Red meat alert

Eating Meat May Increase Risk of Early Death, Study Finds,” ran the headline in The New York Times. “Dying for some red meat? You may be,” quipped the Los Angeles Times.

The big news came from a study that tracked more than half a million people for 10 years. Those who reported eating the most red meat were roughly 30 percent more likely to die — mostly of cancer or heart disease — than those who reported eating the least.

Indeed, cancer, heart disease, diabetes . . . all have been linked to red meat (mostly beef and pork) and processed meats (bacon, ham, hot dogs, sausage, and deli meats), or both. The evidence is stronger for some diseases than others. “But even if only a couple were true, when you put them all together, that would be reason enough to keep red and processed meat consumption pretty low,” says Harvard’s Walter Willett.

Here’s what we know about the risks of eating red and processed meats, and how to minimize them.

Meat and Mortality

A major 2009 study conducted by the US National Institutes of Health (NIH) and the American Association of Retired Persons (AARP) examined how meat consumption affects mortality. The NIH-AARP Diet and Health Study evaluated 545,663 people, ages 50 to 71, with 59-percent men and 41-percent women. In addition to determining meat intake, researchers collected information about each volunteer’s age, education, marital status, family history, exercise habits, alcohol use, vitamin use, and fruit and vegetable intake.

The scientists evaluated three categories of meat. Red meat included all cuts of beef and pork. White meat included poultry and also fish. Processed meat included bacon, sausage, luncheon meats, cold cuts, ham, and hot dogs.

During 10 years of observation, 47,976 men and 23,276 women died. The men who ate the most red meat had a 31-percent higher death rate than the men who ate the least. A high consumption of processed meat was associated with a 16-percent higher death rate. Deaths due to cancer and cardiovascular disease followed the same pattern as total mortality, and women were affected in much the same way as men. In both sexes, a high intake of white meat was linked to a reduced mortality rate.

The NIH-AARP results held up even after scientists took other health habits and risk factors into account. And the link between the red and processed meat and mortality is even more noteworthy because relatively moderate portions were involved. High-risk volunteers consumed an average of four ounces of red meat and one and one-half ounces of processed meat a day. All in all, the scientists estimated that 11 percent of premature deaths in men could be forestalled by reducing red meat intake.

While the NIH-AARP study linked both red and processed meats with deaths from heart disease and cancer, a 2010 meta-analysis reported that a high consumption of processed, but not unprocessed, meat is associated with an increased risk of diabetes and heart disease. But a 2010 Harvard study found that both processed and unprocessed red meat increase cardiac risk, while fish and poultry appear protective.

Rethinking Our Diet

The blizzard of scary studies doesn’t mean you have to swear off red meat altogether, however, and one recent meta-analysis offers a contrarian view: The pooling of prior studies totaling about 1.2 million people concluded that eating red meat was not associated with an increased risk of heart disease or diabetes. But eating just 50 grams (1.8 ounces, about one hot dog or two slices of salami) of processed meat daily was still associated with a 42-percent greater risk of heart disease and 19-percent increased risk of diabetes.

Adam M. Bernstein, MD, of the Harvard School of Public Health, and colleagues, reported that replacing one serving of red meat with one serving of fish, poultry, nuts or low-fat dairy could lower your risk of heart disease by 13 to 30 percent. Dr. Bernstein and colleagues suggested that the saturated fat and a type of iron called “heme” iron (as in hemoglobin) in meat may be to blame. Other contributing culprits could be the heterocycline amines and advanced glycation end products (AGEs) produced in cooking meat, especially at high temperature or with charring. And processed meat is high in nitrite and salt.

Alice Lichtenstein, DSc, director of Tufts University’s Cardiovascular Nutrition Laboratory in Boston, advises that if you do want to eat red meat, make it more the exception than the rule. “Choose lean cuts, limit portion size, use fresh rather than processed types, and prepare without charring. The balance of the meal should include a salad, colorful vegetables, and a whole grain side dish.” Select smaller meat portions — three ounces, about the size of a deck of cards — rather than eight- or 12-ounce slabs.

Take-Home Lessons

Scientists offer the following tips on how to make your red meat choices as lean and healthy as possible:

 • The leanest beef cuts include round steaks and roasts (round eye, top round, bottom round, round tip), top loin, top sirloin and chuck shoulder and arm roasts.

• The leanest pork choices include pork loin, tenderloin, center loin, and ham.

• Choose extra-lean ground beef. The label should say at least 90-percent lean. You may be able to find ground beef that is 93-percent or 95-percent lean.

• Choose lean roast beef, ham or low-fat luncheon meats for sandwiches instead of luncheon meats with more fat, such as bologna or salami.

• Trim away all visible fat from meat before cooking.

• Broil, grill or roast meat instead of frying.

• Drain off any fat that appears during cooking.

• Choose and prepare foods without high-fat sauces or gravies.

Another way to minimize the ill-effects of eating meat is good grilling. Grilling meat or cooking it at high temperatures creates two classes of mutagens — heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). (A mutagen causes changes in DNA, which can lead to cancer.) You can’t take the iron out of red meat, but you can minimize the heterocyclic amines (HCAs) when you grill meat, chicken, or fish. Here’s what the experts suggest:

• Marinate. It doesn’t seem to matter what’s in the marinade or how long the food sits in the liquid. You can dip it in right before you throw it on the grill.

• Microwave before cooking. You can eliminate 90 percent of the HCAs if you microwave the meat, chicken or fish first for one and a half to two minutes and pour off the juices.

• Try seafood. As long as you don’t char seafood, it should have fewer HCAs than meat or poultry.

• Keep it moist. The drier and more well done the meat, the more HCAs you get. Hot dogs and sausages seem to have fewer HCAs, perhaps because their casing prevents drying.

• Bake, roast, or stir-fry. Grilling and barbecuing create the most HCAs. Next come broiling and pan-frying (though frying at a lower temperature helps). Baking, roasting, and stir-frying create less.

• Flip frequently. Cooking meat or poultry for six minutes per side instead of 10 minutes cuts the HCAs by 70 percent because the surface temperature stays lower.

• Skip the pan drippings. If the meat or poultry is well done, the drippings can have more HCAs than the meat or poultry.

• Cook in liquid. Boiling, steaming, poaching, or microwaving generates no HCAs because the temperature never tops the boiling point of water.

• Eat your veggies. Veggie burgers and cooked vegetables generate little or no HCAs. And cruciferous vegetables like broccoli and Brussels sprouts may actually help the liver detoxify HCAs.

But can i still eat red meat?

Your healthy diet can still include the occasional indulgence of red meat despite the drumbeat of mostly bad news about its health effects. The best sources of protein are still fish, beans, nuts, and poultry. But the findings do suggest that eating red meat a few times a week can be part of a healthy diet, and you don’t need to feel guilty when you cook a steak or order a lamb chop. But you should select it carefully, prepare it properly, and eat it sparingly.

How much meat should you eat? Scientists suggest a general goal of no more than 300 grams (about 11 ounces) a week. You may beef about this low amount at first, only to discover that you can actually adapt to a new style of eating later. After all, you still have fish, chicken, beans, tofu, and others as sources of protein. In the final analysis though, given what we know of meat and mortality, only you can decide what’s best for your health.