Background
Methods
Population
Exposure assessment
Outcome assessment
Statistical analysis
Results
All | Red meat | Processed meat | Poultry | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0 to 9.9 g/day | ≥160 g/day | 0 to 9.9 g/day | ≥160 g/day | 0 to 4.9 g/day | ≥80 g/day | ||||||||||||||||
Men
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to 3)
| |||||||
Age at recruitment (years) | 52.3 | 45.1 | -59.1 | 46.9 | 38.0 | -57.0 | 53.3 | 50.1 | -57.7 | 50.7 | 41.2 | -60.1 | 49.5 | 43.1 | -55.5 | 51.3 | 42.6 | -59.6 | 52.3 | 45.9 | -57.8 |
BMI (kg/m2) | 26.1 | 24.0 | -28.5 | 24.4 | 22.4 | -26.6 | 27.0 | 24.9 | -29.8 | 25.8 | 23.4 | -28.4 | 27.1 | 24.8 | -29.8 | 25.3 | 23.2 | -27.7 | 27.4 | 25.1 | -30.1 |
Energy intake (kcal/day) | 2351 | 1947 | -2816 | 2028 | 1659 | -2459 | 3101 | 2680 | -3616 | 2119 | 1749 | -2552 | 3206 | 2739 | -3750 | 2216 | 1814 | -2681 | 2673 | 2240 | -3162 |
Alcohol intake (g/day) | 12.9 | 4.2 | -29.7 | 8.2 | 1.7 | -19.0 | 23.4 | 9.4 | -47.2 | 10.2 | 2.3 | -24.3 | 19.0 | 6.1 | -40.3 | 10.3 | 2.6 | -24.4 | 15.1 | 3.3 | -35.0 |
Red meat (g/day) | 51.0 | 26.3 | -82.4 | -- | -- | 32.5 | 2.9 | -63.8 | 54.0 | 31.7 | -86.7 | 28.0 | 4.9 | -59.9 | 65.8 | 34.8 | -100.5 | ||||
Processed meat (g/day) | 33.2 | 14.7 | -58.3 | 2.0 | 0.1 | -15.9 | 48.2 | 26.8 | -75.1 | -- | -- | 30.1 | 3.8 | -59.7 | 29.3 | 13.6 | -55.0 | ||||
Poultry (g/day) | 15.1 | 6.5 | -27.6 | 0.0 | 0.0 | -8.1 | 24.2 | 12.4 | -38.4 | 12.2 | 0.0 | -30.2 | 13.2 | 5.6 | -26.2 | -- | -- | ||||
Vegetable intake (g/day) | 149.6 | 93.0 | -246.0 | 203.3 | 119.4 | -306.3 | 198.5 | 130.2 | -294.1 | 284.0 | 167.6 | -433.5 | 120.4 | 82.3 | -181.4 | 127.3 | 75.9 | -216.3 | 233.5 | 155.5 | -346.2 |
Fruit intake (g/day) | 157.0 | 82.2 | -280.7 | 182.0 | 97.8 | -304.8 | 142.9 | 64.7 | -254.6 | 251.1 | 139.8 | -388.0 | 115.0 | 66.0 | -207.6 | 135.9 | 72.0 | -242.7 | 235.2 | 115.2 | -391.3 |
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
| ||||||||
Never smoker | 46191 | 36.3 | 5892 | 50.6 | 769 | 28.1 | 9602 | 39.6 | 619 | 28.7 | 10707 | 39.7 | 745 | 33.0 | |||||||
Former smoker | 47210 | 37.1 | 4161 | 35.7 | 877 | 32.1 | 8570 | 35.4 | 816 | 37.8 | 9784 | 36.3 | 909 | 40.2 | |||||||
Current smoker | 33920 | 26.6 | 1592 | 13.7 | 1090 | 39.8 | 6059 | 25.0 | 723 | 33.5 | 6449 | 23.9 | 606 | 26.8 | |||||||
Physically inactivea
| 23258 | 18.3 | 2057 | 17.7 | 408 | 14.9 | 5751 | 23.7 | 346 | 16.0 | 4854 | 18.0 | 397 | 17.6 | |||||||
Physically activea
| 31425 | 24.7 | 2908 | 25.0 | 856 | 31.3 | 5055 | 20.9 | 559 | 25.9 | 6295 | 23.4 | 621 | 27.5 | |||||||
University degree | 34429 | 27.0 | 5335 | 45.8 | 641 | 23.4 | 7956 | 32.8 | 522 | 24.2 | 8859 | 32.9 | 479 | 21.2 | |||||||
Women
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
|
Median
|
(Q1 to Q3)
| |||||||
Age at recruitment (years) | 50.9 | 44.8 | -57.5 | 47.8 | 38.6 | -55.5 | 51.9 | 47.0 | -57.2 | 51.1 | 42.0 | -58.9 | 47.7 | 42.3 | -53.8 | 50.3 | 42.7 | -57.8 | 51.8 | 44.6 | -58.0 |
BMI (kg/m2) | 24.1 | 21.9 | -27.2 | 22.9 | 21.0 | -25.5 | 24.8 | 22.2 | -28.3 | 23.9 | 21.6 | -27.2 | 26.6 | 23.4 | -30.7 | 23.3 | 21.2 | -26.0 | 26.8 | 23.8 | -30.4 |
Energy intake (kcal/day) | 1871 | 1548 | -2252 | 1718 | 1399 | -2087 | 2561 | 2183 | -3057 | 1730 | 1430 | -2079 | 2695 | 2305 | -3154 | 1789 | 1468 | -2156 | 2053 | 1687 | -2509 |
Alcohol intake (g/day) | 3.5 | 0.6 | -11.1 | 3.3 | 0.5 | -10.3 | 6.1 | 0.8 | -18.2 | 2.6 | 0.4 | -10.0 | 4.5 | 0.9 | -12.1 | 3.6 | 0.6 | -10.9 | 1.9 | 0.0 | -10.1 |
Red meat (g/day) | 33.1 | 16.1 | -56.7 | -- | -- | 20.4 | 2.2 | -44.6 | 38.4 | 21.7 | -65.9 | 13.8 | 1.4 | -38.2 | 35.4 | 16.7 | -62.8 | ||||
Processed meat (g/day) | 21.4 | 9.1 | -38.5 | 4.6 | 1.0 | -20.7 | 29.9 | 16.2 | -51.4 | -- | -- | 15.4 | 2.0 | -34.3 | 16.7 | 6.4 | -32.4 | ||||
Poultry (g/day) | 12.6 | 4.6 | -22.3 | 0.6 | 0.0 | -8.1 | 15.1 | 0.0 | -35.7 | 8.2 | 0.0 | -19.5 | 13.2 | 5.5 | -23.8 | -- | -- | ||||
Vegetable intake (g/day) | 184.4 | 117.2 | -284.3 | 219.6 | 133.8 | -327.1 | 290.8 | 188.1 | -419.2 | 241.9 | 150.7 | -362.4 | 159.9 | 101.3 | -244.4 | 179.8 | 108.8 | -286.1 | 259.9 | 171.2 | -375.6 |
Fruit intake (g/day) | 209.9 | 120.1 | -324.0 | 212.7 | 121.0 | -331.9 | 226.4 | 122.4 | -343.5 | 251.6 | 149.9 | -377.7 | 180.5 | 96.3 | -276.4 | 194.7 | 110.7 | -308.0 | 257.8 | 150.0 | -411.2 |
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
|
Number
|
%
| ||||||||
Never smoker | 186026 | 57.9 | 34149 | 61.7 | 640 | 58.8 | 53821 | 63.1 | 333 | 53.5 | 48343 | 58.4 | 1671 | 62.5 | |||||||
Former smoker | 72311 | 22.5 | 13925 | 25.2 | 219 | 20.1 | 18263 | 21.4 | 125 | 20.1 | 19377 | 23.4 | 548 | 20.5 | |||||||
Current smoker | 62910 | 19.6 | 7255 | 13.1 | 230 | 21.1 | 13271 | 15.5 | 164 | 26.4 | 15127 | 18.3 | 454 | 17.0 | |||||||
Physically inactivea
| 69310 | 21.6 | 10273 | 18.6 | 278 | 25.5 | 22890 | 26.8 | 173 | 27.8 | 15243 | 18.4 | 838 | 31.4 | |||||||
Physically activea
| 45458 | 14.2 | 8883 | 16.1 | 125 | 11.5 | 13497 | 15.8 | 75 | 12.1 | 13749 | 16.6 | 377 | 14.1 | |||||||
University degree | 72647 | 22.6 | 18870 | 34.1 | 295 | 27.1 | 23490 | 27.5 | 117 | 18.8 | 23999 | 29.0 | 403 | 15.1 |
Intake (g/d) | Mean (s.e.) intakea (24 hour recall; g/d) | Ncases
| HRb
| 95% CIb
| HRc
| 95% CIc
| HRd
| 95% CId
| |
---|---|---|---|---|---|---|---|---|---|
Men | Women | ||||||||
Red meat
| |||||||||
0 to 9.9 | 20.3 (2.0) | 20.5 (1.0) | 3175 | 1.05 | (0.99, 1.10) | 1.07 | (1.01, 1.13) | 1.04 | (0.99, 1.10) |
10 to 19.9 | 35.5 (2.0) | 25.9 (0.9) | 2774 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
20 to 39.9 | 47.9 (1.5) | 33.1 (0.7) | 6459 | 1.02 | (0.98, 1.07) | 1.01 | (0.97, 1.06) | 1.01 | (0.97, 1.06) |
40 to 79.9 | 62.3 (1.4) | 44.8 (0.8) | 8935 | 1.04 | (0.99, 1.09) | 0.99 | (0.94, 1.03) | 0.99 | (0.94, 1.03) |
80 to 159.9 | 81.0 (2.0) | 55.9 (1.5) | 4639 | 1.15 | (1.09, 1.21) | 1.03 | (0.98, 1.09) | 1.03 | (0.97, 1.08) |
160+ | 110.8 (7.7) | 70.9 (10.8) | 362 | 1.37 | (1.23, 1.54) | 1.14 | (1.01, 1.28) | 1.10 | (0.98, 1.24) |
Processed meat
| |||||||||
0 to 9.9 | 14.9 (0.9) | 14.3 (0.5) | 6236 | 1.00 | (0.96, 1.04) | 1.04 | (0.99, 1.08) | 1.01 | (0.97, 1.06) |
10 to 19.9 | 37.5 (1.5) | 26.9 (0.6) | 4683 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
20 to 39.9 | 51.1 (1.2) | 36.1 (0.6) | 7301 | 1.06 | (1.03, 1.11) | 1.03 | (0.99, 1.07) | 1.03 | (0.99, 1.07) |
40 to 79.9 | 71.6 (1.4) | 46.6 (0.9) | 5997 | 1.17 | (1.12, 1.22) | 1.09 | (1.05, 1.14) | 1.09 | (1.04, 1.13) |
80 to 159.9 | 90.7 (2.4) | 57.8 (2.5) | 1904 | 1.36 | (1.28, 1.44) | 1.21 | (1.14, 1.28) | 1.20 | (1.13, 1.28) |
160+ | 121.3 (7.7) | 71.0 (12.2) | 223 | 1.74 | (1.51, 2.00) | 1.44 | (1.24, 1.66) | 1.43 | (1.24, 1.64) |
Poultry
| |||||||||
0 to 4.9 | 9.7 (0.8) | 10.5 (0.5) | 6973 | 1.08 | (1.04, 1.13) | 1.08 | (1.04, 1.13) | 1.08 | (1.03, 1.12) |
5 to 9.9 | 11.4 (1.0) | 12.5 (0.6) | 4568 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
10 to 19.9 | 20.4 (1.1) | 16.0 (0.6) | 7211 | 0.97 | (0.94, 1.01) | 0.98 | (0.95, 1.02) | 0.98 | (0.95, 1.02) |
20 to 39.9 | 22.4 (1.1) | 22.4 (0.8) | 4563 | 0.95 | (0.91, 0.99) | 0.97 | (0.93, 1.02) | 0.97 | (0.93, 1.01) |
40 to 79.9 | 36.6 (2.2) | 26.3 (1.4) | 2702 | 0.95 | (0.90, 1.00) | 0.97 | (0.93, 1.03) | 0.97 | (0.92, 1.02) |
80+ | 50.3 (6.1) | 35.6 (6.2) | 327 | 1.03 | (0.92, 1.15) | 1.05 | (0.94, 1.18) | 1.05 | (0.94, 1.18) |
Observed | Calibrated | |
---|---|---|
HRa (95% CI) | HRa (95% CI) | |
Red meat (per 100 g) | 1.02 (0.98 to 1.06) | 1.02 (0.98 to 1.06) |
Processed meat (per 50 g) | 1.09 (1.06 to 1.12) | 1.18 (1.11 to 1.25) |
Poultry (per 50 g) | 0.96 (0.92 to 0.99) | 0.95 (0.87 to 1.04) |
Intake (g/day) | ||||||||
---|---|---|---|---|---|---|---|---|
0-9.9 | 10-19.9 | 20-39.9 | 40-79.9 | 80-159.9 | 160+ |
P-interaction
| ||
Sex | ||||||||
Males | HR | 0.99 | 1.00 | 1.00 | 1.04 | 1.13 | 1.32 | |
(95% CI) | (0.91, 1.07) | (ref.) | (0.94, 1.07) | (0.98, 1.12) | (1.04, 1.22) | (1.12, 1.54) | ||
Females | HR | 1.05 | 1.00 | 1.04 | 1.09 | 1.22 | 1.37 | |
(95% CI) | (1.00, 1.10) | (ref.) | (0.99, 1.09) | (1.04, 1.16) | (1.10, 1.34) | (0.94, 2.00) |
0.88
| |
Alcohola
| ||||||||
<median | HR | 1.00 | 1.00 | 1.02 | 1.08 | 1.19 | 1.35 | |
(95% CI) | (0.94 to 1.06) | (ref.) | (0.97 to 1.08) | (1.02 to 1.15) | (1.09 to 1.30) | (1.09 to 1.69) | ||
≥median | HR | 1.03 | 1.00 | 1.05 | 1.1 | 1.19 | 1.45 |
0.71
|
(95% CI) | (0.97 to 1.10) | (ref.) | (0.99 to 1.11) | (1.03 to 1.17) | (1.09 to 1.31) | (1.19 to 1.77) | ||
BMI | ||||||||
<25 kg/m2
| HR | 1.06 | 1.00 | 1.03 | 1.10 | 1.15 | 1.63 | |
(95% CI) | (1.00 to 1.13) | (ref.) | (0.97 to 1.09) | (1.03 to 1.18) | (1.04 to 1.28) | (1.27 to 2.09) | ||
≥25 kg/m2
| HR | 0.99 | 1.00 | 1.04 | 1.09 | 1.25 | 1.38 | |
(95% CI) | (0.93 to 1.05) | (ref.) | (0.99 to 1.10) | (1.03 to 1.15) | (1.15 to 1.35) | (1.15 to 1.65) |
0.04
| |
Smoking status | ||||||||
Never | HR | 1.02 | 1.00 | 0.99 | 1.01 | 1.15 | 1.24 | |
(95% CI) | (0.96, 1.09) | (ref.) | (0.93, 1.05) | (0.94, 1.08) | (1.03, 1.29) | (0.89, 1.72) | ||
Former | HR | 1.03 | 1.00 | 1.07 | 1.14 | 1.26 | 1.68 | |
(95% CI) | (0.95, 1.11) | (ref.) | (0.99, 1.14) | (1.06, 1.24) | (1.12, 1.41) | (1.29, 2.18) | ||
Current | HR | 1.04 | 1.00 | 1.08 | 1.15 | 1.26 | 1.47 | |
(95% CI) | (0.95, 1.13) | (ref.) | (1.01, 1.16) | (1.07, 1.25) | (1.13, 1.40) | (1.18, 1.83) |
0.01
| |
Fruits and vegetables | ||||||||
<median | HR | 1.1 | 1.00 | 1.04 | 1.1 | 1.2 | 1.53 | |
(95% CI) | (1.04 to 1.17) | (ref.) | (0.99 to 1.10) | (1.04 to 1.16) | (1.11 to 1.30) | (1.29 to 1.83) | ||
≥median | HR | 0.99 | 1.00 | 1.03 | 1.08 | 1.2 | 1.27 | |
(95% CI) | (0.94 to 1.05) | (ref.) | (0.97 to 1.08) | (1.01 to 1.15) | (1.09 to 1.32) | (0.99 to 1.63) |
0.001
|
Cardiovascular diseases | Cancer | Respiratory diseases | Digestive tract | Other cause of death | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Intake (g/d) | Ncases
| HRa
| 95% CI | Ncases
| HRa
| 95% CI | Ncases
| HRa
| 95% CI | Ncases
| HRa
| 95% CI | Ncases
| HRa
| 95% CI |
Red meat | |||||||||||||||
0 to 9.9 | 695 | 1.03 | (0.92, 1.16) | 1077 | 1.04 | (0.95, 1.14) | 164 | 1.09 | (0.84, 1.41) | 74 | 0.81 | (0.58, 1.14) | 1019 | 1.10 | (1.00, 1.21) |
10 to 19.9 | 613 | 1.00 | (ref.) | 1052 | 1.00 | (ref.) | 116 | 1.00 | (ref.) | 74 | 1.00 | (ref.) | 833 | 1.00 | (ref.) |
20 to 39.9 | 1395 | 1.01 | (0.91, 1.11) | 2477 | 1.04 | (0.96, 1.12) | 227 | 0.86 | (0.68, 1.09) | 170 | 0.95 | (0.72, 1.25) | 1971 | 1.02 | (0.94, 1.11) |
40 to 9.9 | 1862 | 1.02 | (0.92, 1.12) | 3353 | 0.99 | (0.91, 1.06) | 357 | 0.92 | (0.73, 1.16) | 239 | 0.84 | (0.64, 1.11) | 2800 | 0.98 | (0.90, 1.07) |
80 to 159.9 | 924 | 1.04 | (0.93, 1.17) | 1759 | 1.03 | (0.95, 1.13) | 194 | 1.05 | (0.81, 1.37) | 144 | 0.88 | (0.64, 1.21) | 1433 | 1.03 | (0.94, 1.14) |
160+ | 67 | 1.07 | (0.82, 1.40) | 143 | 1.21 | (1.00, 1.46) | 10 | 0.80 | (0.40, 1.60) | 14 | 1.02 | (0.55, 1.90) | 112 | 1.17 | (0.95, 1.44) |
Per 100 g/day | |||||||||||||||
Observed | 1.10 | (1.00, 1.19) | 1.01 | (0.94, 1.08) | 1.02 | (0.83, 1.24) | 1.04 | (0.82, 1.32) | 1.01 | (0.95, 1.09) | |||||
Calibrated | 1.09 | (1.00, 1.18) | 1.00 | (0.94, 1.07) | 1.06 | (0.88, 1.28) | 1.03 | (0.83, 1.29) | 1.02 | (0.94, 1.10) | |||||
Processed meat | |||||||||||||||
0 to 9.9 | 1635 | 1.06 | (0.96, 1.16) | 2223 | 0.96 | (0.90, 1.03) | 322 | 1.11 | (0.90, 1.37) | 161 | 1.08 | (0.83, 1.41) | 1654 | 1.10 | (1.02, 1.18) |
10 to 19.9 | 855 | 1.00 | (ref.) | 1848 | 1.00 | (ref.) | 171 | 1.00 | (ref.) | 112 | 1.00 | (ref.) | 1547 | 1.00 | (ref.) |
20 to 39.9 | 1335 | 1.05 | (0.96, 1.15) | 2745 | 1.01 | (0.95, 1.07) | 287 | 1.21 | (0.99, 1.47) | 209 | 1.30 | (1.02, 1.64) | 2496 | 1.03 | (0.97, 1.10) |
40 to 79.9 | 1222 | 1.16 | (1.05, 1.28) | 2252 | 1.03 | (0.96, 1.10) | 220 | 1.29 | (1.04, 1.61) | 178 | 1.37 | (1.06, 1.78) | 1889 | 1.09 | (1.02, 1.18) |
80 to 159.9 | 453 | 1.35 | (1.18, 1.54) | 714 | 1.08 | (0.98, 1.19) | 60 | 1.27 | (0.91, 1.77) | 48 | 1.18 | (0.80, 1.73) | 526 | 1.28 | (1.14, 1.43) |
160+ | 56 | 1.72 | (1.29, 2.30) | 79 | 1.15 | (0.90, 1.46) | 8 | 1.73 | (0.82, 3.65) | 7 | 1.58 | (0.70, 3.54) | 56 | 1.64 | (1.24, 2.18) |
Per 50 g/day | |||||||||||||||
Observed | 1.15 | (1.09, 1.21) | 1.06 | (1.02, 1.10) | 1.10 | (0.98, 1.25) | 1.04 | (0.91, 1.20) | 1.11 | (1.06, 1.15) | |||||
Calibrated | 1.30 | (1.17, 1.45) | 1.11 | (1.03, 1.21) | 1.22 | (0.97, 1.54) | 1.09 | (0.82, 1.47) | 1.22 | (1.11, 1.34) | |||||
Poultry | |||||||||||||||
0 to 4.9 | 1494 | 1.05 | (0.96, 1.15) | 2502 | 1.10 | (1.03, 1.17) | 297 | 1.11 | (0.91, 1.35) | 189 | 1.03 | (0.81, 1.30) | 2220 | 1.09 | (1.01, 1.17) |
5 to 9.9 | 982 | 1.00 | (ref.) | 1706 | 1.00 | (ref.) | 184 | 1.00 | (ref.) | 132 | 1.00 | (ref.) | 1383 | 1.00 | (ref.) |
10 to 19.9 | 1565 | 1.00 | (0.92, 1.09) | 2649 | 1.00 | (0.94, 1.06) | 294 | 0.99 | (0.82, 1.20) | 191 | 0.89 | (0.71, 1.12) | 2286 | 0.98 | (0.91, 1.05) |
20 to 39.9 | 907 | 0.92 | (0.83, 1.01) | 1853 | 0.99 | (0.93, 1.07) | 153 | 0.95 | (0.75, 1.20) | 121 | 0.85 | (0.66, 1.11) | 1344 | 1.02 | (0.95, 1.11) |
40 to 79.9 | 541 | 0.90 | (0.81, 1.01) | 1024 | 1.01 | (0.93, 1.10) | 123 | 1.05 | (0.82, 1.34) | 68 | 0.85 | (0.63, 1.16) | 853 | 1.00 | (0.92, 1.10) |
80+ | 67 | 0.94 | (0.73, 1.21) | 127 | 1.00 | (0.83, 1.20) | 17 | 1.37 | (0.82, 2.28) | 14 | 1.42 | (0.80, 2.50) | 82 | 1.10 | (0.88, 1.39) |
Per 50 g/day | |||||||||||||||
Observed | 0.93 | (0.85, 1.01) | 0.97 | (0.91, 1.03) | 1.21 | (1.06, 1.38) | 0.89 | (0.71, 1.13) | 1.01 | (0.95, 1.07) | |||||
Calibrated | 0.84 | (0.69, 1.03) | 0.98 | (0.82, 1.16) | 1.32 | (1.02, 1.73) | 0.72 | (0.41, 1.29) | 1.05 | (0.91, 1.21) |