Meatless Monday and Beyond!

A new study gives more reason to “go fish” and reduce animal-based protein sources in your diet. According to a new study from Northwestern Medicine and Cornell University, consuming just 2 servings of beef, processed meat, or poultry on a weekly basis has been found to raise the risk of cardiovascular disease by 3 to 7%. Having 2 servings of red meat or processed meat weekly (but not poultry or fish) was linked with a 3% risk of all cause mortality.Norrina Allen, associate professor of preventive medicine at Northwestern University Feinburg School of Medicine, states that while the difference is small, it’s worth reducing consumption of red meat and other meats like pepperoni, bologna, and deli meats. In addition to cardiovascular disease, red meat intake is frequently associated with other chronic diseases such as cancer.Victor Zhong, assistant professor of nutritional sciences at Cornell and who worked with Allen as a postdoctoral fellow, notes that adjusting consumption of animal protein is an important step in reducing the chance of cardiovascular disease and early death on a population level.The recent study follows a controversial meta-analysis last November, which suggested that people need not worry about reducing their red meat intake. Most people assumed it was OK to continue to eat red meat, but the latest study does not support this, according to Allen.Linda Van Horn, a professor of preventive medicine at Feinburg and a member of the 2020 US Dietary Guidelines Advisory Committee advises more fish, seafood, nuts, legumes, and other plant-based proteins such as beans and peas. She notes that these foods are under-consumed in the US.Although the study found a positive link between poultry intake and cardiovascular disease, there is not enough evidence to make a distinct recommendation about poultry consumption, according to Zhong. Obviously, fried chicken is not advised.Diverse study samples were pooled from six cohorts which included long follow-up data up to 30 years, harmonized diet data to limit heterogeneity, adjusted a comprehensive set of cofounders and completed multiple sensitivity analysis. Nearly 29,000 participants (average age 53.7 years at baseline, 44.4% mean, 30.7% non-white). Participants self-reported diet data and were questioned about what they’d eaten for the past year or month. Findings included:

• For those consuming two servings a week of red meat or processed meat, a 3 to 7% higher risk of cardiovascular disease and premature death.
• For those consuming two servings of poultry per week, a 4% higher risk of cardiovascular disease, though evidence so far may be related to the cooking method of chicken and consumption of skin versus chicken meat.
• No link observed between fish intake and cardiovascular disease or mortality.

The authors note a few limitations with the study, including subjects’ dietary intake only being evaluated once, and habits may have changed over time. Cooking methods for various foods were not considered, so fried chicken and other deep fat-fried sources that provide trans fat (such as fried chicken or fish), have been associated with chronic diseases, according to Zhong.The study was funded by National Institutes of Health/National Heart, Lung, and Blood Institute (R21 HL085375), American Heart Association Strategically Focused Research Networks and the Feinberg School of Medicine.Finally, here are some tips to advise your clients who are trying to reduce their risk of cardiovascular and other diseases:

• Make Meatless Monday happen more often. Keep beans, lentils and other non-animal protein sources on hand, such as tofu or tempeh.
• Keep fresh or frozen fish or other seafood available to reduce intake of red meat.
• Increase intake of fruits and vegetables and reduce serving sizes of animal protein.
• Limit intake of fried meats -- including fried chicken and/or fish.
• Avoid processed deli meats, sausage, pepperoni, and bacon. In addition to heart disease, these are also linked with several gastrointestinal cancers.

By Lisa Andrews, MEd, RD, LDReferences:

1. Victor W. Zhong, Linda Van Horn, Philip Greenland, Mercedes R. Carnethon, Hongyan Ning, John T. Wilkins, Donald M. Lloyd-Jones, Norrina B. Allen. Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake with Incident Cardiovascular Disease and All-Cause Mortality. JAMA Internal Medicine, 2020; DOI: 10.1001/jamainternmed.2019.6969
2. Diallo A1,2, Deschasaux M1, Latino-Martel P1, Hercberg S1,2, Galan P1, Fassier P1, Allès B1, Guéraud F3, Pierre FH3, Touvier M1. Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study.Int J Cancer. 2018 Jan 15;142(2):230-237.