Red meat intake and risk of coronary heart disease among US men: prospective cohort study

May combine two claims.

Increases in risk were not seen in Asian populations with low consumption of red meat, or in populations in which consumption of red meat has recently increased.

“Increases in risk were not, however, seen in Asian populations with low consumption of red meat, or in populations in which consumption of red meat has recently increased.14 15 16”

• cites [14] sourceNot checked — no full text of the source
• cites [15] sourcePartly supported

  The Discussion (page unavailable) says meat consumption is lower in Asian countries than in Western countries and describes weak associations in Asian cohorts; it also reports an inverse association with CVD mortality in a pooled analysis of eight Asian cohorts. It does not establish that risk increases were absent in populations where red-meat consumption had recently increased. Its reference to changing diets in Asian countries does not make that specific claim. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [16] sourcePartly supported

  The Subgroup and sensitivity analyses report no statistically significant association between unprocessed red meat consumption and mortality risk in Asian populations; the Discussion notes their relatively low intake as a possible explanation. The paper does not report a corresponding risk analysis for populations where red-meat consumption has recently increased, so that part of the claim is unsupported. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Substantial evidence from randomized trials and observational studies suggests that high consumption of red meat, especially processed red meat, is associated with an increased risk of mortality and major chronic diseases, including coronary heart disease.

“Substantial evidence from randomized trials and observational studies suggests that high consumption of red meat, especially processed red meat, is associated with an increased risk of mortality1 2 3 and major chronic diseases,4 5 6 7 8 9 including coronary heart disease (CHD).10 11 12”

• cites [1] sourceSupported
• cites [2] sourcePartly supported

  The Introduction reports associations of red and processed meat with mortality, coronary heart disease, diabetes, and some cancers; the Discussion also describes higher-intake observational studies finding mortality associations. But this paper does not establish the claimed evidence from randomized trials, and its Results found no significant mortality association for processed meat alone, so it does not support the emphasis on processed meat as the stronger risk. Page numbers are unavailable in our copy. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [3] sourceSupported

Classified as probably not a substantial claim. May combine two claims.

These inconsistencies could be due to the variable amounts and duration of red meat consumed in different populations, inadequate differentiation between processed and unprocessed red meat, differences in the levels of controlling for confounding, and differences in the comparison sources of energy.

“These inconsistencies could be due to the variable amounts and duration of red meat consumed in different populations,15 16 inadequate differentiation between processed and unprocessed red meat,15 17 18 19 differences in the levels of controlling for confounding,15 18 and, importantly, differences in the comparison sources of energy.15 20 21 22”

• cites [15] sourcePartly supported

  The Discussion (page unavailable) says heterogeneity could partly reflect differences in meat-consumption amounts, meat-group definitions and follow-up duration. It also discusses residual confounding and the importance of distinguishing processed from unprocessed meat. It does not identify differences in the comparison sources of energy as an explanation, and follow-up duration is not necessarily the duration of meat consumption. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [16] sourcePartly supported

  The Discussion (page unavailable) proposes differences in the amount of red meat consumed as an explanation for inconsistent findings across populations; the Subgroup and sensitivity analyses also report different results by follow-up length. The Study characteristics (page unavailable) document variation in adjustment for dietary variables and energy intake and note that one study did not report unprocessed-red-meat results. Our copy does not identify differences in comparison sources of energy as an explanation, and follow-up length is not necessarily the duration of red-meat consumption. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [17] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

L-carnitine, which is relatively high in red meat, might be metabolized by intestinal microbiota into proatherogenic compounds, trimethylamine-N-oxide, promoting atherosclerosis.

“L-carnitine, which is relatively high in red meat, might be metabolized by intestinal microbiota into proatherogenic compounds, trimethylamine-N-oxide, promoting atherosclerosis.38”

• cites [38] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Both prospective cohorts used one dietary measurement at baseline.

“Yet, both prospective cohorts used one dietary measurement at baseline.29 30”

• cites [29] sourcePartly supported

  The Methods (Study Population; page unavailable) say dietary intake was measured at enrollment, and the Statistical Analysis uses the recruitment questionnaire for the main intake measures. But an 8% subsample also completed a 24-hour dietary recall about 1.4 years after recruitment, so the statement that this cohort used only one dietary measurement is too absolute. This paper addresses one of the two cohorts cited, not both. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [30] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

A prospective study of 409 885 men and women in nine European countries showed that the risk of ischemic heart disease was 19% greater for every 100 g/day increment in the intake of total and processed red meat.

“A prospective study of 409 885 men and women in nine European countries showed that the risk of ischemic heart disease was 19% greater for every 100 g/day increment in the intake of total and processed red meat.29”

• cites [29] sourceSupported

May combine two claims.

In a network meta-analysis of randomized trials, nuts, legumes, and whole grains were each shown to be more effective in reducing low density lipoprotein cholesterol compared with red meat.

“In a network meta-analysis of randomized trials, nuts, legumes, and whole grains were each shown to be more effective in reducing low density lipoprotein cholesterol compared with red meat.32”

• cites [32] sourceSupported

May combine two claims.

We previously found that higher intake of total red meat was statistically significantly associated with an increased risk of coronary heart disease among 84 136 women of the Nurses' Health Study cohort, especially when compared with alternative protein sources.

“Nonetheless, we previously found that higher intake of total red meat was statistically significantly associated with an increased risk of CHD among 84 136 women of the Nurses’ Health Study cohort, especially when compared with alternative protein sources.12”

• cites [12] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Substituting 100 kcal/d of fatty fish, yogurt, cheese, or eggs for 100 kcal/d of red and processed meat was associated with a 15-24% lower risk of ischemic heart disease.

“Substituting 100 kcal/d of fatty fish, yogurt, cheese, or eggs for 100 kcal/d of red and processed meat was associated with a 15-24% lower risk of ischemic heart disease.29”

• cites [29] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

In another prospective US cohort study, the dietary intake of processed and unprocessed red meat was each associated with higher risk of mortality from heart disease.

“In another prospective US cohort study, the dietary intake of processed and unprocessed red meat was each associated with higher risk of mortality from heart disease.30”

• cites [30] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Our group has published similar associations with coronary heart disease among women of the Nurses' Health Study cohort.

“Our group has published similar associations with CHD among women of the Nurses’ Health Study cohort,12”

• cites [12] sourceSupported

May combine two claims.

The included studies in the older meta-analysis were limited by either a small number of events (769 events across all studies), short follow-up, no adjustment for total energy intake, not specifying the comparison food, or not using prospectively collected data.

“However, the included studies were limited by either a small number of events (769 events across all studies), short follow-up, no adjustment for total energy intake, not specifying the comparison food, or not using prospectively collected data.”

• cites [11] sourcePartly supported

  The Results (page unavailable) report that dietary variables were often not controlled for, and the Discussion (page unavailable) notes potential bias in retrospective case-control studies. But the claimed total of 769 events conflicts with the Results, which report 23,889 CHD cases alone. The cited passages do not establish the specific claims about total-energy adjustment, comparison foods, or short follow-up. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

In an older meta-analysis of observational studies, processed meat intake was associated with an increased risk of coronary heart disease, and no statistically significant association was observed with unprocessed red meat.

“In an older meta-analysis of observational studies, processed meat intake was associated with an increased risk of CHD,11 and no statistically significant association was observed with unprocessed red meat.”

• cites [11] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Although the authors did not examine plant sources of proteins, their overall conclusion was consistent with the findings of our study showing that red and processed meat were associated with a higher risk of ischemic heart disease.

“Although the authors did not examine plant sources of proteins, their overall conclusion was consistent with the findings of our study showing that red and processed meat were associated with a higher risk of ischemic heart disease.”

• cites [29] sourceSupported

May combine two claims.

In sensitivity analyses, the associations between red meat intake and CHD risk became slightly weaker after including baseline history of diabetes, hypertension, and hypercholesterolemia in the model, or after adjusting for the modified AHEI score.

“In sensitivity analyses, the associations between red meat intake and CHD risk became slightly weaker after including baseline history of diabetes, hypertension, and hypercholesterolemia in the model, or after adjusting for the modified AHEI score (see supplemental table 3).”

May combine two claims.

During 1,023,872 person years of follow-up of 43,272 participants, 4,456 incident CHD events were documented, of which 1,860 were fatal.

“During 1 023 872 person years of follow-up of 43 272 participants, 4456 incident CHD events were documented of which 1860 were fatal.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The Health Professionals Follow-Up Study cohort included 43,272 men without cardiovascular disease or cancer at baseline.

“43 272 men without cardiovascular disease or cancer at baseline.”

May combine two claims.

Milk (both skimmed and whole), yogurt, and cheese were each associated with a 10% to 22% lower risk of CHD compared with red meat.

“Milk (both skimmed and whole), yogurt, and cheese were each associated with a 10% to 22% lower risk of CHD compared with red meat (table 3).”

The quote only partly states this claim.

Associations of total red meat with fatal CHD were slightly stronger than for total CHD (HR 1.38, 95% CI 1.15 to 1.66).

“Associations of each of total, unprocessed, and processed red meat with fatal CHD were slightly stronger (1.38 (1.15 to 1.66) for total red meat, 1.29 (1.08 to 1.53) for unprocessed red meat, and 1.21 (1.02 to 1.43) for processed red meat) (see supplemental table 2).”

May combine two claims.

In the stratified analysis by calendar year (≥2000), intake of dark meat fish was associated with lower CHD risk compared with total red meat (HR 0.56, 95% CI 0.33 to 0.95), unprocessed red meat (0.54, 0.31 to 0.92), and processed red meat (0.52, 0.30 to 0.90), but not earlier (<2000).

“intake of dark meat fish was observed to be associated with a lower CHD risk compared with intake of total red meat (0.56 (0.33 to 0.95), unprocessed red meat (0.54 (0.31 to 0.92), and processed red meat (0.52 (0.30 to 0.90; table 4), in 2000 or later but not earlier.”

May combine two claims.

Those with higher total red meat consumption were more likely to smoke, consume alcohol, have diabetes, and use aspirin.

“Those with higher total red meat consumption were more likely to smoke, consume alcohol, have diabetes, and use aspirin.”

May combine two claims.

In this prospective cohort study of men with at least 30 years of follow-up, greater intakes of total, unprocessed, and processed red meat were associated with a higher risk of CHD, independent of other dietary and non-dietary cardiovascular disease risk factors.

“In this prospective cohort study of men with at least 30 years of follow-up, greater intakes of total, unprocessed, and processed red meat were associated with a higher risk of CHD, independent of other dietary and non-dietary cardiovascular disease risk factors.”

May combine two claims.

Compared with intake of total, unprocessed, or processed red meat, intake of high quality plant based protein foods such as nuts, legumes, and soy in addition to whole grains and dairy products were each associated with a lower risk of CHD.

“Compared with intake of total, unprocessed, or processed red meat, intake of high quality plant based protein foods such as nuts, legumes, and soy in addition to whole grains and dairy products were each associated with a lower risk of CHD.”

May combine two claims.

Adjusting for other major dietary variables further attenuated the associations, but total, unprocessed, and processed red meat remained significantly associated with risk of CHD.

“Adjusting for other major dietary variables such as poultry, fish, egg, high fat dairy products, low fat dairy products, nuts, legumes, soy, and whole grains in addition to fruit, vegetables, coffee, and glycemic index further attenuated the associations, but total, unprocessed, and processed red meat remained significantly associated with risk of CHD”

May combine two claims.

Those with higher total red meat consumption had higher intakes of total energy and trans fatty acids but were less physically active and less likely to have hypercholesterolemia or a family history of cardiovascular diseases.

“They had higher intakes of total energy and trans fatty acids but were less physically active and less likely to have hypercholesterolemia or a family history of cardiovascular diseases.”

May combine two claims.

The associations observed in the substitution analyses did not seem to diminish with up to 20 years of latency; with greater than 20 years, the associations tended to be weaker, but the number of events was relatively small.

“Overall, the associations observed in the substitution analyses did not seem to diminish with up to 20 years of latency; with greater than 20 years, the associations tended to be weaker, but the number of events was relatively small (supplemental figure 4).”

• Also stated in: § Discussion · hedged

  “The latency analyses suggested that the inverse associations of substituting red meat with major protein sources did not diminish with lags up to 20 years before the diagnosis of CHD.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Similar distributions were observed with processed and unprocessed red meat consumption.

“Similar distributions were observed with processed and unprocessed red meat consumption (table 1).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Total red meat consumption was on average 0.99 (SD 0.73) servings/day at baseline, 0.87 (0.72) servings/day using the most recent diet, and 0.91 (0.64) servings/day using the cumulative average.

“Total red meat consumption was on average 0.99 (SD 0.73) servings/day at baseline, 0.87 (0.72) servings/day using the most recent diet, and 0.91 (0.64) servings/day using the cumulative average.”

May combine two claims.

The associations between red meat and egg intake were stronger among younger men, in whom replacement of red meat with egg was associated with a 20% (95% CI 2% to 35%) lower risk of CHD.

“The associations between red meat and egg intake were stronger among younger men in whom the replacement of red meat with egg was associated with a 20% (95% confidence interval 2% to 35%) lower risk of CHD.”

Classified as probably not a substantial claim.

The models were further adjusted for other dietary variables, including poultry, fish, egg, high fat dairy, low fat dairy, nuts, legumes, soy, whole grains, fruit, vegetables, coffee, and glycemic index.

“We further adjusted for other dietary variables, including poultry (unprocessed), fish, egg, high fat dairy, low fat dairy, nuts, legumes, soy, whole grains, fruit, vegetables, coffee, and glycemic index (all in fifths).”

Classified as probably not a substantial claim.

The main multivariable models were adjusted for age, calendar time, energy intake, BMI, physical activity, smoking status, alcohol intake, family history of myocardial infarction or stroke, multivitamin use, aspirin use, race or ethnicity, work status, profession, living arrangement, and marital status.

“The main models were adjusted for age (in months), calendar time (two year follow-up periods), and energy intake, in addition to BMI, physical activity, smoking status, alcohol intake, family history of myocardial infarction or stroke, multivitamin use, aspirin use, race or ethnicity, work status, profession, living arrangement, and marital status.”

Classified as probably not a substantial claim.

To better represent long term diet and minimize within person variation, the authors calculated the cumulative average of food intake from baseline up to the beginning of each two year follow-up interval.

“To better represent long term diet and minimize within person variation, we calculated the cumulative average of food intake from baseline up to the beginning of each two year follow-up interval.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The proportional hazards assumption was tested by including an interaction term between red meat intake and months to events.

“The proportional hazards assumption was tested by including an interaction term between red meat intake and months to events.”

Classified as probably not a substantial claim. May combine two claims.

The study was a prospective cohort study with repeated measures of diet and lifestyle factors.

“Prospective cohort study with repeated measures of diet and lifestyle factors.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The reproducibility and validity of the food frequency questionnaire in measuring food intake have been described in detail previously.

“The reproducibility and validity of the food frequency questionnaire in measuring food intake have been described in detail previously.25”

• cites [25] sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Physicians blinded to the participants' exposure status reviewed the medical records.

“Physicians blinded to the participants’ exposure status reviewed the medical records.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Data on physical activity were collected using the validated physical activity questionnaire.

“Data on physical activity (<3, 3-8.9, 9-17.9, 18-26.9, and ≥27 in metabolic equivalents of task per week) were also collected using the validated physical activity questionnaire.28”

• cites [28] sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Dietary data were not included if participants left more than 70 items blank in the food frequency questionnaire or had implausible total energy intake (<800 kcal/day or >4200 kcal/day) in any of the food frequency questionnaires.

“Dietary data were not included if participants left more than 70 items blank in the food frequency questionnaire or had implausible total energy intake (<800 kcal/day (1 kcal=4.18 kJ=0.00418 MJ) or >4200 kcal/day)24 in any of the food frequency questionnaires.”

• cites [24] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The 2015-20 US Dietary Guidelines for Americans encourage dietary patterns that are low in red and processed meat intake.

“Consequently, the 2015-20 US Dietary Guidelines for Americans13 encourage dietary patterns that are low in red and processed meat intake.”

• cites [13] U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. https://health.gov/dietaryguidelines/2015/guidelines/.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

To minimize the possibility of reverse causation bias, the authors stopped updating diet after the participant's diagnosis of cancer or stroke, or after reporting diabetes, angina, or CABG.

“To minimize the possibility of reverse causation bias, we stopped updating diet after the participant’s diagnosis of cancer or stroke, or after reporting diabetes, angina, or CABG.”

Probably not a substantial claim: may not pass S4 (based).

In most populations, most energy intake comes from refined starches, sugar, potatoes, and fats that are highly saturated or partially hydrogenated.

“In particular, in most populations, most energy intake come from refined starches, sugar, potatoes, and fats that are highly saturated or partially hydrogenated.”

Classified as probably not a substantial claim.

Participants were excluded if at baseline they had a history of cancer, myocardial infarction, angina, or coronary artery bypass graft (CABG), or stroke.

“Participants were excluded if at baseline they had a history of cancer (n=1645), myocardial infarction, angina, or coronary artery bypass graft (CABG, n=3696), or stroke (n=221).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In case of missing data, the last value was carried forward for one two year cycle; if the last value was missing, then a missing indicator was created.

“In case of missing data, the last value was carried forward for one two year cycle. If the last value was missing, then a missing indicator was created.”

May combine two claims.

The correlation coefficients between the food frequency questionnaire and multiple dietary records were 0.59 for unprocessed red meat; 0.52 for processed red meat; 0.48 for poultry; 0.74 for fish; 0.56 for eggs; 0.62 for each of high fat and low fat dairy products; 0.46 for legumes, including soybeans and tofu; 0.45 for nuts; and 0.27 for whole grains.

“The correlation coefficients between the questionnaire and multiple dietary records were 0.59 for unprocessed red meat; 0.52 for processed red meat; 0.48 for poultry; 0.74 for fish; 0.56 for eggs; 0.62 for each of high fat and low fat dairy products; 0.46 for legumes, including soybeans and tofu; 0.45 for nuts; and 0.27 for whole grains.24”

• cites [24] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In this meta-analysis, the comparison food was not specified, and the results could have been underestimated.

“In this meta-analysis, the comparison food was not specified, and the results could have been underestimated.”

• cites [20] sourceNot checked — no full text of the source

May combine two claims.

Such replacement would decrease the amounts of saturated fats, cholesterol, and heme iron and increase the intake of unsaturated fat, fiber, antioxidants, polyphenols, and many constituents that could reduce the risk of coronary heart disease.

“Such replacement would not only decrease the amounts of saturated fats, cholesterol, and heme iron, but also increase the intake of unsaturated fat, fiber, antioxidants, polyphenols, and many constituents that could reduce the risk of CHD.”

Probably not a substantial claim: may not pass S2 (checkable).

Analyses that do not specify a comparison would be implicitly comparing the food under study with a mixture of all other energy contributing foods in the diet, thus making conclusions and dietary recommendations more difficult.

“Analyses that do not specify a comparison would be implicitly comparing the food under study with a mixture of all other energy contributing foods in the diet, thus making conclusions and dietary recommendations more difficult.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The weaker associations observed when using the most recent dietary data might also be influenced by reverse causation bias, as participants could have changed their diet after developing symptoms or a cardiovascular disease related diagnosis.

“The weaker associations observed when using the most recent dietary data might also be influenced by reverse causation bias, as participants could have changed their diet after developing symptoms or a cardiovascular disease related diagnosis.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

These findings are consistent with the effects of these foods on low density lipoprotein cholesterol levels and support a health benefit of limiting red meat consumption and replacement with plant protein sources.

“These findings are consistent with the effects of these foods on low density lipoprotein cholesterol levels and support a health benefit of limiting red meat consumption and replacement with plant protein sources; this would also have important environmental benefits.44”

May combine two claims.

A meta-analysis of randomized clinical trials showed that consumption of red meat was associated with increased blood levels of low density lipoprotein cholesterol compared with consumption of plant based protein sources, consistent with the high saturated fat and cholesterol content of red meat.

“A meta-analysis of randomized clinical trials showed that consumption of red meat was associated with increased blood levels of low density lipoprotein cholesterol compared with consumption of plant based protein sources, consistent with the high saturated fat and cholesterol content of red meat.31”

• cites [31] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Excessive iron intake might catalyze several cellular reactions involved in the production of reactive oxygen species, thus increasing the levels of oxidative stress.

“Excessive iron intake might catalyze several cellular reactions involved in the production of reactive oxygen species, thus increasing the levels of oxidative stress.37”

• cites [37] sourceNot checked — no full text of the source

May combine two claims.

Substitution of plant based proteins for red meat could improve the cardiometabolic profile of people older than 65 and consequently lower their risk of coronary heart disease, explaining the more favorable substitution effect seen among older men.

“Substitution of plant based proteins for red meat could possibly improve the cardiometabolic profile of this high risk group and consequently lower the risk of CHD, thus explaining the more favorable substitution effect of plant based proteins seen among older men.”

• AssumptionRests on an assumption: Hypercholesterolemia, oxidative stress, and endothelial dysfunction increase with age.

Probably not a substantial claim: may not pass S3 (load-bearing).

The inverse association of dark meat fish with coronary heart disease risk in 2000 and later could be due to variation in the method of food preparation over time, as fish were mostly consumed after being deep fried in the earlier years.

“This could be due to the variation in the method of food preparation over time, as fish were mostly consumed after being deep fried in the earlier years.”

• AssumptionRests on an assumption: Fish were mostly consumed after being deep fried in the earlier years.

May combine two claims.

Substituting whole grains and dairy products for total red meat, and eggs for processed red meat, might also reduce this risk.

“Substituting whole grains and dairy products for total red meat, and eggs for processed red meat, might also reduce this risk.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In a meta-analysis of prospective cohorts, a reduction of three servings per week of unprocessed and processed red meat was each associated with a lower risk of all cause and cardiovascular disease mortality and a lower risk of myocardial infarction.

“In a recent meta-analysis of prospective cohorts, however, a reduction of three servings per week of unprocessed and processed red meat was each associated with a lower risk of all cause and cardiovascular disease mortality and a lower risk of myocardial infarction.20”

• cites [20] sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

In our study, we additionally included substitution analysis that explicitly compared red meat with specific sources of proteins while accounting for total energy intake.

“In our study, we additionally included substitution analysis that explicitly compared red meat with specific sources of proteins while accounting for total energy intake.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Limiting red meat consumption and replacement with plant protein sources would also have important environmental benefits.

“this would also have important environmental benefits.44”

• cites [44] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The sialic acid N-glycolylneuraminic acid in red meat has been hypothesized to generate a proinflammatory, atherogenic state in humans.

“Also, the sialic acid N-glycolylneuraminic acid in red meat has been hypothesized to generate a proinflammatory, atherogenic state in humans.39”

• cites [39] sourceNot checked — no full text of the source

May combine two claims.

The patients were mostly non-Hispanic white men, drawn from a cohort of health professionals of higher socioeconomic status than the overall population, thus affecting the generalizability of the results to other populations.

“Finally, our patients were mostly non-Hispanic white men, drawn from a cohort of health professionals of higher socioeconomic status than the overall population, thus affecting the generalizability of the results to other populations.”

Classified as probably not a substantial claim. May combine two claims.

The 30 years of follow-up, the large number of coronary heart disease events, and the availability of updated dietary data and other risk factors provided an opportunity to evaluate processed and unprocessed red meat and potential replacements with alternative foods in relation to coronary heart disease.

“The 30 years of follow-up, the large number of CHD events, and the availability of updated dietary data and other risk factors, provided an opportunity to evaluate processed and unprocessed red meat and potential replacements with alternative foods in relation to CHD.”

May combine two claims.

One serving per day of total red meat was associated with a 19% higher risk of cardiovascular disease mortality, and this risk was mostly associated with processed red meat.

“one serving per day of total red meat was associated with a 19% higher risk of cardiovascular disease mortality, and this risk was mostly associated with processed red meat.”

May combine two claims.

The cumulative averages of repeated assessments of intake were used to minimize random measurement error resulting from within person variation and to account for real changes in diet over time.

“The cumulative averages of repeated assessments of intake were used to minimize random measurement error resulting from within person variation and to account for real changes in diet over time.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Preservatives in processed red meat, such as nitrates and nitrate byproducts, have been associated with endothelial dysfunction, atherosclerosis, and insulin resistance in some animal models.

“Preservatives in processed red meat, such as nitrates and nitrate byproducts, have been associated with endothelial dysfunction, atherosclerosis, and insulin resistance in some animal models.42 43”

• cites [42] sourceNot checked — no full text of the source
• cites [43] sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The use of isocaloric models enabled interpretation of food substitution analyses by specification of the comparison foods.

“The use of isocaloric models enabled us to interpret food substitution analyses by specification of the comparison foods.”