Table 4.

Statistical model based hazard ratios (95% confidence intervals) for eight year all cause mortality associated with decrease of one serving per day of red meat and simultaneous increase of one serving per day of another major dietary protein source, whole grains, or vegetables over an eight year follow-up in Nurses’ Health Study and Health Professionals Follow-up Study

Mortality	Nuts	Poultry without skin	Fish	Dairy	Eggs	Legumes	Whole grains*	Vegetables without legumes†
Nurses’ Health Study:
Red meat	0.79 (0.75 to 0.83)	0.83 (0.77 to 0.89)	0.84 (0.74 to 0.95)	0.91 (0.83 to 1.01)	0.94 (0.89 to 0.99)	0.95 (0.85 to 1.05)	0.86 (0.79 to 0.94)	0.88 (0.83 to 0.93)
Processed meat	0.68 (0.62 to 0.74)	0.72 (0.65 to 0.81)	0.72 (0.62 to 0.84)	0.79 (0.69 to 0.90)	0.80 (0.72 to 0.89)	0.82 (0.71 to 0.94)	0.74 (0.66 to 0.84)	0.76 (0.69 to 0.84)
Unprocessed meat	0.81 (0.77 to 0.86)	0.84 (0.78 to 0.92)	0.86 (0.76 to 0.99)	0.95 (0.85 to 1.05)	0.99 (0.92 to 1.06)	0.98 (0.88 to 1.10)	0.89 (0.81 to 0.98)	0.91 (0.85 to 0.98)
Health Professionals Follow-up Study:
Red meat	0.84 (0.8 to 0.88)	0.98 (0.91 to 1.04)	0.83 (0.72 to 0.94)	0.93 (0.84 to 1.04)	0.90 (0.86 to 0.95)	0.94 (0.89 to 1.00)	0.90 (0.82 to 0.99)	0.92 (0.87 to 0.97)
Processed meat	0.80 (0.74 to 0.86)	0.93 (0.84 to 1.02)	0.78 (0.68 to 0.91)	0.89 (0.78 to 1.01)	0.86 (0.79 to 0.94)	0.90 (0.82 to 0.98)	0.86 (0.76 to 0.96)	0.87 (0.80 to 0.95)
Unprocessed meat	0.84 (0.79 to 0.89)	0.96 (0.89 to 1.04)	0.82 (0.71 to 0.94)	0.93 (0.83 to 1.05)	0.91 (0.85 to 0.97)	0.94 (0.88 to 1.01)	0.90 (0.81 to 1.00)	0.92 (0.86 to 0.98)
Pooled analysis:
Red meat	0.81 (0.79 to 0.84)	0.90 (0.86 to 0.95)	0.83 (0.76 to 0.91)	0.92 (0.86 to 0.99)	0.92 (0.89 to 0.96)	0.94 (0.90 to 0.99)	0.88 (0.83 to 0.94)	0.90 (0.87 to 0.93)
Processed meat	0.74 (0.70 to 0.79)	0.83 (0.78 to 0.90)	0.75 (0.68 to 0.84)	0.84 (0.76 to 0.92)	0.83 (0.78 to 0.89)	0.87 (0.81 to 0.94)	0.80 (0.74 to 0.87)	0.82 (0.77 to 0.88)
Unprocessed meat	0.82 (0.79 to 0.86)	0.90 (0.85 to 0.96)	0.84 (0.77 to 0.93)	0.94 (0.87 to 1.02)	0.95 (0.90 to 0.99)	0.95 (0.90 to 1.01)	0.89 (0.83 to 0.96)	0.92 (0.87 to 0.96)

Cox proportional hazards models included all protein foods, vegetables and whole grains simultaneously (initial and change, both continuous, per serving), adjusted for age, race (white v other), and body mass index in 1986 (<21, 21-22, 23-24, 25-29, and ≥30); family history of myocardial infarction, diabetes, and cancer; updated aspirin use; multivitamin use; menopausal status and use of postmenopausal hormones (premenopausal, postmenopausal and hormone therapy never user, postmenopausal and hormone therapy current user, postmenopausal and hormone therapy past user, or missing indicator) (only for women); and simultaneous changes in other lifestyle factors: smoking status (never to never, never to current, former, to former, former to current, current to former, current to current, or missing indicator); and initial and changes (all in fifths) in physical activity, alcohol consumption, total energy intake, and other food groups, that is, fruits and sugar-sweetened beverages. The results across the two cohorts were pooled using an inverse variance weighted, fixed effect meta-analysis.

^*Whole grains included whole grain cold breakfast cereal, dark bread, oatmeal, brown rice, popcorn, bran, and germ.

^†Vegetables included green leafy vegetables (such as spinach, kale, and lettuce) and cruciferous vegetables (such as cabbage, cauliflower, Brussel sprouts, and broccoli), but no legumes in the current substitution analysis.