Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, NO-9037Tromsø, Norway.
Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Br J Nutr. 2024 Feb 14;131(3):531-543. doi: 10.1017/S0007114523002040. Epub 2023 Sep 11.
Nordic Nutrition Recommendations recommend reducing red and processed meat and increasing fish consumption, but the impact of this replacement on mortality is understudied. This study investigated the replacement of red and processed meat with fish in relation to mortality. Of 83 304 women in the Norwegian Women and Cancer Study (NOWAC) study, 9420 died during a median of 21·0 years of follow-up. The hazard ratios (HR) for mortality were estimated using Cox proportional hazards regression with analyses stratified on red and processed meat intake due to non-linearity. Higher processed meat (> 30 g/d), red and processed meat (> 50 g/d), and fatty fish consumption were associated with higher mortality, while red meat and lean fish consumption were neutral or beneficial. Among women with higher processed meat intake (> 30 g/d), replacing 20 g/d with lean fish was associated with lower all-cause (HR 0·92, 95 % CI 0·89, 0·96), cancer (HR 0·92, 95 % CI 0·88, 0·97) and CVD mortality (HR 0·82, 95 % CI 0·74, 0·90), while replacing with fatty fish was associated with lower CVD mortality (HR 0·87, 95 % CI 0·77, 0·97), but not with all-cause or cancer mortality. Replacing processed meat with fish among women with lower processed meat intake (≤ 30 g/d) or replacing red meat with fish was not associated with mortality. Replacing processed meat with lean or fatty fish may lower the risk of premature deaths in Norwegian women, but only in women with high intake of processed meat. These findings suggest that interventions to reduce processed meat intake should target high consumers.
北欧营养建议建议减少红肉类和加工肉类的摄入，增加鱼类的食用量，但这种替代对死亡率的影响还需要进一步研究。本研究调查了用鱼类替代红肉类和加工肉类与死亡率之间的关系。在挪威妇女与癌症研究（NOWAC）中，有 83304 名女性参与，其中 9420 人在中位 21.0 年的随访期间死亡。使用 Cox 比例风险回归分析死亡率的危险比（HR），由于存在非线性，因此对红肉类和加工肉类摄入量进行分层分析。较高的加工肉类（>30 g/d）、红肉类和加工肉类（>50 g/d）以及高脂肪鱼类的摄入与更高的死亡率相关，而红肉类和瘦鱼类的摄入则呈中性或有益。在高加工肉类摄入量（>30 g/d）的女性中，用 20 g/d 的瘦鱼类替代与全因（HR 0.92，95%CI 0.89，0.96）、癌症（HR 0.92，95%CI 0.88，0.97）和心血管疾病（CVD）死亡率（HR 0.82，95%CI 0.74，0.90）降低相关，而用高脂肪鱼类替代与 CVD 死亡率降低相关（HR 0.87，95%CI 0.77，0.97），但与全因或癌症死亡率无关。在低加工肉类摄入量（≤30 g/d）的女性中用鱼类替代加工肉类或用鱼类替代红肉类与死亡率无关。用瘦鱼或肥鱼替代加工肉类可能会降低挪威女性过早死亡的风险，但仅限于高加工肉类摄入量的女性。这些发现表明，减少加工肉类摄入量的干预措施应该针对高消费者。
