We’ve been told for the past several years to avoid red meat and instead choose white meat to lower our cholesterol levels and reduce risk of cardiovascular disease. These recommendations are based on observational studies that found that people who consumed more red meat had an increased risk of cardiovascular disease. A new study published in the July 2019 issue of The American Journal of Clinical Nutrition is the first to delve further into the red meat/white meat recommendations, attempting to identify which specific aspects of red meat lead to increased risk. Is the culprit saturated fat? Cholesterol? Or perhaps some other markers that aren’t yet well known?The results seem surprising at first: the effects on body levels of cholesterol are identical when either red meat or white meat are consumed when the saturated fat content is also identical.The APPROACH (Animal and Plant Protein and Cardiovascular Health) trial:The study involved generally healthy men and women who consumed three different diets for 4 weeks in random order:

1. Lean red meat
2. Lean white meat
3. Non-meat sources of protein.

The researchers also tested whether the effects of the different protein sources were modified by including a high saturated fat or a low saturated fat option with each diet.The study found that consuming saturated fat from both red and white meat increased the amount of LDL cholesterol -- the ‘bad’ type of cholesterol in the bloodstream -- by 6-7% with both high and low saturated fat intake. It’s believed that higher amounts of LDL cholesterol are associated with increased risk of cardiovascular disease. However, recent research has provided more information on LDL cholesterol, and we now know that large LDL particles don’t have as much impact on cardiovascular health as do the smaller LDL particles. Since standard lab tests typically look at the larger LDL particles, risk of consuming saturated fat from red or white meat on cardiovascular health may be exaggerated.What does this new information actually mean?The study results show that, compared with a non-meat diet, both red and white meat increase blood levels of LDL cholesterol. That doesn’t mean that we should start to eat as much red meat as we want; it simply means that the LDL cholesterol levels in our bloodstream from eating red and white meat are the same, and that we need to keep looking for reasons why eating more red meat is closely associated with increased cardiovascular disease risk.It shouldn’t be a surprise that this study showed that eating less meat -- both red meat and white meat -- and instead choosing plant proteins is the best way to reduce blood cholesterol levels. Plant proteins include vegetables, grains, and legumes (dried beans and peas such as pinto beans, garbanzo beans, lentils and black beans).The researchers note that additional studies to identify other potential effects of red meat that contribute to cardiovascular disease need to be explored in more detail. For example, a previous analysis from the APPROACH study showed that eating red meat every day triples blood levels of TMAO, a chemical produced in the gut that is linked to increased risk of heart disease. Other studies have shown that chemicals used in processed meats, such as sodium and nitrates and their byproducts, may play a role in increased cardiovascular risk. Finally, daily intake of heme iron, a type of iron that is primarily found in red meat, is an important factor in increased cardiovascular disease risk.Some things to consider:

• Beef, pork and lamb are considered red meat; chicken and turkey are white meat.
• The study did not include grass-fed beef or fish which have healthier fat profiles. It also didn’t include processed meats such as bacon or sausage which are believed to have more negative health effects.
• This was a small study with only 113 participants and lasted only 16 weeks. While the study contributes important new information, it doesn’t change the current health recommendations to choose more poultry and fish, consume less red meat, and to replace animal proteins with plant-based proteins.
• This study also had quite a bit of individual variation among the participants, which could be due to genetic differences in how the body metabolizes various nutrients.

By Lynn Grieger, RDN, CDE, CPT, CHWCReferences:

1. Nathalie Bergeron, Sally Chiu, Paul T Williams, Sarah M King, Ronald M Krauss, Effects of red meat, white meat, and nonmeat protein sources on atherogenic lipoprotein measures in the context of low compared with high saturated fat intake: a randomized controlled trial, The American Journal of Clinical Nutrition, Volume 110, Issue 1, July 2019, Pages 24–33, https://doi.org/10.1093/ajcn/nqz035
2. National Heart, Lung and Blood Institute. Say What? Scientists Claim Red Meat and White Meat can have Equal Effects on Blood Cholesterol. https://www.nhlbi.nih.gov/news/2019/say-what-scientists-claim-red-meat-and-white-meat-can-have-equal-effects-blood published 6-7-19; accessed 7-7-19American Heart Association. Meat, Poultry and Fish. Picking Health Proteins. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/meat-poultry-and-fish-picking-healthy-proteins last reviewed 3-26-17; accessed 7-7-19