@article{3105921,
    title = "Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases among 409 885 Participants in the Pan-European EPIC Cohort",
    author = "Key, T.J. and Appleby, P.N. and Bradbury, K.E. and Sweeting, M. and Wood, A. and Johansson, I. and Kühn, T. and Steur, M. and Weiderpass, E. and Wennberg, M. and Lund Würtz, A.M. and Agudo, A. and Andersson, J. and Arriola, L. and Boeing, H. and Boer, J.M.A. and Bonnet, F. and Boutron-Ruault, M.-C. and Cross, A.J. and Ericson, U. and Fagherazzi, G. and Ferrari, P. and Gunter, M. and Huerta, J.M. and Katzke, V. and Khaw, K.-T. and Krogh, V. and La Vecchia, C. and Matullo, G. and Moreno-Iribas, C. and Naska, A. and Nilsson, L.M. and Olsen, A. and Overvad, K. and Palli, D. and Panico, S. and Molina-Portillo, E. and Quirós, J.R. and Skeie, G. and Sluijs, I. and Sonestedt, E. and Stepien, M. and Tjønneland, A. and Trichopoulou, A. and Tumino, R. and Tzoulaki, I. and Van Der Schouw, Y.T. and Verschuren, W.M.M. and Di Angelantonio, E. and Langenberg, C. and Forouhi, N. and Wareham, N. and Butterworth, A. and Riboli, E. and Danesh, J.",
    journal = "CIRCULATION",
    year = "2019",
    volume = "139",
    number = "25",
    pages = "2835-2845",
    publisher = "Lippincott Williams and Wilkins",
    issn = "0009-7322",
    doi = "10.1161/CIRCULATIONAHA.118.038813",
    keywords = "cholesterol;  lipid;  yoghurt;  biological marker;  high density lipoprotein cholesterol, adult;  Article;  blood pressure;  cardiovascular risk;  cheese;  cohort analysis;  dairy product;  egg;  Europe;  female;  fish;  follow up;  food intake;  heart infarction;  human;  ischemic heart disease;  major clinical study;  male;  meat;  middle aged;  milk;  poultry meat;  priority journal;  processed meat;  prospective study;  questionnaire;  risk assessment;  systolic blood pressure;  adverse event;  aged;  blood;  clinical trial;  cross-sectional study;  diet;  dietary reference intake;  heart muscle ischemia;  multicenter study;  nutritional value;  pathophysiology;  protection;  risk factor;  risk reduction;  sea food;  time factor, Adult;  Aged;  Biomarkers;  Blood Pressure;  Cholesterol, HDL;  Cross-Sectional Studies;  Dairy Products;  Diet Surveys;  Diet, Healthy;  Eggs;  Europe;  Female;  Humans;  Male;  Meat;  Middle Aged;  Myocardial Ischemia;  Nutritive Value;  Prospective Studies;  Protective Factors;  Recommended Dietary Allowances;  Risk Assessment;  Risk Factors;  Risk Reduction Behavior;  Seafood;  Time Factors",
    abstract = "Background: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition). Methods: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates. Results: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06-1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89-0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86-0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88-0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-high-density lipoprotein cholesterol. Conclusions: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects. © 2018 American Heart Association, Inc."
}