I had the great fortune to stumble upon an excellent article in the German medical media outlet “Ärzteblatt”. In this piece titled “Nutrition and climate: Eating meat-free, healthy and climate-friendly – the evidence is missing“, Dr. med. Johannes Scholl, President of the German Academy for Preventive Medicine lays out the varying myths surrounding meat consumption. It is increasingly known that the enemies of meat are going to great length to demonise its prevalence, by making statements about its health effects and impact on the environment. I’ve had my own experience arguing against these tendencies on a TV panel on TRT World:

Back to the article in question. Scholl presents a number of highly interesting points, and I’d like to give you the most informative nuggets.

“Reports of disadvantages of meat consumption are increasing and are adding up to a seemingly consistent bouquet of arguments for a meat-free diet. Recently, for example, a new study has been published which proclaims an association between increased meat consumption and cardiovascular mortality and all-cause mortality. In 6 cohorts (29,682 patients), a risk increase was found for both endpoints in 19 years of observation per consumption of 2 portions of unprocessed red meat per week – but only by 3%.

This is a “pseudo result” and can easily be invalidated. Both inaccuracies in data collection and possible systematic errors in observational studies mean that a relative risk of 1.03 (95% confidence interval: 1.01-1.06) simply says nothing. A glance at the details also renders this study unreliable: allegedly, the average alcohol consumption in the study was 1 g per day. This underestimates the real drinking amounts by at least ten times, as has been sufficiently proven by other studies.”

Scholl shows how any blatant claims on nutritional science must be taken with a grain of salt. After decades of nutritional science, we know how difficult it is to account for the multifactorial aspects of human health. He raises a similar point later on:

“For example, studies on meat consumption show that the groups with low meat consumption were on average more educated, slimmer, more athletically active, less likely to smoke, and generally healthier than the groups of meat-eaters. Such systematic differences are attempted to be statistically extrapolated – multivariate adjusted, that is. However, this is often not transparent, because the extent of the adjustment for individual, unevenly distributed risk factors is not disclosed. A distortion of the results is therefore unavoidable even in meta-analyses. A further problem is the so-called “recall bias”. It refers to the uncertainty regarding the correct recall of nutritional behaviour. The authors around Guyatt, therefore, stress that meta-analyses could also provide insufficient evidence for an influence of meat on disease risks. The overall evidential value is too weak to derive serious recommendations for the population.”

Scholl also brings us concerning news about the state of academic debate within nutritional science, notably how some in the camp of activist science are trying to prevent evidence-based information to come out.

“Scientific discussion is called for instead of polemics and defamation, demands Sharp from Harvard. He emphasized that there was no evidence that the meat industry had sponsored the studies. It is true: Texas A&M University, as an institution for its agricultural sector, also receives donations from the meat industry amounting to approximately 1.5% of its total budget.

The stumbling block to the fierce dispute was a series of articles published in 2019 in the Annals of Internal Medicine. In it, the authors concluded, on the basis of strictly evidence-based criteria, that there was no qualitatively sufficient scientific evidence to justify a recommendation to reduce meat consumption. One of the main authors of the publication is Dr Gordon H. Guyatt from the Canadian McMaster University in Hamilton/Ontario, one of the fathers of evidence-based medicine.

There are hardly any randomized controlled nutritional studies with hard endpoints on the topic of meat consumption. In the Womensʼ Health Initiative Study, women who were randomized to a low-fat diet reduced their meat consumption by about 20%. However, this did not result in any difference in the various endpoints such as all-cause mortality, cancer or cardiovascular disease.”

In fact, it turns out that a purely plant-based diet might even produce the opposite effect.

“From the point of view of nutritional medicine, the distinction between animal and plant foods makes no sense anyway. Because not only vegetables, fruit and olive oil, but also sugar, soft drinks and all starch-rich white flour products are vegetables. With an assumed basal metabolic rate of 2,000 kcal, the “Planetary Health Diet” would correspond to an intake of more than 330 g of carbohydrates per day or 55-60% of the total calories. The PURE study had shown that such a high-carbohydrate diet is harmful to the vast majority of people and increases overall mortality (23, 24). It is not without reason that many experts consider carbohydrate reduction – “low carb” – to be a milestone in healthy eating.”

Lastly, Scholl also looks at the claim of environmental damage due to meat consumption. Here again, the accusation doesn’t match the crime.

“The argument that meat consumption is already sufficiently high – not least in Germany – and a further increase would definitely not be sensible may be true. But even if all of Germany were vegan, according to climate researcher Frank Mitloehner, the impact on global CO2 emissions would not even be measurable.

In the past it used to be said: “Meat is a piece of vitality”, today it is more likely: “Meat consumption is the number one climate killer” The content of such a statement is however just as questionable as statements about meat consumption that is harmful to health. According to updated data from the US Environmental Protection Agency (EPA), the entire agricultural sector contributes 9.3 % of greenhouse gas emissions. However, more than three quarters come from transport (27.9 %), energy production (26.9 %) and industry (22.2 %). Fermentation in ruminants accounts for 2.7% of total emissions. Almost three times as much methane is released from fracking, landfills and coal and gasoline production, an aspect that is often overlooked.”

Meat consumption is under fire from activists who use questionable nutritional science to back up their claims. It is our responsibility as consumer choice advocates to set the record straight and defend choice in all aspects of life. This is not to say that we endorse eating meat per se. We defend the right of responsible consumers to make their own choices, with accurate data-points, driven by science, not ideology. 

Sources:

Zeraatkar D, Johnston BC, Bartoszko J, et al.: Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials. Ann Intern Med 2019; 171 (10): 721–31 CrossRef MEDLINE

Zeraatkar D, Han MA, Guyatt GH, et al.: Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med 2019; 171 (10): 703–10 CrossRef MEDLINE

Han MA, Zeraatkar D, Guyatt GH, et al.: Reduction of Red and Processed Meat In-take and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med 2019; 171 (10): 711–20 CrossRef MEDLINE

Johnston BC, Zeraatkar D, Han MA, et al.: Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium. Ann Intern Med 2019; 171 (10): 756–64 CrossRef MEDLINE

Vernooij RWM, Zeraatkar D, Han MA, et al.: Patterns of Red and Processed Meat Consumption and Risk for Cardiometabolic and Cancer Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med 2019; 171 (10): 732–41 CrossRef MEDLINE

Valli C, Rabassa M, Johnston BC, et al.: Health-Related Values and Preferences Regarding Meat Consumption: A Mixed-Methods Systematic Review. Ann Intern Med 2019; 171 (10): 742–55.
CrossRef MEDLINE

Carroll AE, Doherty TS: Meat Consumption and Health: Food for Thought. Ann Intern Med 2019; 171 (10): 767–8 CrossRef MEDLINE

Assaf AR, Beresford SAA, Risica PM, et al.: Low-Fat Dietary Pattern Intervention and Health-Related Quality of Life: The Women‘s Health Initiative Randomized Controlled Dietary Modification Trial. J Acad Nutr Diet 2016; 116 (2): 259–71 CrossRef MEDLINE PubMed Central

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