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April 10, 2012

What’s the beef with red meat?

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Healthy Eating: A guide to the new nutrition
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Get your copy of Healthy Eating: A guide to the new nutrition

Eat real food. That’s the essence of today’s nutrition message. Our knowledge of nutrition has come full circle, back to eating food that is as close as possible to the way nature made it. Based on a solid foundation of current nutrition science, Harvard’s Special Health Report Healthy Eating: A guide to the new nutrition describes how to eat for optimum health.

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A study linking red meat and mortality lit up the media in more ways than one. Hundreds of media outlets carried reports about the study. Headline writers had a field day, with entries like “Red meat death study,” “Will red meat kill you?” and “Singing the blues about red meat.”

The warning from the study, done by researchers at the Harvard School of Public Health, sounded ominous. Every extra daily serving of unprocessed red meat (steak, hamburger, pork, etc.) increased the risk of dying prematurely by 13%. Processed red meat (hot dogs, sausage, bacon, and the like) upped the risk by 20%. The results were published in the Archives of Internal Medicine.

The study included more than 121,000 men and women followed for an average of 24 years. All submitted information about their diets every four years. Over the course of the study, almost 24,000 of the participants died. Death rates among those who ate the most red meat were higher than among those who ate the least.

Because this was the largest, longest study to date on the connection between eating red meat and survival, the findings are worth paying attention to. But they aren’t the last word on the topic, and the numbers need to be put into perspective.

A month ago, a Japanese study of more than 51,000 men and women followed for 16 years found no connection between moderate meat consumption (up to three ounces a day) and premature death. Last year, a study by different researchers from the Harvard School of Public Health found no connection between eating unprocessed red meat and the development of heart disease and diabetes, though there was a strong connection with eating processed red meat.

Now for the numbers

Upping your risk of dying by 13% or 20% may nudge you toward becoming a vegetarian—but those are relative risks, comparing death rates in the group eating the least meat with those eating the most. The absolute risks (see them for unprocessed red meat in the table below) sometimes help tell the story a bit more clearly. These numbers are somewhat less scary.


Deaths per 1,000 people per year


1 serving unprocessed meat a week

2 servings unprocessed meat a day

Women

7.0

8.5


3 servings unprocessed meat a week

2 servings unprocessed meat a day

Men

12.3

13.0

The authors of the Archives paper suggest that the increased risk from red meat may come from the saturated fat, cholesterol, and iron it delivers. Potentially cancer-causing compounds generated when cooking red meat at high could also contribute. Sodium, particularly in processed foods, may also play a role. It’s also possible that red-meat eaters may be more likely to have other risk factors for serious, life-shortening diseases.

Try a Mediterranean approach

Given how hard it is to study the effect of food on long-term health, there probably won’t ever be a definitive study of red meat and mortality. The evidence that’s accumulating has me believing that less meat is probably better for health.

One way to cut back on red meat is to follow a Mediterranean-style diet. It is rich in plant-based foods, and doesn’t emphasize meat.

Keep in mind that there’s no such thing as the Mediterranean diet. Instead, there are many ways to go Mediterranean. Here are the basics:

  • Eat fruits, vegetables, whole grains, beans, nuts, and seeds every day; they should make up the lion’s share of foods.
  • Fat, much of it from olive oil, may account for up to 40% of daily calories.
  • Small portions of cheese or yogurt are usually eaten each day, along with a serving of fish, poultry, or eggs.
  • Red meat makes an appearance now and then.
  • Small amounts of red wine are typically taken with meals.

Cutting back on meat can also help the health of the planet. According to an eye-opening book from the Union of Concerned Scientists called The Consumer’s Guide to Effective Environmental Choices, meat consumption is the second most environmentally expensive consumer activity, behind how we transport ourselves from place to place. Making one pound of beef for the table creates 17 times more water pollution and 20 times more habitat alteration than making its caloric equivalent in pasta.

That makes eating less meat an excellent two-fer.


Does folic acid improve immunity?

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Vitamins and Minerals: Choosing the nutrients you need to stay healthy
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Get your copy of Vitamins and Minerals: Choosing the nutrients you need to stay healthy

About half of all Americans routinely take dietary supplements, the most common being multivitamin and multimineral supplements. This report explains the different types of studies used to assess the benefits and safety profiles of various nutrients. It also includes the recommended minimum and maximum amounts of the vitamins and minerals you should consume, as well as good food sources of each.

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Q. What do you know about taking extra folic acid to boost the immune system?

A. Folic acid is the synthetic form of folate, a B vitamin that occurs naturally in some foods, including vegetables, fruits, and dried beans and peas—and is essential for health. Folate is vital for the production and maintenance of our bodies’ cells, especially during rapid periods of growth, such as pregnancy and infancy. It’s needed to make DNA and RNA, the genetic material that dictates cell functions, and it helps prevent changes to DNA that may lead to cancer.

Since folate helps make and repair DNA, it makes theoretical sense that a deficiency of the vitamin could hamper immunity. In some animal experiments, severe folate deficiency has been found to impair immunity, but this hasn’t yet been shown in human studies, and even in animals, the health impact remains unclear. With regard to taking higher-than-recommended doses of folate or folic acid to prevent disease or improve overall health, the evidence from clinical trials is conflicting.

For most healthy adults, the Recommended Dietary Allowance (RDA) of folate from both natural and synthetic sources (fortified foods and vitamin supplements) is 400 micrograms (mcg) a day. Pregnant women should take more—600 mcg a day—to reduce the risk of neural tube defects such as spina bifida in their babies. Others who may need more than the RDA include people with intestinal disorders that interfere with absorption of nutrients; people who take certain medications; and alcoholics, because alcohol reduces the absorption of folate and promotes its excretion through the kidneys.

The Tolerable Upper Intake Level for folic acid from supplements or fortified foods is 1,000 mcg a day. Folic acid is water-soluble and any excess is excreted in the urine, so the risk of toxicity is small even if you exceed that limit. However, experts are uncertain about the long-term health effects of excess folic acid supplementation. Naturally occurring folate from foods is not associated with any health risk, so get as much of your daily requirement as you can from a healthy diet. If that’s not possible, take a multivitamin that contains 400 mcg of folic acid.

— Celeste Robb-Nicholson, M.D.
Editor in Chief, Harvard Women’s Health Watch