Is Lean Red Meat Really That Bad?

Nutrition Research Newsletter, August, 1999 by Michael H. Davidson, Donald Hunninghake, Kevin C. Maki

The association between serum total and low-density lipoprotein (LDL) cholesterol and risk for coronary heart disease is a well-known fact these days. Numerous studies have shown that reducing LDL cholesterol reduces the risk of CHD morbidity and mortality. For those people with high total and LDL cholesterol, diet intervention in the form of the National Cholesterol Education Program (NCEP) Step I diet is recommended. The NCEP Step I diet limits intake of fat to 30% or less of caloric intake, saturated fat to 8-10% of energy, and cholesterol to [is less than] 300 mg per day.

One of the main pieces of dietary advice given to those following a Step I diet is to reduce the amount and frequency of red meat consumption (a major contributor of saturated fat). However, recent studies have suggested that lean red meats (LRMs) may not adversely affect the serum lipid profile when compared with lean white meats (LWMs). A new study, recently published in Archives of Internal Medicine, compared the effect on serum lipids of incorporating LRM (beef, veal, pork) or LWM (poultry and fish) into a NCEP Step I diet in people with hypercholesterolemia.

Subjects were randomly selected from either the Chicago Center for Clinical Research, the University of Minnesota Hospital and Clinics, or the Johns Hopkins University Lipid Clinic. One hundred and sixty subjects participated in the study and were randomly assigned to the LRM (n=77) or LWM (n=83) groups. After a four-week baseline period, subjects were counseled by a nutritionist on the NCEP Step I diet, including 6 oz of lean meat per day, five to seven days per week. Subjects were instructed to consume at least 80% of their meat in the form of LRM or LWM. Lipid profiles were checked five times during the 36-week study.

Treatment groups did not differ significantly in mean age, body mass index (BMI), or serum lipid measures at baseline. During treatment, mean concentrations of total cholesterol (235.7 mg/dL vs. 235.2 mg/dL) and LDL-C (154.1 mg/dL vs. 154.7 mg/dL) were nearly identical in the LRM and LWM groups. HDL cholesterol (the "good" cholesterol) increased by approximately 2% in both groups and mean triglyceride levels remained similar to baseline values.

These results together with similar prior results provide good enough reason to support the view that instructing patients with high cholesterol to eliminate or greatly reduce all red meat intake is unnecessarily restrictive. It is true that replacement of high-fat meats with leaner red or white meats has the potential to improve long-term dietary compliance by increasing the variety of food choices. However, another fact to consider is that other studies have shown that vegetarian diets or diets containing very little meat can improve lipid profiles even more.

Michael H. Davidson, Donald Hunninghake, Kevin C. Maki, et al., Comparison of the Effects of Lean Red Meat vs Lean White Meat on Serum Lipid Levels Among Free-living Persons with Hypercholesterolemia, Arch Intern Med 159:1331-1338 (June 28, 1999) [Correspondence: Michael H. Davidson, MD, Chicago Center for Clinical Research, 515 N. State St., Ste. 2700, Chicago, IL 60610. E-mail: mdavidson@protocare.com.]