Beef under fire

If you want to piss someone off, it seems that telling them what to eat would be a good start. If you want to start a culture war, going after beef seems to be a good bet. Recent recommendations by scientists advising the US government appear to be having that effect. Current guidelines have hinted at leaning toward lean meats but have until now not called out red meat as something to avoid.

Excellent nutrition data is tough to come by- it’s possible to do survey studies on tens of thousands or people, but survey data is notorious for questionable quality. Its also possible to do highly controlled nutrition research on small numbers of people, but expanding this to large representative populations can be cost prohibitive.

Large trial supports EVOO (Rachel Ray was right)

Some of the best data on heart healthy nutrition comes from the PREDIMED Study, updated and published in the New England Journal of Medicine in 2018. This study was designed to confirm previous observational data that the Mediterranean diet lead to decreased cardiovascular events compared to a standard diet. Participants (men and women over the age of 55 with no previous cardiac disease, but with risk factors like diabetes, smoking or high cholesterol) were divided into three groups- one received olive oil, one received nuts, and one got no supplemental food from the study.

Participants were scored on their adherence to a Mediterranean style diet, rich in olive oil, nuts, vegetables, fruit, legume, fish and wine, but lower in red meat, sausage, hamburger, butter, cream, sweets, and pastries. Over the study, the olive oil group and the nuts group showed significantly increased adherence to a Mediterranean diet.

At the end of the study, 3.6% of the participants in the olive oil group, 4% in the nuts group, and 5.7% of those in the control group had a heart related event like a heart attack or a stroke. It is important to note the relatively low rates of events across all groups. However, if we look at it another way, adhering to a Mediterranean diet resulted in a 30% relative decrease in heart related events.

What’s the skinny?

Anecdotally, I have seen patients who adhere to a meat based diet have labs with extremely high cholesterol numbers. I would advise against this. In general, dietary data that is widely applicable is hard to come by. The PREDIMED study above is probably one of the better recent sources, but reading through the paper makes it plain how complex these studies are to perform. Current thinking is that a diet high in vegetables, fruits, legumes, olive oil, fish and nuts tends to be more heart healthy, and that red meats should be more rare than common.

At the end of the day, eat a balanced diet, enjoy exercise and please don’t shoot the messenger.

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As always, health is personal, and for personalized advice please consult your healthcare professional.