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Red Meat and Your Diet

October 18, 2019

A recent article in the prestigious medical journal, Annals of Internal Medicine, is getting a lot of attention after it reviewed the evidence on the potential adverse health effects of red meat. The article did not find good evidence to suggest that reducing the consumption of red meat, whether it is unprocessed or processed, would benefit health. This new message is contrary to recommendations from the Dietary Guidelines for Americans and from the World Health Organization, who recommend reducing red meat intake. How can this be? Is this another swing of the nutrition science pendulum? What are we to make of this new information?

By Will S. Yancy - Medical Director of the Duke Diet & Fitness Center


In the article, a group of experts in health research methodology, nutrition and medicine (plus three non-experts for additional balance) from seven countries reviewed the current scientific literature regarding intake of red meat and health effects, such as mortality, cardiovascular disease and cancer. They used rigorous methods following guidelines on how to perform such a literature review as well as how to rate the strength of the evidence. Then they voted in consensus fashion based on the evidence: 11 of the 14 panel members suggested that people should continue their current unprocessed and processed meat consumption. The other three panelists voted for a weak recommendation to reduce processed meat consumption. 

All of the panel members agreed that the evidence supporting the idea that meat consumption causes harm to human health was weak. While this might seem to drastically differ from  other panels of experts, in actuality, it’s simply a matter of perspective.

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Red meat risks are all in the numbers

One key reason why the interpretation of the results of these studies is uncertain is because the strength of the relationship between red meat intake and increased mortality is really small. For example, in one study that was part of the above review, the risk of dying in the people eating the least amount of red meat was 1.1% per person per year; this increased to 1.4% per person per year in the people who consumed the greatest amount of red meat. A scientific article (and therefore, any non-academic or scientific press article covering it) might describe this as a “27% increase in risk,” because 1.4% is approximately 27% higher, speaking in relative terms, than 1.1%. A 27% increase in risk might catch your attention. However, few people would feel it is worthwhile to cut back on any food in order to reduce their risk of dying from 1.4% to 1.1%. Essentially, the risk is 1% in both scenarios. Additionally, this is the benefit you might expect if you were among the highest consumers of red meat and reduced to the amount of the lowest consumers; the benefit would be even less if you were to reduce red meat intake by say one serving per week, or even one serving per day.

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Red meat’s association with unhealthy behaviors

Another reason the interpretation of the results from these studies is inexact has to do with confounding. Confounding means that a relationship might be noted between an exposure (in this case, red meat) and increased rates of an outcome (in this case, mortality), but people who eat red meat may have many other reasons to be unhealthy and die at a higher rate. For example, in the article mentioned previously, the authors noted that people who ate more red meat also were “less likely to be physically active and were more likely to be current smokers, to drink alcohol, and to have a higher body mass index.” All of these personal characteristics could also lead to dying at a higher rate, and in fact, likely have a stronger association with mortality than does red meat intake. Statisticians can make adjustments for these characteristics in their analyses but the reality is that there will be many other characteristics that are not assessed. For example, people who eat higher amounts of red meat might also avoid going to the doctor, drive faster or do other things that might increase their risk of dying.

What do red meat recommendations mean for you?

While there is no one-size-fits-all eating plan, thoughtful eaters should be careful when reading nutrition science. Pay attention to comments from the author about the yearly “absolute” risks in the different groups of people, rather than the relative increase in risk comparing one group of people to another. This will give you a better idea of whether making the dietary change is worth your effort. Also, pay attention whether the author mentions caveats about other factors that might confound the results. Meanwhile, the jury is still out on whether reducing red meat intake might have any health benefits, but if it does, the benefit is likely to be small.

Weight management experts at the Duke Diet and Fitness Center are available to answer all your questions about red meat and more. Meet your weight management goals and discover eating patterns that work for you. Learn more about how the Duke Diet and Fitness Center can help at www.dukedietandfitness.org

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