More red meat consumption= increased risk of death

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Eating more red meat appears to be associated with an increased risk of all-cause mortality and death from cardiovascular disease and cancer, but substituting other foods including fish and poultry for red meat is associated with a lower mortality risk, according to a study published Online First by Archives of Internal Medicine, one of the JAMA/Archives journals.

Meat is a major source of protein and fat in many diets and previous studies suggest that eating meat is associated with increased risk for diabetes, cardiovascular disease (CVD) and certain cancers, the authors write in their study background.

An Pan, Ph.D., of the Harvard School of Public Health, Boston, and colleagues analyzed data from two prospective cohort studies with repeated measures of diet and up to 28 years of follow-up. Data from 37,698 men and 83,644 women were used. Researchers documented 23,926 deaths, including 5,910 from CVD and 9,464 from cancer.

"We found that a higher intake of red meat was associated with a significantly elevated risk of total, CVD and cancer mortality, and this association was observed for unprocessed and processed red meat, with a relatively greater risk for processed red meat," the authors comment. "Substitution of fish, poultry, nuts, legumes, low-fat dairy products and whole grains for red meat was associated with a significantly lower risk of mortality."

The elevated risk of total mortality in the pooled analysis for a one-serving-per-day increase was 12 percent for total red meat, 13 percent for unprocessed red meat and 20 percent for processed red meat, the results indicate.

In their substitution analyses, the authors estimated that replacing one serving of total red meat with one serving of fish, poultry, nuts, legumes, low-fat dairy products or whole grains daily was associated with a lower risk of total mortality: 7 percent for fish, 14 percent for poultry, 19 percent for nuts, 10 percent for legumes, 10 percent for low-fat dairy products and 14 percent for whole grains.

"We estimated that 9.3 percent in men and 7.6 percent in women of total deaths during follow-up could be prevented if all the participants consumed fewer than 0.5 servings per day of total red meat in these cohorts," they comment.

"Our study adds more evidence to the health risks of eating high amounts of red meat, which has been associated with type 2 diabetes, coronary heart disease, stroke, and certain cancers in other studies," said lead author An Pan, research fellow in the Department of Nutrition at HSPH.

The researchers, including senior author Frank Hu, professor of nutrition and epidemiology at HSPH, and colleagues, prospectively observed 37,698 men from the Health Professionals Follow-up Study for up to 22 years and 83,644 women in the Nurses' Health Study for up to 28 years who were free of cardiovascular disease (CVD) and cancer at baseline. Diets were assessed through questionnaires every four years.

A combined 23,926 deaths were documented in the two studies, of which 5,910 were from CVD and 9,464 from cancer. Regular consumption of red meat, particularly processed red meat, was associated with increased mortality risk. One daily serving of unprocessed red meat (about the size of a deck of cards) was associated with a 13% increased risk of mortality, and one daily serving of processed red meat (one hot dog or two slices of bacon) was associated with a 20% increased risk.

Among specific causes, the corresponding increases in risk were 18% and 21% for cardiovascular mortality, and 10% and 16% for cancer mortality. These analyses took into account chronic disease risk factors such as age, body mass index, physical activity, family history of heart disease, or major cancers.

Red meat, especially processed meat, contains ingredients that have been linked to increased risk of chronic diseases, such as cardiovascular disease and cancer. These include heme iron, saturated fat, sodium, nitrites, and certain carcinogens that are formed during cooking.

Replacing one serving of total red meat with one serving of a healthy protein source was associated with a lower mortality risk: 7% for fish, 14% for poultry, 19% for nuts, 10% for legumes, 10% for low-fat dairy products, and 14% for whole grains. The researchers estimated that 9.3% of deaths in men and 7.6% in women could have been prevented at the end of the follow-up if all the participants had consumed less than 0.5 servings per day of red meat.

"This study provides clear evidence that regular consumption of red meat, especially processed meat, contributes substantially to premature death," said Hu. "On the other hand, choosing more healthful sources of protein in place of red meat can confer significant health benefits by reducing chronic disease morbidity and mortality."



Commentary: What is Good for Patients is Good for the Planet

In an invited commentary, Dean Ornish, M.D., of the University of California, San Francisco, writes: "In addition to their health benefits, the food choices we make each day affect other important areas as well. What is personally sustainable is globally sustainable. What is good for you is good for our planet."

"More than 75 percent of the $2.6 trillion in annual U.S. health care costs are from chronic disease. Eating less red meat is likely to reduce morbid