Stroke Clinical Trial
Official title:
Red Meat Consumption and Risk of Cardiovascular Diseases - is Increased Iron Load a Possible Link?
Increased iron load could be a risk factor for cardiovascular diseases (CVD). Red meat consumption affects iron status and has also been shown to be related to increased CVD risk. The investigators hypothesized that risk associations between red meat intake and cardiovascular disease risk can to some degree be explained by higher iron load among individuals with higher meat intake. Thus, the investigators evaluate associations between red meat consumption, iron status, and CVD risk in a large-scale population based study, the European Prospective Investigation into Cancer and Nutrition (EPIC) - Heidelberg.
The present study part of the the European Prospective Investigation into Cancer and
Nutrition (EPIC) - Heidelberg, a large-scale observational cohort study located at the German
Cancer Research Center, Heidelberg, Germany. The study started between 1994 and 1998, when 25
540 adults from the local general population were recruited. Study participants are being
followed-up by active and passive procedures. The main aim of the study is to evaluate
associations between diet, lifestyle as well as metabolism and risks of major chronic
diseases (cancer, cardiovascular diseases, diabetes).
Here, the investigators register a project from within EPIC-Heidelberg on prediagnostic iron
status as a potential mediator of associations between pre-diagnostic red meat consumption
and cardiovascular disease risk. For this particular project, an embedded case-cohort set-up
was chosen, i.e. iron status markers (primary marker: serum ferritin; secondary markers:
serum transferrin, serum iron) were measured in baseline blood samples from a random
subcohort (n=2738) and all validated incident cases of myocardial infarction (n=556), stroke
(n=513), and CVD death (n=327) that occured until the closure date of the present study
(12-31-2009).
Statistical analyses follow four steps to assess whether iron status may mediate associations
between red meat consumption and CVD risk, as proposed by Wittenbecher et al. (Am J Clin
Nutr, 2015: www.ncbi.nlm.nih.gov/pubmed/25948672):
1. Multivariable Cox regression analyses on red meat consumption and CVD risk, assuming a
significant positive association
2. Multivariable linear regression analyses on red meat consumption and iron status,
assuming a significant positive association
3. Multivariable Cox regression analyses on iron status and CVD risk, assuming a
significant positive association
4. Multivariable Cox regression analyses on red meat consumption and CVD risk, additionally
adjusting for iron status, assuming that the association will be attenuated by
adjustment for iron status
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