“No Need to Cut Down Red and Processed Meat for Health Reasons…” That headline has sent shockwaves through the media, across the medical community, and throughout the health and wellness space.
Much to the contrary of what we’ve heard shouted from the medical mountaintops for years, the latest “dietary guideline recommendations”—conclusions made as a result of rigorous application of the statistical analyses—apparently put to rest concerns that eating meat has negative effects on health.
Meat lovers rejoice! Finally, the long-standing notion that meat is bad for you has officially been validated as a myth. Or has it? Is red meat good for you?
What are the Health Benefits of Red Meat?
This polarizing topic isn’t going anywhere anytime soon. The conversation’s pendulum continues to swing from one extreme to another. When you look at the evidence, the answer, I’m afraid, isn’t quite as straightforward as either camp may lead you to believe. One of the many challenges is that it’s difficult—almost irresponsible—to speak in generalities. Individual differences apply.
However, establishing population-wide dietary guidelines doesn’t allow for the nuance personalized nutrition demands. In other words, when speaking to the masses, my favorite answer—“It depends”—isn’t really an option. And this need for taking a clear position, one way or another, is in large part responsible for the red meat controversy.
It’s hard to argue that minimally processed and preserved red meat from pasture-raised, ruminant animals isn’t nutritious. Generally speaking, it’s rich in:
- Vitamin B6
- Vitamin B12
- Vitamin E
- Omega-3 fats
- Conjugated linoleic acid (CLA)
- And of course, high-quality protein
Consider that deficiencies in B12 and iron are the top two nutrient deficiencies worldwide, especially among women and children. And plants are typically either completely absent or, at best, poor sources of these nutrients, and you can start to see red meat has its place.
On top of that, despite what some say, few people are routinely consuming an optimal amount of high-quality protein. In addition, red meat is a robust source of amino acids complemented by nutrients not found in abundant quantities in other popular protein sources (including poultry and pork). Choline, an often overlooked, mission-critical nutrient, is basically a B vitamin essential for nervous system function, detoxification, liver and gallbladder function, and healthy cell membranes. But, if you aren’t routinely consuming red meat and whole eggs and/or supplementing with it, you’re falling far short of your choline needs.
Simply put, red meat is a nutrition powerhouse. On an energy-density basis, you cannot match its nutrient-density with readily-accessible plants.
I’ll be the first to admit, however, that nutritious doesn’t always mean healthy. In other words, whether or not red meat is good for you is another question entirely. And the answer isn’t as straightforward as you may have been led to—or want to—believe. As often is the case, it depends. (There I go again…)
What is Considered Red Meat Anyway?
Part of the nuance in addressing concerns surrounding the question of whether red meat is good for you lies simply with defining what constitutes red meat anyway. One of the confounding factors, for example, is that some studies—particularly some of the earlier work that sounded the figurative alarm on red meat—lumped all the following into one category:
Unprocessed Red Meats:
- Wild game
Processed Red Meats:
- Hot dogs
- Other cold cuts
In other words, there was no difference between the meat on a bologna sandwich and a lamb chop from a locally-sourced, pastured animal. More recently, however, studies tend to put red meat into two buckets: unprocessed and processed.
This, of course, makes more sense. However, there are still plenty of qualitative issues. For instance, there’s no weight given to grass-fed beef from a local, pasture-raised source over a fast-food hamburger that contains “meat” coming from an animal fed a completely different diet and raised in an overcrowded feedlot. Further, a piece of convenience-store pizza (with pepperoni and sausage) looks the same on this type of scale as carefully-cured Italian meats.
And what’s more, the nature of typical scientific research on the topic, as you’ll soon see, isn’t properly calibrated to tease out whether the meat was eaten between two slices of white bread and washed down with a sugar-sweetened beverage or plated next to a side of leafy greens and complemented with fresh, filtered water.
Red Meat: Villain or Scapegoat?
When it comes to nutrition, we love for topics to be laid out for us in black in white. Something is either “good” or “bad.” And even more, we seem to have a love affair with playing the blame game. In particular, we tend to label that “one thing” as the problem. (And on the flip side, we continue to look for the next big thing. The magic bullet—one diet, food, or supplement—that will solve all our problems.)
Even though, deep down, we know it’s probably not that simple, red meat has long been dubbed the villain. For years, we’ve been told—by very credible, respected, and presumably, well-meaning healthcare clinicians and health organizations—to reduce, if not completely eliminate, red meat under the guise that it causes a litany of health issues like:
- Cardiovascular disease
- Heart attacks
- Type 2 diabetes
- And certain types of cancer
But is that really the case? Do we really have reliable, replicable, high-quality evidence that red meat causes these problems?
While the red meat debate is nothing new, a handful of studies published within the last year has not just shaken off the cobwebs of the topic, it’s stirred up enormous controversy. Taking center stage is a series of privately-funded articles published in the well-respected peer-reviewed journal Annals of Internal Medicine, which was spearheaded by the Nutritional Recommendations (NutriRECS).
Is Red Meat Good For You? The NutriRECS Study
NutriRECS is an independent group comprised of 14 individuals with clinical and nutritional content expertise and skilled in the methodology of systematic reviews and practice guidelines. The methods include careful management of conflicts of interest. The end goal is producing trustworthy recommendations based on the values and preferences of guideline users.
In a nutshell, the group performed four parallel systematic reviews that focused both on randomized trials and observational studies addressing the possible impact of unprocessed red meat and processed meat consumption on cardiometabolic and cancer outcomes. They then performed a fifth systematic review addressing people’s health-related values and preferences related to meat consumption. On the basis of these reviews, they developed recommendations for unprocessed red meat and processed meat consumption specific to health outcomes. 1–6
The end result of the reviews was not all that surprising. Like much of the preceding research, their intense scrutiny of the research revealed some associations (albeit considerably smaller and weaker than traditionally broadcast) between red meat consumption and certain health outcomes. What was surprising and flipped conventional “wisdom” on its head were the dietary guidelines the committee formulated based on its findings.
At the end of the day, the NutriRECS group suggested that adults “continue current unprocessed red meat consumption” and “continue current processed meat consumption.” 4 In other words, disregard what you’ve likely heard for years about limiting, or altogether eliminating, red meat from your diet.
How is that possible?
The Problem with the “Red Meat is Bad” Science
You see, complicating the matter and clouding the reliability of the often-cited results (that red meat is “bad”) is that virtually all the studies that collectively contribute to the red meat debate are observational in nature. In essence, observational studies recruit a group of people, collect information about food intake (using diet recall surveys, which have been shown to be unreliable and inaccurate), and record information about health outcomes over a certain period of time. After gathering all the data, they run statistical tests to see any associations between variables (such as food intake) and outcomes (such as heart disease).
While these types of studies can reveal important information and key findings that can help shape public policy, dietary guidelines, and future research, the evidence they provide is typically regarded as “weak” and “low- to very-low certainty.” Yet, the most prestigious and reliable professionals and organizations the general population trusts and turns to for health advice have hung their collective hats on these studies. And those trusted organizations and professionals then reported that intake of red meat is associated with heart disease and certain types of cancer.
As such, health authorities have recommended limiting, if not altogether eliminating, intake of red and processed meat for decades. However, according to a large group of researchers responsible for a robust series of recently-published analyses in the Annals of Internal Medicine, “Such recommendations are primarily based on observational studies that are at high risk for confounding.”1
For example, it is very difficult for observational studies to completely and accurately account for confounding variables, such as diet quality. Along those lines, studies have shown that high consumption of red and processed meat is inversely associated with consumption of fruits, vegetables, and nuts. Thus, as a group of Finnish researchers concluded in a study published in the European Journal of Clinical Nutrition, which examined the association between meat intake and diet quality, “The association between meat consumption and a lower-quality diet may complicate studies on meat and health.” 7
Correlation ≠ Causation
Simply put, correlation is not causation. We have to be very cautious when drawing conclusions, especially when careful analysis of the data actually reveals the association isn’t nearly as strong as the voices shouting that we should restrict red meat. In actuality, intense statistical scrutiny of the data reveals that the magnitude of the association is “very small.” The findings are “inconsistent.” And the certainty of the totality of the evidence is “low to very low.” 2,3
In simple terms, it seems a bit aggressive, if not downright appalling, for health professionals to make such bold, blanket recommendations (bordering on accusations) when the supporting evidence is so meager. And again, it bears repeating that correlation does not equal causation.
Steven Levitt and Stephen J. Dubner illustrated the difference between correlation and causality beautifully in their book Freakonomics. Here are two interesting illustrations to belabor the point:
- Does eating ice cream cause drowning?
- Does eating more margarine cause divorce?
On the other hand, unlike observational studies, randomized trials provide higher-certainty evidence that supports causal relationships. If we, as health-care professionals, want to admonish red meat as causing heart disease, obesity, diabetes, and cancer, these are the types of studies we would need to hang our hat on. Along those lines, the evidence just isn’t there.
For instance, a recent systematic review of randomized trials published in the Annals of Internal Medicine evaluated the effect of reducing red meat intake on a variety of clinically important health outcomes. All said and done, the results of this robust analysis found that diets lower in red meat have “little or no effect” on all-cause mortality, cardiovascular mortality ,and heart disease. What’s more, there’s “low- to very-low-certainty evidence” that diets lower in red meat have “little to no effect” on total cancer mortality and the incidence of cancer. This includes colorectal and breast cancer. 1
Statistically speaking, the “little to no effect” that diets lower in red meat may have on these health parameters range from 1 – 5%. While it may not be prudent to completely ignore those potential effects—although they could easily be the result of confounding variables—they hardly represent evidence that would be worth basing entire dietary guidelines off.
All You Can Meat?
Now, don’t go throwing out the baby with the bathwater. One thing that’s increasingly emerging in the nutrition world is that individual differences apply. Recent research suggests that seems to be the case with red meat as well.
Recently published in the journal Nutrition & Metabolism, the Diabetes Education to Lower Insulin, Sugars, and Hunger Study (also known as the DELISH Study) provided evidence that red meat may actually not be good for a certain subgroup of folks. 9
In the study, participants with Type 2 diabetes followed a calorie- and carbohydrate-restricted, diet that ultimately involved consuming < 50 grams of non-fiber carbohydrate per day for a total of 6 months. They were permitted to eat fat to satiety and consume an adequate amount of protein. Overall, the intervention led to positive changes in the participants’ lipid profiles that correlated with a lower risk of cardiovascular disease. Interestingly, however, about a quarter of the participants had a ≥ 5% increase in small low-density lipoprotein particle number (sLDL-P). This number is more closely associated with heart disease risk than the more commonly measured total LDL cholesterol (LDL-C). When the researchers looked further into this finding, they discovered increasing red meat consumption was associated with increases in sLDL-P, though increasing saturated fat was not. Making matters more interesting, the researchers did not find a dose-response association between red meat consumption and sLDL-P in participants without increased sLDL-P. In other words, red meat—independent of saturated fat—was associated with increased sLDL-P in some people. See, I told you it’s complicated. For example, some people have a genetic variant (e.g., apoE4) making them particularly sensitive to the potential effects of saturated fat intake on blood fats. This is because the apoE gene is a major determinant of LDL particle size. And it interacts with the quantity and quality of dietary fat to modify the size of LDL molecules.
Studies have shown, for example, that when folks with the apoE4 genetic variant swap saturated fat for monounsaturated fat or low-glycemic carbohydrates, their blood lipids improve. 10,11
So, Is Red Meat Good For You?
As an omnivore who regularly eats meat—on average, three times per week—I’d like to make the broad statement that red meat is good for you, and you can eat as much as you want. And further, the long-standing notion that you should avoid red meat for optimal health isn’t strongly rooted in science (if not complete rubbish).
But as a caring, responsible, open-minded healthcare professional, broadcasting that message would be ignorant when weighing the scientific evidence we have. Now, that’s not to say eating red meat is bad, particularly in the context of an otherwise healthy diet and lifestyle. And as I mentioned previously, red meat can be a tremendous nutritional powerhouse. It’s a one-stop-shop of critical nutrients you’d be hard-pressed to find in any other single food.
Its nutritional value notwithstanding, there’s not much evidence that increasing red meat consumption improves any variety of health outcomes. What’s more, I don’t think you’d be out of bounds to conclude it’s a good idea to limit consumption of so-called processed meat, especially if that directive leads you to eating fewer junk, fast, and processed foods altogether.
And I think that’s the real guideline we should be encouraging: Eat less junk and eat more real food, including the best-quality unprocessed red meat you can get your hands on.
How much red meat is okay to eat? That’s a question we don’t really have an answer to. In other words, it depends. And remember, individual differences apply. The pragmatic scientific community suggests eating three or fewer portions of unprocessed red meat per week. If you do choose to cut back on red meat, my advice is to replace a serving or two with sustainably-caught fish, not junky processed carbs (even if they are plant-based)—that may have substantial benefit. 12
One final take-home point to hammer again is that individual differences apply. While public policy typically requires population-wide general recommendations, few one-size-fits-all “rules” or blanket-statement advice apply on the individual level. Like most things in life, nutrition is nuanced and must be personalized. Heck, even if a food is nutritious, that doesn’t always make it healthy for you.