挪威西部B族维生素干预试验（Western Norway B-Vitamin Intervention Trial），共纳入1929例稳定性心绞痛患者，其中男性占比80%，平均年龄为62岁。膳食摄入情况通过半定量食物频率问卷进行评估。本研究采用Cox比例风险模型（Cox proportional hazards models），分析总肉类摄入相对增加量与目标结局之间的关联。
研究结果：每1000千卡能量摄入中总肉类摄入增加50g时，总肉类摄入与发病率及死亡率的关联整体尚无定论，但提示急性心肌梗死风险升高[风险比（Hazard Ratio, HR）：1.26，95%置信区间（95% Confidence Interval, 95%CI）：0.98~1.61]以及胃肠道癌症风险升高[1.23，0.70~2.16]。然而，本研究观察到年龄对上述关联存在明确的修饰效应：在较年轻人群中，总肉类摄入与死亡率及急性心肌梗死风险升高相关；而随着年龄增长，该风险关联会出现减弱，甚至完全逆转。
结论：本研究结果支持当前针对心血管疾病患者限制肉类摄入的膳食指南，但同时强调，仍需针对老年人群开展更多关于肉类摄入与健康结局之间的关联研究。未来研究可在其他心血管疾病队列、不同年龄群体以及普通人群中，分别探讨不同类型肉类摄入的健康影响。