Eating more red meat appears to be associated with an increased risk of all-cause mortality and death from cancer and cardiovascular disease, but substituting fish, poultry, nuts, legumes, low-fat dairy products, and whole grains for red meat is associated with a lower mortality risk, according to a study published online first by Archives of Internal Medicine.
The study documented 23,926 deaths, including 9,464 deaths from cancer and 5,910 from cardiovascular disease among 37,698 men in the Health Professionals Follow-up Study (1986–2008) and 83,644 women in the Nurses’ Health Study (1980-2008) who were free of cancer and cardiovascular disease at baseline. “Diet was assessed by validated food frequency questionnaires and updated every 4 years,” the investigators reported.
The elevated risk of total mortality in the pooled analysis for a one-serving-per-day increase was 12% for total red meat, 13% for unprocessed red meat, and 20% percent for processed red meat. “We found no statistically significant differences among specific unprocessed red meat items or among specific processed red meat items for the associations with total mortality,” the authors reported. “However, bacon and hot dogs tended to be associated with a higher risk than other items.”
In their substitution analyses, the authors estimated that replacing one serving of total red meat with one serving of fish, poultry, nuts, legumes, low-fat dairy products, or whole grains daily was associated with a lower risk of total mortality: 7% for fish, 10% for legumes and for low-fat dairy products, 14% for poultry and for whole grains, and 19% for nuts. The investigators estimated that 9.3% of total deaths in men and 7.6% in women during follow-up could be prevented if all the participants consumed fewer than 0.5 servings per day of total red meat.
“Regarding cancer mortality, red meat intake has been associated with increased risks of colorectal cancer and several other cancers,” the authors commented. “Several compounds in red meat or created by high-temperature cooking, including N-nitroso compounds (nitrosamines or nitrosamides) converted from nitrites, polycyclic aromatic hydrocarbons, and heterocyclic amines, are potential carcinogens. Heme iron and iron overload might also be associated with increased cancer risk through promotion of N-nitroso compound formation, increased colonic cytotoxicity and epithelial proliferation, increased oxidative stress, and iron-induced hypoxia signaling.”
In an invited commentary, entitled “Holy Cow! What’s Good for You Is Good for Our Planet,” Dean Ornish, MD, of the University of California, San Francisco, wrote, “In addition to their health benefits, the food choices we make each day affect other important areas as well. What is personally sustainable is globally sustainable. What is good for you is good for our planet.”
Pointing out that plant-based foods “are rich in phytochemicals, bioflavonoids, and other substances that are protective,” he noted, “what we include in our diet is as important as what we exclude, so substituting healthier foods for red meat provides a double benefit to our health.” ■
Pan A, et al: Arch Intern Med. March 12, 2012 (early release online).