Four months ago, the Annals of Internal Medicine published a controversial report that encouraged people not to worry about the health risks of eating red and processed meat, contradicting decades of nutrition advice.
The report was widely criticised by public health experts, including leading health groups like the American Heart Association and the American Cancer Society. Some experts called for the paper to be retracted. Others celebrated its findings and used it to raise questions about dietary guidelines discouraging meat consumption.
Those who ate the greatest amount of red meat had a small but increased risk of cardiac illness.Credit:William Meppem. Styling by Hannah Meppem
Last week, a group of prominent researchers pushed back, publishing a large study in JAMA Internal Medicine that once again highlighted the potential harms of a meat-heavy diet. The researchers analysed data on a diverse group of thousands of people who were followed for an average of three decades. They found that people who had the highest intakes of red meat, processed meat and poultry had a small but increased risk of developing cardiovascular disease. People who regularly ate fish did not have an increased cardiovascular risk.
The new findings are unlikely to settle the debate over red meat and its link to chronic disease. But they provide further evidence for experts who argue that red and processed meats contribute to the risk of heart disease, and they suggest that health authorities are unlikely to alter their recommendations to limit meat consumption.
One of the authors of the new study, Dr Linda Van Horn, is a member of the advisory panel that is helping the US government update its influential Dietary Guidelines for Americans, which have long recommended that people limit their intake of red and processed meat. Van Horn is a member of two advisory panel subcommittees, including one that is drafting recommendations on dietary fats and seafood.
In an interview, Van Horn said that the new study relied on some of the highest quality data available. She said the findings reinforced recommendations that people should prioritise foods such as fresh fruits and vegetables, whole grains, legumes, fish, nuts and seeds, and limit their intake of foods such as red and processed meats, refined grains, fried foods and sugar-sweetened beverages.
When you eat a diet rich in processed and refined foods, it … denies you the benefits of the fibre, vitamins and plant-based proteins.
"When you eat a diet that is rich in processed and refined foods, it collectively contributes to increased risk of disease and denies you the benefits of the fibre, vitamins, minerals and plant-based proteins that contribute to health," said Van Horn, division chief of nutrition in the department of preventive medicine at the Northwestern University Feinberg School of Medicine.
The conclusions of the new study contrast with those of the report last fall in Annals, which found that reductions in red and processed meat intake resulted in fewer deaths from cancer and heart disease but concluded that the evidence was weak because much of the data came from observational studies that cannot show cause and effect. The authors said that any increased risk was too minimal to warrant telling people that they should cut back on meat.
Critics complained that the research was flawed. They argued that the authors evaluated the evidence against meat using a tool that was designed for clinical drug trials, not dietary studies. The lead author of the report came under fire for failing to disclose conflicts of interest, including taking money from a food industry group to publish a similar paper in the Annals three years earlier that used the same methods to discredit widespread guidelines urging people to eat less sugar. In December, the Annals issued a correction on the meat paper acknowledging the lead author's undisclosed conflicts.
The authors of the latest paper had a different interpretation of the evidence on meat consumption. Their analysis, initiated a year ago and funded in part by the American Heart Association and the National Institutes of Health, looked at data on 30,000 people who were followed for decades as part of six long-running studies on cardiovascular disease.
Among the studies included in the analysis was the landmark Framingham Heart Study. Begun in 1948, the Framingham study has helped scientists identify what are now recognised as some of the leading risk factors for heart disease, such as smoking, high blood pressure, obesity, diabetes and physical inactivity.
The researchers examined the subjects' diets and whether it affected their heart disease and mortality rates. The study was observational, meaning the scientists could isolate links between diet and lifestyle behaviours and cardiovascular outcomes but they could not prove cause and effect. Ultimately they concluded that eating two or more servings of red meat, processed meat or poultry per week was linked to a 4 per cent to 7 per cent higher risk of developing heart disease. They found that the higher the intake, the higher the risk.
While many people who eat meat do not develop heart disease, the findings reflect what other large studies have consistently found as well, including the recent Annals report: Higher amounts of meat intake are associated with a small but increased risk of developing heart disease.
Norrina Allen, a senior author on the latest study and associate professor of preventive medicine at the Feinberg School of Medicine, said red and processed meat consumption is one of many overall diet and lifestyle factors that play a role in cardiovascular health. She said that while some people might consider it a minor factor, it is nonetheless important not to dismiss.
"I would say that even though it seems to be a small amount of risk," she said, "any excess risk for something as major as heart disease and mortality is worth considering."
The New York Times
Source: Read Full Article