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Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1957 (Published 09 May 2017) Cite this as: BMJ 2017;357:j1957

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Re: Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study

This paper is very intriguing (1); before generalizing its conclusions to everything and everyone, some points need to be raised.

1. The way meat is eaten in every country is very different both in quantity and quality; so we must be very careful to generalize conclusions

2. In “white meat” the authors place canned tuna and fish; in a way food that is not meat and has a peculiar protective effect on CV death and total mortality; this could maximize the “protective effect” by white meat

3. The quintiles are divided according to “red meat” and “white meat” expressed in gr/1000 kcal; in Italy the data I cloud gather were expressed in gr/day; so assuming a caloric intake of more or less 2000 kcal/day the assumption of the lowest quintile would be 18,6 gr/day for red meat and 74 gr/day for “white meat”, summing 92,6 gr/day non so distant from 106,0 gr/day which is the average consumption in Italy for meat (2) ; it would mean that the Italian population, eating meat as they are eating today would be in lowest quintile, therefore in lowest risk-group

4. In the paper I didn’t find any comment about the way of cooking the meat; in Italy, for example, grilled meat is very seldom cooked (usually in public parties “en plain air”) but not as usual way of cooking, so it could make some difference in the meat content of “cyclic amines” which are supposed to be carcinogenic (3) .

In conclusion the paper has to be taken in consideration cautiously for populations, such as people living in Italy, where the quantity of meat and the way is cooked, is very different from in the USA.

1. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study . BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1957(Published 09 May 2017)
2. Reduction of meat consumption and greenhouse gas emissions associated with health benefits in Italy. Farchi S, Lapucci E, Michelozzi P. Epidemiol Prev 2015;39(5-6);308-313
3. Carcinogenicity of consumption of red meat and processed meat: A review of scientific news since the IARC decision. José L. Domingo, Martí Nadal. Food and Chemical Toxicology Volume 105, July 2017, Pages 256–261; https://doi.org/10.1016/j.fct.2017.04.028

Competing interests: No competing interests

15 May 2017
Carlo Pedrolli
Clinical Nutritionist
S. Chiara Hospital
Via P. Orsi n. 1 38121 Trento Italy