Table 3.
Estimated hazard ratios a and confidence intervals for all-cause and 15 cancer incidence for different combinations of intake levels of red and processed meat with vegetables and fruit, whole grains, and fiber among women, Alberta’s Tomorrow Project (n = 16,393).
| All-Cause Cancers b | 15 Cancers c | |||||
|---|---|---|---|---|---|---|
| Vegetables and Fruit (Serving/Day) d | Vegetables and Fruit (Serving/Day) d | |||||
| <3 | 3–5 | >5 | <3 | 3–5 | >5 | |
| Red meat (gram/week) e | ||||||
| <150 | 1.02 (0.83–1.25) | 1.01 (0.91–1.12) | Ref. | 0.94 (0.76–1.17) | 0.97 (0.87–1.08) | Ref. |
| 150–300 | 1.06 (0.90–1.27) | 1.00 (0.88–1.13) | 0.93 (0.84–1.04) | 1.02 (0.84–1.22) | 0.96 (0.83–1.09) | 0.90 (0.80–1.01) |
| >300 | 1.12 (0.91–1.37) | 0.99 (0.82–1.18) | 0.87 (0.70–1.08) | 1.09 (0.87–1.37) | 0.94 (0.78–1.14) | 0.81 (0.64–1.02) |
| Processed meat (gram/week) f | ||||||
| <28 | 1.13 (0.90–1.43) | 1.06 (0.95–1.20) | Ref. | 1.07 (0.84–1.38) | 1.036 (0.91–1.17) | Ref. |
| 28–112 | 1.28 (1.07–1.53) | 1.21 (1.06–1.39) | 1.15 (1.02–1.29) | 1.26 (1.04–1.54) | 1.21 (1.05–1.40) | 1.16 (1.02–1.31) |
| >112 | 1.44 (1.17–1.77) | 1.38 (1.14–1.67) | 1.32 (1.05–1.67) | 1.49 (1.19–1.86) | 1.41 (1.15–1.73) | 1.34 (1.04–1.72) |
| Whole grains (serving/day) g | Whole grains (serving/day) g | |||||
| <0.6 | 0.6–1.1 | >1.1 | <0.6 | 0.6–1.1 | >1.1 | |
| Red meat (gram/week) | ||||||
| <150 | 0.90 (0.73–1.10) | 0.95 (0.86–1.05) | Ref. | 1.00 (0.81–1.25) | 1.00 (0.90–1.12) | Ref. |
| 150–300 | 0.95 (0.80–1.12) | 0.93 (0.82–1.05) | 0.92 (0.82–1.02) | 1.06 (0.88–1.26) | 0.97 (0.85–1.11) | 0.90 (0.80–1.01) |
| >300 | 1.00 (0.82–1.21) | 0.91 (0.77–1.09) | 0.84 (0.68–1.05) | 1.11 (0.91–1.37) | 0.95 (0.78–1.14) | 0.81 (0.64–1.02) |
| Processed meat (gram/week) | ||||||
| <28 | 0.94 (0.75–1.18) | 0.97 (0.87–1.08) | Ref. | 1.07 (0.83–1.36) | 1.03 (0.91–1.17) | Ref. |
| 28–112 | 1.12 (0.94–1.35) | 1.11 (0.97–1.27) | 1.10 (0.97–1.23) | 1.30 (1.07–1.58) | 1.21 (1.05–1.40) | 1.12 (0.99–1.27) |
| >112 | 1.34 (1.09–1.66) | 1.27 (1.05–1.54) | 1.20 (0.95–1.52) | 1.59 (1.27–1.99) | 1.42 (1.16–1.74) | 1.26 (0.98–1.62) |
| Fiber (gram/week) h | Fiber (gram/week) h | |||||
| <110 | 110–161 | >161 | <110 | 110–161 | >161 | |
| Red meat (gram/week) | ||||||
| <150 | 1.11 (0.88–1.39) | 1.05 (0.94–1.18) | Ref. | 1.01 (0.79–1.30) | 1.01 (0.89–1.14) | Ref. |
| 150–300 | 1.13 (0.93–1.38) | 1.02 (0.89–1.18) | 0.93 (0.83–1.04) | 1.03 (0.84–1.28) | 0.98 (0.84–1.13) | 0.93 (0.82–1.05) |
| >300 | 1.15 (0.93–1.43) | 1.00 (0.83–1.21) | 0.87 (0.69–1.09) | 1.05 (0.83–1.33) | 0.95 (0.78–1.17) | 0.861 (0.67–1.10) |
| Processed meat (gram/week) | ||||||
| <28 | 1.27 (0.99–1.62) | 1.13 (1.00–1.27) | Ref. | 1.1 (0.85–1.43) | 1.05 (0.92–1.20) | Ref. |
| 28–112 | 1.38 (1.12–1.69) | 1.28 (1.11–1.49) | 1.19 (1.05–1.36) | 1.26 (1.01–1.57) | 1.228 (1.05–1.44) | 1.20 (1.04–1.38) |
| >112 | 1.50 (1.20–1.87) | 1.46 (1.19–1.79) | 1.43 (1.10–1.85) | 1.44 (1.14–1.82) | 1.44 (1.15–1.79) | 1.433 (1.08–1.90) |
a Adjusted for total energy intake, smoking status, alcohol use, family history of cancer, personal history of chronic disease, rural/urban residence, Body Mass Index, physical activity, and education. b Primary malignant cancers, excluding non-melanoma skin cancer. c Overall, 15 cancers with possible links to red and processed meat intake, including colorectal, stomach, pancreas, prostate, breast, bronchus/lung, esophagus, kidney, bladder, ovary, endometrium, non-Hodgkin lymphoma, liver and intrahepatic bile ducts, leukemia, and other (thyroid, gallbladder and biliary tract, testis, and brain) [11]. d The cut-off value for the highest tertile was chosen such that the median intake in the highest tertile approximated the Canada’s Food Guide recommendations of 7 servings per day [19]. e The cut-off values for the tertiles were chosen such that the median intake approximated the WCRF/AICR recommendations of 350–500 g per week [1], Canadian Cancer Society recommendations of 250 g per week (3 portions of <85 g) [20], and Global Burden of Disease recommendations of 126–189 g per week (8–27 g per day) [22]. f The cut-off value for the lowest tertile was guided by the Global Burden of Disease recommendations of 28 g per week (0–4 g per day) [22]. g As the consumption levels for whole grains were substantially lower than the existing recommendations (e.g., Canada’s Food Guide recommends 4 servings per day) [19], the cut-off values for the tertiles were guided by the actual consumption. h The cut-off values for the middle and highest tertiles were chosen such that the median intake approximated the Global Burden of Disease and Dietary Guidelines for Americans recommendations of 133 and 196 g per week (19 and 28 g per day) [21,22]. Bolded numbers indicate statistical significance at p < 0.05.