Meat intake and risk of diverticulitis among men
- Yin Cao1,2,3,
- Lisa L Strate4,
- Brieze R Keeley5,
- Idy Tam6,
- Kana Wu3,
- Edward L Giovannucci3,7,8,
- Andrew T Chan1,2,8,9
- 1Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- 2Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- 3Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- 4Division of Gastroenterology, University of Washington School of Medicine, Harborview Medical Center, Seattle, Washington, USA
- 5Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- 6Tufts University School of Medicine, Boston, Massachusetts, USA
- 7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- 8Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- 9Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Correspondence to Dr Andrew T Chan, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;
- Received 20 September 2016
- Revised 4 November 2016
- Accepted 20 November 2016
- Published Online First 9 January 2017
Objective Diverticulitis is a common disease with a substantial clinical and economic burden. Besides dietary fibre, the role of other foods in the prevention of diverticulitis is underexplored.
Design We prospectively examined the association between consumption of meat (total red meat, red unprocessed meat, red processed meat, poultry and fish) with risk of incident diverticulitis among 46 461 men enrolled in the Health Professionals Follow-Up Study (1986–2012). Cox proportional hazards models were used to compute relative risks (RRs) and 95% CIs.
Results During 651 970 person-years of follow-up, we documented 764 cases of incident diverticulitis. Compared with men in the lowest quintile (Q1) of total red meat consumption, men in the highest quintile (Q5) had a multivariable RR of 1.58 (95% CI 1.19 to 2.11; p for trend=0.01). The increase in risk was non-linear, plateauing after six servings per week (p for non-linearity=0.002). The association was stronger for unprocessed red meat (RR for Q5 vs Q1: 1.51; 95% CI 1.12 to 2.03; p for trend=0.03) than for processed red meat (RR for Q5 vs Q1: 1.03; 95% CI 0.78 to 1.35; p for trend=0.26). Higher consumption of poultry or fish was not associated with risk of diverticulitis. However, the substitution of poultry or fish for one serving of unprocessed red meat per day was associated with a decrease in risk of diverticulitis (multivariable RR 0.80; 95% CI 0.63 to 0.99).
Conclusions Red meat intake, particularly unprocessed red meat, was associated with an increased risk of diverticulitis. The findings provide practical dietary guidance for patients at risk of diverticulitis.
Contributors YC and ATC had full access to all of the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YC, LLS, ELG and ATC. Acquisition of data: LLS, BRK, IT and ATC. Analysis and interpretation of data: all coauthors. Drafting of the manuscript and statistical analysis: YC. Critical revision of the manuscript for important intellectual content: all coauthors. Obtained funding: LLS, ELG and ATC. Administrative, technical or material support and study supervision: LLS and ATC.
Funding This work was supported by grants R01 DK101495, R01 DK084157, K24 DK098311 and UM1 CA167552 from the National Institutes of Health.
Competing interests ATC previously served as a consultant for Bayer Healthcare, Aralaz Pharmaceuticals and Pfizer Inc. for work unrelated to the topic of this manuscript. This study was not funded by Bayer Healthcare, Pozen Aralez Pharmaceuticals or Pfizer Inc.
Ethics approval Harvard T.H. Chan School of Public Health.
Provenance and peer review Not commissioned; externally peer reviewed.