% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Bajracharya:278401,
      author       = {R. Bajracharya$^*$ and R. Kaaks$^*$ and V. Katzke$^*$},
      title        = {{F}ood {S}ources of {A}nimal {P}rotein in {R}elation to
                      {O}verall and {C}ause-{S}pecific {M}ortality-{C}ausal
                      {A}ssociations or {C}onfounding? {A}n {A}nalysis of the
                      {EPIC}-{H}eidelberg {C}ohort.},
      journal      = {Nutrients},
      volume       = {15},
      number       = {15},
      issn         = {2072-6643},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2023-01635},
      pages        = {3322},
      year         = {2023},
      note         = {#EA:C020#LA:C020#},
      abstract     = {While prior prospective iso-caloric substitution studies
                      show a robust association between higher intake of animal
                      protein and risk of mortality, associations observed for
                      mortality risk in relation to major food sources of animal
                      protein have been generally more diverse. We used the
                      EPIC-Heidelberg cohort to examine if confounding, notably,
                      by smoking, adiposity, or alcohol intake, could cause
                      inconsistencies in estimated mortality hazard ratios (HR)
                      related to intake levels of different types of meat and
                      dairy products. Higher intakes of red or processed meats,
                      and lower intakes of milk or cheese, were observed among
                      current heavy smokers, participants with obesity, or heavy
                      alcohol drinkers. Adjusting for age, sex, and total energy
                      intake, risk models showed increased all-cause,
                      cardiovascular, and cancer-related mortality with higher red
                      or processed meat intakes (HR ranging from 1.25 $[95\%$
                      confidence interval = 1.15-1.36] to 1.76 [1.46-2.12]
                      comparing highest to lowest tertiles), but reduced risks for
                      poultry, milk, or cheese (HR ranging from 0.55 [0.43-0.72]
                      to 0.88 [0.81-0.95]). Adjusting further for smoking history,
                      adiposity indices, alcohol consumption, and physical
                      activity levels, the statistical significance of all these
                      observed was erased, except for the association of processed
                      meat intake with cardiovascular mortality (HR = 1.36 [CI =
                      1.13-1.64]) and cheese intake with cancer mortality (HR =
                      0.86 [0.76-0.98]), which, however, were substantially
                      attenuated. These findings suggest heavy confounding and
                      provide little support for the hypothesis that animal
                      protein, as a nutrient, is a major determinant of mortality
                      risk.},
      keywords     = {dairy (Other) / mortality (Other) / poultry (Other) /
                      processed meat (Other) / red meat (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37571259},
      pmc          = {pmc:PMC10421322},
      doi          = {10.3390/nu15153322},
      url          = {https://inrepo02.dkfz.de/record/278401},
}