title: The Netherlands Cohort Study−Meat Investigation Cohort; a population-based cohort over-represented with vegetarians, pescetarians and low meat consumers.
abstract: BACKGROUND
  Vegetarian diets have been associated with lower risk of chronic disease, but little is known about the health effects of low meat diets and the reliability of self-reported vegetarian status. We aimed to establish an analytical cohort over-represented with vegetarians, pescetarians and 1 day/week meat consumers, and to describe their lifestyle and dietary characteristics. In addition, we were able to compare self-reported vegetarians with vegetarians whose status has been confirmed by their response on the extensive food frequency questionnaire (FFQ).
  
  
  METHODS
  Embedded within the Netherlands Cohort Study (n = 120,852; including 1150 self-reported vegetarians), the NLCS-Meat Investigation Cohort (NLCS-MIC) was defined by combining all FFQ-confirmed-vegetarians (n = 702), pescetarians (n = 394), and 1 day/week meat consumers (n = 1,396) from the total cohort with a random sample of 2-5 days/week- and 6-7 days/week meat consumers (n = 2,965 and 5,648, respectively).
  
  
  RESULTS
  Vegetarians, pescetarians, and 1 day/week meat consumers had more favorable dietary intakes (e.g., higher fiber/vegetables) and lifestyle characteristics (e.g. lower smoking rates) compared to regular meat consumers in both sexes. Vegetarians adhered to their diet longer than pescetarians and 1 day/week meat consumers. 75% of vegetarians with a prevalent cancer at baseline had changed to this diet after diagnosis. 50% of self-reported vegetarians reported meat or fish consumption on the FFQ. Although the misclassification that occurred in terms of diet and lifestyle when merely relying on self-reporting was relatively small, the impact on associations with disease risk remains to be studied.
  
  
  CONCLUSIONS
  We established an analytical cohort over-represented with persons at the lower end of the meat consumption spectrum which should facilitate prospective studies of major cancers and causes of death using ≥20.3 years of follow-up.
authors.affiliation: Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, PO Box 616, Maastricht 6216, MD, The Netherlands. anne.gilsing@maastrichtuniversity.nl.
authors.forename: Anne M J
authors.initials: AM
authors.lastname: Gilsing
authors.forename: Matty P
authors.initials: MP
authors.lastname: Weijenberg
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D014676:Diet, Vegetarian / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012306:Risk; D017747:Seafood / Q000009:adverse effects*; D057566:Self Report; D009626:Terminology as Topic