Processed meat
Processed Meat Consumption and All-Cause Mortality: Risk Ranges and Evidence Synthesis
1. Introduction
A substantial body of epidemiological research has investigated the relationship between processed meat consumption and all-cause mortality. Multiple large-scale cohort studies and meta-analyses consistently report that higher intake of processed meats is associated with a modestly increased risk of all-cause mortality, with hazard ratios (HRs) or relative risks (RRs) for the highest versus lowest consumption categories typically ranging from 1.10 to 1.25—indicating a 10–25% higher risk of death for high consumers compared to low consumers (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Rohrmann et al., 2013; Taneri et al., 2022; , 2022; Wolk, 2017; Rohrmann & Linseisen, 2015; Van Den Brandt, 2019). Dose-response analyses suggest that each additional daily serving (often 50 g) of processed meat is linked to a 10–15% increase in mortality risk (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Wolk, 2017). While the association is generally robust across populations, some heterogeneity exists by region, sex, and underlying health status, and confounding by lifestyle factors remains a consideration (Rohrmann & Linseisen, 2015; Bajracharya et al., 2023; Wang et al., 2024). Substitution analyses indicate that replacing processed meat with plant-based or other protein sources may reduce mortality risk (Van Den Brandt, 2019; Sun et al., 2021; Pan et al., 2012). Overall, the evidence supports a moderate, dose-dependent association between processed meat intake and all-cause mortality.
Figure 1: Consensus meter visualizing the association between processed meat intake and all-cause mortality.
2. Methods
A comprehensive literature search was conducted across major scientific databases, targeting cohort studies, meta-analyses, and systematic reviews examining the relationship between processed meat consumption and all-cause mortality, with a focus on quantifying risk ranges and dose-response effects. In total, 1,083 papers were identified, 415 were screened, 271 were deemed eligible, and the top 50 most relevant papers were included in this review.
| Identification | Screening | Eligibility | Included |
|---|---|---|---|
| 1083 | 415 | 271 | 50 |
Figure 2: Flow diagram of the search and selection process for included studies.
Eight unique search groups were used, focusing on foundational evidence, risk quantification, subpopulations, and methodological critiques to ensure comprehensive coverage.
3. Results
3.1. Summary of Risk Ranges
Across multiple meta-analyses and large cohort studies, the hazard ratios (HRs) or relative risks (RRs) for all-cause mortality associated with high versus low processed meat intake generally fall between 1.10 and 1.25 (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Taneri et al., 2022; , 2022; Wolk, 2017; Rohrmann et al., 2013; Rohrmann & Linseisen, 2015; Van Den Brandt, 2019). For example, a meta-analysis of prospective cohorts found a pooled RR of 1.15 (95% CI: 1.10–1.21) for highest versus lowest processed meat intake (Taneri et al., 2022; , 2022). Another meta-analysis reported a 15% higher risk per additional daily serving (50 g) of processed meat (RR 1.15, 95% CI: 1.11–1.19) (Wang et al., 2015). The European Prospective Investigation into Cancer and Nutrition (EPIC) study found an HR of 1.18 (95% CI: 1.11–1.25) per 50 g/d processed meat (Rohrmann et al., 2013).
3.2. Dose-Response Relationships
Dose-response analyses consistently show a linear or slightly nonlinear increase in mortality risk with higher processed meat intake. Each 50 g/day increment is associated with a 10–15% increase in all-cause mortality risk (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Wolk, 2017). For example, one meta-analysis found RRs of 1.11 for 1 serving/day, 1.19 for 2 servings/day, and 1.27 for 3 servings/day (Wang et al., 2015). Some studies report a plateau at higher intakes, but the overall trend remains positive (Schwingshackl et al., 2017; Wolk, 2017).
3.3. Subgroup and Contextual Analyses
The association between processed meat and mortality is generally consistent across sexes and age groups, though some studies report stronger associations in men or in Western populations (Rohrmann et al., 2013; Schwingshackl et al., 2017; Wolk, 2017; Van Den Brandt, 2019). Substitution analyses indicate that replacing processed meat with poultry, fish, nuts, or plant-based proteins is associated with lower mortality risk (Van Den Brandt, 2019; Sun et al., 2021; Pan et al., 2012). In populations with low overall meat intake, even moderate processed meat consumption is linked to increased mortality (Alshahrani et al., 2019).
3.4. Confounding, Heterogeneity, and Critiques
While the association is robust, some studies highlight the potential for residual confounding by lifestyle factors such as smoking, physical activity, and overall dietary quality (Rohrmann & Linseisen, 2015; Bajracharya et al., 2023; Wang et al., 2024). Heterogeneity exists between studies, with stronger associations often observed in US cohorts compared to European or Asian populations (Wolk, 2017; Schwingshackl et al., 2017; Wang et al., 2015). Some umbrella reviews and specification curve analyses suggest that the magnitude of association is modest and sensitive to analytic choices (Bajracharya et al., 2023; Wang et al., 2024; , 2020).
Results Timeline
- 2013
- 1 paper: (Rohrmann et al., 2013)
- 2014
- 1 paper: (Abete et al., 2014)
- 2015
- 2 papers: (Rohrmann & Linseisen, 2015; Wang et al., 2015)
- 2017
- 2 papers: (Etemadi et al., 2017; Wolk, 2017)
- 2019
- 4 papers: (Van Den Brandt, 2019; Zheng et al., 2019; Alshahrani et al., 2019; Zeraatkar et al., 2019)
- 2020
- 2 papers: (Zhong et al., 2020; , 2020)
- 2021
- 4 papers: (Huang et al., 2021; Sun et al., 2021; Farvid et al., 2021; Iqbal et al., 2021)
- 2022
- 2 papers: (Chen et al., 2022; De Medeiros et al., 2022)
- 2024
- 2 papers: (Fang et al., 2024; Kennedy et al., 2024)
Figure 3: Timeline of key studies on processed meat and all-cause mortality. Larger markers indicate more citations.
Top Contributors
| Type | Name | Papers |
|---|---|---|
| Author | F. Hu | (Pan et al., 2012; Wang et al., 2015; Zheng et al., 2019; Abete et al., 2014; Zeraatkar et al., 2019) |
| Author | W. Willett | (Fang et al., 2024; Pan et al., 2012; Zheng et al., 2019) |
| Author | S. Rohrmann | (Rohrmann et al., 2013; Rohrmann & Linseisen, 2015) |
| Journal | The BMJ | (Fang et al., 2024; Etemadi et al., 2017; Zheng et al., 2019) |
| Journal | Annals of Internal Medicine | (Zeraatkar et al., 2019; , 2009) |
| Journal | Nutrients | (Alshahrani et al., 2019; Bajracharya et al., 2023; Lupoli et al., 2021) |
Figure 4: Authors & journals that appeared most frequently in the included papers.
4. Discussion
The evidence linking processed meat consumption to all-cause mortality is consistent and moderate in strength. Most high-quality meta-analyses and large cohort studies report a 10–25% increased risk for high versus low processed meat intake, with a clear dose-response relationship (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Taneri et al., 2022; , 2022; Wolk, 2017; Rohrmann et al., 2013; Van Den Brandt, 2019). The association persists after adjustment for major confounders, though some attenuation occurs with more rigorous control for lifestyle factors (Rohrmann & Linseisen, 2015; Bajracharya et al., 2023; Wang et al., 2024). The risk increase is modest compared to other dietary and lifestyle risk factors (e.g., smoking), but is meaningful at the population level due to the high prevalence of processed meat consumption (Taneri et al., 2022; Springmann et al., 2018; Kennedy et al., 2024).
Substitution analyses and modeling studies suggest that reducing processed meat intake and replacing it with healthier protein sources could prevent a significant number of deaths and chronic disease cases (Van Den Brandt, 2019; Sun et al., 2021; Kennedy et al., 2024; Pan et al., 2012). However, the certainty of evidence is limited by potential residual confounding, heterogeneity between populations, and the observational nature of most studies (Rohrmann & Linseisen, 2015; Bajracharya et al., 2023; Händel et al., 2019; Wang et al., 2024). Some umbrella reviews and specification curve analyses highlight the modest effect sizes and the influence of analytic choices on reported associations (Bajracharya et al., 2023; Wang et al., 2024; , 2020).
Claims and Evidence Table
| Claim | Evidence Strength | Reasoning | Papers |
|---|---|---|---|
| High processed meat intake increases all-cause mortality risk (10–25%) | Strong (8/10) | Supported by multiple large meta-analyses and cohort studies with consistent dose-response findings. | (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Taneri et al., 2022; , 2022; Rohrmann et al., 2013; Wolk, 2017; Van Den Brandt, 2019) |
| Each 50 g/day processed meat increases mortality risk by ~10–15% | Strong (8/10) | Dose-response meta-analyses show linear or slightly nonlinear risk increases per serving. | (Wang et al., 2015; Schwingshackl et al., 2017; Abete et al., 2014; Pan et al., 2012; Wolk, 2017) |
| Substituting processed meat with plant-based proteins reduces risk | Moderate (7/10) | Substitution analyses and modeling studies show lower mortality with alternative protein sources. | (Van Den Brandt, 2019; Sun et al., 2021; Pan et al., 2012; Kennedy et al., 2024) |
| Association is stronger in Western vs. Asian/European populations | Moderate (6/10) | Regional heterogeneity observed in meta-analyses; possible differences in diet and confounding. | (Wolk, 2017; Schwingshackl et al., 2017; Wang et al., 2015; Van Den Brandt, 2019) |
| Residual confounding may influence observed associations | Moderate (5/10) | Some studies show attenuation after adjusting for lifestyle; specification curve analyses show variability. | (Rohrmann & Linseisen, 2015; Bajracharya et al., 2023; Wang et al., 2024; , 2020) |
| No significant association in some low-meat or non-Western populations | Weak (3/10) | Some studies in low-meat intake or non-Western settings report null or weaker associations. | (Alshahrani et al., 2019; Kityo & Lee, 2023; Bajracharya et al., 2023) |
Figure 5: Key claims and support evidence identified in these papers.
5. Conclusion
The current body of evidence indicates that higher processed meat consumption is associated with a modestly increased risk of all-cause mortality, with risk increases of 10–25% for high versus low intake and a clear dose-response relationship. Substituting processed meat with healthier protein sources may reduce mortality risk. However, the magnitude of the association is modest, and residual confounding cannot be fully excluded.
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