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
Open accessAbstract
Background Dietary recommendations to limit red meat are based on observational studies linking intake to cardiovascular disease (CVD) risk together with the potential of its saturated fatty acid (SFA) content to raise low-density lipoprotein (LDL) cholesterol. However, the relation of white meat to CVD risk, and the effects of dietary protein source on lipoprotein particle subfractions, have not been extensively evaluated. Objective We tested whether levels of atherogenic lipids and lipoproteins differed significantly following consumption of diets with high red meat content compared with diets with similar amounts of protein derived from white meat or nonmeat sources, and whether these effects were modified by concomitant intake of high compared with low SFAs. Methods Generally healthy men and women, 21-65 y, body mass index 20-35 kg/m2, were randomly assigned to 1 of 2 parallel arms (high or low SFA) and within each, allocated to red meat, white meat, and nonmeat protein diets consumed for 4 wk each in random order. The primary outcomes were LDL cholesterol, apolipoprotein B (apoB), small + medium LDL particles, and total/high-density lipoprotein cholesterol. Results Analysis included participants who completed all 3 dietary protein assignments (61 for high SFA; 52 for low SFA). LDL cholesterol and apoB were higher with red and white meat than with nonmeat, independent of SFA content (P < 0.0001 for all, except apoB: red meat compared with nonmeat [P = 0.0004]). This was due primarily to increases in large LDL particles, whereas small + medium LDL and total/high-density lipoprotein cholesterol were unaffected by protein source (P = 0.10 and P = 0.51, respectively). Primary outcomes did not differ significantly between red and white meat. Independent of protein source, high compared with low SFA increased LDL cholesterol (P = 0.0003), apoB (P = 0.0002), and large LDL (P = 0.0002). Conclusions The findings are in keeping with recommendations promoting diets with a high proportion of plant-based food but, based on lipid and lipoprotein effects, do not provide evidence for choosing white over red meat for reducing CVD risk. This trial was registered at Clinicaltrials.gov as NCT01427855.
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Restriction of SFA intake reduced the large buoyant LDL-C level but not the small dense LDL-C level.
“According to the lipoprotein subfraction analysis by Bergeron et al. (10), restriction of SFA intake reduced the large buoyant LDL-C level but not the small dense LDL-C level, which are the most atherogenic lipoproteins.”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [10]
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- Authors
- Bergeron, N., Chiu, S., Williams, P. T., M King, S., & Krauss, R. M.
- Affiliations
- Touro University California (US)
- Lawrence Berkeley National Laboratory (US)
- Corresponding author
- Krauss, Ronald M
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 110
- Issue
- 1
- Pages
- 24-33
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC6599736
- OpenAlex
- W2948744545
- Cited by
- 160
- References
- 47
- Citations by year
- 2026: 11 · 2025: 24 · 2024: 19 · 2023: 34 · 2022: 26 · 2021: 19 · 2020: 21 · 2019: 6
- FWCI
- 16.58
- Type
- journal article
- Language
- en
- Update notices
- erratum (2019-09-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Touro Scholar (Touro College) (submittedVersion)
- Funders
- National Heart, Lung and Blood Institute
- National Institutes of Health (R01HL106003)
- National Center for Advancing Translational Sciences
- University of California
- San Francisco Clinical & Translational Science Institute (UL1TR000004)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- red meat, white meat, dietary protein source, saturated fatty acids, LDL cholesterol, apolipoprotein B, LDL particle size, atherogenic lipoproteins, cardiovascular risk, plant-based diet, dietary intervention, HDL cholesterol, small dense LDL, healthy adults, men, body mass index
- MeSH terms
- Red Meat, Adult, Apolipoproteins B, Dietary Fats, Dietary Proteins, Female, Humans, Lipoproteins, Cholesterol, LDL, Male, Meat, Middle Aged, Particle Size, Body Mass Index, Cross-Over Studies, Atherosclerosis
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