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@ARTICLE{QuintanaPacheco:132507,
      author       = {D. A. Quintana Pacheco$^*$ and D. Sookthai$^*$ and C.
                      Wittenbecher and M. Graf$^*$ and R. Schübel$^*$ and T. S.
                      Johnson$^*$ and V. Katzke$^*$ and P. Jakszyn and R.
                      Kaaks$^*$ and T. Kühn$^*$},
      title        = {{R}ed meat consumption and risk of cardiovascular
                      diseases-is increased iron load a possible link?},
      journal      = {The American journal of clinical nutrition},
      volume       = {107},
      number       = {1},
      issn         = {1938-3207},
      address      = {Bethesda, Md.},
      publisher    = {Soc.},
      reportid     = {DKFZ-2018-00194},
      pages        = {113 - 119},
      year         = {2018},
      abstract     = {High iron load and red meat consumption could increase the
                      risk of cardiovascular diseases (CVDs). As red meat is the
                      main source of heme iron, which is in turn a major
                      determinant of increased iron load, adverse cardiometabolic
                      effects of meat consumption could be mediated by increased
                      iron load.The object of the study was to assess whether
                      associations between red meat consumption and CVD risk are
                      mediated by iron load in a population-based human study.We
                      evaluated relations between red meat consumption, iron load
                      (plasma ferritin), and risk of CVD in the prospective
                      EPIC-Heidelberg Study using a case-cohort sample including a
                      random subcohort (n = 2738) and incident cases of myocardial
                      infarction (MI, n = 555), stroke (n = 513), and CVD
                      mortality (n = 381). Following a 4-step mediation analysis,
                      associations between red meat consumption and iron load, red
                      meat consumption and CVD risk, and iron load and CVD risk
                      were assessed by multivariable regression models before
                      finally testing to which degree associations between red
                      meat consumption and CVD risk were attenuated by adjustment
                      for iron status.Red meat consumption was significantly
                      positively associated with ferritin concentrations and MI
                      risk [HR per 50 g daily intake: 1.18 $(95\%$ CI: 1.05,
                      1.33)], but no significant associations with stroke risk and
                      CVD mortality were observed. While direct associations
                      between ferritin concentrations and MI risk as well as CVD
                      mortality were significant in age- and sex-adjusted Cox
                      regression models, these associations were substantially
                      attenuated and no longer significant after multivariable
                      adjustment for classical CVD risk factors. Strikingly,
                      ferritin concentrations were positively associated with a
                      majority of classical CVD risk factors (age, male sex,
                      alcohol intake, obesity, inflammation, and lower
                      education).Increased ferritin concentrations may be a marker
                      of an overall unfavorable risk factor profile rather than a
                      mediator of greater CVD risk due to meat consumption.},
      cin          = {C020},
      ddc          = {570},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {323 - Metabolic Dysfunction as Risk Factor (POF3-323)},
      pid          = {G:(DE-HGF)POF3-323},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29381787},
      doi          = {10.1093/ajcn/nqx014},
      url          = {https://inrepo02.dkfz.de/record/132507},
}