Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus: A Systematic Review and Meta-Analysis
Open accessAbstract
Background— Meat consumption is inconsistently associated with development of coronary heart disease (CHD), stroke, and diabetes mellitus, limiting quantitative recommendations for consumption levels. Effects of meat intake on these different outcomes, as well as of red versus processed meat, may also vary. Methods and Results— We performed a systematic review and meta-analysis of evidence for relationships of red (unprocessed), processed, and total meat consumption with incident CHD, stroke, and diabetes mellitus. We searched for any cohort study, case-control study, or randomized trial that assessed these exposures and outcomes in generally healthy adults. Of 1598 identified abstracts, 20 studies met inclusion criteria, including 17 prospective cohorts and 3 case-control studies. All data were abstracted independently in duplicate. Random-effects generalized least squares models for trend estimation were used to derive pooled dose-response estimates. The 20 studies included 1 218 380 individuals and 23 889 CHD, 2280 stroke, and 10 797 diabetes mellitus cases. Red meat intake was not associated with CHD (n=4 studies; relative risk per 100-g serving per day=1.00; 95% confidence interval, 0.81 to 1.23; P for heterogeneity=0.36) or diabetes mellitus (n=5; relative risk=1.16; 95% confidence interval, 0.92 to 1.46; P =0.25). Conversely, processed meat intake was associated with 42% higher risk of CHD (n=5; relative risk per 50-g serving per day=1.42; 95% confidence interval, 1.07 to 1.89; P =0.04) and 19% higher risk of diabetes mellitus (n=7; relative risk=1.19; 95% confidence interval, 1.11 to 1.27; P <0.001). Associations were intermediate for total meat intake. Consumption of red and processed meat were not associated with stroke, but only 3 studies evaluated these relationships. Conclusions— Consumption of processed meats, but not red meats, is associated with higher incidence of CHD and diabetes mellitus. These results highlight the need for better understanding of potential mechanisms of effects and for particular focus on processed meats for dietary and policy recommendations.
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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.”
From Red meat intake and risk of coronary heart disease among US men: prospective cohort study (2020) · cites this paper as [11]
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 measuredIn 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.”
From Red meat intake and risk of coronary heart disease among US men: prospective cohort study (2020) · cites this paper as [11]
Multiple whole-food meal patterns improve glycemia, blood pressure, and cardiovascular risk factors in diabetes.
“Regarding whole foods, multiple meal patterns have been shown to be advantageous for the management of DM, which promote reductions in glycemia, BP, and CVD risk factors.679,901,920–924”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [924]
The Meat Intake and Diabetes Mellitus section examines meat consumption and new cases of diabetes, not meal patterns used to manage existing diabetes. The Discussion addresses processed meat and cardiometabolic risk, but our copy does not report that multiple whole-food meal patterns reduce glycemia, blood pressure, and cardiovascular risk factors in people with diabetes. Searches for whole-food meal patterns and diabetes management found no supporting passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn meta-analyses of prospective cohort studies, total red meat consumption was associated with overall nonsignificant trends toward higher risk of CHD and DM.
“In meta-analyses of prospective cohort studies, total red meat consumption was associated with overall nonsignificant trends toward higher risk of CHD and DM (Figure 1).61,65”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [65]
Adverse effects of preservatives and/or preparation methods could influence health effects of meat consumption.
“These findings suggest that adverse effects of preservatives (eg, sodium, nitrites, and phosphates) and/or preparation methods (eg, high-temperature commercial cooking/frying) could influence health effects of meat consumption.65”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [65]
Consumption of processed meats but not unprocessed red meats was associated with higher incidence of CHD and DM.
“When different types of meat were evaluated systematically, consumption of processed meats but not unprocessed red meats was associated with higher incidence of CHD and DM.65”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [65]
Intake of red or processed meat was not associated with stroke.
“Intake of red or processed meat was not associated with stroke, but only three studies evaluated these relationships (169).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [169]
In a meta-analysis of 17 cohort studies, consumption of red and processed meat increased T2DM and CHD risk.
“In a meta-analysis of 17 cohort studies (16 from Western countries), consumption of red and processed meat increased T2DM and CHD risk; but few included studies examined unprocessed red meat (169).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [169]
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- Authors
- Micha, R., Wallace, S. K., & Mozaffarian, D.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Circulation
- Published
- 2010-06
- Volume
- 121
- Issue
- 21
- Pages
- 2271-2283
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC2885952
- OpenAlex
- W2109401990
- Cited by
- 1,244
- References
- 40
- Citations by year
- 2026: 29 · 2025: 50 · 2024: 58 · 2023: 74 · 2022: 105 · 2021: 82 · 2020: 66 · 2019: 109 · 2018: 96 · 2017: 100 · 2016: 100 · 2015: 106 · 2014: 74 · 2013: 62 · 2012: 64
- FWCI
- 61.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL085710)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Meat and Animal Product Quality
- Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
- Keywords
- red meat consumption, processed meat consumption, coronary artery disease, stroke, diabetes mellitus, dietary risk factors, dose-response relationship
- MeSH terms
- Coronary Disease, Diabetes Mellitus, Diet, Humans, Meat, Meat Products, Risk Factors, Incidence, Stroke
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