hanksgiving is the only American holiday not traditionally associated with eating red meat. But Turkey Day may be a trendsetter if the current onslaught of negative news about the health effects of red and processed meats continues: July 4th grilled fish… Labor Day roast chicken… Christmas tofu…A key goal of recent recommenda-tions from the Dietary Guidelines for Americans Advisory Committee calls for US consumers to eat less meat of all kinds: Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products, and consume only moderate amounts of lean meats, poultry and eggs.But its red meat in particular, along with processed versions such as bacon and salami, thats been in the bulls-eye of recent research. Eating too much red meat has been linked to chronic conditions including heart disease, diabetes and cancer, as well as simply a higher risk of dying sooner rather than later. Dietary patterns that emphasize protein sources other than red meat, such as the so-called Mediterranean Diet, have been credited with reduc-ing the risk of heart disease, cancer and Alzheimers disease.So whats a red-blooded meat lover to do? Is it time to cancel that Omaha Steaks holiday gift basket, put the steak knives on the rummage sale and learn to love veggie burgers?Heart-Healthy SwitchesLets
look at the latest evidence. Adam M. Bernstein, MD, PhD, of Harvard School of Public Health, and colleagues reported that replacing one serving of red meat daily with one serving of fish, poultry, nuts or low-fat dairy could lower your risk of heart disease by 13%-30%.The researchers analyzed data on 84,136 initially healthy women, ages 30 to 55, participating in the Nurses Health Study over 26 years. After adjusting for other risk factors, averag-ing two daily servings of red meat (beef, pork or lamb) or processed meat was associated with a 29% greater risk of heart disease compared to averaging a half-serving per day. Even just one daily serving was linked to a 16% higher risk. Replacing one serving a day of red or processed meat with nuts was associ-ated with a 30% risk reduction; with fish, 24%; chicken or turkey, 19%; and low-fat dairy, 13%.Although the subjects were all women, researchers said the findings would likely apply also to men.Dr. Bernstein and colleagues sug-gested that the saturated fat and a type of iron called heme iron (as in hemoglobin) in meat may be to blame. Other contributing culprits could be the heterocycline amines and advanced gly-cation end products (AGEs) produced in cooking meat, especially at high temperature or with charring. And pro-cessed meat is high in nitrite and salt.The heart benefits of shifting to other protein sources, the scientists added, likely come not only from re-ducing intake of unhealthy ingredients but also adding healthier ones such as omega-3 and polyunsaturated fats. Publishing their results in the American Heart Association journal Circulation, they noted, The benefit on coronary heart disease risk of such a substitution is thus likely to be due to multiple si-multaneous changes in nutrient intake.The findings, Dr. Bernstein said, support recommendations by groups such as the American Heart Associa-tion to eat less red and processed meat: Really, what we would say is in order to reduce the risk of coronary disease, patients should consider reducing or eliminating red meat from the diet.
| Going Lean
The USDAs MyPyramid website has these tips for making your red meat choices as lean and healthy as possible:
The leanest beef cuts include round steaks and roasts (round eye, top round, bot-tom round, round tip), top loin, top sirloin and chuck shoulder and arm roasts.
The leanest pork choices include pork loin, tenderloin, center loin and ham.
Choose extra-lean ground beef. The label should say at least 90% lean. You may be able to find ground beef that is 93% or 95% lean.
Choose lean roast beef, ham or low-fat luncheon meats for sandwiches instead of luncheon meats with more fat, such as regular bologna or salami.
Trim away all visible fat from meat before cooking.
Broil, grill or roast meat instead of frying.
Drain off any fat that appears during cooking.
Choose and prepare foods without high-fat sauces or gravies.
The Heart-Failure Connection
The ink was hardly dry on that study when another group of research-ers, led by Luc Djouss, MD, DSc, of Harvard Medical School, published findings linking red meat consumption to an increased risk of heart failure. Writing in Nutrition, Metabolism and Cardiovascular Diseases, they noted, To the best of our knowledge, this is the first study to evaluate the relation-ship between red meat consumption and heart-failure risk in a large cohort.Heart failure is not the same as a heart attack. Rather, heart failure is a chronic, progressive condition in which the heart cant keep up with its work-load, usually resulting in an enlarged heart. Its the number-one cause of hospitalization among older Americans.Dr. Djouss and colleagues fol-lowed 21,120 apparently healthy men, average age 54.6, participating in the Physicians Health Study over a 26-year span. They divided the subjects into five groups based on average red-meat consumption. As the amount of red meat consumed went up, so did the risk of heart failure. Men with the highest intake of red meat-almost 10 servings per week-were 24% more likely to develop heart failure than those eating the least.The researchers cited red meats high saturated fat and cholesterol con-tent, as well as heme iron, as possible explanations.Chronic-Disease Cautions
But these two new studies, both focused on heart dangers, are only the latest in a drumbeat of bad news for red-meat lovers. Other recent research has linked eating red meat to a range of health risks:Cancer-In 2007, the World Cancer Research Fund published a report link-ing consumption of red or processed meats, along with alcohol, to cancer. Among studies cited in the report was US National Cancer Institute research that linked eating lots of red and pro-cessed meat with up to a 20% greater risk of lung and colorectal cancer.In 2009, data from more than a half-million participants in the Na-tional Institutes of Health (NIH)-AARP Health Study pointed to high intake of fat from animal products, such as red meat, as a risk factor for pancreatic cancer. Overall, participants consum-ing the most saturated fat had a 36% higher rate of pancreatic cancer than those consuming the least.Diabetes-It may not be simply that eating too much calorie-laden red meat can make you overweight, boosting diabetes risk. In 2009, a Norwegian-US meta-analysis pooling 12 previous stud-ies found that people eating the most red meat were at 21% greater risk of developing type 2 diabetes. Those with the highest consumption of processed meat were 41% more likely to develop diabetes.Age-Related Macular Degeneration-Even your eyes may suffer from too much red meat in your diet. Australian scientists found that eating two servings of red meat daily was associated with a 50% greater risk of age-related macular degeneration (AMD), the leading cause of blindness among older Americans.Mortality-Add it all up and both red and processed meats are associ-ated with an increased overall risk of dying. In another 2009 finding from the NIH-AARP Diet and Health Study, researchers tracked more than 500,000 participants, ages 50 to 71, for 10 years. The one-fifth of men and women eating the most red meat had a higher risk of overall death and death from cancer and heart disease than those eating the least. The same was true for those eating the most processed meat. Overall, researchers calculated that 11% of deaths in men and 16% in women could be prevented if red-meat consumption were cut to that of the lowest group (an average 1.6 grams per 1,000 calories per day-less than an ounce a week).Rethinking Dinner
This blizzard of scary studies doesnt mean you have to swear off red meat altogether, however, and one recent meta-analysis offers a contrarian view: The pooling of 20 prior studies totaling about 1.2 million people con-cluded that eating red meat was not associated with an increased risk of heart disease or diabetes. But eating just 50 grams (1.8 ounces, about one hot dog or two slices of salami) of processed meat daily was still associated with a 42% greater risk of heart disease and 19% increased risk of diabetes. (See the August 2010 Health-letter.)Nonetheless, most Americans probably need to make some of those substitutions suggested by Dr. Bernstein and colleagues study. In particular, most experts advise eating fish at least twice a week; if youre not already serv-ing enough seafood, try making steak or burger night prime time for salmon or tuna instead.Nonetheless, most Americans probably need to make some of those substitutions suggested by Dr. Bernstein and colleagues study. In particular, most experts advise eating fish at least twice a week; if youre not already serv-ing enough seafood, try making steak or burger night prime time for salmon or tuna instead.Nonetheless, most Americans probably need to make some of those substitutions suggested by Dr. Bernstein and colleagues study. In particular, most experts advise eating fish at least twice a week; if youre not already serv-ing enough seafood, try making steak or burger night prime time for salmon or tuna instead.Alice Lichtenstein, DSc, director of Tufts HNRCA Cardiovascular Nutri-tion Laboratory, advises that if you do want to eat red meat, make it more the exception than the rule: Choose lean cuts, limit portion size, use fresh rather than processed types and prepare with-out charring. The balance of the meal should include a salad, colorful vegeta-bles and a whole-grain side dish. Select smaller meat portions-three ounces, about the size of a deck of cards-rather than 8- or 12-ounce slabs.Concentrate in particular on reduc-ing saturated fat. The Dietary Guide-lines for Americans Advisory Commit-tees (DGAC) report suggests that, for starters, you should aim to consume less than 10% of your calories in the form of saturated fat. Over time, try to gradually reduce even that amount, while increasing polyunsaturated and monounsaturated fat sources. The DGAC says those at high risk for car-diovascular disease or diabetes should shoot for 7%-a percentage the Ameri-can Heart Association recommends for everybody.Do the math: A 10-ounce ribeye steak, cooked, contains a little over 13 grams of saturated fat. At 9 calories per gram of fat, that works out to 117 calories from saturated fat; at 2,000 calories a day, that steak totals more than half your daily goal of saturated fat.The DGAC also recommends limiting dietary cholesterol to less than 300 milli-grams daily; those at high risk for car-diovascular disease or diabetes should aim for less than 200 milligrams. That 10-ounce ribeye packs 259 milligrams of cholesterol.Portion control plus picking lean cuts can put red meat back on your menu. Compare that big ribeye with three ounces of trimmed top round, at only 1.8 grams of saturated fat and 56 milligrams of cholesterol. Or try three ounces of trimmed pork tender-loin-1.9 grams of saturated fat and 80 milligrams of cholesterol.Your healthy diet can still include the occasional indulgence of red meat, despite the drumbeat of mostly bad news about its health effects. But maybe Thanksgiving shouldnt be the only time that turkey takes center stage on your dinner table. And fish, chicken, rice and beans, and even tofu can also help answer the question, Whats for dinner?. TO LEARN MORE: Circulation, online ahead of print; abstract at circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.109.915165v1. Nutri-tion, Metabolism and Cardiovascular Diseases, online ahead of print; abstract at dx.doi.org/10.1016/ j.numecd.2010.03.009. Dietary Guidelines for Americans www.dietaryguidelines.gov. MyPyra-mid www.mypyramid.gov.