Editor's Correspondence |

Higher Red Meat Intake May Be a Marker of Risk, Not a Risk Factor Itself—Reply

Rashmi Sinha, PhD; Barry I. Graubard, PhD; Amanda J. Cross, PhD; Michael F. Leitzmann, MD, DrPH; Arthur Schatzkin, MD
Arch Intern Med. 2009;169(16):1539. doi:10.1001/archinternmed.2009.279.
Text Size: A A A
Published online


In reply

We thank Mozaffarian for his thoughtful comments about our article.1 We agree with Mozaffarian that residual confounding may be an issue, and we acknowledge this in the article as follows: “The problem of residual confounding may still exist and could explain the relatively small associations found throughout this study despite the care taken to adjust for known confounders.”1(p569) To decrease the possibility of residual confounding, Mozaffarian suggests that we could use the “all other deaths” category as a negative control; this assumes that meat consumption is not associated with mortality in this category of deaths, which may not be a valid assumption. As pointed out in our article, the “all other deaths” category is heterogeneous, including such causes as diabetes mellitus, Alzheimer disease, stomach and duodenal ulcers, chronic liver disease, cirrhosis, nephritis, nephrotic syndrome, and nephrosis, a number of which may be associated with meat intake. For example, diabetes and insulin resistance have been linked to increased red and processed meat consumption.2 In addition, red meat consumption has been implicated in the etiology of hepatocellular carcinoma, for which chronic liver disease is often a precursor.3 Red meat has also been positively associated with lung cancer, which is linked to chronic pulmonary disease.3,4


red meat

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles