Publications this month analyze data from PHRI’s PURE study to reveal new insight into the association of fish intake, and of processed and unprocessed meat, with major cardiovascular disease and mortality. In both cases, the global study is the first to so widely include health outcomes from low-, middle- and high-income countries.

The PURE study team published Associations of unprocessed and processed meat intake with mortality and cardiovascular disease in 21 countries in the American Journal of Clinical Research today. During 9.5 years of followup of a cohort of almost 135,000 people in 21 low-, middle- and high-income countries, the study did not find significant associations between unprocessed red meat and poultry intake and mortality or major CVD. Conversely, a higher intake of processed meat – salted, cured, or treated with preservations and/or food additives – was associated with a higher risk of major CV and mortality.

“Evidence of an association between meat intake and cardiovascular disease is inconsistent. We therefore wanted to better understand the associations between intakes of unprocessed red meat, poultry, and processed meat with major cardiovascular disease events and mortality,” says Romaina Iqbal, first author of the study and an associate professor at the Aga Khan University in Karachi, Pakistan.

Consumption of processed and unprocessed meat

Mahshid Dehgha

“The totality of the available data indicates that consuming a modest amount of unprocessed meat as part of a healthy dietary pattern is unlikely to be harmful,” corresponding author Mahshid Dehghan, PHRI investigator.

After following for almost a decade, the researchers found consumption of 150 grams or more of processed meat a week was associated with a 46 per cent higher chance of cardiovascular disease and 51 per cent higher chance of death than those who ate no processed meat. However, moderate levels of consumption of non processed meats had a neutral effect on health.

“The PURE study examines substantially more diverse populations and broad patterns of diet, enabling us to provide new evidence that distinguishes between the effects of processed and unprocessed meats,” says senior author and PHRI Executive Director Salim Yusuf.

Fish intake and CVD risk

Meanwhile, an analysis of four international cohorts – PHRI’s PURE, ONTARGET, TRANSCEND and ORIGIN – indicated that a minimal fish intake of 175 g (approximately 2 servings) weekly is associated with lower risk of major CVD and mortality among patients with prior CVD but not in general populations.

Andrew Mente

The pooled analysis of individual participant data involved 147,645 people (139,827 without CVD and 7,818 with CVD) in 21 countries from the PURE study, and 43,413 patients with vascular disease from 40 countries in the other three prospective studies.

“This is by far the most diverse study of fish intake and health outcomes in the world and the only one with sufficient numbers with representation from high-, middle- and low-income countries from all inhabited continents of the world,” said PHRI Scientist Andrew Mente, coauthor of Associations of fish consumption with risk of cardiovascular disease and mortality among individuals with or without vascular disease from 58 countries in JAMA Internal Medicine. (Deepa Mohan, Madras Diabetes Research Foundation, India is first author.)

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