title: [Study on the multilevel and longitudinal association between red meat consumption and changes in body mass index, body weight and risk of incident overweight among Chinese adults].
abstract: OBJECTIVE
  To examine the longitudinal association between red meat consumption and changes in body mass index(BMI), body weight and overweight risk in Chinese adults.
  
  
  METHODS
  Data from the open, prospective cohort study 'China Health and Nutrition Survey' (CHNS), 18 006 adults(47.5% males)were chosen as the study subjects who participated in at least one wave of survey between 1991 and 2009. Three-level(community-individual-measure occasion) mixed effect modeling was performed to investigate the effect of red meat consumption on BMI, body weight changes and risk of overweight. The average daily red meat intake was assessed using consecutive 3 d 24 h recalls.
  
  
  RESULTS
  In general, participants with higher red meat intake appeared to be those with younger age, higher personal income and higher education level, lower physical activities, higher total energy intake, smokers and alcohol drinkers. 3-level mixed-effects linear regression models showed that red meat intake was positively associated with changes in BMI and body weight. Compared to those who consumed no red meat, men and women in the highest quartile of red meat intake showed an increase of 0.17(95% CI:0.08-0.26, P < 0.0001)and 0.12 kg/m(2) (95%CI:0.02-0.22, P < 0.05) on BMI and increase of 596 g (95%CI:329-864, P < 0.0001) and 400 g (95%CI:164-636, P < 0.0001) on body weight, respectively, after adjustment for potential confounders (age, income, education, smoking, alcohol, physical activity level, community urbanization index and total energy intake). After adjustment for above confounders and baseline BMI, results from the 3-level mixed effect logistic model indicated that the odds ratios of being overweight in males and females who had the highest quartile of red meat intake were 1.21 (95%CI:1.01-1.46, P < 0.05)and 1.18(95% CI:1.01-1.37, P < 0.05) in comparison with non-consumers of red meat, respectively.
  
  
  CONCLUSIONS
  Higher red meat intake was associated with increased BMI and body weight, as well as increased overweight risk.
authors.affiliation: National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Zhi-hong
authors.initials: ZH
authors.lastname: Wang
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
authors.forename: Hui-jun
authors.initials: HJ
authors.lastname: Wang
authors.forename: Ji-guo
authors.initials: JG
authors.lastname: Zhang
authors.forename: Wen-wen
authors.initials: WW
authors.lastname: DU
authors.forename: Chang
authors.initials: C
authors.lastname: Su
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.forename: Feng-ying
authors.initials: FY
authors.lastname: Zhai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008460:Meat; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology*; D011795:Surveys and Questionnaires