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Animal Frontiers - AMSA Perspectives

Coming to terms: meat’s role in a healthful diet

 

This article in

  1. Vol. 7 No. 4, p. 34-42
     
    Published: September 21, 2017


    * Corresponding author(s): smcneill@beef.org
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doi:10.2527/af.2017.0441
  1. S. H. McNeill *,
  2. K. E. Belk,
  3. W. W. Campbell§ and
  4. C. L. Gifford
  1.  National Cattlemen’s Beef Association, Human Nutrition Research, Centennial, CO 80112
     Colorado State University, Department of Animal Science, Fort Collins, CO 80523
    § Purdue University, Department of Nutrition Science, West Lafayette, IN 47907

Implications

  • Meat provides high quality protein and other essential nutrients to the body, but its role in human health continues to be debated.

  • Meat is a vague term and there is a lack of consistency and specificity in the definition and characterization of meat by nutrition scientists versus meat scientists.

  • The leanness of today’s beef and pork is the result of continuous improvement throughout the meat supply chain, yet lean meat availability is inadequately considered in nutrition research.

  • More consumer research is needed on the understanding of the term “meat” as well as industry and government support and education to help consumers make informed choices about what they eat.


Introduction

Consumption of meat has been a foundational part of human survival for centuries. Yet, in the last few decades, it has become one of the most debated topics regarding the human diet. Widely acknowledged for its nutritive value, meat, recently defined by the American Meat Science Association as “skeletal muscle and associated tissues, fat, bone, etc. derived from mammals, avian, and aquatic species” (AMSA, 2017), contributes high quality protein by providing an adequate pattern of essential amino acids and bioavailable nutrients including iron, zinc, and other essential vitamins and minerals to the diet (FAO, 2011). In fact, 25 yr of advice from the Food and Agriculture Organization of the United Nations (FAO) reflects the value of meat in the human diet, i.e., concluding in 1992, “While…meat is not essential in the diet…the inclusion of animal products makes it easier to ensure a good diet” (FAO, 1992) and in 2011, “Livestock source food is not essential to human nutrition but it is highly beneficial” (FAO, 2011). Despite these facts, all of the “Five W’s” have been asked and continue to be debated regarding the consumption of meat. Who, if anyone, should eat meat? When should meat be included in the diet (how often)? What is meat and what kind of meat is most healthful? Why should meat consumption be encouraged or limited? Where should meat come from? The answer to these questions is beyond the scope of any one review although the following will explore aspects of the ongoing meat debate, including how a lack of standardized methodology to categorize and assess meat intake limits the ability to provide clearer nutrition guidance for meat consumption.

Meat: A Complex Food Group that Lacks a Standardized Lexicon

Scientific confusion on meat’s role in the diet is due, at least in part, to a lack of consistency and specificity with the way meat is defined in human nutrition studies. Defining and assigning meat to researchable categories is an important first step in evaluating and clarifying the role of meat in the diet. Several factors contribute to the heterogeneity of meat definitions used in nutrition research including: investigator definition and/or category assignment, differences in food composition databases and intake assessment questionnaires, variability in consumption practices, and the diversity of products in the meat category. For example, the United States Department of Agriculture (USDA) Food Composition Database, inclusive of the Standard Reference (USDA, 2015), which is considered the gold standard reference for food nutrient data that most nutrition studies rely on for nutrient analysis, includes 3,777 foods that contain the word “beef.” A variety of factors, including grazing and feeding practices, the location and composition of whole-muscle cuts, comminution and/or the addition of varying levels of fat (i.e., ground beef, hamburger), curing (i.e., adding salt, sugar, nitrate, or nitrite for preservation and flavor), enhancement/deep marination (i.e., adding water, phosphates, enzymes, etc. for tenderization), or thermal processing through cooking, smoking, or drying, results in a virtually unlimited degree of meat specifications. Yet, in nutrition studies, the simple term “meat” is often used to represent this wide, complex category of foods. A broad overview of meat definitions in the nutrition literature from epidemiologic studies is presented in Table 1. Many researchers include poultry in their definition of meat, but others separate poultry from meat. It is also common, although not always, to exclude fish/seafood from the definition of meat (Sinha et al., 2009; Missmer et al., 2002), despite consensus among meat scientists that all skeletal muscle qualifies as meat regardless of mammalian, avian, or aquatic origin (AMSA, 2017).


European Prospective Investigation into Cancer (EPIC); n = 519,978 beef, pork, mutton/lamb, horse, goat all meat products including ham, bacon, sausages and a small part of minced meat in ready-to-eat products Ward et al., 2016
Cancer Prevention Study II Nutrition Cohort (CPS II); n = 148,610 bacon, sausage, hamburgers, cheeseburgers, meatloaf or casserole with ground beef, beef (steaks, roasts, etc., including sandwiches), beef stew or pot pie with carrots or other vegetables, liver including chicken livers, pork including chops, roast, hot dogs, ham, bologna, salami, lunch-meat bacon, sausage, hot dogs, ham, bologna, salami, lunch-meat Chao et al., 2005
Women’s Health Initiative (WHI); n = 93,676 red meat not defined, but associations with outcome presented processed meat not defined, associations not reported Thomson et al., 2011
Nurses’ Health Study (NHS); n = 87,108 beef or lamb as main dish, pork as main dish, hamburger, beef, pork, or lamb as a sandwich or mixed dish bacon, beef or pork hot dogs, salami, bologna, or other processed meat sandwiches, and other processed red meats such as sausage, kielbasa, etc. Bernstein et al., 2015
Japan Public Health Center-based Prospective (JPHC); n = 80,658 beef steak, grilled beef, stewed beef, stir-fried pork, deep-fried pork, stewed pork in Western style, stewed pork in Japanese style, pork in soup, pork liver, ham, sausage or Weiner sausage, bacon, luncheon meat, chicken liver ham, sausage or Weiner sausage, bacon, luncheon meat, chicken liver Takachi et al., 2011
Shanghai Women’s Health Study; n = 73,224 red meat not defined, but associations with outcome presented processed meat not defined, no related outcomes reported Lee et al., 2009
Swedish Mammography Cohort; n = 61,433 total red meat consisted of: whole beef, chopped meat, minced meat, bacon, hot dogs, ham or other lunch meat, blood pudding, kidney or liver, liver pate bacon, hot dogs, ham or other lunch meat and blood pudding Larrson et al., 2005
The Japan Collaborative Cohort Study (JACC); n = 51,683 beef and pork not defined, but associations with outcome reported Nagao et al., 2012
Health Professionals Follow-up Study (HPFS); n = 46,461 beef, pork or lamb as main dish, hamburger and beef, pork or lamb as a sandwich or mixed dish bacon, beef or pork hot dogs, sausage, salami, bologna or other processed meat sandwiches, other processed red meats such as sausage, kielbasa, etc. Cao et al., 2017
The Melbourne Collaborative Cohort Study (MCCS); n = 41,514 beef, veal, beef steak, mixed dishes with lamb, mixed dishes with beef, pork chops or roast, rabbit or other game, other offal meats, lamb chops or roast ham, bacon, corned beef, salami or continental sausages, sausages or frankfurters Amirul Islam et al., 2014
The top 10 relevant cohorts, based on sample size, were selected. Cohorts typically publish multiple reports. The source selected to represent a cohort provided the most detailed information regarding meat products.

Processed meat is also inconsistently defined and categorized, often including a combination of red meat and poultry-based products though they are rarely reported separately in observational studies (Oostindjer et al., 2014). As demonstrated in Table 1, liver and other organ meats are inconsistently classified, but more often than not are considered as processed meat. Similarly, blood sausage or blood/black pudding are most often considered processed meat in research cohorts although national regulations often exclude blood only products from the category of meat. Definitions of red meat may include both processed and unprocessed products without any further consideration of these types independently while some cohorts double-count the contribution of processed meat by including ham, bacon, etc. as both red meat and processed meat (Chao et al., 2005). Food frequency questionnaires used to assess dietary intake often combine processed (ham) and unprocessed (pork chops) items into a single question. This persistent discrepancy between the definitions of meat considered by nutrition versus meat scientists complicates the interpretation of meat intake data and the subsequent determination of dietary guidance.

Authoritative guidance providing meat specific public health recommendations have recognized the challenge posed by the inconsistency of meat categorization in the nutrition literature. Yet, despite the ambiguity of the evidence base supporting the recommendation, guidance to “eat less red meat” is a common nutrition mantra (WCRF, 2007; SACN, 2010; USDA and USDHHS, 2015a; ANSES, 2016). Recently, the United States 2015 Dietary Guidelines Advisory Committee (DGAC) (USDA and USDHHS, 2015b), grappled with the variability used by nutrition scientists in defining meat group foods, noting in the final scientific report that “‘total meat’ may have been defined as ‘meat, sausage, fish, eggs,’ ‘red meat, processed meat, poultry’ or various other combinations of meat.” In their 2007 report on diet and cancer, the World Cancer Research Fund and the American Institute for Cancer Research (WCRF and AICR, 2007) also acknowledges this point, stating: “There is no generally agreed definition of ‘processed meat.’ The term is used inconsistently in epidemiologic studies. Judgments and recommendations are therefore less clear than they could be.” In addition to the ambiguity in the definition of processed meat, “some studies may have included processed meats in their classification of red meat intake,” thus, further confusing the relationship between red meat or processed meat and cancer. Similarly, the French food-based dietary guidelines (ANSES, 2016) include the following clarification regarding nutrition studies: “The limitations associated with the term ‘delicatessen meats’ (charcuterie) should be clarified. Epidemiological studies conducted in English-speaking countries make reference specifically to delicatessen meats, as well as more generally to all processed meats. This description of ‘processed meat’ corresponds to meat that has undergone transformation processes with the aim of improving storage and/or developing the aromas, such as salting, drying, fermentation, or smoking. Examples include ham, sausages, bacon, corned beef, dried beef, and canned meats. In the French context, processed meats correspond essentially to delicatessen meats—charcuterie (cooked or raw ham, sausages, dried sausage, pâté, etc.). Thus, the conclusions relating to delicatessen meats are extrapolated to studies of a wider food group, that of processed meat.”

Consumer Perceptions of the Term ‘Meat’

While there is a need for more published research on consumers’ understanding of the term “meat,” it is certain that public health guidance on meat and diet lacks clarity for consumers. In one recent market research study (Beef Checkoff, unpublished), a representative sample of US consumers ages 20–68 (n = 479) indicated that they found dietary advice confusing, such as statements in the 2015 DGAC. For example, the 2015 DGAC concluded that healthy dietary patterns are “lower in red and processed meats” and also added a footnote that “lean meats can be part of a healthy dietary pattern.” In the survey, this advice regarding healthy dietary patterns was interpreted by 18% of consumers as consuming only white meat or fish; 5% interpreted this advice as recommending vegetarianism; and another 6% had no idea what it meant. In other words, nearly one-third of consumers were unable to deduce that “red meats” such as lean beef and pork can be part of a healthy dietary pattern.

In another nationwide survey (Beef Checkoff, unpublished) (n = 988 adults), it was found that the public has a disconnect between the terms red meat and lean meat. Results from this survey indicated that 88% viewed “lean meat” as a part of a heart healthy lifestyle, but approximately 50% thought that eating “red meat” could be a part of a heart healthy lifestyle.

Historically, the Dietary Guidelines for Americans (DGA; USDA and USDHHS, 2005, 2010) have identified a food group combining meat, poultry, fish, beans, eggs, and nuts as one of the core food groups recommended in building a balanced, nutritious diet. In 2005, these foods were separated into two groups, identified as “lean meats, poultry, fish” and “nuts, seeds, and legumes.” In 2010, the groups were once again combined and renamed as “protein foods” consisting of the following subgroups: meat, poultry, fish/seafood, beans and peas, nuts, seeds, and soy products. Although it is not explicitly stated, the term “meat” used by the 2015 DGA refers to “lean red meats” and excludes other protein sources commonly defined as “meat” such as poultry and fish/seafood. The DGA use of the term “meat” to define “lean red meat” has been a source of confusion for understanding the types and amounts of meat the DGA recommends for a healthy dietary pattern. As noted in a recent publication by Wolfe et al. (2017), dietary patterns recommended by the DGA rely heavily on animal sources of protein, referred to as “meat equivalents,” which consists of a variety of protein food sources that include fish, poultry, milk, and cheese in addition to meat. Use of the term “meat equivalents” is misleading. In fact, protein from vegetable sources generally contributes more calories to achieve the same quantity of protein (Figure 1).

Figure 1.
Figure 1.

An illustration of the number of calories and servings of food needed to obtain 25 g of protein from various protein sources (USDA-ARS, 2015).

 

As discussed in a review by Font-i-Furnols and Guerrero (2014), consumers generally perceive meat as a healthy and important component of the diet due to its provision of protein and vitamins. The positive perception of meat with nutritious elements is further reflected by vegetarian dishes that contain vegetables prepared as if they were meat or presented in restaurants to appear as meat dishes (Font-i-Furnols and Guerrero, 2014). It is this positive perception that likely drives the derivation of vegan and vegetarian product names from meat, animal species, and specific meat cuts, e.g., “vegetarian chicken nuggets” or “vegetarian hamburgers.” The Liaison Center for the Meat Processing Industry considers such blurring of the lines between vegetarian and meat product names a source of consumer ambiguity remedied only by development of specific regulation that prohibits of combination of meat terms with vegetarian product names (EU Food Policy, 2017).

The imminent introduction of meat derived from cell culture into the United States marketplace serves to further complicate consumer understanding and perception of meat. Referred to as “in vitro meat,” “cultured meat,” “cowless meat,” “schmeat,” or “synthetic meat” produced via “cellular agriculture,” these products are met with mixed consumer response and would be expected to promote further confusion about what meat is.

Assessing Meat Intake and Related Health Outcomes

Determining the when (i.e., how often) and why (i.e., encourage or discourage) of meat consumption begins with the estimation of consumption levels. For practicality, it is important to know what and how much is being consumed. Currently, the available scientific evidence provides imperfect measurements of amounts of meat and meat-related compounds consumed (Alaejos and Afonso, 2011). Since there is a lack of valid biomarkers for meat-related exposures (Klurfeld, 2015; Gibis, 2016; Le Marchand et al., 2016), dietary intake estimates in the United States are primarily obtained via the National Health and Nutrition Examination Survey (NHANES), which is based on each subject’s self-reported, retrospective account of food and beverage consumption in the recent 24 h. Self-reported food recalls are widely acknowledged for their limitations (Oostindjer et al., 2014; Archer et al., 2015). As noted by Nicklas and colleagues (2015), “All traditional dietary analyses in epidemiology share one strong but incorrect assumption: that exposures, such as foods or nutrients, were measured with great accuracy.” Cut-points of intake groups and the types of exposure metrics (e.g., servings per month, times per day, grams per day, and unspecified quintiles of intake) also vary significantly across studies.

Despite these well-acknowledged limitations, survey data are still the primary source of information on consumption/food intake patterns in the United States and global diet. Acknowledging that current meat intake data lack specificity and come with some level of uncertainty, available data sources estimating meat consumption (disappearance date, food intake surveys, food diaries collected through market research, etc.) of intake data commonly cited in the nutrition literature are surprisingly consistent with each other. The most commonly cited US data comes from What We Eat in America (WWEIA), the dietary intake interview component of NHANES (CDC-NCHS, 2014). It captures food consumption data for approximately 5,000 subjects annually and is a nationally representative statistically based intake of individuals residing in the United States. Americans are, on average, consuming total (red) meat, poultry, and seafood at levels very close to the 2015 DGA recommendations (Figure 2).

Figure 2.
Figure 2.

Protein foods and red meat intake calculated for individuals 2 yr and over from the What We Eat in America Food Patterns Equivalents Database (WWEIA-FPED 2013-2014; USDA-ARS, 2014) vs. recommended intakes from the 2015 Dietary Guidelines for Americans (DGA). Total protein foods include lean red meat/poultry, lean seafood, lean cured/processed meat (both red meat and poultry), organ meat, eggs, nuts and seeds, and soybean products. Total meat includes all the above minus eggs, nuts and seeds, and soybean products. Total red meat includes lean fresh beef and pork.

 

Data from NHANES from 2013–2014 show that total meat intake is roughly only one-tenth of an ounce above current 2015 DGA recommendations and fresh red meat is below recommendations (Figure 2). The DGA makes no specific recommendation for processed red meat, but on average, US intake of processed meat (red and white meat) is less than 1 oz equivalent per day (i.e., 0.96 oz equivalents) (USDA-ARS, 2014).

In addition to average consumption, it is also important to consider the range of consumption within the population. For example, the US Food Commodities Intake Database was designed to complement NHANES WWEIA data for use in estimating population exposure levels across a broad range of commodities. Figure 3 indicates the mean consumption is 2.8 oz of total red meat and processed meat per day and that 40% consume less total red and processed meat than the DGA recommends for fresh red meat alone (USDA and USEPA, 2010).

Figure 3.
Figure 3.

Distribution of total red meat intake (fresh and processed) across the population, calculated using the Food Commodity Intake Database (FCID).

 

Also using NHANES data, Paisakos and coworkers recently showed that animal foods (meat, seafood, eggs and dairy) currently make up about 62% of the protein consumed by US adults, 30% comes from plants and 8% was unable to be classified (Pasiakos et al., 2015). According to USDA Economic Research Service Loss-Adjusted Food Availability data, between 2000 and 2010, the proportion of calories from meat, poultry, and fish stayed the same at 17% of total calories, but there was an increase in calories per capita from poultry and fish and a decrease in calories from red meat (USDA-ERS, 2016). Plant-based foods made up about 70% of calories in American diets in 2010, which is relevant considering the American diet is often characterized as being “meat-based.”

The Evolving Meat Supply Challenges Interpretation of Dietary Assessments

The changing meat supply should also be taken into consideration when interpreting evidence on meat’s role in health. Observational evidence is often collected from cohorts where initial dietary assessments are completed at enrollment but outcomes assessed years or decades later. As such, the nutrient composition of meat consumed at enrollment likely differs significantly from that at the time of disease onset, making associations between foods/nutrients and outcomes tenuous. In fact, progress toward a leaner meat supply has been made over the last three-plus decades, particularly with beef and pork (McNeill et al., 2012). The result is greater availability of leaner meat cuts, which has primarily been achieved through leaner cattle and trimming external fat before the product is marketed. Additionally, more than 50% of the processed meat category has undergone sodium reformulation in recent years. In fact, a recent study reported that some of the greatest sodium decreases in food have occurred in meat products (Jacobson et al., 2013). Efforts continue in this area as the United States Food and Drug Administration has issued a Voluntary Sodium Reduction Goals Initiative draft for comment (2016) that targeted reducing sodium by 10% (2-yr goal) and 30% (10-yr goal) in processed meats and whole-muscle marinated products, in line with the World Health Organization’s initiative (2016) to reduce sodium by 30% by 2025 in all processed foods.

Based on recent sales data, approximately 60% of beef cuts sold at retail locations are lean by USDA standards, having less than 10 g of total fat, 4.5 g or less of saturated fat, and less than 95 mg of cholesterol per serving and per 100 g (cooked and trimmed). Sirloin steak contains 34% less fat than it did in the 1960s, and external fat in retail cuts has decreased 80% (McNeill et al., 2012). In 2013, 38 cuts of beef, and six cuts of pork, met the USDA definition of lean (NCBA, 2014). While consumers have ready access to lean and lower sodium meat, the impact of consuming these foods may not be readily recognized due to infrequent updates of the nutrient composition data for various beef cuts in the USDA Standard Reference.

Red Meat Consumption and Health Outcomes

Most observations regarding red meat and chronic disease risk are weak, and many are nonsignificant. Chance, bias, and confounding are all important considerations when explaining associations between exposures and outcomes, particularly when weak associations (RR < 1.5) are observed. In the case of dietary assessment, measurement error, the correlation between foods and nutrients, displacement and substitution effects, and consumer bias toward “healthy” vs. “unhealthy” foods, all contribute to decreasing confidence in the likelihood that an observed association between diet and health is real (Maki et al., 2014). Despite these limitations, the DGAC concluded, “the overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar sweetened foods and drinks and refined grains.” However, the DGAC then qualified the “lower in red and processed meat” component of its “healthy dietary pattern” definition with a footnote, stating “As lean meats were not consistently defined or handled similarly between studies, they were not identified as a common characteristic across the reviews. However, as demonstrated in the food pattern modeling of the Healthy US-style and Healthy Mediterranean-style patterns, lean meats can be a part of a healthy dietary pattern.”

Unlike epidemiological studies, randomized controlled trials (RCTs) represent the “gold standard” in determining cause-and-effect relationships. They typically provide more details on types and amounts of red meat evaluated. Few, if any, RCTs of lean red meat intake were evaluated by the 2015 DGAC. Interestingly, those RCTs that were considered by the DGAC in its deliberations regarding meat intake do not provide direct evidence of the role of lean red meat in a healthy dietary pattern. In the OmniHeart study, for example, participants in all the diet groups consumed, on average, approximately one serving of beef, pork, and ham (Appel et al., 2005). The independent effects of lean red meat intake on cardiovascular risk factors were not evaluated. Similarly, in the Prevención con Dieta Mediterránea study, lean red meat was not directly compared with other protein sources (Estruch et al., 2006, 2013). In fact, the effects on lipids were stated to have been primarily attributable to supplementary olive oil and nuts and not to differences in red meat intake between diets. The original Dietary Approaches to Stop Hypertension trial (Appel et al., 1997) designed nearly two decades ago, used red meat restriction as a means of controlling saturated fat intake, and it did not directly compare the independent effects of a “reduced” meat diet. More appropriate evidence to support a recommendation for red meat intake can be found in a recent meta-analysis of RCTs (n = 24) comparing red meat interventions above and below 1.25 oz (35 g) per day. This evaluation showed that consumption of greater than 1.25 oz (range 1.25–17.6 oz) does not influence blood lipids and lipoproteins or blood pressure (O’Connor et al., 2017; Figures 4 and 5). These findings are in contrast to evidence from observational studies that would suggest that consumption of red meat above 1.25 oz (or 0.5 servings per day) is associated with higher chronic disease risk. In fact, the authors note, “There is no visual threshold of total red meat consumption that indicates an apparent negative effect on blood lipids, lipoproteins, and blood pressures, as shown by the nondescript dispersal of the data.” Collectively, the results from RCT and observational studies are presently inconsistent. It is important to note that the RCT studies have assessed the effects of red meat intake on cardiovascular risk factors (cause and effect) over relatively short periods of time (weeks to months) while observational studies have assessed associations (not cause and effect) between red meat intake and cardiovascular disease morbidities and mortality after longer periods of time (years to decades). Consensus on the impact of red meat intake on health will require new integrative research using improved and novel experimental designs and outcome measures, complemented by more precise and globally accepted descriptions and definitions of dietary red meat.

Figure 4.
Figure 4.

Intake of ≥0.5 servings/d of red meat is not associated with negative blood lipid outcomes (O'Connor et al., 2017).

 
Figure 5.
Figure 5.

Intake of ≥0.5 servings/d of red meat is not associated with negative blood pressure outcomes (O'Connor et al., 2017).

 

Meat in Healthy Dietary Patterns

The public needs support in making informed choices about what they eat. Nutrition education programs that offer actionable advice are an effective means of improving health. Authoritative guidance, such as the DGA, is a foundational tool in helping people choose and enjoy foods that can improve their health and also play a pivotal role in motivating industry to produce options that help Americans follow dietary advice and achieve better health. Rather than broad/overgeneralized advice for omnivores to reduce meat/red meat consumption, nutrition education and advice to choose meats as part of an overall healthy dietary pattern, with specific actionable and memorable guidance such as choosing leaner cuts or trimming excess fat, serving recommended portions, and pairing meat in a balanced diet with vegetables, fruits, and whole grains is likely more effective for supporting behavior change (Ratner and Riis, 2014). Meat nutrition facts in the form of on-pack or point-of-sale nutrition labeling and nutrient specific call-outs, nutritious recipes, and tips for balanced meal planning in the retail setting are all tools that can help the public in choosing a balanced diet with meat.

The American Heart Association (AHA) Scientific Statement on Recommended Dietary Patterns to Achieve Adherence to AHA/American College of Cardiology Guidelines encourages lean meat in healthy dietary patterns (Van Horn et al., 2016), yet limited guidance for choosing and preparing lean red meat is offered. Practical advice for future heart-healthy nutrition guidance regarding lean meat selections might include tips such as “look for 95% lean ground beef,” “choose loin or round cuts,” “consider lean steaks such as T-bone, sirloin, and flank steak,” and “choose low-sodium or low-fat processed meats.” Preparation advice might include, “replace cheese and cream sauces with flavor-rich vegetable toppings such as mushrooms and peppers” and “when dining out, order smart portions, such as child-sized burgers, or eat half a steak for dinner and save the rest for lunch the next day.”

The recently issued AHA Scientific Statement also recognizes, “By considering nutrient-dense choices that meet but do not exceed calorie needs, individuals can achieve further weight control goals” (Van Horn et al., 2016). Animal-based proteins such as lean meats are nutrient dense and contribute more protein (Figure 1) and several nutrients (e.g., zinc, B12, phosphorus, and iron) per calorie than do plant-based protein sources. Encouraging consumers to choose lean meat more often supports more calorie-efficient diets. For example, based on current estimated intake, total beef intake contributes only 5% of total caloric intake in the US diet but provides more than 5% of eight essential nutrients (Figure 6).

Figure 6.
Figure 6.

Beef's contribution to calories and nutrients in the diets of US adults (Zanovec et al., 2010). *NHANES = National Health and Nutrition Examination Survey (1999-2004)

 

Established health-focused certification programs, such as AHA’s Heart-Check Food Certification Program, further guide the public in choosing lean meats. Nine cuts of extra-lean beef (extra lean ground beef, bottom round steak, sirloin steak, sirloin tip steak, boneless top sirloin petite roast, top sirloin strips, top sirloin filet, top sirloin kabob, boneless, and center-cut top sirloin steak) and three cuts of lean pork (pork tenderloin and two varieties of pork sirloin roast) have been certified by AHA as meeting its requirements for heart-healthy foods as part of an overall healthy dietary pattern. Among participating suppliers and retailers, these cuts display the Heart-Check mark, helping nutrition-conscious shoppers make healthy choices in the meat case. These are just a few examples of practical advice to help people who consume meat to choose lean meat more often as part of a healthy diet.

Conclusions and Future Research Recommendations

Meat, in its varied forms, is consumed in the context of a total diet, and its health impact must be considered as such. There seems to be a growing recognition among meat scientists and nutrition scientists alike that the scientific dilemma posed by inconsistent meat definitions, lack of specificity of meat intake data, and the current reliance on observational evidence to assess the effect of red meat on human health needs to be addressed to improve evaluation of meat’s role in health. To date, available data supporting a recommendation to restrict meat intake in a healthy dietary pattern are limited and inconsistent. Standardized meat definitions and their consistent use across nutrition studies will support more reliable interpretation of meat’s contribution to the diet and its impact on health, both fundamental considerations to inform public health and dietary guidance.

Shalene H. McNeill, Ph.D. and RD, has 18 years of experience in food, nutrition, and agriculture research and public nutrition education. She serves as the Executive Director of Human Nutrition Research for the National Cattlemen’s Beef Association (NCBA). Her experience in nutrition and animal foods is diverse, and her areas of expertise include the role of dietary protein in weight management and optimal health, the contribution of animal source foods to a healthy diet, and meat’s function as a nutrient-rich food. Dr. McNeill holds a bachelor’s degree in biomedical science and a doctorate in human nutrition, both from Texas A&M University.

Dr. Keith Belk is a Professor and Holder of the Ken and Myra Monfort Chair in the Department of Animal Sciences at Colorado State University, Adjunct Professor in the Colorado School of Public Health, and Director of the Center for Meat Safety and Quality at Colorado State University. His research focuses on antimicrobial resistance, meat nutrient composition, meat quality and safety, live animal development, international marketing, and safety/quality management systems. Belk earned his B.S. and M.S. from Colorado State University and received his Ph.D. in Meat Science from Texas A&M University.

Dr. Wayne Campbell, Professor of Nutrition Science at Purdue University, has expertise integrating human nutrition, exercise physiology, and geriatrics. His research interests include assessing the effects of dietary energy and macronutrients, especially protein, and healthy dietary patterns on human body composition and indexes of cardiometabolic health. Campbell has served on research advisory panels for the National Institutes of Health, US Department of Agriculture, National Aeronautics and Space Administration, US Army Research Institute of Environmental Medicine, and the Federal Aviation Administration. He also served on the 2015 Dietary Guidelines Advisory Committee and the 2018 Physical Activity Guidelines Advisory Committee.

Cody Gifford earned a B.S. in Animal Sciences, M.S. in Animal Sciences, M.S. in Food Science and Human Nutrition, and completed the Coordinated Master’s Program in Dietetics at Colorado State University. As a graduate student pursuing a Ph.D. in Animal Sciences from Colorado State University, his current research is characterizing red meat in human health. Previously, he conducted a nutrient analysis of the current US retail lamb supply in addition to working on other meat quality research. He is a member of the Academy of Nutrition and Dietetics and the American Meat Science Association.

 

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