Page last updated at 00:48 GMT, Tuesday, 18 May 2010 01:48 UK
'Sausage not steak' increases heart disease risk
Researchers believe it may be the salt, not the fat, that's the problem
Eating processed meat such as sausages increases the likelihood of heart disease, while red meat does not seem to be as harmful, a study suggests.
A Harvard University team which looked at studies involving over one million people found just 50g of processed meat a day also raised the risk of diabetes.
But there was no such risk from eating even twice as much unprocessed meat, such as beef, lamb or pork.
This was despite the fact the two forms of meat have a similar fat content.
Writing in the journal Circulation, the researchers speculated that given the similar quantities of cholesterol and saturated fats, the difference may be explained by the salt and preservatives added to processed meats.
This is defined as any meat preserved by smoking, curing or salting and includes bacon, sausages, salami and other luncheon meats.
Salt can increase blood pressure in some people, a key risk factor for heart disease.
In animal experiments, nitrate preservatives can promote atherosclerosis and reduce glucose tolerance, which can in turn lead to heart problems and diabetes.
The team from Harvard School of Public Health looked at 20 studies involving more than one million participants from 10 countries.
On average, each 50g serving of processed meat per day - the equivalent of a sausage or a couple of rashers of bacon - was associated with a 42% higher chance of developing coronary heart disease and a 19% higher risk of diabetes.
Go for lean cuts and aim to cook from scratch using healthier cooking methods like grilling or baking
Victoria Taylor, British Heart Foundation
"Although cause-and-effect cannot be proven by these types of long-term observational studies, all of these studies adjusted for other risk factors," said Renata Micha, lead author.
"Also, the lifestyle factors associated with eating unprocessed meats and processed meats were similar, but only processed meats were linked to higher risk."
Victoria Taylor, senior heart health dietician at the British Heart Foundation, said: "If you like red meat, this can still be included as part of a balanced heart-healthy diet.
"Go for lean cuts and aim to cook from scratch using healthier cooking methods like grilling or baking. If you need to add flavour, then try using fresh and dried herbs, spices and chillies instead of salt."
A spokesman for BPEX, which represents pork producers, insisted processed meats could form part of a balanced diet.
He suggested further research was needed before any dietary recommendations could be made.
"Various studies indicate that high consumption of processed meat can be indicative of an overall poorly balanced diet: therefore it could be other aspects of the diet that are contributing to the increase in risk," he added.
Circulation, May 2010; doi:10.1161/CIRCULATIONAHA.109.924977
Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus. A Systematic Review and Meta-Analysis
Renata Micha RD, PhD*, Sarah K. Wallace BA, and Dariush Mozaffarian MD, DrPH
From the Department of Epidemiology (R.M., S.K.W., D.M.), Harvard School of Public Health, and Division of Cardiovascular Medicine and Channing Laboratory (D.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.
* To whom correspondence should be addressed. E-mail: firstname.lastname@example.org.
Background―Meat consumption is inconsistently associated with development of coronary heart disease (CHD), stroke, and diabetes mellitus, limiting quantitative recommendations for consumption levels. Effects of meat intake on these different outcomes, as well as of red versus processed meat, may also vary.
Methods and Results―We performed a systematic review and meta-analysis of evidence for relationships of red (unprocessed), processed, and total meat consumption with incident CHD, stroke, and diabetes mellitus. We searched for any cohort study, case-control study, or randomized trial that assessed these exposures and outcomes in generally healthy adults. Of 1598 identified abstracts, 20 studies met inclusion criteria, including 17 prospective cohorts and 3 case-control studies. All data were abstracted independently in duplicate. Random-effects generalized least squares models for trend estimation were used to derive pooled dose-response estimates. The 20 studies included 1 218 380 individuals and 23 889 CHD, 2280 stroke, and 10 797 diabetes mellitus cases. Red meat intake was not associated with CHD (n=4 studies; relative risk per 100-g serving per day=1.00; 95% confidence interval, 0.81 to 1.23; P for heterogeneity=0.36) or diabetes mellitus (n=5; relative risk=1.16; 95% confidence interval, 0.92 to 1.46; P=0.25). Conversely, processed meat intake was associated with 42% higher risk of CHD (n=5; relative risk per 50-g serving per day=1.42; 95% confidence interval, 1.07 to 1.89; P=0.04) and 19% higher risk of diabetes mellitus (n=7; relative risk=1.19; 95% confidence interval, 1.11 to 1.27; P<0.001). Associations were intermediate for total meat intake. Consumption of red and processed meat were not associated with stroke, but only 3 studies evaluated these relationships.
Conclusions―Consumption of processed meats, but not red meats, is associated with higher incidence of CHD and diabetes mellitus. These results highlight the need for better understanding of potential mechanisms of effects and for particular focus on processed meats for dietary and policy recommendations.
Key words: cardiovascular diseases • diabetes mellitus • diet • meat • meta-analysis
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