Hamburgers, steaks and other red meats are staples of the American diet, and their effects on the heart have been under scrutiny for some time. So are these foods behind heart disease — or not?
The answer isn't completely clear-cut. While most studies have concluded that red and processed meats increase the risk for heart disease, other studies do not confirm that link.
Still, the American Heart Association (AHA) recommends keeping the amount of saturated fat, found mostly in red meat and full-fat dairy products, to just 5 to 6 percent of your daily calories. That means if you eat 2,000 calories a day, you should have just 100 to 120 calories, or about 13 grams, of saturated fat. Keep in mind that fatty or marbled cuts of red meat can be especially high in saturated fat. Saturated fat raises LDL (low-density lipoprotein) cholesterol — the bad type — which is known to raise the risk for heart disease.
The World Cancer Research Fund International notes that meat can be a good source of certain nutrients, including protein, vitamin B12, iron and zinc. But this organization also recommends limiting red meat in your diet to no more than three servings a week of about 4 to 6 ounces per serving. It also advises eating little or no processed meats, which have the additional negatives of preservatives and a lot of salt.
Red meat officially includes:
- Lamb and mutton
Any meat that has been altered by salting, smoking, curing or another processing method to enhance flavor is considered processed. Examples include:
- Deli ham
- Hot dogs
- Some types of sausage, such as chorizo
What we know about red meat and heart health
In its 2019 guidelines for preventing heart and blood vessel conditions, the AHA recommended a healthy diet focusing on vegetables, fruits, nuts, whole grains, lean plant or animal protein and fish. It also recommended limiting refined carbohydrates, sweetened drinks, red meat and processed meats.
These guidelines were based on a review of extensive research, including multiple studies on nutrition. Most of these were observational studies, which makes it difficult to prove a definite link between one type of food and a bad health outcome, such as heart disease. However, based on the available evidence, which consistently suggests a link between red and processed meats and heart and blood vessel disease, the association recommended limiting the consumption of these types of foods.
However, the AHA guidelines were largely contradicted by research published in November 2019 in the Annals of Internal Medicine. This was a systematic review that concluded that the guidelines that advise limiting red and processed meats are based on low-certainty evidence. The analysis that led to this conclusion involved dozens of studies with millions of participants. But the findings are controversial, and some health experts have questioned the methods this research team used to determine those findings.
Authors of an editorial about this study in The BMJ noted that the researchers had no new data, but rather used the same information that other scientists have used but came to a different conclusion. The editorial authors reiterated that eating less meat and more vegetables, fruits and fiber is still a good bet for good health.
Another recent study done at Harvard, also published in The BMJ, didn't look specifically at heart and blood vessel disease, but rather at whether eating red and processed meat was associated with a higher risk of dying in general. The study included 80,000 adults. The Harvard research team found that the more red or processed meat consumed, the higher the risk of dying during the study period. Also, the risk of dying was more heavily associated with processed meat than with unprocessed red meat.
Also in November 2019, an international team of scientists published a study in PNAS (Proceedings of the National Academy of Sciences of the United States of America) that looked at the health and environmental impacts of food. They found that foods with the biggest negative environmental impacts were unprocessed and processed red meats, and that these foods were also consistently linked to the greatest increases in disease risk. The researchers said that if people moved toward healthier diets, the health of the environment would likely improve, too.
How much red meat is too much?
If research can't definitively prove that red and processed meats are bad for the heart, you might be wondering if you really need to stop eating these foods. One thing that many experts do agree on is that it's a good idea to limit both red and processed meats. Health groups, including the AHA and the American Cancer Society (ACS), state that a diet with less red meat or processed meat is a healthier diet.
One reason is that although the link between heart disease and red and processed meats isn't as clear as people would like, the ACS notes that processed meat has been classified as a probable carcinogen by the International Agency for Research on Cancer. A carcinogen is a substance that causes cancer.
Eating processed meat daily has been linked to a slightly higher risk for colon and rectal cancer, the ACS says. Eating red meat has been associated with colon, rectal, pancreatic and prostate cancer.
What to eat instead
Since red meat and processed meats are such staples of the American diet, you may be asking exactly what you’d eat if you limited or gave up these foods entirely.
Chicken, turkey, fish and shellfish are all excellent protein sources with less saturated fat than red meat. Slice home-roasted chicken or turkey breast for a to-go sandwich or turn a salad into a meal by adding grilled chicken slices. Be sure to skip the skin to limit saturated fat. Take it off before cooking or definitely before eating to keep your meal leaner.
Fish is a great way to get the protein you usually get from meat. And fatty fish, such as salmon, contain omega-3 fatty acids, which are thought to be good for heart health. These fatty acids help reduce the risk for heart disease and stroke, according to the AHA. Try replacing processed deli meat with tuna salad on your sandwich, and consider grilling a salmon steak for dinner once a week.
Low- or no-fat dairy products, eggs, nuts and nut butters are also good sources of protein. So are legumes, such as lentils, dried peas and beans. From red and brown lentils to yellow and green peas to beans in every color, there’s room for experimenting, and many exotic cuisines use them as the base of main dishes. In the morning, you can add beans to scrambled eggs, a breakfast burrito or a vegetable omelet. At lunch or dinner, try a hearty lentil soup or a black bean burger. Add a few types of beans to a dinner casserole, the AHA suggests.
If you want to keep eating some red meat, the AHA advises choosing leaner cuts. Look for cuts like round, sirloin or loin — the less white fat you see, the less saturated fat is in the cut. Before cooking any meat, trim off all visible fat.
In addition to limiting red and processed meat, there are other important ways to boost your heart health. The AHA also advises limiting the sodium in your diet to less than 2,300 milligrams a day. Lower would be even better. Also, watch out for foods high in calories and low in nutrients, like sugar-sweetened beverages and desserts that have both fat and sugar.
- Circulation. "2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease." https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678
- Annals of Internal Medicine. "Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium." https://annals.org/aim/fullarticle/2752328/unprocessed-red-meat-processed-meat-consumption-dietary-guideline-recommendations-from
- American Heart Association. "Saturated Fat." https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats
- World Cancer Research Fund International. "Limit Red and Processed Meat." https://www.wcrf.org/dietandcancer/recommendations/limit-red-processed-meat
- The BMJ. "Bacon Rashers, Statistics, and Controversy." https://blogs.bmj.com/bmj/2019/10/09/bacon-rashers-statistics-and-controversy
- The BMJ. "Association of Changes in Red Meat Consumption With Total and Cause Specific Mortality Among U.S. Women and Men: Two Prospective Cohort Studies." https://www.bmj.com/content/365/bmj.l2110
- PNAS, Proceedings of the National Academy of Sciences of the United States of America. "Multiple health and environmental impacts of foods." https://www.pnas.org/content/116/46/23357
- American Cancer Society. "What's Wrong with Hot Dogs, Hamburgers, and Bacon?" https://www.cancer.org/latest-news/hot-dogs-hamburgers-bacon.html
- American Heart Association. "Meat, Poultry and Fish: Picking Healthy Proteins." https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/meat-poultry-and-fish-picking-healthy-proteins
- American Heart Association. "The American Heart Association Diet and Lifestyle Recommendations." https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations