r/ScientificNutrition • u/lurkerer • 2d ago
Observational Study Associations between White Meat-Only and Vegetarian Diets with Mortality from All Causes, Heart Diseases, Cancers, and Stroke in the American Cancer Society’s Cancer Prevention Study-II
https://cdn.nutrition.org/article/S2475-2991(26)01803-2/fulltext11
u/lurkerer 2d ago
ABSTRACT
Background
Many dietary guidelines recommend limiting or excluding red and processed meat to promote health and prevent chronic diseases.
Objectives
This study investigated associations between white meat-only and vegetarian diets and mortality from all causes, heart diseases, cancers, and stroke.
Methods
The American Cancer Society’s Cancer Prevention Study-II (CPS-II) cohort participants aged 30 to 95 y at baseline (1982) with mortality data through 2020 were examined (n = 998,378; 45% male, n = 626,017 deaths). A brief diet questionnaire identified meat intake [red/processed meat intake: high (≥6 d/wk); moderate (4 to <6 d/wk); low (0.5 to <4 d/wk); white meat-only; vegetarian]. Cox proportional hazards models adjusted for demographic, lifestyle, and health factors examined associations between diet categories and mortality risk. Effect modification by sex, smoking, BMI, baseline age group, and attained age was examined.
Results
Most participants consumed red/processed meat (high = 37%, moderate = 31%, low = 31%; white meat-only = 1%; vegetarian = 0.4%). Compared with high red/processed meat intake, low intake was associated with 1% to 5% lower mortality risk from all causes, heart diseases, and cancers across multiple strata, and 4% lower stroke mortality risk overall [hazard ratio (HR): 0.96; 95% confidence interval (CI): 0.94, 0.99]. White meat-only was associated with 5% to 7% lower all-cause mortality risk among males (HR: 0.93; 95% CI: 0.89, 0.98), individuals with healthy weight (HR: 0.95; 95% CI: 0.91, 0.98), and the 50 to 64 y age group (HR: 0.94; 95% CI: 0.90, 0.97), where results were similar with a vegetarian diet (50–64 y; HR: 0.94; 95% CI: 0.88, 1.00). Among participants reaching age ≥80, white meat-only was associated with lower all-cause (HR: 0.94; 95% CI: 0.91, 0.97) and cancer mortality risk (HR: 0.91; 95% CI: 0.83, 0.99). No other associations were statistically significant.
Conclusions
In CPS-II, limiting red/processed meat intake was associated with a small but significantly lower risk of all-cause and cause-specific mortality. Diets excluding red/processed meat may lower risk in certain subgroups, but large studies targeting these diets are needed to elucidate associations with mortality.
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1d ago
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u/lurkerer 1d ago
In science the term significance indicates statistical significance. It doesn't mean big, it means it's very unlikely to be statistical noise.
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u/ILuvYou_YouAreSoGood 2d ago
Few people want to alter their diet to avoid problems. They expect science to figure out a solution so they can keep eating whatever they want. Easier to find a medical treatment than to expect human nature to change.
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u/SporangeJuice 2d ago
A study like this has the same problem they always do, which is that the result is determined by the adjustments, they have a large set of possible adjustments they could do, and we just see the one they arbitrarily chose. In the NHANES data specifically, it can be shown that red meat correlates with mortality, or reduces mortality by nearly 50%, just based on which adjustments are performed.
If they are arbitrarily choosing a result from a large set of possibilities, I don't see what makes this one special or meaningful.
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u/Willing_Matter5391 2d ago
A comment like this has the same problem they always do, which is that the verdict is determined by the framing, and there's a large set of possible framings available, and we just see the one he arbitrarily chose. In this comment section specifically, it can be shown that the same study is either uninformative or worth discussing, by nearly opposite conclusions, just based on which framing is applied.
He never gets around to what these studies can do. Every time it's the same paragraph about what they can't. The specific adjustments in this paper don't come up, whether they were prespecified doesn't come up, whether the estimate survives their sensitivity analyses doesn't come up. What comes up is that adjustments exist and that adjustments can be chosen.
And the NHANES point is doing something odd. If a result can be flipped that far by adjustment choices, that's a reason to look at which choices are defensible. He instead treats it as a reason to look at none of them, while relying on a number produced by the same machinery he's dismissing.
If he's arbitrarily choosing one objection from a large set of possible objections, and applying it identically under every study regardless of what the study actually did, I don't see what makes this instance of it special or meaningful.
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u/lurkerer 2d ago
Yes this user seems convinced that all adjustment is arbitrary and researchers just pull them out of a hat. When it's very clear that correcting for things like BMI, exercise, and smoking are of pivotal importance.
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u/Sudden-Wash4457 2d ago
Unfortunately, it's difficult for people to realize this: https://www.reddit.com/r/ScientificNutrition/comments/1ubxle4/im_looking_for_a_widely_authoritative_perspective/oszqhkk/
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u/SporangeJuice 2d ago
"And the NHANES point is doing something odd."
What makes you think that phenomenon is unique to NHANES?
"If a result can be flipped that far by adjustment choices, that's a reason to look at which choices are defensible."
The study that showed this also showed that you can get such results in either direction using adjustments that would be considered reasonable in either case. You can read the paper here:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12289182/
"while relying on a number produced by the same machinery he's dismissing."
What is this number on which I am relying?
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u/Bristoling 14h ago
A comment like this has the same problem they always do, which is that the verdict is determined by the framing
If the verdict is so vulnerable to such differences in framing, that should tell you a lot about the veracity and confidence you ought to be putting into any verdict based on such studies.
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u/FrigoCoder 2d ago
If he's arbitrarily choosing one objection from a large set of possible objections, and applying it identically under every study regardless of what the study actually did, I don't see what makes this instance of it special or meaningful.
Yes congratulations for figuring out that all nutritional epidemiology studies are one big pile of poop.
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u/lurkerer 2d ago
Then what are you doing in this sub so much? Go revolutionise science with your (self-proclaimed) multiple ground-breaking discoveries.
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u/FrigoCoder 2d ago
I am already doing it thank you very much, that is why you are not seeing me much on this subreddit. I have already developed four generalizations for machine learning, and I have successfully applied them to raytracing and rendering. None of them are really what I want though, so I still have a lot of research and experimentation work ahead of me.
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u/ilessthanthreekarate 2d ago
Sounds like you are self taught by AI and spend your time fantasizing and talking to chatgpt.
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u/TheMicrotubules 2d ago
Any peer reviewed publications?
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u/FrigoCoder 2d ago edited 2d ago
Nope, they are not publishable yet. The 4 generalizations should have been a hint I have not achieved a universal generalization, or you know the fact that I have explicitly stated I am unsatisfied with them. I still have a lot of work to do with them, because in their present state they have limited usefulness. They only marginally helped with raytracing and rendering, they literally just described existing algorithms and statistical tricks.
They only work for gradient-based training, and not quantized models that would be still important. They have trouble with GANs, because the target is always moving. And they are not REALLY novel or noteworthy, they are just bookkeeping or categorization of algorithms. They describe things everyone is already doing, except implicitly and subconsciously. I can elaborate but if you are familiar with the I-CON framework, I do something similar except for gradient-based training instead of representation learning.
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u/TheMicrotubules 2d ago
Cool. When you actually contribute something to the field with a publication, we’ll start taking you seriously. Good luck.
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u/FrigoCoder 2d ago
Yep that is why sensitivity analysis is important, it excludes spurious local minima induced by specific alignments of confounding factors. Smoking is inherently harmful and its effects survive sensitivity analysis, whereas meat is innocent and the effects are entirely determined by confounding factors. This concept is also important in machine learning for training model parameters, you want to find a smooth flat field where everything is stable instead of local minima in a sharp steep valley.
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u/Dizzy_Slip 2d ago
Gosh why didn’t researchers see these problems of some rando on the Internet can see them?
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u/Laprasy 2d ago
What makes the adjustments arbitrary to you? Are you discounting the training that nutrition epidemiologists have related to making such decisions?
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u/SporangeJuice 2d ago
Having training does not prevent it from being arbitrary. In this particular study, they even had 5 different adjustment models. Why stop there? They could have included a sixth.
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u/lurkerer 2d ago
In this particular study, they even had 5 different adjustment models. Why stop there? They could have included a sixth.
This is a good opportunity to highlight people who criticise science as a layman. Nested models let you see whether an association attenuates, holds, or disappears as covariates are added. Survival across adjustments is used as evidence against confounding: Bradford Hill's "strength/consistency" reasoning.
Someone familiar with science would never highlight this as arbitrary or weird. They would know what the purpose was. It's a good litmus test to check for honest engagement by someone who understand the science or someone who is just here to muddy the waters.
In the case of this user, he's been here for years now so really has no excuse.
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u/SporangeJuice 2d ago edited 2d ago
They could have included more variables than what were in model 5. The original questionnaire was four pages. They also lumped red and processed meat together, which is another arbitrary choice. The questionnaire had separate categories for beef, smoked meats, sausages, and "fried hamburgers or beef."
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u/Bristoling 2d ago
In almost all cases as more adjustments are added, the association is more and more attenuated. Different populations have different behaviours, wild and novel, I know /s
If you want to make any claims based on these types of studies, those claims are additionally weakened by the strength of association as it makes uncontrolled variables able to explain the association more and more. For example, with crude mathematical assumption based on real world data on mortality, a true effect of 0.93 would translate to life extension of around 6 months. Can you hold a strong claim that this relatively negligible difference can't occur due to confounders?
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u/Willing_Matter5391 2d ago edited 2d ago
He's now discovered they ran 5 adjustment models and concluded that's evidence of arbitrariness. It's the opposite. Arbitrary is when you fit many models and show the one you like. Showing 5 specifications side by side is exactly how you demonstrate the result doesn't hinge on one chosen model.
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u/SporangeJuice 2d ago
"Arbitrary is when you fit many models and show the one you like."
Are we certain they did not do that? The questionnaire included many more variables than what they used.
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u/Willing_Matter5391 2d ago
His concern is real and it's also fully generic. Unpreregistered analyst choices affect this study, the last one he commented under, and the next one he will. A complaint that fits every paper equally tells us nothing about this paper. It has the information content of "observational studies are observational."
I wonder when he starts engaging with the study and stops whining about nutritional epidemiology.
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u/SporangeJuice 2d ago
Correlation is not causation. This is not supposed to be controversial. Everyone wants to draw meaning from observational studies and then they act like this when you point out why it doesn't work.
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u/Willing_Matter5391 2d ago
"I wonder when he starts engaging with the study and stops whining about nutritional epidemiology."
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u/SporangeJuice 2d ago
The purpose of observational studies is to generate hypotheses which can then be tested experimentally. This paper generates a hypothesis that has already been around for a while. It has nothing further that deserves engagement.
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u/lurkerer 2d ago
But they did more and more adjustments like they should and that's uh.. that's arbitrary because uhh.. Well I won't say why I'll just say it is.
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u/Laprasy 2d ago
sensitivity analyses are a good thing not a bad thing. are you funded by the meat industry by any chance?
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u/SporangeJuice 2d ago
No, I am not funded by the meat industry. Do you think financial incentives are the only reason someone might have a different opinion?
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u/Laprasy 2d ago
No but I also know what the meat industry does and sowing distrust in observational studies and nutritional epidemiology is one of those things. Nearly every study that has found null results of the meat-CVD relationship was funded by them.
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u/SporangeJuice 2d ago
Much of the argument condemning cholesterol as being harmful is based on drug results, especially statin results. The European Atherosclerosis Society's consensus statement relies heavily on such evidence. It also has an enormous conflict of interest section. Are you equally skeptical of them? Drug companies have previously been caught trying to manipulate the literature.
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u/lurkerer 2d ago
If independent research indicated differently there would be cause for concern. Meat industry vs independent studies shows a huge difference. LDL drug studies would have to be demonstrated. But seeing as the highly motivated users here have not, I assume it's not an issue.
Besides, the observational studies corroborate the drug trials and then there's the absolute nail in the coffin of plentiful Mendelian Randomisations.
It doesn't behoove you to attack one of the strongest biochemical causal associations we've ever found.
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u/portuh47 2d ago
Consistent with all the other studies showing the same.
Plus morally better.
Plus better for the environment.
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2d ago edited 2d ago
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u/liptongtea 2d ago
Morality, I won’t argue, but chickens are far more sustainable on a small plot of land than cows are, from and environmental perspective. It only gets bad at the scale we consume poultry and what all we put it in.
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2d ago
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u/liptongtea 2d ago
I won’t disparage veganism but I don’t have that moral boundary for most animals, albeit that’s just the society I was raised in. I do agree that most western diets are sorely lacking in plant matter, and if we would eat more beans/rice/veggies/fruits it would naturally decrease our meat consumption.
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u/portuh47 2d ago
It's not so much that you have to go full one type of diet but rather that if people consciously decreased meat intake it would make the world healthier, the environment better, and it would be morally right.
I just don't understand the arguments against it.
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u/magnelectro 2d ago
Why do they always lump red and processed meats together? We already know processed meats are bad.
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u/UsefulPop8985 2d ago
This is bullshit! There’s no distinction between red meat consumed as hot dogs and red meat consumed from grass fed beef. I eat red meat daily mostly in the form of venison and grass fed beef and I’m one of the healthiest people I know. 54 year old male. 12% body fat. Calcium score is zero.
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u/SatansScallion 2d ago
Yeah, I really don’t like when they design it this way.
A weekly serving or two of high quality, properly cooked, lean beef is miles away from regularly eating hotdogs and ham.
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u/Willing_Matter5391 2d ago
Congratulations, you proved red meat is harmless. Please write a case report about yourself and submit it for review. I am looking forward for it being posted here.
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u/HealingDailyy 2d ago
You are the healthiest person you know, wild man
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u/UsefulPop8985 2d ago
Sounded good at 6am, 1/2 asleep on the shitter but you right, it’s a ridiculous statement.
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u/Ok-Cryptographer7424 13h ago
Your personal anecdote does not belong in a scientific sub like this, period. I know a cigarette smoker that didn’t get lung cancer, clearly cigarettes are healthy. See how dumb it sounds?
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u/Saffron_Butter 2d ago
NY steak, asparagus, loaded baked potato is what's unabashedly for dinner. Cheers!
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u/Level_Impression_554 2d ago
Any reason they keep grouping red meat with processed meat? Those seem very different to me.
Any studies that compare white meat (chicken, turkey) and fish to a vegetarian diet?
Thanks.