Are meat, high protein diets, and veggie burgers good for health?
Numerous studies have considered the health effects of high meat and high animal protein consumption.1 Evidence shows that higher red meat consumption, especially processed red meat (e.g., bacon, hot dogs, and sausages), is associated with an increased risk of type 2 diabetes, cardiovascular disease, certain types of cancer, including colorectal cancer, and mortality. Additional negative health outcomes associated with consumption of processed red meat include chronic obstructive pulmonary disease, heart failure, and hypertension. Consuming processed red meat may entail a greater risk because along with high amounts of saturated fats, there are adverse effects from preservatives (e.g. sodium, nitrites, and phosphates) and preparation methods (e.g., potential cancer-causing polycyclic aromatic hydrocarbons from high-temperature commercial cooking/frying) that could influence health outcomes.2 3 4
In one observational analysis, both unprocessed and processed meat consumption was associated with higher cardiovascular risk when meat replaced foods, such as low-fat dairy, nuts, and fish.5 A meta-analysis of prospective studies indicates that high consumption of red meat, especially processed meat, may increase all-cause and cardiovascular disease (CVD) mortality.6 7 In one study, the substitution of one serving per day of other foods (e.g., fish, poultry, nuts, legumes, low-fat dairy, and whole grains) for one serving per day of red meat was associated with a 7% to 19% lower mortality risk.8 9 A related study evaluated 85,168 women and 44,548 men without heart disease, cancer, or diabetes from the Nurses' Health Study and the Health Professionals' Follow-Up Study. It concluded, "A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates."10
A 2015 meta-analysis of prospective cohort studies found an association between processed meat consumption and a 15% increased risk of all-cause and cardiovascular mortality in U.S. populations.11 And a 2017 NIH-AARP study found that high intakes of red and processed meat elevated all-cause mortality and mortality from nine different causes. They included cardiovascular disease, diabetes, cancer, hepatic, renal, and respiratory diseases.12 The strongest association was death from chronic liver disease, which more than doubled with the highest intake. The fifth of the study participants consuming the most red and processed meat had a 26% greater all-cause mortality than the fifth of the study subjects consuming the least. The study also showed reduced risks were associated with substituting white for red meat, particularly unprocessed white meat.
Similar findings were reported from a long-term Spanish study of older adults with cardiovascular risk factors that assessed protein consumption for roughly five years. The study found that when protein replaced carbohydrates, the eating pattern was linked to a 90% greater risk of gaining more than 10% of body weight and to a 59% higher risk of death from any cause. When protein replaced fat, the risk of death rose by 66%. The study authors concluded that "These results do not support the generalized use of high-protein diets as a good strategy for losing weight," and suggested that “Long-term efficacy and safety of these diets deserve more attention."13
A meta-analysis of randomized clinical trials published in 2019 in the journal Circulation found that replacing red meat with nuts, legumes, and other plant-based protein foods (but not with fish or low-quality carbohydrates), reduced levels of CVD risk factors such as total cholesterol and LDL-C.14 A long-term epidemiologic study published in 2019 in the British Medical Journal, found that increases in red meat consumption over eight years were associated with a higher mortality risk in the following eight years. An increase in total red meat consumption of at least half a serving per day was associated with a 10% higher mortality risk. The risk was increased by 13% for processed meat, and for unprocessed red meat consumption, there was a 9% higher mortality risk. An increase in consumption of whole grains, vegetables, or other protein sources was associated with a lower risk of death.15
Additional information on the CVD effects of processed meat, unprocessed red meat, poultry, or fish intake comes from a 2020 analysis of six prospective cohort studies.16 Two or more servings of processed meat, unprocessed red meat, or poultry, but not fish, per week was significantly associated with a small (about 4% to 7%) increased risk of CVD, and higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality.
The vast majority of studies show that red and processed meat consumption increases the risk of all-cause and cardiovascular mortality. My advice is to stick with the recommendations of the nutrition experts and minimize the consumption of red and processed meat.
Veggie burgers or meatless burgers are a rapidly growing option that in 2019 was available at 20,000 restaurants across the U.S. Some of these products may be highly processed and high in sugar, salt, and fat. For example, Beyond Meat's ingredients for its plant-based patties are high in sodium and saturated fat. They include water, pea protein isolate, expeller-pressed canola oil, refined coconut oil, rice protein, and other natural flavors. Ingredients for Impossible Foods burgers are also high in sodium and saturated fat. They include water, soy protein concentrate, coconut oil, sunflower oil, potato protein, soy leghemoglobin, and natural flavors. Artificial meats may or may not be healthy for the environment but do not always fit the profile of healthy foods for human consumption.17 It is important to read the labels of meatless burgers because some may be healthy foods, but others are not.
Another important reason to cut back on eating meat, especially from ruminants such as beef cattle and lambs that emit large amounts of methane, is because global livestock production is the source of about 18% of all greenhouse gas emissions.18 There is little evidence that more than the recommended minimum of about 10% to 15% of total calories from protein a day are beneficial. Avoiding high red and processed meat consumption is advisable to support both human health and the planet's health.
Note: This timely topic presents opinions and ideas and is intended to provide helpful general information and is not for the purpose of rendering advice or services to the individual reader. The ideas, procedures, and suggestions that are presented are not in any way a substitute for the advice and care of the reader's own physician or other medical professional based on the reader's own individual conditions, symptoms, or concerns. If the reader needs personal medical, health, dietary, exercise, or other assistance or advice, the reader should consult a physician and/or other qualified health professionals. Catalyst for Children specifically disclaims all responsibility for any injury, damage, or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this report or participating in any programs described in this report. For additional information, please consult the book: The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist by J. Joseph Speidel MD, MPH, available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere.
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3 Micha R, Wallace S, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes:a systematic review and meta-analysis. Circulation. 2010;121:2271–2283.
4 Mozaffarian D, Appel LJ, Van Horn L. Components of a Cardioprotective Diet: New Insights. Circulation. 2011;123:2870-2891. DOI: 10.1161/CIRCULATION AHA.110.968735
5 Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC. Major dietary protein sources and risk of coronary heart disease in women. Circulation. 2010;122:876–883.
6 Larsson SC, Orsini N. Red meat and processed meat consumption and all-cause mortality: a meta-analysis. Am J Epidemiol. 2014;179: 282-9.
7 Abete I, Romaguera D, Vieira AR et al. Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies. Br J Nutr. 2014;112, 762–775.
8Pan A, Sun Q, Bernstein AM, Schulze MB, Manson JE, Stampfer MJ, Willett WC, Hu FB. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med. 2012;172(7):555-63. doi: 10.1001/archinternmed.2011.2287. Epub 2012 Mar 12.
9 Ornish D. Holy Cow! What's Good for You Is Good for Our Planet Comment on “Red Meat Consumption and Mortality”. Arch Intern Med. 2012;172(7):563-564. doi:10.1001/archinternmed.2012.174
10Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med. 2010;153(5):289-98. doi: 10.7326/0003-4819-153-5-201009070-00003.
11Wang X, Lin X, Ouyang YY, Liu J, Zhao G, Pan A, Hu FB. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr. 2016 Apr;19(5):893-905. doi: 10.1017/S1368980015002062. Epub 2015 Jul 6.
12 Etemadi A, Sinha R, Ward MH, et al. Mortality from different causes associated with meat,
13 Bullo M, Virgili P, Heller S, Fonarow G. May 8, 2015, presentation, European Congress on Obesity, Prague, Czech Republic
14Guasch-Ferré M, Satija A, Blondin SA, et al. Meta-analysis of randomized controlled trials of red
15 Zheng Y, Li Y, Satija A, et al. Association of changes in red meat consumption with total and
16 Zhong VW, Van Horn L, Greenland P, et al. Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality. JAMA Intern Med. Published online February 03, 2020. doi:10.1001/jamainternmed.2019.6969
17 Hu FB, Otis BO, McCarthy G. Can Plant-Based Meat Alternatives Be Part of a Healthy and Sustainable Diet? JAMA. Published online August 26, 2019. doi:10.1001/jama.2019.13187
18 IPCC. Summary for Policymakers. In: Global Warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty [Masson-Delmotte, V., P. Zhai, H.-O. Pörtner, D. Roberts, J. Skea, P.R. Shukla, A. Pirani, W. Moufouma-Okia, C. Péan, R. Pidcock, S. Connors, J.B.R. Matthews, Y. Chen, X. Zhou, M.I. Gomis, E. Lonnoy, T. Maycock, M. Tignor, and T. Waterfield (eds.)]. World Meteorological Organization, Geneva, Switzerland, 2018. 32 pp.