Notes:

However, it is possible to have a high meat content in a healthy diet [9]. Therefore, we suggest that analyses of associations between meat intake and disease risk should be stratified by dietary quality. Dietary quality should be expressed as a diet qualityindex and not as division in, e.g., “Western” and “Mediterranean” diets, where a high meat intake automatically becomes a proxy for an unhealthy diet, and where it is not possible to correct for all the dietary confounders, of which several are inter-correlated

This paper is unique in that the food survey tracks compliance with sugar intake as well, so that is more well controlled in this study.

Most characteristics seemed to differ when groups with different DGC and meat intake were compared. For example, men made up a large proportion of those with a high meat intake and low compliance with dietary guidelines, whereas the women dominated the low-meat groups. In the groups with high DGC, more participants had a long education, and fewer were current smokers compared with groups with low DGC. Participants in groups with high DGC were more physically active in their leisure time compared with groups with low DGC, but this was not reflected in the weight status of the groups.

So when people ate lots of sugar/carbs (outside of the DGC (Dietary guidelines compliance) they had worse outcomes

A pronounced difference in meat content in high-meat diets with different healthy eating indices was found by Kappeler et al. [ 4]. Thus, comparing groups with low and high meat intake without considering dietary quality and what foods replace the meat will simultaneously be a comparison of healthy and unhealthy diets. Therefore, we analysed our data by looking at the effects of meat intake stratified by DGCS to reduce the confounding from dietary quality. However, when stratified by DGC, we found no statistically significant differences in the associations between meat intake and CRC risk in low-compliers and high-compliers

From dietary patternanalyses of our participants’ diet, we know that those who comply well with dietary guidelines had both a high whole-grain intake and total fibre intake, but it apparently did not influence the CRC risk associated with meat intake

Interesting, fibre was not protective

Weaknesses:

• Food Surveys
• Arbitrary Dietary compliance scores
• Epidemiology can only show association and not causation