Guide to red meat – is it healthy?

Is red meat healthy or harmful? Should you enjoy it freely on your low-carb, keto diet, or limit your consumption?

Depending on which expert you ask, those questions may receive a very different answer.

However, has a truly strong link between red meat and heart disease, cancer, or other diseases been established? Will consuming it on a regular basis shorten your life or put you at risk of health problems?

Here is our guide to what we currently know about red meat, so you can make an informed decision about whether to include it in your own diet and, if you do, how much of it you may decide to eat each week.


What is “red meat”?

Red meat comes from mammals. When raw, it usually appears dark red because it contains a lot of myoglobin, the iron-rich protein that stores oxygen in animal muscle. The red meat category includes beef, pork, lamb, veal, goat, bison, venison and other game. The term “red meat” can be a bit confusing, though, since veal and pork flesh are often light in color while duck, as well as salmon and some other fish are reddish. However, when discussing meat from a nutritional standpoint, “white meat” refers to poultry and fish, which contain less myoglobin and iron than red meat.

Red meat can be fresh or processed. Fresh red meat is exactly what it sounds like: meat that contains no additives, requires refrigeration, and needs to be consumed within a few days, after roasting, grilling, or stewing etc.

Processed red meat is a broader term referring to meat that’s been modified by salting, curing, smoking, canning, or treating with preservatives. Popular types include bacon, salami, sausage, hot dogs, and jerky. The shelf life of various processed meats span a very wide range; certain types last for only a few days in the refrigerator, while dried or canned types can remain edible for several months or even years when stored at room temperature. Additionally, some processed meats contain salt as their sole additive, whereas others may include sugar, starch, other fillers, and chemicals such as nitrites.


Benefits of eating red meat

Animal foods are an important part of our evolutionary past, playing critical roles in our development as a species. Meat in particular has been credited with allowing us to develop the large, complex brains that are unique to humans.1 Indeed, we may be genetically wired to enjoy the flavor and texture of meat from a very early age.

In addition to being tasty and filling, red meat provides many nutritional benefits:

  • High-quality protein: A 100-gram (3.5-ounce) serving of red meat contains about 20-25 grams of protein, depending how fatty it is (leaner cuts have more protein). Like eggs, dairy, and other animal products, red meat provides protein that is considered complete, meaning it contains all nine essential amino acids in the optimal amounts your body needs.2 Learn more about protein:
    Eggs_dark_gray_background

    Protein on a low-carb or keto diet

    Guide Along with fat and carbohydrates, protein is one of the three macronutrients (“macros”) found in food, and it plays unique and important roles in the body. Here’s a guide to everything you need to know about protein on a low-carb or keto lifestyle.

  • Several vitamins and minerals: Red meat is an excellent source of many important micronutrients, including vitamin B12, niacin, selenium, and zinc. A 4-ounce (114-mg) serving of red meat also provides about 400-500 mg of potassium — the same or more than you’d get in an average-size banana (422 mg).
  • Heme iron: All types of red meat are rich in heme iron, which your body absorbs more easily than the non-heme form of iron found in plants. Consuming red meat on a regular basis may help optimize your iron stores and prevent iron-deficiency anemia.3
  • May help preserve muscle: It’s an unfortunate fact that we usually lose muscle as we age due to hormonal and other physiological changes. In one study, older women who consumed 160 grams (5.6 ounces) of red meat six days a week in combination with resistance training achieved greater gains in lean muscle and strength than the resistance-training-only group.4 Similar improvements have been shown in studies of young and middle-aged men who consumed beef and triathletes who took beef-based supplements, when compared to men of similar age who ate lacto-ovo vegetarian diets or took whey-based supplements during strength training.5


What does the research show with respect to meat’s potential harm?

Over the past several years, no doubt you’ve noticed that news media have increasingly featured studies showing an association between eating a lot of red meat and increased risks of cancer and heart disease. Some articles have even stated that meat is flat-out “killing us.” But how strong are these associations? Moreover, is relying on results from a few observational studies without taking all available research into account giving us a truly accurate picture of meat’s true effects on health? Let’s take a look at the research on red meat and disease risk to date and assess the strength of the evidence.


Red meat and cancer

In October of 2015, the International Agency for Research on Cancer (IARC) issued a press release classifying processed meat as “carcinogenic” and red meat as “probably carcinogenic” in humans. Yet results of studies examining a link between meat and cancer have been decidedly mixed.

  • Cancers other than colorectal: In large systematic reviews and meta-analyses of observational studies, researchers have found that if there was an increased risk to eating red meat or processed meat it was very weak or not at all associated with developing gastric, esophageal, breast, or prostate cancer.6 (If an association existed at all, the hazard ratios were around 1.18 to 1.2, meaning only a slight increase in risk, which could have been attributed to multiple factors. In comparison, cigarette smoking has a hazard ration of 3.0, meaning people who smoke are three times more likely to get cancer than those who don’t smoke.)
  • Colorectal cancer: By far the most common type of cancer studied for its relationship to red meat, colorectal cancers, however, have shown very weak associations with high red meat intake in systematic reviews of observational research.7 In some cases, this association has been attributed to heterocyclic amines (HCAs) and other potentially harmful compounds that form when meat is cooked at high temperatures.8 The heme iron found in red meat has also been suggested as a possible risk factor for any increased association, based on findings in animal and observational studies.9 However, other studies have failed to show a connection between ingesting these substances and developing colorectal cancer.10

Some researchers have pointed out that a clear relationship between red meat and colon cancer hasn’t been established due to weak correlations and different findings among studies. They note that many other lifestyle factors, other than meat eating, could in fact be influencing results, such as high sugar and/or alcohol intake, smoking, and decreased physical activity — or even another dietary factor.11 Some of these factors may be contributing to the recent global steady rise in colorectal cancer among those under 40 years of age. In general, young people today are not heavy-meat eaters, in fact, they tend to adopt vegetarian or vegan lifestyles more often than older people do.

As an illustration to how weak and uncertain the potential link between red meat and colon cancer appears to be, a large UK study looking at relationships between nutrition and cancer found more cases of colorectal cancer among vegetarians compared to meat eaters.12

In contrast to the large amount of weak observational research available, very little experimental research on red meat consumption and colon cancer exists, at least in humans. One study in people with precancerous colon polyps found that drastically cutting back on red meat over a four-year period did NOT decrease the risk of polyp recurrence.13 Results from animal and cell studies on red meat and colorectal cancer have been mixed. Moreover, a 2017 systematic review of these experimental studies found that the meat amounts tested were frequently much larger than what most people eat, and that many didn’t include potentially protective whole foods that are typically consumed in healthy, balanced diets.14


Red meat and heart disease

Some studies have claimed to show a relationship between eating a lot of red meat and increased cardiovascular disease (CVD) risk, although here again, results have been inconclusive.

In a few comprehensive reviews and meta-analyses of observational studies, red meat has been weakly associated with heart disease and CVD-related death.15 A 2010 review found that consuming processed meat was weakly associated with an increased risk of heart disease whereas consuming red meat was not.16 Another showed that eating a lot of red meat was associated with a slightly increased the risk of having a stroke but it was not associated with an increased the risk of stroke-related death.17

Other large reviews have failed to find any relationship between red meat and increased risk of ischemic heart disease (also known as coronary artery disease), the most common form of CVD.18 And recently, a meta-analysis of randomized controlled trials (considered the strongest, highest-quality evidence) showed that eating three or more servings of red meat per week had no adverse effects on CVD risk factors like cholesterol, triglyceride or blood pressure values.19

For many years, health authorities have been recommending that in order to protect the health of our hearts, we should choose lean cuts of meat rather than marbled steak and other meats high in saturated fat. However, this advice may be misguided, as there really isn’t any strong, convincing evidence that consuming saturated fat contributes to heart disease.

Fresh organic dairy products

A user guide to saturated fat

Guide This guide explains what is known about saturated fat, discusses the scientific evidence about its role in health, and explores whether we should be concerned about how much we eat it.

Another concern that’s been raised about red meat is that it may raise levels of TMAO (trimethylamine-N-oxide) in the body, which some researchers believe may increase heart disease risk. Yet what’s often not mentioned is that eating many other foods — including plants — results in the same effect. Cardiologist Dr. Bret Scher, a contributor to Diet Doctor, wrote about the inconclusive evidence for a relationship between TMAO and CVD, citing a recent study and saying: “Based on these mixed findings, the jury is still out, and we have plenty of reason to question the importance of elevated TMAO as an independent risk marker or causative factor of coronary disease.”20


Red meat and insulin-resistant conditions

Some studies suggest that eating red meat on a regular basis may increase the risk of diabetes and other conditions characterized by insulin resistance.

  • Diabetes: Several large reviews of observational studies have found weak associations between frequent red meat and processed meat consumption and diabetes risk.21
  • Obesity and metabolic syndrome: A 2014 systematic review showed a weak relationship between red meat and obesity but a much stronger one between red meat and large waist size.22 Analysis of data from the PREDIMED trial — a large study exploring health-related effects of the Mediterranean diet — found that people who reported the highest red meat intake were more than twice as likely to develop metabolic syndrome and eight times as likely to be centrally obese (defined as having a very large waist size) as those who reported the lowest meat consumption.23This association remained even after researchers made adjustments for the participants’ self-reported smoking, alcohol consumption, calorie intake and physical activity.24On the other hand, a well-controlled trial in overweight and obese people found that including 500 grams (about 5 servings) of lean red meat per week as part of a Mediterranean diet resulted in equal or better weight loss and reduction in metabolic risk factors compared to following the same basic diet but eating much less red meat.25
  • Gout: A painful form of arthritis, gout is characterized by high levels of uric acid in the blood (hyperuricemia). People with gout are usually advised to strictly limit the amount of red meat they eat. However, a recent systematic review of 19 observational studies found that consuming red meat intake was only weakly associated with gout and elevated uric acid levels, whereas alcohol and fructose intake were found to have stronger correlations with each of these conditions.26


Red meat and all-cause mortality

It may be difficult to count all the times you’ve heard that eating red meat on a regular basis could shorten your life. Although researchers may conclude that high intake of red meat has been linked to increased risk of death from any cause in several studies, the associations have always been very weak, with hazard ratios consistently under 1.4.27 What’s more, a 2013 review of dietary habits among Asians not only found no association with increased risk of death among red meat eaters but also a slightly decreased risk of CVD mortality in men and cancer mortality in women who reported the highest intake of meat.28

Videos about meat

Five facts to keep in mind about red meat evidence

When you repeatedly hear that eating red meat is unhealthy and could possibly shorten your life, it’s entirely understandable to become concerned. However, keep several things in mind.

  1. Observational data: Studies showing a relationship between red meat and disease risk have several problems, first and foremost being that they rely on observational rather than experimental data. Observational studies can only infer a relationship between a behavior (such as meat eating) and an outcome (such as cancer or heart disease), and unless correlations between the two are extremely strong (hazard ratios greater than 3) and consistent across multiple studies, they can’t be relied upon to draw conclusions. Too many other factors can influence the results. For instance, red meat is often singled out as the villain regardless of overall diet quality and composition. Does a person who typically consumes a dinner of 150 grams (5 ounces) of steak, salad, and coffee with cream carry the same level of disease risk as someone who typically eats the same amount of steak with french fries, a soda and a sugary dessert? It seems highly unlikely.
  2. Food frequency questionnaires: Another major problem with observational studies is the common practice of using food frequency questionnaires to assess how much red meat people actually consume. They rely on memory recall and annual estimates and are notoriously unreliable.29 Moreover, these questionnaires are usually only filled out a few times over the course of a long study period. Obviously, what someone eats can change dramatically within a 5-year period, even if reporting food intake with 100% accuracy were at all possible.
  3. Processed meat not all alike: Processed meat elicits more health warnings, but lumping all processed meat into the same category when assessing risk isn’t really fair. Although many types are made with poor-quality meat and unhealthy ingredients, other smoked and cured meats contain few additives and can be quite nutritious. What’s more, even though correlations are stronger for processed meat than fresh meat, they are still extremely weak overall.
  4. Healthy user bias: With red meat getting a bad rap these past few decades, the healthy user bias also comes into play. Many people who heed the warnings in recent years to eat little or no red meat will also follow advice to exercise regularly, avoid fast food and reduce alcohol intake. Such people also tend never to smoke and to practice other health-conscious behaviors. They also tend to have more education, better jobs and earn more money. The reduced disease risk found in these individuals is much more likely due to their healthier lifestyles and their better socio-economic factors, which have all been linked to better health, than to their lack of red meat consumption alone.
  5. Few human RCTs: Unfortunately, very few randomized controlled trials looking at humans eating red meat and health have been conducted, although those that do exist suggest that consuming it regularly might in fact be beneficial for our health.30 At this point, we have many observational studies that in nearly all cases show less-than-convincing associations between red meat and disease risk, and sometimes no relationship between the two at all.

Because of the lack of high-quality research in this area, it’s impossible to state that eating red meat on a regular basis will jeopardize your health or longevity.


Healthy choices for red meat eaters

While there isn’t enough evidence to indict red meat as harmful, these options for including it in your diet could potentially be best for your own health and the health of our planet.

  • Choose fresh red meat over processed types: Like other types of food, fresh usually wins over processed because it contains no preservatives or additives. If you are consuming processed red meat, look for types without sugar, fillers, or other questionable ingredients.
  • Avoid charring or overcooking meat: Although the evidence to date remains inconclusive, the heterocyclic amines (HCAs) that form when meat cooked at high temperatures and allowed to burn or char may possibly raise the risk of cancer, especially colon cancer. Enjoy your burgers and steaks cooked to medium or less doneness.
  • Whenever possible, select red meat from naturally raised animals: Grass-fed or pastured animals have better omega-3 fatty acid, conjugated linoleic acid, and antioxidant profiles than grain-fed animals.31
  • Make environmentally healthy red meat choices: Learn more in Anne Mullens‘s three-part series, The green keto meat eater:

So, all-in-all: should you eat red meat?

Based on what is currently known, should you consume red meat?

It really depends on your personal preferences and beliefs.

If you don’t like the taste of red meat or don’t want to eat animals, you don’t need to feel you must eat red meat or any meat at all. You can still enjoy the benefits of a carb-restricted lifestyle by following a well-balanced diet that doesn’t include red meat, poultry or fish and eat instead a keto vegetarian diet:

Vegetarian keto

How to follow a healthy vegetarian keto diet

Guide Are you a vegetarian interested in experiencing the many benefits of a keto diet? A vegetarian keto lifestyle is definitely doable. However, there are some potential health issues to be aware of. Read this guide to learn how to follow a vegetarian keto diet in a healthy, sustainable way.

However, if you avoid or limit red meat because you’re concerned about its health effects, you may want to reconsider. Although it can be hard to ignore the many negative messages about red meat, the science around its health impact is decidedly weak, if conclusive at all. It’s equally hard to accept that a food humans evolved on and our ancestors consumed for millions of years could suddenly become harmful.

Interestingly, despite red meat being classified as a “probable carcinogen,” the American Institute for Cancer Research recommends consuming up to 18 ounces (510 grams) per week (about 5-6 servings per week), although they do advise choosing lean cuts and avoiding processed meat altogether. The American Heart Association makes similar recommendations for red meat consumption.

Overall, the evidence against red meat is very weak; more rigorous experimental research is necessary in order to determine its health impacts, particularly when included in healthy diets based on a variety of whole foods. Making red meat a regular part of your diet will help ensure that you receive high-quality protein and many important nutrients in a tasty, satisfying package.


Additional resources

Videos

Nina Teicholz: What about red meat and health?
 
Dr. Peter Ballerstedt: Grass-based health and the ruminant revolution

Article

Dr. Jason Fung: Why red meat won’t kill you

/ Franziska Spritzler, RD


  1. Journal of Nutritition. 2003: The critical role of animal source foods in human (Homo) evolution [weak evidence]

  2. Journal of Sports Science Medicine 2005: Protein – Which is best? [weak evidence]

  3. Nutrients 2016: Is higher consumption of animal flesh foods associated with better iron status among adults in developed countries? A systematic review [moderate evidence]

  4. American Journal of Clinical Nutrition 2014: Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial [moderate evidence]

  5. Consumed beef

    American Journal of Clinical Nutrition 1999: Effects of an omnivorous diet compared with a lactoovovegetarian diet on resistance-training-induced changes in body composition and skeletal muscle in older men [weak evidence]

    Beef-based supplements

    Journal of American College of Nutrition 2017: Effects of supplementation with beef or whey protein versus carbohydrate in master triathletes [moderate evidence]

  6. Gastric

    Oncotarget 2017: Red and processed meat consumption and gastric cancer risk: a systematic review and meta-analysis [Weak statistical correlation; likely random and false]

    Esophageal

    Nutrition Review 2013: Meat, fish, and esophageal cancer risk: a systematic review and dose-response meta-analysis [Weak statistical correlation; likely random and false]

    Breast

    International Journal of Cancer 2018: Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies [Weak statistical correlation; likely random and false]

    European Journal of Cancer 2018: Red and processed meat consumption and breast cancer: UK Biobank cohort study and meta-analysis [Weak statistical correlation; likely random and false]

    Prostate

    Nutrition Journal 2015: A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer [Weak statistical correlation; likely random and false]

  7. Oncotarget 2017: Red and processed meat consumption and colorectal cancer risk: a systematic review and meta-analysis [Weak statistical correlation; likely random and false]

    International Journal of Cancer 2016: Meat subtypes and their association with colorectal cancer: Systematic review and meta‐analysis [Weak statistical correlation; likely random and false]

  8. Cancer Epidemiology, Biomarkers & Prevention 2018: Dietary heterocyclic amine intake and colorectal adenoma risk: A systematic review and meta-analysis [Weak statistical correlation; likely random and false]

    Nutrients 2017: Dietary intake of meat cooking-related mutagens (HCAs) and risk of colorectal adenoma and cancer: A systematic review and meta-analysis [Weak statistical correlation; likely random and false]

  9. Cancer Research 2015: A central role for heme iron in colon carcinogenesis associated with red meat intake [Weak statistical correlation; likely random and false]

  10. Nutrition Journal 2015: A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer [Weak statistical correlation; likely random and false]

    Environmental Health Perspectives 2016: A prospective analysis of meat mutagens and colorectal cancer in the nurses’ health study and health professionals follow-up study [Weak statistical correlation; likely random and false]

  11. European Journal of Cancer Prevention 2011: Meta-analysis of prospective studies of red meat consumption and colorectal cancer [Weak statistical correlation; likely random and false]

    Obesity Review 2011: Red meat and colorectal cancer: a critical summary of prospective epidemiologic studies [Overview article]

  12. This in no way proves that being a vegetarian increases the risk of cancer – observational data like this is notoriously weak evidence. However, it is a bit stronger for questioning any stronger link between meat and cancer. It’s questionable that meat could be a major cause of colorectal cancer, with a finding like this, pointing in the opposite direction.

    American Journal of Clinical Nutrition 2009: Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) [Weak statistical correlation; likely random and false]

  13. European Journal of Cancer Prevention 2004: Meat intake and the recurrence of colorectal adenomas [moderate evidence]

  14. Experimental Biology and Medicine (Maywood) 2017: Association between red meat consumption and colon cancer: A systematic review of experimental results [weak evidence]

  15. British Journal of Nutrition 2014: Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies [Weak statistical correlation; likely random and false]

    Current Atherosclerosis Report 2013: Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes – An updated review of the evidence [Weak statistical correlation; likely random and false]

  16. Circulation 2010: Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis [Weak statistical correlation; likely random and false]

  17. Journal of the American Heart Association. 2017. Role of total, red, processed, and white meat consumption in stroke incidence and mortality: A systematic review and meta‐analysis of prospective cohort studies [Weak statistical correlation; likely random and false]

  18. Meat Science 2015 Red meat consumption and ischemic heart disease. A systematic literature review [Weak statistical correlation; likely random and false]

  19. American Journal of Clinical Nutrition 2017: Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials [strong evidence]

  20. Journal of the American Heart Association 2016: Microbiota-dependent metabolite trimethylamine n-oxide and coronary artery calcium in the coronary artery risk development in young adults study (CARDIA) [weak evidence]

  21. Diabetologia 2009: Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies [Weak statistical correlation; likely random and false]

    Health and Quality of Life Outcomes 2018: Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis [weak evidence]

    European Journal of Epidemiology 2017: Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies [Weak statistical correlation; likely random and false]

    Nutrients 2017: Dietary protein consumption and the risk of type 2 diabetes: A systematic review and meta-analysis of cohort studies [Weak statistical correlation; likely random and false]

  22. Obesity Review 2014: Is there a relationship between red or processed meat intake and obesity? A systematic review and meta-analysis of observational studies [weak evidence]

  23. New England Journal of Medicine 2018: Primary prevention of cardiovascular disease with a Mediterranean diet [moderate evidence]

  24. Nutrition, Metabolism & Cardiovascular Diseases 2012: Association between red meat consumption and metabolic syndrome in a Mediterranean population at high cardiovascular risk: cross-sectional and 1-year follow-up assessment [weak evidence]

  25. American Journal of Clinical Nutrition 2018: A Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial [moderate evidence]

  26. Asia Pacifica Journal of Clinical Nutrition 2018: Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review [Weak statistical correlation; likely random and false]

  27. American Journal of Clinical Nutrition 2017: Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies [Weak statistical correlation; likely random and false]

    American Journal of Epidemiology 2014: Red meat and processed meat consumption and all-cause mortality: a meta-analysis [Weak statistical correlation; likely random and false]

    British Medical Journal 2017: Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study [Weak statistical correlation; likely random and false]

    Public Health Nutrition 2016: Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies [Weak statistical correlation; likely random and false]

  28. American Journal of Clinical Nutrition 2013: Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies [Weak statistical correlation; likely random and false]

  29. Cancer Epidemiology, Biomarkers & Prevention 2005: Is It Time to Abandon the Food Frequency Questionnaire? [Commentary — no evidence]

  30. American Journal of Clinical Nutrition 2017: Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials [strong evidence]

  31. American Journal of Clinical Nutrition 2018: A Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial [moderate evidence]

    British Journal of Nutrition 2011: Red meat from animals offered a grass diet increases plasma and platelet n-3 PUFA in healthy consumers [moderate evidence]

    Journal of Nutrition 2010: A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef [weak evidence]