Red Meat and Early Mortality

When the Archives of Internal Medicine published the article “Red Meat Consumption and Mortality” all I could think of is “here we go again.”

First to go through this paper- which is a statistical population study from the Health Professionals Follow-up Study (HPFS) and the Nurses’ Health Study (NHS). Of the 140,000 combined participants they tossed out 20,000 because of a history of the diseases reported or those who did not fill out the forms perfectly.

To start with – this is not a study where people were followed from baseline to death to see if what they ate contributed, and determining amounts along with following other variables as they progress (lifestyle issues with exercise, smoking, etc). This instead is a study based on food questionnaires, and statistical analysis. Correlation does not imply causation.

One has to be careful with epidemiological studies, as they are not  proof of a cause, rather they point to a number of variables that might be involved to form a hypothesis. It is these same types of statistical studies that told us that women should use hormone replacement therapy because it prevents heart attacks in 1991, only to be told 11 years later that it might cause heart attacks. It is a sampling bias of those individuals who choose to participate in the studies that led to the erroneous conclusions.

The second issue with these studies is the ability of the food questionnaire and its accuracy. This has been studied – that is, the ability of people to recall and fill out what they ate. We do this in our office all the time- ask people what they eat—and since we are involved in weight loss and healthy lifestyle here is what we can say: people have no ability to remember what they ate, how much they ate much beyond the last day. When studied by others, looking at the questionnaire (FFQ or Food Frequency Questionnaire) in the Nurses’ Health Study was found to be useless. As reported by others, the accuracy of the questionnaire compared to reality was unacceptable.

For example, 20 per cent of the nurses reported living on 1200 calories per day or less, and low intake of red meat, and 20 percent report over 2000 calories a day.

In the study the first table showed that the highest reported red meat consumption was associated with smoking, drinking more, obesity, and higher calories. Oh wait- have you ever heard that smoking, obesity, eating more calories, or drinking more might lead to an early death? Perhaps you have, in fact, there are some correlations (which don’t imply causation) for these, and there are some great prospective studies showing that obesity leads to early death.  Of course, in any statistical paper you can remove the confounding factors – and THEY DID NOT in this paper.

One other cute correlation- in the data, those who report eating the most red meat had the lowest cholesterol levels. Yes, that is odd isn’t it. Readers of this blog know that cholesterol and meat have less to do with one another – and that isn’t a statistical issue, that is just basic biology.  Eating more meat does not mean you will have a higher cholesterol – having bad genetics does.

Here is what three systematic reviews of prospective studies show in the relationship between saturated fat and heart disease- zip. There has been a consistent lack of an associated between saturated fat intake and heart disease. While this new study statistically makes the argument that changing diet would decrease events from heart disease and cancer, when looked at (references below) none of the pooled studies show a change in that risk relationship. And, when some studies have shown a change in risk, when the data was examined there was no difference in mortality. While some say red meat clearly is bad, the evidence is anything but clear. Proving again that population studies, without isolating the variables, without having a scientific basis, are worthless.

Finally, the science of red meat—what do we know? Red meat is a large category of meats includes everything from bacon (considered “processed” by some and delicious by others) to cows raised on grain, and cows raised on grass. Grass fed beef have higher levels of omega-3 fatty acids. Consuming different red meats mean you are consuming different levels of ingredients. Lumping them together is just sloppy science. For part two of this click here.

Nothing like great grill marks on a steak

Skeaff CM, Miller J. Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials. Ann Nutr Metab 2009;55:173–201.

Mente A. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 2009;169:659–69.

Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 2010;91:535–46.

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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Latest Comments

  1. Ken Smith says:

    I gave up meat for a while until I heard about grass fed beef. It’s amazing how much healthier it is for you than grain fed and I know it has higher levels of omega-3 fatty acids. It took me a while to find out where to buy it. But now I order my meats online.

  2. The Doc says:

    We are fortunate that our grocery store carries grass fed beef. Another good source is bison, leaner than beef, always grass fed, and healthy also. Lamb is another red meat that is often grass fed. There are many on-line places to order from, and if you go to public markets often people who raise cattle on grass are there.

  3. Jerry Jones says:

    According to Dr. John A McDougall we can get our Omega-3’s from plant sources saying further, “after all, where do you think the fish are getting them from?” I see you feel grass-fed cattle have higher Omega-3’s than grain-fed cattle. So is Dr. McDougall right? Can I not get my Omega-3’s from Flax Seed Oil? If so, then why would I eat cattle?

  4. The Doc says:

    because cattle taste better.
    Apparently my humor was lost with another reader, so let me answer this more fully. Most human beings cannot digest Flax Seed directly, and the oil can pass through. Having the omega-3 fatty acids broken down by other animals is a more efficient way for humans to digest them. In fact, take any vegetable or grain, and grind it up and do chemical analysis- you will get one level. However, the real question is what happens when the human body gets it and what it does with it. Flax seed oil in a flask is different than how it is obtained and processed by the human body. Humans do not have the capacity to break down cell walls of grains or plants – we need heat, we need acid, we need a lot of things — or we can have an animal that has that capability do it for us, then extract it that way.

  5. Lindsay says:

    “I will lead my life and practice my art with integrity and honor, using my power wisely.” – the Hippocratic Oath

    In response to this person’s honest health question, you actually responded, “Because cattle tastes better?” Does being a doctor mean nothing to you? Do you even have a degree? Have you ever had nutritional training? Your site is beginning to scare me, and I really can’t understand why or how you are helping people create healthy habits in their lives, when you can’t even honor answering a person’s sincere nutritional question. Oh, and remember the quote above? It’s from that Oath you took however many years ago when you became a doctor.

  6. The Doc says:

    Hippocratic Oath is not what most doctors use today – it was ok maybe a thousand years ago, but has been refined and changed and so has the field of medical ethics. I didn’t pledge to it, nor did any from my class. However, we do take our job and education, and ethics seriously. That man’s question was why eat it from cattle- and for many- cattle taste better than flax seed oil.
    But I could give a more refined answer to his question – and will go back and do that.
    You seem to spend a lot of time on this site for someone who doesn’t like it

  7. mhikl says:

    We are all responsible for our own deaths.

    Those who choose to use Crisis Medicine only, who fail to do their own research, who do not take the time to listen to what their bodies are telling them, who rarely modify and experiment with different foods and life styles to understand their powers and who accept without question what the media, the government, the food industry, their friends and the medical profession say without question, get the health and death they have chosen. Yet we have entered a golden age of information and choice, and are better able to choose to learn and educate ourselves as to what is the best way to lead healthy lives. Instead, so many waste their spare time on irrelevant mind dulling activities and blindly accept the dogma that is fed them daily.

    If I have a broken bone, desire analysis of my blood, or have some mysterious ailment, I will choose to go to an heroic practitioner. But for information on nutrition and answers to good health, going to most government sanctioned sources is like going to charlatans who works by incantation and mysterious card tricks. They dumb down the information and interpretation of your medical condition according to convention and spout out recipes that fail to heal the underlying conditions responsible for your discomfort.

    My doctor kept telling me that my LDL numbers were too high. What she fails to tell me, unless I ask, is that my HDL is high and my triglycerides, exceptionally low (0.9 mmoL/L ~ 80 mg/dl). I have to explain to her that the most likely scenario is that I have no dangerous small compact LDL molecules, only the more numerous large fluffy healthy kind. She agrees that is a possibility. Further testing or faction of my LDL shows this to be true. Is she so overwhelmed by the dogma spouted by the likes of that pompous flake, Dean Ornish, the government, the media, the food corporations and her profession’s expectations of its members that her understanding of the facts are not her first resource for understanding?

    A friend my age, had/still has pancreatic cancer and it has moved to his liver. He will suffer further radiation and chemotherapy. He will die. The industries that profit from human miseries will gleefully profit until cancer finally triumphs. I have read now a number of times that one out of two men and one out of three women will die from cancer. These were not the statistics from 1900. Illness and death from cancer and heart disease was a rarity; meat and animal fat were cheap and plentiful, processed foods a rarity.

    The body, given proper nutrition, heals itself. And I must reiterate, we choose our own deaths by how we treat our bodies. I do not think it is too far fetched to say that the medical profession, the corporate food industry and the government agencies responsible for this mayhem are truly amoral and need to be held responsible for the travesty they have perpetrated on humanity.

    Glad I found your site, Dr Simpson.

  8. The Doc says:

    Thank you for your comments. The nutrition in 1900 was not as good as we have today – we have, in spite of our affinity for the cheeseburger (and I am hungry now so that is a tempting thought) – a much more balanced diet. The statistics from 1900 were also where lifespan was 46years old, so people didn’t live long enough to get cancer.

    That being said- I spend more time thinking about, and more time teaching patients how to cook and how to eat than I do performing surgery. My belief is based on one glaring statistic: patients of mine (weight loss surgery) who learn to cook, and cook – do very well, and those who do not cook do not. Those who eat out- and where they eat is not a great restaurant with good local foods, with plenty of vegetables — do not lose the weight as much as those who spend time learning about their own nutrition.

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