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Food and health

Meat consumption and diet quality and mortality in NHANES III



There is growing evidence that meat consumption is associated with total and cause-specific mortality. Our objective was to evaluate the association of meat intake and the healthy eating index (HEI) with total mortality, cancer and cardiovascular disease (CVD) mortality.


Analyses are based on 17 611 participants from Third National Health and Nutrition Examination Survey (NHANES III) (1986–2010). Meat intake was assessed using a food frequency questionnaire administrated at baseline. Adherence to the HEI was analyzed with a single 24-h dietary recall. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality according to five categories of meat consumption and three categories of the HEI score.


During the follow-up period, 3683 deaths occurred, of which 1554 were due to CVD and 794 due to cancer. After multivariable adjustment, neither red and processed meat, nor white meat consumption were consistently associated with all-cause or cause-specific mortality. In men, white meat consumption tended to be inversely associated with total mortality (P for trend=0.02), but there was no such association among women. Significantly decreased mortality was observed in the top compared with the bottom third of the HEI score (HR=0.70, 95% CI 0.52–0.96). This association was only observed in men, but not in women.


Meat consumption was not associated with mortality. A healthy diet according to HEI, however, was associated with a decreased total mortality in men, but not in women.

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Correspondence to S Rohrmann.

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Kappeler, R., Eichholzer, M. & Rohrmann, S. Meat consumption and diet quality and mortality in NHANES III. Eur J Clin Nutr 67, 598–606 (2013).

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  • cohort study
  • mortality
  • meat consumption
  • healthy eating index (HEI)

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