Replacing red meat with high quality plant foods such as beans, nuts, or soy may be associated with a modestly reduced risk of coronary heart disease, suggests a study from Harvard T.H. Chan School of Public Health.
Substituting whole grains and dairy products for red meat, and eggs for processed red meat, might also reduce the risk.
Substantial evidence suggests that high intakes of red meat, especially processed red meat (e.g., bacon, hot dogs, sausages, salami) is associated with an increased risk of death and major chronic diseases, including coronary heart disease.
About the study
For the study, a team of US researchers examined the relationship between total, processed, and unprocessed red meat and risk of CHD and estimated the effects of substituting other protein sources for red meat with heart disease risk.
The findings are based on data from 43,272 US men (average age 53) from the Health Professionals Follow-Up Study who were free from cardiovascular disease and cancer when they enrolled.
Participants filled in a detailed diet questionnaire in 1986 and every four years thereafter, up to 2016, and provided information on their medical history and lifestyle.
Medical records were used to track coronary heart disease events (fatal and non-fatal) over this 30-year period.
The findings
After taking account of other cardiovascular disease risk factors, the researchers found that for every one serving per day, total red meat (unprocessed and processed) was tied to a modest (12%) higher risk of CHD. Similar associations were seen for unprocessed (11% higher risk) and processed red meat (15% higher risk).
Compared with red meat, though, intake of one serving per day of combined plant protein sources, including nuts, legumes (e.g., peas, beans and lentils) and soy was associated with a 14% lower risk of CHD.
This risk was lower still (18%) among men over the age of 65, and when compared with processed red meat (17%).
Substituting whole grains and dairy products (e.g., milk, cheese, yogurt) for total red meat and eggs for processed red meat were also associated with lower risk of coronary heart disease. This association was particularly strong among younger men, in whom the replacement of red meat with egg was associated with a 20% lower risk of CHD.
Replacing red meat with fish wasn’t linked with risk. But this could be due to cooking method (e.g., deep frying) and the fact that this food group also included processed fish products.
Caveats
This was an observational study, so it can't establish cause, and despite adjusting for important personal and lifestyle factors, the researchers can't rule out the possibility that other unmeasured factors might have influenced their results.
What's more, study participants were mainly white health professionals so the findings may not be generalized to other populations.
Still, this was a large study with repeated measures of diet during 30 years of follow-up, suggesting that the findings withstand scrutiny.
As such, the findings suggest that greater intakes of total, unprocessed and processed red meat are associated with a higher risk of coronary heart disease.
Substituting plant proteins, whole grains or dairy products for total red meat and substituting eggs for processed red meat may lower the risk.
Source: The BMJ, December 2, 2020
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