Meta-analysisindependent cross-checkabstract checked★ key study I-CHK-101 in-depth review
Eating more poultry is not linked to earlier death
Association of poultry consumption with cardiovascular diseases and all-cause mortality: a systematic review and dose response meta-analysis of prospective cohort studies.
Overview
Papp RE et al.. Crit Rev Food Sci Nutr 2023 · PMID 34542332 · DOI 10.1080/10408398.2021.1975092
Across 24 cohort studies, people eating the most poultry did not die earlier; the risk was slightly lower (RR 0.96).
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Is poultry intake associated with CVD, CHD, stroke and all-cause mortality?
- How was the study done?
Systematic review and dose-response meta-analysis of 24 prospective cohort studies
- How many people, animals or samples were studied?
24 cohort studies (participant total not given in abstract)
- What was actually found?
Highest vs lowest poultry intake: all-cause mortality RR 0.96 (95% CI 0.93-0.98; I2 = 5%); no association for CVD, CHD or stroke. Per 100 g/day: no association for any outcome. Some evidence of non-linearity for CVD and all-cause mortality. Substituting red/processed meat with poultry was inversely associated with all outcomes. Certainty of evidence rated very low or low by the authors.
- How large was the observed effect?
Highest vs lowest poultry intake: all-cause mortality RR 0.96 (95% CI 0.93-0.98; I2 = 5%); no association for CVD, CHD or stroke. Per 100 g/day: no association for any outcome. Some evidence of non-linearity for CVD and all-cause mortality. Substituting red/processed meat with poultry was inversely associated with all outcomes. Certainty of evidence rated very low or low by the authors.
- What do the results mean in everyday life?
Chicken eaters in long-term studies did not have more heart disease or earlier death.
- What are the study's limitations?
Observational data; residual confounding; Authors rate certainty very low to low; Overlaps with earlier meta-analyses (e.g. I-CHK-08)
- What does it say about Elawady's specific claim?
Contradicts the idea that chicken is harmful in itself; does not prove benefit.
- Do the results apply to Germany and Europe?
Cohorts mainly from Europe, North America and Asia; transferable in general.
- What can explicitly not be concluded from this study?
Cannot exclude small effects or effects of specific preparation methods.
Scientific in-depth review
1. Full reference
- Authors
- Papp RE et al.
- Journal
- Crit Rev Food Sci Nutr
- Year
- 2023
- Identifier
- PMID 34542332 DOI 10.1080/10408398.2021.1975092
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Is poultry intake associated with CVD, CHD, stroke and all-cause mortality?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and dose-response meta-analysis of 24 prospective cohort studies
- Population
Adults in 24 prospective cohorts
- Country
multinational
- Period
cohorts up to 2021
- Sample size
24 cohort studies (participant total not given in abstract)
- Inclusion and exclusion criteria
as described in the abstract
4. Methods and endpoints
- Exposure / intervention
Poultry intake (highest vs lowest; per 100 g/day)
- Comparator
Lowest poultry intake
- Endpoints
CVD, CHD, stroke, all-cause mortality
- Statistical methods
as reported in the abstract
5. Actual results
- Results
Highest vs lowest poultry intake: all-cause mortality RR 0.96 (95% CI 0.93-0.98; I2 = 5%); no association for CVD, CHD or stroke. Per 100 g/day: no association for any outcome. Some evidence of non-linearity for CVD and all-cause mortality. Substituting red/processed meat with poultry was inversely associated with all outcomes. Certainty of evidence rated very low or low by the authors.
- Absolute risks
not reported
- Authors' conclusion
Poultry could be a healthier alternative to red and processed meat, based on substitution analyses.
6. Strengths
- Prospective cohorts only
- Dose-response and substitution analyses
- Authors graded certainty
7. Weaknesses
- Observational data; residual confounding
- Authors rate certainty very low to low
- Overlaps with earlier meta-analyses (e.g. I-CHK-08)
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Abstract only; protocol registration not stated in abstract.
9. Assessment of the statistical interpretation
A 4% lower relative risk with narrow CI is a trivial effect; it shows no harm signal but cannot prove benefit.
10. Relevance to the specific claim
Direct test of whether higher poultry intake is associated with major health outcomes.
11. Independent contrary findings
12. Transferability to Germany and Europe
13. Overall methodological judgement
Across 24 cohort studies, people eating the most poultry did not die earlier; the risk was slightly lower (RR 0.96).
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Chicken is forbidden because it is harmful in itself, not because of how it is raised (it is 'the pig of birds'); its fibres and waste products are hard to digest. – Studies contradicting or limiting the claim