美国哈佛大学陈曾熙公共卫生学院Walter C Willett团队研究了美国男性红肉摄入量与冠心病风险的相关性。2020年12月2日，该研究发表在《英国医学杂志》上。

为了研究总的、加工和未加工红肉与冠心病（CHD）风险的相关性，并评估用其他蛋白质来源替代具有CHD风险的红肉的效果，1986-2016年，研究组在美国进行了一项对饮食和生活方式因素进行反复评估的前瞻性队列研究。共招募了43272名基线无心血管疾病或癌症的男性。主要结局为总CHD，包括急性非致命性心肌梗塞或致命性冠心病。

研究组共进行了1023872人次的随访，共发生4456起CHD事件，其中1860人死亡。在对饮食和非饮食风险因素进行多因素校正后，总红肉摄入量、未加工红肉摄入量和加工红肉摄入量均与CHD风险的小幅增加相关，风险比分别为1.12、1.11和1.15。

与红肉相比，每天摄入一份植物蛋白源（坚果，豆类和大豆）可显著降低冠心病的风险，与总红肉的风险比为0.87，与未加工红肉相比为0.87，与加工红肉相比为0.83。用全谷物和乳制品代替总红肉和用鸡蛋代替加工红肉也与较低的冠心病风险有关。

研究结果表明，用优质的植物性食品（例如豆类、坚果或大豆）代替红肉可能会降低冠心病的风险。用全谷物和乳制品代替总的红肉，用鸡蛋代替加工红肉，也可以降低这种风险。

附：英文原文

Title: Red meat intake and risk of coronary heart disease among US men: prospective cohort study

Author: Laila Al-Shaar, Ambika Satija, Dong D Wang, Eric B Rimm, Stephanie A Smith-Warner, Meir J Stampfer, Frank B Hu, Walter C Willett

Issue&Volume: 2020/12/02

Abstract:

Objectives To study total, processed, and unprocessed red meat in relation to risk of coronary heart disease (CHD) and to estimate the effects of substituting other protein sources for red meat with CHD risk.

Design Prospective cohort study with repeated measures of diet and lifestyle factors.

Setting Health Professionals Follow-Up Study cohort, United States, 1986-2016.

Participants 43272 men without cardiovascular disease or cancer at baseline.

Main outcome measures The primary outcome was total CHD, comprised of acute non-fatal myocardial infarction or fatal CHD. Cox models were used to estimate hazard ratios and 95% confidence intervals across categories of red meat consumption. Substitution analyses were conducted by comparing coefficients for red meat and the alternative food in models, including red meat and alternative foods as continuous variables.

Results During 1023872 person years of follow-up, 4456 incident CHD events were documented of which 1860 were fatal. After multivariate adjustment for dietary and non-dietary risk factors, total, unprocessed, and processed red meat intake were each associated with a modestly higher risk of CHD (hazard ratio for one serving per day increment: 1.12 (95% confidence interval 1.06 to 1.18) for total red meat, 1.11 (1.02 to 1.21) for unprocessed red meat, and 1.15 (1.06 to 1.25) for processed red meat). Compared with red meat, the intake of one serving per day of combined plant protein sources (nuts, legumes, and soy) was associated with a lower risk of CHD (0.86 (0.80 to 0.93) compared with total red meat, 0.87 (0.79 to 0.95) compared with unprocessed red meat, and 0.83 (0.76 to 0.91) compared with processed red meat). Substitutions of whole grains and dairy products for total red meat and eggs for processed red meat were also associated with lower CHD risk.

Conclusions Substituting high quality plant foods such as legumes, nuts, or soy for red meat might reduce the risk of CHD. Substituting whole grains and dairy products for total red meat, and eggs for processed red meat, might also reduce this risk.

DOI: 10.1136/bmj.m4141

Source: https://www.bmj.com/content/371/bmj.m4141