Presentation Abstract

Session: MP01-Nutrition
Wednesday, Mar 23, 2011, 5:00 PM - 7:00 PM
Presentation: MP001 - Changes in Fish and Meat Intake after Medical Diagnoses in Men and Women
Location: MP001
Pres. Time: Wednesday, Mar 23, 2011, 5:00 PM - 7:00 PM
Category: +EPI - Nutrition
Keywords: Diet; Outcomes; Longitudinal studies
Author(s): Martin Lajous, Miguel Hernan, James Robins, Walter Willett, Dariush Mozaffarian, Harvard Sch fo Public Health, Boston, MA
Abstract: Background_Studies on fish and meat intake could be confounded by decisions to increase or decrease intake depending on specific medical diagnoses. The extent to which medical diagnoses can influence change in fish and meat intake has not been evaluated.
Methods and Results_ We evaluated change in fish and red meat intake after medical diagnoses in two large prospective studies of 72,591 women in the Nurses’ Health Study and 48,533 men in the Health Professionals Follow-up Study over 20-year follow-up. The relations of prevalent and incident disease compared to absence of disease were evaluated in 4-year periods accounting for within-person correlation. Diet was assessed using a validated food-frequency questionnaire every 4 years. Prevalent cases and incident cases after 1986 of angina, coronary artery by-pass grafting (CABG), non-fatal myocardial infarction and stroke, diabetes, high blood pressure, elevated cholesterol, cancer and hip fracture and, only among men, elevated triglycerides were prospectively identified. The 4-year change in intake of fish and meat was calculated for the following periods: 1986-1990, 1990-1994, 1994-1998, 1998-2002, 2002-2006. In multivariate analyses we adjusted for age, period of follow-up, baseline fish and meat consumption, physical activity, BMI, alcohol intake, healthy behavior and fruits and vegetables. Among men, the largest increases in fish intake for incident disease in servings/week were seen for angina [+0.36 (95%CI +0.26, +0.45)], myocardial infarction [+0.28 (95%CI +0.17, +0.40)] and elevated cholesterol [+0.19 (95%CI +0.16, +0.22)]. For women, the largest increases in fish intake were seen for CABG [+0.20 (95%CI +0.13, +0.27)], myocardial infarction [+0.16 (95%CI +0.04, +0.28)], angina [+0.15 (95%CI+ 0.09, +0.22)] and elevated cholesterol [0.15 (95%CI 0.12,0.17)]. For red meat intake among men a the largest reductions in intake were observed for angina [-1.60 (95%CI -1.80,-1.40)], myocardial infarction [-0.96 (95%CI -1.21,-0.71)] and stroke [-1.05 (95%CI -1.16,-0.93)]. Among women, a significant reduction was observed for myocardial infarction [-0.87 (95%CI -1.10,-0.64)] and CABG [-0.44(95%CI -0.59,-0.30)]. Changes were minimal or not apparent for cancer and hip fracture.
Conclusion_In two large prospective cohorts we observed an increase in fish intake and a decrease in red meat intake after specific medical diagnoses in men and women. These relations could result in an underestimation of the benefits of fish consumption and the risks of meat intake for cardiovascular health.
Disclosures:  M. Lajous: None. M. Hernan: None. J. Robins: None. W. Willett: None. D. Mozaffarian: None.