title: Substitutions of red meat, poultry and fish and risk of myocardial infarction.
abstract: Red meat has been suggested to be adversely associated with risk of myocardial infarction (MI), but previous studies have rarely taken replacement foods into consideration. We aimed to investigate optimal substitutions between and within the food groups of red meat, poultry and fish for MI prevention. We followed up 55 171 women and men aged 50-64 years with no known history of MI at recruitment. Diet was assessed by a validated 192-item FFQ at baseline. Adjusted Cox proportional hazard models were used to calculate hazard ratios (HR) and 95 % CI for specified food substitutions of 150 g/week. During a median follow-up time of 13·6 years, we identified 656 female and 1694 male cases. Among women, the HR for replacing red meat with fatty fish was 0·76 (95 % CI 0·64, 0·89), whereas the HR for replacing red meat with lean fish was 1·00 (95 % CI 0·89, 1·14). Similarly, replacing poultry with fatty but not lean fish was inversely associated with MI: the HR was 0·81 (95 % CI 0·67, 0·98) for fatty fish and was 1·08 (95 % CI 0·92, 1·27) for lean fish. The HR for replacing lean with fatty fish was 0·75 (95 % CI 0·60, 0·94). Replacing processed with unprocessed red meat was not associated with MI. Among men, a similar pattern was found, although the associations were not statistically significant. This study suggests that replacing red meat, poultry or lean fish with fatty fish is associated with a lower risk of MI.
authors.affiliation: 1Department of Public Health,Section for Epidemiology,Aarhus University,DK-8000 Aarhus C,Denmark.
authors.forename: Anne M L
authors.identifier: 0000-0002-0060-2680
authors.initials: AM
authors.lastname: Würtz
authors.affiliation: 1Department of Public Health,Section for Epidemiology,Aarhus University,DK-8000 Aarhus C,Denmark.
authors.forename: Mette D
authors.initials: MD
authors.lastname: Hansen
authors.affiliation: 2Danish Cancer Society Research Center,DK-2100 Copenhagen Ø,Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: 3Department of Medicine,Channing Division of Network Medicine,Brigham and Women's Hospital,Harvard Medical School,Boston,MA 02115,USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: 5Department of Cardiology,Center for Cardiovascular Research,Aalborg University Hospital,DK-9000 Aalborg,Denmark.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Schmidt
authors.affiliation: 1Department of Public Health,Section for Epidemiology,Aarhus University,DK-8000 Aarhus C,Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.affiliation: 1Department of Public Health,Section for Epidemiology,Aarhus University,DK-8000 Aarhus C,Denmark.
authors.forename: Marianne U
authors.initials: MU
authors.lastname: Jakobsen
mesh_terms: D000818:Animals; D004032:Diet; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control*; D011200:Poultry; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000069466:Red Meat; D012307:Risk Factors; D017747:Seafood
chemical_list: D004041:Dietary Fats
keywords: Cohort studies; Fish; HR hazard ratio; MI myocardial infarction; Myocardial infarction; Poultry; Red meat; Substitution models