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Relation of unprocessed, processed red meat and poultry consumption to blood pressure in East Asian and Western adults

Oude Griep, Linda M.a; Seferidi, Paraskevib; Stamler, Jeremiahc; Van Horn, Lindac; Chan, Queeniea; Tzoulaki, Ioannaa; Steffen, Lyn M.d; Miura, Katsuyukie; Ueshima, Hirotsugue; Okuda, Nagakof; Zhao, Lianchengg; Soedamah-Muthu, Sabita S.h; Daviglus, Martha L.i; Elliott, Paula,j for the INTERMAP Research Group

doi: 10.1097/HJH.0000000000001008

Background: Epidemiologic evidence suggests that relationships of red meat consumption with risk of cardiovascular diseases depends on whether or not the meat is processed, including addition of preservatives, but evidence is limited for blood pressure (BP).

Objective: To examine cross-sectional associations with BP of unprocessed and processed red meat and poultry consumption, total and by type, using data from the INTERnational study on MAcro/micronutrients and blood Pressure.

Design: INTERnational study on MAcro/micronutrients and blood Pressure included 4680 men and women ages 40–59 years from 17 population samples in Japan, China, the United Kingdom, and the United States. During four visits, eight BP measurements, four multipass 24-h dietary recalls, and two timed 24-h urine samples were collected.

Results: Average daily total unprocessed/processed meat consumption (g/1000 kcal) was 20/5 in East Asian and 38/21 in Western participants. Unprocessed meat intakes comprised red meat for 75% in East Asian and 50% in Western participants. In Westerners, multiple linear regression analyses showed SBP/DBP differences for total unprocessed red meat consumption higher by 25 g/1000 kcal +0.74/+0.57 mmHg (P = 0.03/0.01) and for unprocessed poultry of +0.79/+0.16 mmHg (P = 0.02/0.50). Unprocessed red meat was not related to BP in East Asian participants. In Westerners, SBP/DBP differences for processed red meat higher by 12.5 g/1000 kcal were +1.20/+0.24 mmHg (P < 0.01/0.24), due to consumption of cold cuts and sausages (+1.59/+0.32 mmHg, P < 0.001/0.27).

Conclusion: These findings are consistent with recommendations to limit meat intake (processed and unprocessed) to maintain and improve cardiovascular health.

aDepartment of Epidemiology and Biostatistics, School of Public Health

bDepartment of Primary Care and Public Health, Imperial College London, London, UK

cDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

dSchool of Public Health, University of Minnesota, Minneapolis, Minnesota, USA

eDepartment of Public Health, Shiga University of Medical Science, Otsu

fDepartment of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan

gDepartment of Epidemiology, Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, People's Republic of China

hDivision of Human Nutrition, Wageningen University, Wageningen, The Netherlands

iInstitute for Minority Health Research, University of Illinois – Chicago, Chicago, Illinois, USA

jMRC-HPA Centre for Environment and Health, Imperial College London, London, UK

Correspondence to Linda M. Oude Griep, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK. Tel: +44 0 2075943300; e-mail:

Abbreviations: BP, blood pressure; CVD, cardiovascular diseases; INTERMAP, INTERnational study on MAcro/micronutrients and blood Pressure

Received 16 October, 2015

Revised 4 May, 2016

Accepted 15 May, 2016

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