Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type 2 Diabetes – An Updated Review of the Evidence
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Growing evidence suggests that effects of red meat consumption on coronary heart disease (CHD) and type 2 diabetes could vary depending on processing. We reviewed the evidence for effects of unprocessed (fresh/frozen) red and processed (using sodium/other preservatives) meat consumption on CHD and diabetes. In meta-analyses of prospective cohorts, higher risk of CHD is seen with processed meat consumption (RR per 50 g: 1.42, 95 %CI = 1.07–1.89), but a smaller increase or no risk is seen with unprocessed meat consumption. Differences in sodium content (~400 % higher in processed meat) appear to account for about two-thirds of this risk difference. In similar analyses, both unprocessed red and processed meat consumption are associated with incident diabetes, with higher risk per g of processed (RR per 50 g: 1.51, 95 %CI = 1.25–1.83) versus unprocessed (RR per 100 g: 1.19, 95 % CI = 1.04–1.37) meats. Contents of heme iron and dietary cholesterol may partly account for these associations. The overall findings suggest that neither unprocessed red nor processed meat consumption is beneficial for cardiometabolic health, and that clinical and public health guidance should especially prioritize reducing processed meat consumption.
KeywordsReview Meat Red meat Processed meat Cardiovascular disease Diabetes
R. Micha: none; G. Michas: none; D. Mozaffarian: Received ad hoc honoraria from Nutrition Impact, Unilever, and SPRIM.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.•• Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271–83. The first systematic review and meta-analysis that assessed relationships between unprocessed red and processed meat consumption and risk of incident coronary heart disease, stroke, and type 2 diabetes. This meta-analysis provided evidence that the effects of meat consumption on cardiometabolic outcomes might vary depending on the extent of processing i.e., whether or not the meat is fresh (unprocessed) or has been processed and preserved for long-term storage, typically by adding high amounts of salt, as well as other preservatives such as nitrates.PubMedCrossRefGoogle Scholar
- 4.Mozaffarian D. Chapter 48: Nutrition and Cardiovascular Diseases, in Braunwald's Heart Disease: a Textbook of Cardiovascular Medicine. 2012: Philadelphia.Google Scholar
- 5.Institute of Medicine of the National Academies, Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease. 2010.Google Scholar
- 7.World Health Organization, Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation, in World Health Organ Tech Rep Ser. 916: i–viii. 2003: Geneva. p. 1–149.Google Scholar
- 9.World Cancer Research Fund/ American Institute for Cancer Research, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. 2007: Washington DC: AICR.Google Scholar
- 14.Liu J, Stampfer MJ, Hu FB, et al. Dietary iron and red meat intake and risk of coronary heart disease in postmenopausal women. Am J Epidemiol. 2003;157:S100.Google Scholar
- 16.• Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and risk of coronary heart disease in women. Circulation. 2010;122(9):876–83. Bernstein and colleagues evaluated the association between unprocessed red and processed meat consumption and incidence of coronary heart disease in the Nurse’s Health Study cohort.PubMedCrossRefGoogle Scholar
- 17.• Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med. 2012;172(7):555–63. Pan and colleagues evaluated the Nurse’s Health Study and the Health Professionals Follow-up Study cohort to assess the associations between unprocessed red and processed meat consumption and risk of CVD death.PubMedCrossRefGoogle Scholar
- 18.• Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr. 2011;94(4):1088–96. An updated meta-analysis, using the methods reported in our meta-analysis , which evaluated the relationship between unprocessed red and processed meat consumption and incident type 2 diabetes, including our previously identified studies plus updated findings from three Harvard cohorts [19–21].PubMedCrossRefGoogle Scholar
- 24.• Fretts AM, Howard BV, McKnight B, et al. Associations of processed meat and unprocessed red meat intake with incident diabetes: the Strong Heart Family Study. Am J Clin Nutr. 2012;95(3):752–8. Fretts and colleagues evaluated relationships between unprocessed red and processed meat consumption and incident diabetes in the Strong Heart Family Study cohort, in a population of American Indians characterized by relative high rates of obesity and diabetes.PubMedCrossRefGoogle Scholar
- 41.Singh G.M., Danaei G., Farzadfar F., et al., Effect sizes for cardiovascular disease and diabetes outcomes of metabolic risk factors for population-based comparative risk assessment (CRA). Int J Cardiol, 2012. Under Review.Google Scholar
- 45.Gajdosik A., Gajdosikova A , Stefek M., et al., Streptozotocin-induced experimental diabetes in male Wistar rats. Gen Physiol Biophys, 1999. 18 Spec No: p. 54–62.Google Scholar
- 58.Dietary Guidelines Advisory Committee. 2010 Dietary Guidelines For Americans. 2010 [cited Jan 31, 2011]; Available from: http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/PolicyDoc.pdf.
- 59.Steinfeld H., Gerber P.,Wassenaar T., et al. Livestock's Long Shadow: Environmental Issues and Options, FAO, Editor. 2006: Rome.Google Scholar
- 60.Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. [cited; Available from: http://www.cdc.gov.nchs/nhanes.htm.