Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes A Systematic Review of Randomized Trials
Por:
Zeraatkar, D, Johnston, BC, Bartoszko, J, Cheung, K, Bala, MM, Valli, C, Rabassa, M, Sit, D, Milio, K, Sadeghirad, B, Agarwal, A, Zea, AM, Lee, Y, Han, MA, Vernooij, RWM, Alonso-Coello, P, Guyatt, GH, El Dib, R
Publicada:
19 nov 2019
Resumen:
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).
Filiaciones:
Zeraatkar, D:
McMaster Univ, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
Johnston, BC:
Dalhousie Univ, Halifax, NS, Canada
Dalhousie Univ, Dept Community Hlth & Epidemiol, Clin Res Ctr, Room 404,5790 Univ Ave, Halifax, NS B3H 1V7, Canada
Bartoszko, J:
McMaster Univ, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
Cheung, K:
McMaster Univ, Hamilton, ON, Canada
114 Loganberry Crescent, Toronto, ON M2H 3H1, Canada
Bala, MM:
Jagiellonian Univ, Coll Med, Krakow, Poland
Jagiellonian Univ, Coll Med, Dept Hyg & Dietet, 7 Kopernika St, PL-31034 Krakow, Poland
Valli, C:
Biomed Res Inst San Pau IIB St Pau, Iberoamer Cochrane Ctr Barcelona, Barcelona, Spain
Inst Invest Biomed St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167, Barcelona 08025, Spain
Rabassa, M:
Biomed Res Inst San Pau IIB St Pau, Iberoamer Cochrane Ctr Barcelona, Barcelona, Spain
Inst Invest Biomed St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167, Barcelona 08025, Spain
Sit, D:
Univ British Columbia, 107-1165 West 13th Ave, Vancouver, BC V6H 1N4, Canada
Milio, K:
McMaster Univ, Hamilton, ON, Canada
592 Regal Pl, Waterloo, ON N2V 2G3, Canada
Sadeghirad, B:
McMaster Univ, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
Agarwal, A:
Univ Toronto, Toronto, ON, Canada
Univ Toronto, Dept Med, Suite RFE 3-805,200 Elizabeth St, Toronto, ON M5G 2C4, Canada
Zea, AM:
Clin Amer, Diagonal 75B,N 2A-80-140, Medellin, Colombia
Lee, Y:
McMaster Univ, Hamilton, ON, Canada
30 White Lodge Crescent, Richmond Hill, ON L4C 9A1, Canada
Han, MA:
Chosun Univ, Gwangju, South Korea
Chosun Univ, Dept Prevent Med, Coll Med, 309 Philmun Daero, Gwangju 61452, South Korea
Vernooij, RWM:
Netherlands Comprehens Canc Org IKNL, Utrecht, Netherlands
Netherlands Comprehens Canc Org, Dept Res, Godebaldkwartier 419, NL-3511 DT Utrecht, Netherlands
Alonso-Coello, P:
Biomed Res Inst San Pau IIB St Pau, Iberoamer Cochrane Ctr Barcelona, Barcelona, Spain
Inst Invest Biomed St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Carrer St Antoni Maria Claret 167, Barcelona 08025, Spain
Guyatt, GH:
McMaster Univ, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
El Dib, R:
Univ Estadual Paulista Sao Jose, Inst Sci & Technol, Sao Paulo, Brazil
Inst Sci & Technol, Ave Engn Francisco Jose Longo 77, BR-12245000 Sao Paulo, Brazil
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