The Wall Street Journal, May 18, 2010, Ron Winslow

Maybe that juicy steak you ordered isn’t a heart-attack-on-a-plate after all. (But still raises the risk of colon cancer sic.)

A new study from the Harvard School of Public Health suggests that the heart risk long associated with red meat comes mostly from processed varieties such as bacon, sausage, hot dogs and cold cuts—and not from steak, hamburgers and other non-processed cuts.

The finding is surprising because both types of red meat are high in saturated fat, a substance believed to be partly responsible for the increased risk of heart disease. But the new study raises the possibility that when it comes to meat, at least, the real bad actor may be salt. Processed meats generally have about four times the amount of salt as unprocessed meats.

While the study is far from definitive, researchers said the findings suggest that people, especially those already at risk of heart problems or with high blood pressure, should consider reducing consumption of bacon, processed ham, hot dogs and other packaged meats that have a high salt content. Salt increases blood pressure, a major risk factor for cardiovascular disease.In a report that pooled data from 20 different studies from around the world, the researchers found that daily consumption of about two ounces of processed meat was associated with a 42% increased risk of heart disease and a 19% heightened chance of diabetes. By contrast, a four-ounce daily serving of red meat from beef, hamburger, pork, lamb or game wasn’t linked to any increased risk of heart disease. There was, however, a small, but statistically insignificant risk of diabetes.

“The conventional wisdom is that red meats have higher saturated fat and cholesterol levels,” factors that have made all red meats potential culprits in raising the risk of cardiovascular disease, said Renata Micha, a research fellow in the Harvard School of Public Health’s epidemiology department. “But when you try to separate processed from unprocessed meats, you get an entirely different picture.” She is lead author of the study, which appears in Tuesday’s issue of the American Heart Association journal Circulation.

None of this suggests that steak is a new health food. While red meat wasn’t linked to an increased risk of heart disease in the study, it didn’t lower it either. Other research suggests frequent red meat consumption is associated with increased risk of colon cancer. The new report didn’t look at cancer effects.Based on information about meat products sold in the U.S., levels of saturated fats are similar in processed and unprocessed meats, while steak and other red meats have on average slightly higher levels of cholesterol, the researchers found. But sodium levels average about 622 milligrams per two-ounce serving of processed meat, about four times the 155 milligrams found in steak, hamburger or pork. Other preservatives, called nitrites, were also higher in the processed meats. In some studies, nitrates have been shown to interfere with the health of blood vessels and the body’s ability to process glucose.

“Should people eat more red meat because of this analysis?” asked Robert Eckel, a cardiologist and nutrition expert at University of Colorado, Denver. “I don’t think that is what the study is saying.”

The study was a meta-analysis, which combines the results of several studies looking at the same issue. Like others of its kind, the study “is limited in terms of scientific value,” Dr. Eckel said. None of the studies in the analysis, for example, was a randomized controlled clinical trial, just one factor affecting the strength of the findings. The report is helpful in raising issues for further study, but “it doesn’t answer any questions,” he said.

Nevertheless, Dr. Eckel said, “I was amazed to see the differences in sodium content” between the two categories of meat.” It suggests that people with high blood pressure “might need an [additional] drug” to control their condition if they eat a lot of processed meat,” he said.

The American Meat Institute Foundation took issue with the findings, saying they conflict with national dietary guidelines. “The body of evidence clearly demonstrates that processed meat is a healthy part of a balanced diet,” James H. Hodges, president, said in a statement. He said the study didn’t “achieve the standard threshold that would generate concern” and that “it is no reason for dietary changes.”

Current U.S. dietary guidelines call for limiting saturated fats—the kind found in red meats and dairy products such as milk, cheese and butter—to less than 10% of calories consumed each day—while keeping overall fat consumption to under 30% of calories. A big reason is that saturated fats are associated with higher levels of cholesterol in the blood. Dr. Eckel said that “is still a reasonable recommendation.”

“There is growing evidence that it’s not which nutrient we eat, but the type of foods we eat that is important,” said Harvard’s Dr. Mozaffarian. “We have to get away from trying to micromanage nutrients and look at the health quality of foods.”The report is the second meta-analysis in recent weeks to question just how much of a culprit saturated fats are when it comes to cardiovascular risk. In March, a meta-analysis (involving 21 different studies) by a team headed by Ronald Krauss at Children’s Hospital Oakland Research Institute, Oakland, Calif., found that intake of saturated fat wasn’t linked to a statistically-significant increased risk of heart disease, stroke or cardiovascular disease.

That a good cut of red meat might be healthier than a heavily processed serving of other meat, he added, “is intuitive to most Americans. Maybe the science is catching up with the intuitive sense.”

That’s not necessarily a license to unleash your inner carnivore. Calorie control as well as a diet rich in fruits and vegetables, fish, whole grains and nuts remain the mainstay of heart-healthy eating, he said.

“If once in a while somebody wants to eat meat, our study suggests steak or other unprocessed cuts aren’t going to increase their heart risk,” he said.

Eating Hamburger, Steak Dont Raise Heart-Disease Risk, Study Says – WSJ.com.

Meat and meat-related compounds and risk of prosta… [Am J Epidemiol. 2009] – PubMed result.

There was a time when red meat was a luxury for ordinary Americans, or was at least something special: cooking a roast for Sunday dinner, ordering a steak at a restaurant. Not anymore. Meat consumption has more than doubled in the United States in the last 50 years.

Now a new study of more than 500,000 Americans has provided the best evidence yet that our affinity for red meat has exacted a hefty price on our health and limited our longevity.

The study found that, other things being equal, the men and women who consumed the most red and processed meat were likely to die sooner, especially from one of our two leading killers, heart disease and cancer, than people who consumed much smaller amounts of these foods.

Results of the decade-long study were published in the March 23 issue of The Archives of Internal Medicine. The study, directed by Rashmi Sinha, a nutritional epidemiologist at the National Cancer Institute, involved 322,263 men and 223,390 women ages 50 to 71 who participated in the National Institutes of Health-AARP Dietand Health Study. Each participant completed detailed questionnaires about diet and other habits and characteristics, including smoking, exercise, alcohol consumption, education, use of supplements, weight and family history of cancer.

Determining Risk

During the decade, 47,976 men and 23,276 women died, and the researchers kept track of the timing and reasons for each death. Red meat consumption ranged from a low of less than an ounce a day, on average, to a high of four ounces a day, and processed meat consumption ranged from at most once a week to an average of one and a half ounces a day.

The increase in mortality risk tied to the higher levels of meat consumption was described as “modest,” ranging from about 20 percent to nearly 40 percent. But the number of excess deaths that could be attributed to high meat consumption is quite large given the size of the American population.

Extrapolated to all Americans in the age group studied, the new findings suggest that over the course of a decade, the deaths of one million men and perhaps half a million women could be prevented just by eating less red and processed meats, according to estimates prepared by Dr. Barry Popkin, who wrote an editorial accompanying the report.

To prevent premature deaths related to red and processed meats, Dr. Popkin suggested in an interview that people should eat a hamburger only once or twice a week instead of every day, a small steak once a week instead of every other day, and a hot dog every month and a half instead of once a week.

In place of red meat, nonvegetarians might consider poultry and fish. In the study, the largest consumers of “white” meat from poultry and fish had a slight survival advantage. Likewise, those who ate the most fruits and vegetables also tended to live longer.

Anyone who worries about global well-being has yet another reason to consume less red meat. Dr. Popkin, an epidemiologist at the University of North Carolina, said that a reduced dependence on livestock for food could help to save the planet from the ravaging effects of environmental pollution, global warming and the depletion of potable water.

“In the United States,” Dr. Popkin wrote, “livestock production accounts for 55 percent of the erosion process, 37 percent of pesticides applied, 50 percent of antibiotics consumed, and a third of total discharge of nitrogen and phosphorus to surface water.”

Finding a Culprit

A question that arises from observational studies like this one is whether meat is in fact a hazard or whether other factors associated with meat-eating are the real culprits in raising death rates. The subjects in the study who ate the most red meat had other less-than-healthful habits. They were more likely to smoke, weigh more for their height, and consume more calories and more total fat and saturated fat. They also ate less fruits, vegetables and fiber; took fewer vitamin supplements; and were less physically active.

But in analyzing mortality data in relation to meat consumption, the cancer institute researchers carefully controlled for all these and many other factors that could influence death rates. The study data have not yet been analyzed to determine what, if any, life-saving benefits might come from eating more protein from vegetable sources like beans or a completely vegetarian diet.

The results mirror those of several other studies in recent years that have linked a high-meat diet to life-threatening health problems. The earliest studies highlighted the connection between the saturated fats in red meats to higher blood levels of artery-damaging cholesterol and subsequent heart disease, which prompted many people to eat leaner meats and more skinless poultry and fish. Along with other dietary changes, like consuming less dairy fat, this resulted in a nationwide drop in average serum cholesterol levels and contributed to a reduction in coronary death rates.

Elevated blood pressure, another coronary risk factor, has also been shown to be associated with eating more red and processed meat, Dr. Sinha and colleagues reported.

Poultry and fish contain less saturated fat than red meat, and fish contains omega-3 fatty acids that have been linked in several large studies to heart benefits. For example, men who consume two servings of fatty fish a week were found to have a 50 percent lower risk of cardiac deaths, and in the Nurses’ Health Study of 84,688 women, those who ate fish and foods rich in omega-3 fatty acids at least once a week cut their coronary risk by more than 20 percent.

Ties to Cancer

Choosing protein from sources other than meat has also been linked to lower rates of cancer. When meat is cooked, especially grilled or broiled at high temperatures, carcinogens can form on the surface of the meat. And processed meats like sausages, salami and bologna usually contain nitrosamines, although there are products now available that are free of these carcinogens.

Data from one million participants in the European Prospective Investigation Into Cancer and Nutrition trial found that those who ate the least fish had a 40 percent greater risk of developing colon cancer than those who ate more than 1.75 ounces of fish a day. Likewise, while a diet high in red meat was linked to an increased risk of prostate cancer in the largeSelenium and Vitamin E Cancer Prevention Trial, among the 35,534 men in the study, those who consumed at least three servings of fish a week had half the risk of advanced prostate cancer compared with men who rarely ate fish.

Another study, which randomly assigned more than 19,500 women to a low-fat diet, found after eight years a 40 percent reduced risk of ovarian cancer among them, when compared with 29,000 women who ate their regular diets.

Personal Health – Paying a Price for Loving Red Meat – NYTimes.com.