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Last fall I was tasked with writing a term paper for my Principles of Physiology class on any topic related to physiology of my choosing. I had the idea of writing something about the health impacts of eating meat, due to the connection between meat consumption and the many environmental and ethical issues related to its production. Upon doing a bit of research, I realized that eating certain types of meat has known connections with the leading cause of death in the world, cardiovascular disease. So, essentially, not only does meat contribute to some of the worst environmental problems in the world, but also to some of the worst health problems.
The resulting paper, found below, details the evidence for the connection between red meat consumption (the type of meat most commonly implicated) and cardiovascular disease, and the physiological mechanisms proposed for the cause. The results are just one more reason why cutting meat from your diet is a responsible decision.
Red Meat Consumption Association
with Cardiovascular Disease
Introduction
According to the World Health Organization, cardiovascular-related
diseases are the leading cause of death in the world, based on deaths due to
ischaemic heart disease and stroke. In
2015, ischaemic heart disease accounted for 8.76 million deaths worldwide, more
than any other single factor. Stroke
followed as the second largest factor, with 6.24 million deaths. Together these two factors accounted for
approximately 27 percent of total global mortality (1). In 2015, diseases of the heart was similarly
the leading cause of death in the United States with 23.4 percent of total
deaths, while stroke was ranked as the fifth leading cause with 5.2 percent of
deaths (2).
Although there are
many factors that likely contribute to the development of cardiovascular
diseases in individuals, diet is a major factor that has often been implicated
in affecting one’s risk. This is
particularly true in Western countries, such as the United States, where the so
called “Western diet” of high fat and processed food has been linked to high
prevalence of cardiovascular and other diseases. One specific characteristic of this diet is
high intake of red meat (3). Unlike
white meat and fish, red meat consumption is often associated with risk of developing
cardiovascular diseases (4). Coronary
(ischaemic) heart disease is one type of cardiovascular disease that has seen
particular association with red meat consumption in studies (3), but other
conditions have also been linked, including stroke (5), and hypertension (6). Understanding the risks of developing these
diseases associated with consuming red meat, as well as the physiological
mechanisms through which regular consumption of red meat may lead to
cardiovascular diseases is important from both a scientific and general dietary
perspective, especially in light of the high rate of cardiovascular
disease-related mortality and high red meat consumption seen in today’s
society. These issues are analyzed here
based on current research and established physiological knowledge.
Evidence of Association
Association between red meat consumption and various types of
cardiovascular disease has been observed in numerous prospective cohort-based and
case-control studies. Red meat typically
refers to most meat from mammals, such as beef, pork, lamb, or mammalian game,
and excludes poultry and fish (7).
One form of
cardiovascular disease in particular that has drawn associations with red meat
is coronary heart disease. Micha et al.
conducted a review and meta-analysis of 20 prospective cohort and case-control
studies that assessed the risk of eating meat on developing cardiovascular
disease. Based on four studies that
assessed risk of consuming unprocessed red meat on developing coronary heart
disease, there was no association found.
However, an analysis of five studies that assessed risk of consuming
processed meat revealed a 42 percent greater risk of developing coronary heart
disease per each serving in a day. This
processed meat included any preserved meat treated by smoking, curing, or
salting and any meat with added chemical preservatives, however this was mainly
restricted to red meats (7). Despite
this study not finding an association between unprocessed red meat consumption
and coronary heart disease, the fact that consuming processed red meat was
instead likely to have a link is still particularly significant, as much of
meat consumption in Western culture today such as in the United States is of
processed meats (3).
Another type of
cardiovascular disease that has been associated with red meat consumption is
stroke. Micha et al. did not find an
association between either unprocessed red meat consumption or processed meat
consumption, although this was only based on a review of three studies (7). Chen at al. performed a review and
meta-analysis of five prospective cohort studies assessing relation between
unprocessed red meat and processed meat consumption and risk of stroke, and
found an overall association between both unprocessed red meat and processed
meat and risk of stroke. Here, again,
“processed meat” consisted largely of red meat.
Based on a dose-response analysis, it was found that risk of stroke
increased 13 percent for each 100 gram per day increase for unprocessed red
meat consumption, and 11 percent for each 50 gram per day increase in processed
meat consumption (5).
Another cardiovascular condition which
has been seen to be positively associated with red meat consumption is
hypertension. Hypertension is a major
risk factor for other cardiovascular diseases, including coronary heart disease
and stroke, so determining risk factors for this has been of great concern for
researchers. One example of the
connection that has been found between red meat and hypertension includes
results from the Coronary Artery Risk Development in Young Adults (CARDIA)
Study, a 15 year prospective cohort study of 4304 men and women ages 18 to 30
years old at baseline. In this study, higher consumption of both unprocessed
red meat and processed meat among individuals way seen to result in a significantly
greater incidence of high blood pressure.
This was true even after adjusting for factors including demographics,
lifestyle, and other dietary factors (6).
In another prospective cohort study of an older subset of individuals
(men aged 41-57 at experiment baseline) performed over seven years, a positive
association was also seen between red meat consumption and increase in blood
pressure (8).
Physiological Mechanisms
There are many factors that may contribute to the development of
cardiovascular diseases, as well as a number of mechanisms that have been
proposed as potential explanations for how consumption of red meat may
contribute to the development of these diseases. A common theme seen in many of these
explanations, however, is the narrowing of the arteries. There are several factors related to eating
red meat that may contribute to this (7).
The primary factor
cited as a likely explanation for red meat’s contribution to cardiovascular
disease is the high saturated fat and LDL cholesterol content in red meat (7). LDL cholesterol, sometimes referred to as
“bad cholesterol”, is a form of cholesterol that often can lead to negative
health effects when existing at raised levels in the body. Saturated fat increases the production of LDL
cholesterol, and so when ingested at high levels this raises LDL cholesterol
concentration in the blood, along with consuming it directly. When LDL cholesterol is at a high
concentration in the blood, it can combine with other materials to form a thick
substance called plaque that sticks to the walls of the arteries, thereby
narrowing the passageway through these vessels, and making it harder for blood
to flow through. This condition, known
as atherosclerosis, can lead to a number of health problems, including those
cardiovascular diseases discussed above (9).
There most obvious of
the conditions discussed that can be caused by atherosclerosis is
hypertension. As the arteries narrow from
plaque build-up, the body still tries to pump blood through them at a normal
rate. This same volume of blood trying
to squeeze through a smaller space means that blood is pushing harder against
the walls of the artery, increasing pressure within the vessel. Hypertension is defined by an elevated
pressure in the arteries (9).
Many of the conditions
that lead to hypertension, including atherosclerosis, also contribute to other
cardiovascular problems. One of the most
serious of these is coronary heart disease.
Coronary heart disease occurs when there is obstruction in the coronary
arteries, which provide blood flow to the tissues of the heart. Intuitively, atherosclerosis can be a major
contributor to this, as the plaques in on the artery walls prevent normal flow
through the vessels. Serious problems
can occur from the obstruction that occurs in coronary heart disease, including
myocardial infarction, or heart attack.
A heart attack occurs when a coronary artery somewhere in the heart
becomes completely occluded, prohibiting flow of blood that the heart need to
function. This is most often occurs when
a clot in the artery blocks the flow of blood, but the narrowing of the vessel
due to atherosclerosis greatly increases the chance of this occurring (9).
The impact of
atherosclerosis on stroke occurs by much the same mechanism. A stroke occurs when there is insufficient
blood flow provided to the brain, such as due to occlusion of a cerebral
artery. Just like in the heart, these
arteries can become narrowed by build-up of plaques, and if complete occlusion
occurs, a stroke will take place (9).
The mechanisms
described above detail how high intake of saturated fats and LDL cholesterol
from regular consumption of red meat may contribute to various cardiovascular
diseases. Another possible explanation
that may contribute in addition to this is the high sodium and nitrate content
found in processed red meats. Large
amounts of salt and nitrates are often added in processed meats to help
preserve them, and in the case of salt for added taste. These substances have a number of effects
that contribute to narrowing of the arteries.
Sodium from salt in food directly contributes to raising blood pressure,
and also may increase stiffness of blood vessels, making them harder to expand
as blood flows through them. Nitrates
have been seen to contribute to atherosclerosis and vascular dysfunction. All of these effects have the similar result
of decreasing the area through which blood can flow through the arteries and
increasing the risk of the cardiovascular diseases mentioned above (7). Decreased radius in the arteries increases
resistance and thus pressure, leading to hypertension. It also increases difficulty for blood
flowing through the coronary arteries and cerebral arteries, increasing risk of
coronary heart disease, heart attack, and stroke (9). This mechanism may also explain why higher
incidence of coronary heart disease was seen in some studies for consumption of
processed red meat that for unprocessed red meat (7).
Evidence for some
other proposed mechanisms through which red meat consumption may contribute to
development of cardiovascular disease has been found. One of these proposed mechanisms is by
effects of iron intake that occurs through red meat consumption. Heme iron, a type of iron found only in meat,
has been linked to increased risk of coronary heart disease. An explanation for this is that heme iron may
catalyze oxidation of LDL cholesterol, leading to atherosclerosis. A meta-analysis conducted by Hunnicutt et al.
of studies looking at the potential coronary heart disease risk of different
types of iron, heme iron was found to increase risk, while nonheme iron from
plant and other non-meat sources did not (10).
Other studies have implicated the metabolism of a particular nutrient
found in red meat, L-carnitine, by microbiota in the intestines as another
potential contributor to cardiovascular disease. This intestinal microbiota metabolism has
been found to increase atherosclerosis in mice, suggesting a similar effect in
humans (11). Both of these proposed
mechanisms, through their potential to incite atherosclerosis, thereby
narrowing the passageway of the arteries, have the potential to increase risk
of hypertension, coronary heart disease, stroke, and other cardiovascular
diseases (9).
Conclusions
Cardiovascular disease, representing the number one cause of death in
the world, is a major human health problem facing societies throughout the
globe (1). This is especially true in
Western countries, such as the United States, where a diet of high fat,
processed foods has been implicated in the prevalence of cardiovascular
diseases. Red meat is one particular,
highly consumed staple of this diet (3).
Numerous prospective cohort and case-control studies of individuals with
varying levels of red meat consumption have found positive associations between
red meat intake and incidence of cardiovascular disease, including coronary
heart disease (7), stroke (5), and hypertension (6,8). A variety of mechanisms have been proposed to
explain these associations, including the high saturated fat and LDL
cholesterol content of red meat producing atherosclerosis in the arteries, and
the effects of sodium and nitrates in processed red meat on the arteries (7). These mechanisms share the common theme,
however, of narrowing of the arteries, a hallmark of cardiovascular disease
which contributes to many serious conditions (9).
There are a variety of
factors that may contribute to development of cardiovascular disease, including
consumption of other foods that are high in fat, cholesterol, or sodium
(9). Consumption of red meat is only one
particular factor that may play a contributing role towards this. However, a review of the literature
surrounding red meat’s potential to contribute to cardiovascular disease
reveals that eating this type of meat poses a significant and well documented
risk towards this end. This is
particularly true for processed red meat, which carries the added risk of
consuming preservatives it is treated with, such as high amounts of sodium
(7). The risk of consuming red meat is
particularly highlighted by the contrast with the studied effects of eating
other types of meat, such as poultry and fish, which have not shown this type
of risk (4). Numerous studies have shown
the benefits of eating plant-based diets that are high in fruits, vegetables,
nuts, and whole grains on prevention of many chronic diseases, including
cardiovascular diseases (12). Reducing
red meat consumption may be one particularly important step that can be taken
to move towards this seemingly healthier diet.
References
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Top 10 causes of death. 2017. Retrieved from http://www.who.int/mediacentre/factsheets/fs310/en/
2. National Center for Health
Statistics. Health, United States, 2016: With Chartbook on Long-Term Trends in
Health. 2017.
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Hu F.B., Rimm E.B., Stampfer M.J., Ascherio A., Spiegelman D., Willett
W.C. Prospective study of major dietary
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F.E., Hennekens C.H., Willett W.C. Dietary
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10. Hunnicutt, J., He, K., Xun,
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Levison, B.S., Buffa, J.A., Org, E., Sheehy, B.T., Britt, E.B., Fu, X., Wu, Y.,
Li, L., Smith, J.D., DiDonato, J.A., Chen, J., Li, H., Wu, G.D., Lewis, J. D.,
Warrier, M., Brown, J.M., Krauss, R.M.,
Wilson Tang, W.H., Bushman, F.D., Lusis, A.J., Hazen, S.L. Intestinal
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