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Will Processed Meat Kill You?

May 5, 2026 by Dr. Steve Chaney

What Is The Truth About Meat?

Author: Dr. Stephen Chaney

Vegans will tell you that any meat is bad for you. Keto enthusiasts haven’t found a meat they don’t like. To them grains and most fruits and vegetables are the problem.

But what about those of us who aren’t at either extreme? Which meat, if any, should be part of a healthy diet? And how much of them should we eat?

For years the paradigm had been clear:

Fish was best, especially fish rich in omega-3s. They were good for your heart and your brain. And some studies suggested that high intake of omega-3-rich fish might help you live longer.

Poultry and other white meats were neutral.

Red meat was probably bad for you. It was high in saturated fat and cholesterol, and some studies linked it to an increased risk of heart disease. Plus, the International Agency for Research on Cancer (IARC), an agency of the WHO, listed it as a probable carcinogen. [Note: Recent studies have questioned concerns about red meat. I will discuss this below.]

Processed meats were considered a “no-no” The IARC listed processed meat as a definite carcinogen for humans based on studies linking it to colon, stomach, lung, and pancreatic cancers. It is also linked to an increased risk of heart disease.

However, most of these studies were done in the United States. And our diet is very different from that of many other countries.

That’s why a recent study (R Iqbal et al, American Journal of Clinical Nutrition, 114:1049-1058, 2021) caught my eye. The study was designed to measure the association between unprocessed red meat & poultry and processed meat intake with the risk both mortality and major cardiovascular disease with cancer as a secondary end point. And the study used data from 21 countries around the world except the United States.

How Was This Study Done?

The authors used data from the Prospective Urban Rural Epidemiology (PURE) study. The study is a large-scale (164,007 individuals), prospective (meaning it follows the individuals over time rather than taking measurements from them at a single time) study. The individuals in the study were aged 35-70 years and were followed for an average of 9.5 years.

The individuals came from 21 low-, middle-, and high-income countries.

The low-income countries included Bangladesh, India, Pakistan, Tanzania, and Zimbabwe.

The middle-income countries included Argentina, Brazil, Chile, China, Columbia, Iran, Poland, South Africa, and Turkey.

The high-income countries included Canada, Saudi Arabia, Sweden, and the United Arab Emirates. [Note: The United States was not included in the study.]

At the beginning of the study and at 3, 6, and 9 years the following data were collected from everyone enrolled in the study.

Demographic information (age, sex, location, education, wealth index, and smoking status).
Lifestyle information (diet and physical activity).
Health history.
Medication use.
Cardiovascular events and mortality.

Will Processed Meat Kill You?

The authors compared high intake of processed meats (5 ounces per week, the equivalent of two sausages/week) with zero intake of processed meats. They reported that high intake of processed meats increased the risk of:

Mortality by 51%.
Major cardiovascular disease by 46%.
Non-cardiovascular mortality by 50%
Cancer by 84%.
Heart attack by 62%.
Stroke by 56%.

Furthermore, even as little as 1.5 ounces of processed meat per week significantly increased the risk of mortality.

For red meat and poultry, the authors compared high intake (9 ounces per week) with low intake (2 ounces per week). For both red meat and poultry they did not find any association between high weekly intake and any of the health outcomes.

[I would note however, that many Americans consume 4 ounces of chicken or an 8-ounce steak at dinner – that’s one meal on one day. The corresponding weekly intake would be 28 ounces of chicken or 56 ounces of red meat. That’s significantly higher than the highest weekly intake used in this study.]

The authors concluded, “We observed no significant association between the consumption of unprocessed red meat and poultry intake and health outcomes. And higher intake of processed meat was associated with higher risks of mortality and cardiovascular disease. These findings may indicate that limiting the intake of processed meat should be encouraged.”

In my opinion, there are so many studies linking the consumption of processed meat with heart disease, cancer, and premature death that the last sentence of their conclusion should have said, “These findings unambiguously confirm that limiting the intake of processed meats should be encouraged.”

What Is The Truth About Meat?

Red Meat:

Yes, there is a lot of confusion about red meat. Many studies, like this one, find no adverse health effects associated with red meat consumption. That has led many experts to conclude that the dangers of red meat have been greatly exaggerated.

I think we should dig a little deeper. Most of the studies showing that red meat consumption increases the risk of heart disease, cancer, and mortality have been done in this country. So, perhaps we should be asking what is different about red meat consumption in our country.

There are several factors to consider:

Cooking Methods: The authors of this article pointed out that we often grill our meat at high temperatures which causes the formation of cancer-causing chemicals, while many of the countries in the PURE database stew their red meat at much lower temperatures.

Diet Context: As I have explained in a previous article of Health Tips From the Professor, fruits, vegetables, and whole grains are the antidotes to the cancer-causing chemicals formed when we cook red meat. And they bind to cholesterol in the intestine and flush it out of the body. Finally, they dilute the saturated fat in red meat with polyunsaturated fats, which helps create a healthier balance of fats.

In this country we often pair our steaks with French fries or a baked potato loaded with butter and sour cream. However, in low- and middle-income countries red meat is an expensive luxury and is often used as a garnish to dishes containing lots of vegetables and whole grains.

Amount Consumed: As a mentioned above, the amount of red meat most Americans consume in a week far exceeds the highest weekly intake of red meat in this study. The highest weekly consumption of red meat in this study is more consistent with using red meat as a garnish than as a main course.

Poultry:

For poultry, there is no confusion. Studies done in this country also find no association between poultry consumption and cardiovascular disease, cancer, or mortality. That may be due to a healthier fat profile and the ways in which poultry is usually cooked.

Processed Meat:

For processed meat, there is also no confusion. Virtually every published study from across the world agrees that it increases the risk of cancer, heart disease, and premature death. And the effect is not trivial. This study suggests that just 2 sausages a week is enough to increase your risk of premature death by 50%! So, the answer to the question, “Will processed meat kill you?” appears to be, “Yes”.

The authors of this article pointed out that the saturated fat and cholesterol in processed meat and red meat were very similar. They didn’t mention it, but the cooking techniques are also similar. So, neither of these explain why processed meat is so bad for us.

However, the amounts of preservatives and food additives in processed and unprocessed meats differ greatly. Based on this, the authors of the study and many other experts postulate that it is the preservatives and food additives that are responsible for the health risks of processed meats.

What Does this Mean For You?

This study agrees with many other studies showing that processed meats are bad for us. The authors recommend limiting your intake of processed meats.

However, their data show that as little as two strips of bacon, one hot dog, or half a large sausage per week significantly increases your risk of heart disease, cancer, and premature death. Based on that, my advice would be to avoid processed meats as much as possible.

As I described above, most experts feel that it is the preservatives and food additives that are responsible for the health risks associated with processed meats.

Some studies suggest that nitrates in processed meats may be the main culprit. Based on that belief, some food companies are offering nitrate-free processed meats as a healthier option.

However, there still may be some additives in nitrate-free processed meats (read the label carefully), and we have no clinical studies showing that the nitrate-free processed meats in the marketplace are good for us.

Red meat is more confusing. This study and others suggest it poses no health hazards. And many experts are telling you that the warnings about consuming red meat were overblown. They are telling you that red meat is good for you.

However, some studies suggest that red meat increases your risk of heart disease, cancer and premature death. When you examine the data behind the studies, I think that better advice would be that red meat can be good for you or bad for you depending on three factors:

Portion size: We should think of red meat as a garnish rather than a main course – 3-4 ounces is a healthy portion size. 8-12 ounces may be too much.
Cooking method: Many of the bad things associated with red meat are the result of high temperature cooking, especially over a flame or on a grill. Choose low temperature cooking methods whenever possible.
Diet context: Whole fruits, vegetables and whole grains are the antidotes to all the bad things associated with red meat. 3-4 ounces of red meat in a vegetable stir fry or green salad is likely to be much better for you than an 8-ounce steak with French fries.

Also, red meat already has more than enough saturated fat and cholesterol. Adding foods or sauces high in fat and cholesterol may overload the body’s ability to safely process them. But adding vegetables or vegetable oils helps to restore a better balance between good and bad fats.

Finally, this and other studies agree that white meat is healthy. My only advice is:

Avoid white meat that has been fried (especially by fast food restaurants that only change their oil every 20,000 miles) or cooked with fatty sauces.
Think of the whole diet rather than just the protein source. White meat will be the healthiest as part of a whole food, primarily plant-based diet.

The Bottom Line

A recent study reported that eating as 5 ounces of processed foods per week increases your risk of heart disease, cancer, and premature death by 50%. That is equivalent to two sausages per week!) The authors of the study recommended that you limit your intake of processed meats.

However, the study showed that even as little as 1.5 ounces (2 strips of bacon, one hot dog, or half of a large sausage) per week significantly increases your risk of all three. Based on that data, my recommendation is to consider avoiding processed meat altogether.

The study reported that unprocessed red and white meat are not associated with increased health risks. I put those findings into the context of other published studies on the topic. I discuss my recommendations for unprocessed red and white meat in the article above.

For more information on this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Can You Cut Your Risk Of Heart Disease By 90%?

March 31, 2026 by Dr. Steve Chaney

The Effect Of Ultra-Processed Foods On Heart Disease Risk

Author: Dr. Stephen Chaney

Heart disease is a killer. It continues to be the leading cause of death – both worldwide and in industrialized countries like the United States and the European Union. When we look at heart disease trends, it is a good news – bad news situation.

The good news is that heart disease deaths are continuing to decline in adults over 70.

- The decline among senior citizens is attributed to improved treatment of heart disease and more seniors following heart-healthy diets.

The bad news is that heart disease deaths are starting to increase in younger adults, something I reported in an earlier issue of “Health Tips From the Professor.”

- The reason for the rise in heart disease deaths in young people is less clear. However, the obesity epidemic, junk and convenience foods, and the popularity of fad diets all likely play a role.

Everyone has a magic diet to reduce the risk of heart disease. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and Keto enthusiasts tell us carbs are the problem.

But what if we eliminated junk and convenience food AND switched to a really healthy diet? How much would that reduce heart disease risk? A recent study (Y Willett et al, The American Journal of Medicine, in press, 2026) looked at the first part of that question. It looked at the effect of ultra-processed food (what we call junk and convenience foods) consumption on the risk of developing heart disease.

How Was This Study Done?

The scientists analyzed data from 4787 participants in the most recently published (2021 to 2023) National Health and Nutrition Examination Survey (NHANES). The average age of participants in the survey was 55 years, with 56% of them being women.

All the participants in this study had completed a dietary survey of everything they ate over the last two days. They also reported whether they had ever experienced a heart attack or stroke.

Ultra-processed foods were defined as foods that are industrially modified and loaded with added fats, sugars, starches, salts, and chemical additives.

The percentage of ultra-processed foods in their diet was calculated, and the participants were divided into quartiles based on the percentage of ultra-processed foods they consumed.

Participants with the highest quartile of ultra-processed food consumption were compared to those in the lowest quartile with respect to the risk of cardiovascular disease (self-reported heart attack or stroke). The data were corrected for age, sex, race, ethnicity, smoking status, and income.

The Effect Of Ultra-Processed Foods On Heart Disease Risk

The results were striking:

The participants in the highest quartile for ultra-processed food consumption had a 47% higher risk of heart disease compared to those in the lowest quartile for ultra-processed food consumption.

The authors concluded, “Adults who consumed the highest amount of ultra-processed foods had a statistically significant 47% increased risk of heart disease. Large scale randomized trials are needed, but in the meantime, health care providers should advise patients to decrease consumption of ultra-processed foods in addition to adopting other therapeutic lifestyle changes and adjunctive drug therapies of proven benefit.”

The authors recognized the difficulty of making those changes in a world where ultra-processed foods are ubiquitous and cheap.

However, they drew parallels to tobacco use in this country. They said, “Just as it took decades for the dangers of smoking to become widely accepted, reducing reliance on ultra-processed foods may take time. This is partly due to the influence of large multinational companies that dominate the food market. In addition, many people face limited access to healthier food options.”

They went on to say, “Addressing ultra-processed foods isn’t just about individual choices – it’s about creating environments where the healthy option is the easy option.”

Can You Cut Your Risk Of Heart Disease By 90%?

The short answer is, “probably not”. But you can reduce the risk of heart disease by a lot – and probably by a lot more than 47%.

That’s because this study did not look at what the participants were replacing the ultra-processed foods with. Some participants may have replaced them with whole food, primarily plant-based diets. Others may have replaced ultra-processed foods with whole food, meat-based diets high in saturated fats.

So, let’s look at the other side of the equation – how much you can reduce your risk of heart disease by eating a healthier diet. In a recent issue of “Health Tips From The Professor”, I reviewed a meta-analysis published in 2022 that looked at 99 clinical studies with tens of thousands of participants that measured the associations between foods or food groups and heart disease risk.

That study reported that:

Processed Meat: A single serving of processed meat increased heart disease risk by 27% to 44%.

Red Meat: Unprocessed red meat increased heart disease risk by as much as 27% – but only at ≥3 servings per day. The results with lower intakes were inconsistent – some studies showed increased risk, but others did not.

Poultry, Eggs, and Dairy Foods: They did not appear to affect heart disease risk.

Fish: Two to four servings per week of fatty fish decreased heart disease risk by around 12%.

Fruit: Two servings per day of fruit reduced heart disease risk by 21-32%.

Vegetables: Two servings of vegetables per day reduced heart disease risk by 18-21%.

Legumes (beans and peas): Four servings per week reduced the risk of heart disease by around 14%.

Nuts: One serving (a handful) per day reduced the risk of heart disease by around 25%.

Whole Grains: Two servings of whole grains per day reduced the risk of heart disease by 25%-34%.

Overall: When heart-healthy foods were consumed as part of the Mediterranean diet heart disease risk was reduced by 47%. Similar overall reductions in heart disease risk are likely with other heart-healthy diets like DASH, MIND, Flexitarian (flexible semi-vegetarian), and vegan diets.

In summary:

The first study shows that eliminating ultra-processed foods (junk and convenience foods) from your diet can decrease heart disease risk by 47% – but doesn’t tell us what the ultra-processed foods were replaced with. And it would take a much larger study to determine which food swaps were most effective at reducing heart disease risk.

The second study was a meta-analysis that told us that eating more fish and plant foods in the context of a heart-healthy diet can decrease your risk of heart disease by 47% – but doesn’t tell us what those healthy foods were replacing. And many of the individual studies included in the meta-analysis were conducted when ultra-processed food consumption was much less than it is today.

It would be tempting to add 47% plus 47% and conclude that eliminating ultra-processed food consumption and replacing ultra-processed foods with heart-healthy foods could decrease your risk of heart disease by 94%. But it’s not that simple. There are too many unanswered questions from these studies.

But it is safe to say that if we eliminated ultra-processed foods AND replaced them with heart-healthy foods in the context of a heart-healthy diet, we should be able to reduce our heart disease risk by more than 47% – perhaps much more.

What Do These Studies Mean For You?

There are two important lessons from these studies:

#1: Eliminating ultra-processed foods from your diet will significantly decrease your risk of heart disease.

And it isn’t just heart disease. Other recent studies have shown that eliminating ultra-processed foods from your diet helps you:

Control your weight (It is perhaps the most important lifestyle change to make if you want to maintain GLP-1-aided weight loss).

Reduce your risk of cancer.

Reduce your risk of diabetes.

Reduce your risk of inflammatory diseases.

Reduce anxiety and depression.

Increase your healthspan (your healthy years).

In short, ultra-processed foods are killers.

#2: Replacing ultra-processed foods with heart-healthy foods (fruits, vegetables, legumes, nuts, whole grains, and fish) in the context of a healthy diet (Mediterranean, DASH, MIND, Flexitarian, and vegan, for example) is likely to decrease your risk of heart disease even more.

And if your diet consists of mostly heart-healthy foods, you can add moderate amounts of heart-neutral foods (poultry, eggs, and dairy).

And the latest evidence suggests that you can even add small amounts of red meat in the context of a heart-healthy diet (As I have said in previous issues of “Health Tips From the Professor”, plant foods contain the antidotes to all the bad things about red meat.)

Finally, you might ask why I emphasize both heart-healthy foods and heart-healthy diets. There are two reasons:

Most of us think in terms of foods rather than diets.

The food industry is only too happy to provide us with ultra-processed foods for “heart-healthy” diets like the vegan and Mediterranean diet.

The Bottom Line

Two recent studies have shown how each of us can dramatically reduce our risk of heart disease.

The first study showed that eliminating ultra-processed foods from our diet can significantly decrease our heart disease risk – but didn’t tell us what the ultra-processed foods were replaced with.

The second study showed that eating more heart-healthy foods in the context of a heart-healthy diet can significantly decrease our risk of heart disease – but didn’t tell us what those healthy foods were replacing.

Taken together, those studies show us a clear path for dramatically decreasing our heart disease risk.

For more details about these studies and what they mean for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_____________________________________________________________________________

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Eating For A Healthy Heart

February 11, 2025 by Dr. Steve Chaney

What Does This Mean For You?

Author: Dr. Stephen Chaney

You may remember the nursery rhyme, “Jack Sprat could eat no fat. His wife could eat no lean…” You may know people who fit these extremes. And in terms of diets these extremes might represent the vegan and keto diets in today’s world.

The nursery rhyme assures us that, “…between them they licked the platter clean.” But were their diets equally healthy? Which of them would have been more likely to live a long and healthy life?

And, since this is Heart Health Month, we might ask, “Which diet would have been better for their hearts?”

If you search Mr. Google – even with AI assist – you might be confused. That’s because AI bases its recommendations on the quantity of posts, not the accuracy of posts. And lots of media influencers recommend both diets, and just about every popular diet in between for heart health.

But what does good science say on the topic of heart healthy diets? Fortunately, a recent comprehensive review and meta-analysis (G. Riccardi et al, Cardiovascular Research, 118: 1118-1204, 2022) has answered that question.

How Was The Study Done?

The investigators reviewed 99 clinical studies with tens of thousands of participants that looked at the associations between foods or food groups and heart disease risk.

Most of the studies were “prospective cohort” studies in which:

Populations are divided into groups (cohorts) based on the foods they consume…

…and followed for a number of years (this is where the term “prospective” comes from)…

…and at the end of the study, the association between food and heart outcomes is measured.

However, the review also included several major randomized controlled clinical trials, including:

The DASH diet study.
The Lyon Diet Heart study.
The PREDIMED study.

Eating For A Healthy Heart

Here are the findings of the study. Most will sound very familiar. But you will note some subtle differences based on recent data.

The overall summary was that for a healthy adult population:

Low consumption of salt and foods of animal origin…

…and increased intake of plant foods…

…are associated with reduced heart disease risk.

Of course, we have known that for years. It’s when they broke the data down further that it became more interesting.

Foods Of Animal Origin:

Processed meats increase heart disease risk. A single serving of processed meat is associated with a 27% to 44% increased risk of heart disease. This is not new.

Unprocessed red meat is also associated with increased risk of heart disease, but this association is not as consistent as for processed meats. The authors noted that some of this may be due to differences in saturated fat content or cooking methods of the red meats included in individual studies.

But this analysis also showed that the effect of red meat on heart disease risk may be dose dependent. For example:

- The studies they reviewed suggested that consuming ≥2 servings per day of red meat is associated with a 27% increased risk of heart disease. However, consuming <3 servings per week may not increase risk.

- The idea that the effect of red meat on heart disease risk may be dose-dependent is novel. However, the authors said we also need to ask what replaces red meat in the diet. They postulated that when red meat consumption is decreased, it is often replaced with healthier protein sources.

White meat such as poultry does not appear to affect heart disease risk. This has been predicted by earlier reports, but this analysis strengthens those predictions.

Fish consumption decreases heart disease risk. This is not new. But this review added precision about recommended fish intake (2-4 servings/week) and a couple of caveats:

- The heart benefits of fish may be due to their omega-3 content and may not apply equally to fish with lower omega-3 content.

- The authors also expressed concerns about the sustainability of high-omega-3 fish populations. I would also add that our oceans are increasingly polluted, so contamination is another concern.

Egg consumption up to one egg/day does not appear to increase heart disease risk. This is consistent with the current American Heart Association recommendations.

However, the authors noted that the effect of eggs on serum cholesterol, and hence heart disease risk depends on several factors.

- Genetics, obesity, and diabetes can make it more difficult to regulate serum cholesterol levels. For these individuals, eggs may need to be eaten only sparingly.

- Diets low in saturated fat and high in fiber from plant foods help the body regulate serum cholesterol. Several studies suggest that eggs may decrease heart disease risk in the context of this type of diet.

Dairy: Neither low-fat nor high-fat dairy foods appear to influence heart disease risk. This is different from the standard recommendation to consume low-fat dairy foods. But it is in line with the trend of recent research studies on dairy and heart disease.

Once again, there were a couple of caveats:

- There is increasing evidence that fermented dairy foods may decrease heart disease risk which may explain why certain high-fat cheeses and other high-fat fermented dairy foods appear to have a neutral or slightly beneficial effect on heart disease risk.

- As with eggs the effect of high-fat dairy foods on heart disease risk may be influenced by genetics and diet context.

Foods Of Plant Origin: The effect of plant foods have been known for some time, and the most recent studies included in this analysis have not changed those conclusions.

Fruits and Vegetables consistently reduce heart disease risk in multiple studies. In each case, the optimal intake appears to be about 2 servings of each per day which provides an 18-21% risk reduction for vegetables and a 21-32% risk reduction for fruits.

Legumes (beans and peas) also consistently reduce heart disease risk in multiple studies. At the optimal intake of around 4 servings per week the risk reduction is around 14%.

Nuts also consistently reduce heart disease risk. At the optimal intake of around one serving (a handful) per day, the risk reduction is around 25%.

Cereals (grains) were divided into 3 categories:

- Refined carbohydrates with a high glycemic index (e.g., white rice, white bread) are associated with increased heart disease risk in multiple studies probably due to their effect on blood sugar levels. And the increased risk is significant (Around 66% higher risk for every 2 servings).

- Refined carbohydrates with a low glycemic index (e.g., pasta, corn tortillas) show an inconsistent effect on heart disease risk.

- Whole grains are consistently associated with a lower heart disease risk. Two servings of whole grains per day are associated with a 25%-34% decreased risk.

Miscellaneous Foods:

Soft Drinks are associated with increased heart disease risk. One serving per day increases the risk by around 15-22% and recent evidence suggests that artificially sweetened soft drinks offer no heart health benefits compared to sugar sweetened soft drinks.

Coffee and Tea are both associated with decreased heart disease risk. For coffee the optimal benefit may occur at around 3 cups/day. Higher levels may have an adverse effect on heart disease risk.

Summary of Heart Health Recommendations

If you are thinking that was a lot of information, the authors provided a numerical summary of their recommendations for a heart-healthy diet. They are:

Two servings per day of vegetables, fresh fruits, and whole grains.

One serving per day of nuts and seeds, low-glycemic index refined cereals, extra-virgin olive oil or non-tropical vegetable oils, and yogurt.

Four servings per week of legumes and fish.

No more than 3 servings per week of white meat, eggs, cheese, and milk.

No more than 2 servings per week of high-glycemic index refined starchy foods, red meat, and butter.

Only occasional consumption of processed meats.

What Does This Study Mean For You?

Of course, nobody wants to follow a “diet by the numbers”. If you are like most of us, you want flexibility and you want to be able to eat some of your favorite foods. So, let me put these recommendations into a more “user friendly” form.

If you want a healthy heart:

Whole, unprocessed or minimally processed, plant foods are your friends.

Your heart-healthy foundation should be fruits, vegetables, whole grains, nuts and seeds, healthy plant oils, and legumes.

Your heart-healthy foundation can also include fermented dairy foods and low-glycemic index refined grains.

Your “go-to” beverages should be water, tea (both caffeinated and herbal teas), and coffee. You should avoid soft drinks and other sugar-sweetened or artificially sweetened beverages.

Once you have achieved a heart-healthy foundation you can add a few servings per week of white meat, eggs, cheese, and dairy, even high-fat dairy.

If you have good adherence to the heart-healthy foundation described above and no genetic or health issues that increase your risk of heart disease, you can probably eat more of these foods.

Conversely, if your adherence to the heart-healthy foundation is poor and/or you are at high risk of heart disease, you may wish to consume less of these foods.

If you have good adherence to the heart-healthy foundation, you can also add up to 1-2 servings of high-glycemic index refined carbohydrates, red meat, or butter per week. With red meat, you may want to consider it as a garnish that adds flavor to a plant-based meal rather than the centerpiece of the meal.

You should eat processed meats seldom or never.

The Bottom Line

A new comprehensive review and meta-analysis of 99 clinical studies with tens of thousands of participants has updated the correlation between foods and heart disease risk.

Many of the recommendations based on this analysis are identical to previous recommendations for a heart-healthy diet.

But there are some subtle changes to those recommendations based on the latest data.

For more details about this study and what a heart-healthy diet might look like for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

_______________________________________________________________________________

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years. Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Which Diet Is Best For Your Heart?

June 29, 2021 by Dr. Steve Chaney

Why Are Dietary Studies So Confusing?

Author: Dr. Stephen Chaney

You are concerned about your heart.

Perhaps it is because of genetics. Everyone on one side of your family tree had their first heart attack in their mid-forties.

Perhaps it is because your doctor has warned you that your heart is a ticking time bomb. Unless you make some drastic changes, you will die of a heart attack in the near future.

Perhaps you already have some symptoms of heart disease, and you are scared.

You want to make some changes. You want to protect your heart. What should you do?

The short answer is that a holistic approach is best, and I will share the American Heart Association recommendations below. But let’s start by asking what you should eat. There are two important questions:

#1: Which diet is best for your heart?

A whole food vegan diet, the Mediterranean diet, and the DASH diet are all strong contenders for the best heart healthy diet.

But there are many other diets that claim to be heart healthy. Some enthusiasts even claim the Paleo and keto diets are heart healthy.

The problem is that few studies have compared these diets against each other. That makes it difficult to settle the question of which diet is best for your heart.

#2: Which protein source is best for your heart – plant protein, fish, poultry, or red meat?

Plant and fish protein are both strong contenders for the most heart healthy protein.

Poultry has the reputation of being more heart healthy than red meat. But this has become controversial. Some recent studies suggest poultry is no better than red meat in terms of heart health.

Fortunately, a recent study (F Petermann-Rocha et al, European Heart Journal, 42: 1136-1143, 2021) has made this comparison. It compared vegetarians, fish eaters, poultry eaters, and red meat eaters for the risk of developing heart disease.

How Was This Study Done?

This study made use of data from the UK Biobank program. The UK Biobank program recruited over 500,000 participants (ages 37-73) from England, Wales, and Scotland between 2006 and 2010 and followed them for an average of 8.5 years.

At entry into the program, each participant filled out a touchscreen questionnaire, had physical measurements taken, and provided biological samples.

Dietary intake was assessed based on the touchscreen questionnaire and the average of 5 24-hour dietary recalls. The participants were divided into four groups based on this dietary analysis:

Vegetarians (All participants in the study consumed cheese and eggs, so this group would more accurately be described as lacto-ovo-vegetarians).

Fish eaters.

Poultry eaters.

Red meat eaters.

Over the next ~8.5 years, each group was compared with respect to the following heart health parameters:

Risk of developing cardiovascular disease (all diseases of the circulatory system).

Risk of developing ischemic heart disease (lack of sufficient blood flow to the heart. The most common symptom of ischemic heart disease is angina).

Risk of having a myocardial infarction (commonly referred to as a heart attack).

Risk of having a stroke.

Risk of developing heart failure.

Which Diet Is Best For Your Heart?

The study compared vegetarians, fish eaters, and poultry eaters with red meat eaters with respect to each of the heart disease parameters listed above. The results were:

When fish eaters were compared with meat eaters, they had:

- 7% lower risk of cardiovascular diseases of all types.

- 21% lower risk of ischemic heart disease (angina).

- 30% lower risk of myocardial infarction (heart attack).

- 21% lower risk of stroke.

- 22% lower risk of heart failure.

When vegetarians were compared with meat eaters, they had:

- 9% lower risk of cardiovascular diseases of all types.

- Lower, but statistically non-significant, risk of other heart disease parameters.

When poultry eaters were compared with meat eaters there were no significant differences in heart disease outcomes.

The authors concluded, “Eating fish rather than meat or poultry was associated with a lower risk of adverse cardiovascular outcomes…supporting its role as a healthy diet that should be encouraged. Vegetarianism was only associated with a lower risk of cardiovascular disease incidence.”

Why Are Dietary Studies So Confusing?

So, you are probably thinking, “Are diets with fish protein really more heart healthy than diets with plant protein?”

Fish have a lot going for them. They are an excellent source of heart healthy omega-3 fats. And, when substituted for red meat protein, they decrease intake of saturated fats.”

But plant protein has a lot going for it as well. Numerous studies have shown that vegetarian diets are more heart healthy than the typical American diet. And only plant-based diets have been shown to reverse atherosclerosis.

So, why are dietary studies so confusing? The problem is that diets are complex. They have many moving parts. When we focus on one aspect of a diet, we are ignoring the rest of the diet. The food we have focused on may be healthy. But if it is paired with unhealthy foods, the overall diet can still be unhealthy.

The current study is a perfect example of that principle:

The participants represented a cross section of the British population. All the “diets” were high in sugar, sugary drinks, saturated fat, and processed meals bought from the supermarket. None of them were optimal.

In addition to consuming cheese and eggs, “vegetarians” consumed more crisps, slices of pizza, and smoothie drinks than meat-eaters. [In case you were wondering, the English refer to small thin salty snacks like potato chips as crisps. They reserve the term chips for what we call French Fries.]

“Vegetarians” also consumed a lot of highly processed vegetarian alternatives designed to taste like other meat products.

On the other hand, fish eaters consumed more fruits and vegetables than meat-eaters. It wasn’t just the fish that made this diet more heart healthy.

In other words, the “vegetarian diet” in this study was not nearly as healthy as the whole food vegetarian diets that have previously been shown to be heart healthy. And the “fish-eaters diet” was healthier than the “meat-eaters diet” because of both the fish and the extra fruits and vegetables these people were consuming.

In the words of the authors, “…As a group, vegetarians consumed more unhealthy foods, such as crisps, than meat eaters. Therefore, vegetarians should not be considered a homogeneous group, and avoidance of meat will not be sufficient to reduce health risk if the overall diet is not healthy.”

My summary:

Whole food plant-based diets (the true definition of vegetarianism) are very heart healthy. [Note: The diet in this study was lacto-ovo-vegetarian rather than a true vegetarian diet. However, recent studies have suggested that addition of small amounts of dairy and eggs to a vegetarian diet may make them more heart healthy rather than less heart healthy.]

Primarily plant-based diets with fish as the main protein source (otherwise known as pescatarian diets) are also very heart healthy.

If you want a healthy heart, choose the one that best fits your preferences and your lifestyle.

A Holistic Approach: The American Heart Association Recommendations

If you smoke, stop.

Choose good nutrition.

- Choose a diet that emphasizes vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts.

- Choose a diet that limits sweets, sugar-sweetened beverages, and red meats.

- Reduce high blood cholesterol and triglycerides.

- Reduce your intake of saturated fat, trans fat and cholesterol.

Lower High Blood Pressure.

Be physically active every day.

- Aim for at least 150 minutes per week of moderate-intensity physical activity per week.

Aim for a healthy weight.

Manage diabetes.

Reduce stress.

Limit alcohol.

Have a regular physical checkup.

The Bottom Line

A recent study in the United Kingdom compared vegetarians, fish eaters, poultry eaters, and red meat eaters for the risk of developing heart disease and the risk of dying from heart disease. The results were:

When fish eaters were compared with meat eaters, they had:

- 7% lower risk of cardiovascular diseases of all types.

- 21% lower risk of ischemic heart disease (angina).

- 30% lower risk of myocardial infarction (heart attack).

- 21% lower risk of stroke.

- 22% lower risk of heart failure.

When vegetarians were compared with meat eaters, they had:

- 9% lower risk of cardiovascular diseases of all types.

- Lower, but statistically non-significant, risk of other heart disease parameters.

When poultry eaters were compared with meat eaters there were no significant differences in heart disease outcomes.

However, the “vegetarian diet” in this study was not nearly as healthy as the whole food vegetarian diets that have previously been shown to be heart healthy. And the “fish-eaters diet” was healthier than the “meat-eaters diet” because of both the fish and the extra fruits and vegetables this group of people were consuming.

In the words of the authors, “…As a group, vegetarians consumed more unhealthy foods, such as crisps [potato chips], than meat eaters. Therefore, vegetarians should not be considered a homogeneous group, and avoidance of meat will not be sufficient to reduce health risk if the overall diet is not healthy.”

My summary:

Whole food plant-based diets (the true definition of vegetarianism) are very heart healthy.

Primarily plant-based diets with fish as the main protein source (otherwise known as pescatarian diets) are also very heart healthy.

If you want a healthy heart, choose the one that best fits your preferences and your lifestyle.

For more details about this study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.