Substitution of processed meat for fish or poultry and the impact on hypertension in the E3N cohort

Abstract Objectives Processed meat has been associated with an increased risk of hypertension (1). This study aimed to determine the possible effect of substituting processed meat (PM) with fish using specified food substitution models (2), in the French E3N cohort study. Methods This study included 46843 women from the prospective E3N study who had no hypertension at 1993, and completed a first food frequency questionnaire (FFQ) sent in 1993 which was used to estimate dietary intakes of various foods including PM, and fish, considering serving sizes of 150 g. Estimates of the hazard ratio for incident hypertension were obtained using Cox Proportional Hazard Models, and the substitution method (2) was used to obtain estimates for substitution of PM for fish. Boot-strapping with 50 samples was used to estimate 95% confidence intervals for the substitution. Models were sequentially adjusted for age and risk-factors for hypertension, then dietary variables, and finally energy. Results During follow-up, 12,465 cases of hypertension were reported over 712,703 personyears. Mean consumption of processed meat was 1.3 servings/week, 1.3 servings/week for fish and 2.3 servings/week for poultry. Substitution of one serving of processed meat for fish per week was associated with a slightly reduced risk of hypertension in all models, regardless of the underlying restrictions placed on diet, or energy (HR = 0.95(0.91: 0.98)). The association was weaker for poultry (HR = 0.98 (0.96, 1.01)). Conclusions Substitution one serving of PM for fish per week could be associated with a small reduction in the risk of hypertension amongst French women. References: (1) Lajous M, et al. Processed and unprocessed red meat consumption and hypertension in women. Am J Clin Nutr. 2014 Sep;100(3):948-52. (2) Ibsen D, et al, Food substitution models for nutritional epidemiology, Am J Clin Nutr, 2021 Feb;113(2):294-303 Key messages Processed meat is associated with an increased risk of hypertension. Substitution of processed meat for fish may reduce this risk.