Heart Care Info - Heart Disease Prevention & Treatment

Response to Letter Regarding Article,“Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus: A ...

R Micha, SK Wallace... - Circulation, 2011 - Am Heart Assoc We appreciate the interest from Dr Bryan in our meta-analysis of unprocessed red and processed meat consumption and risk of coronary heart disease (CHD), stroke, and diabetes mellitus. 1 On the basis of current worldwide evidence, eating one serving per ...

We appreciate the interest from Dr Bryan in our meta-analysis of unprocessed red and processed meat consumption and risk of coronary heart disease (CHD), stroke, and diabetes mellitus.1 On the basis of current worldwide evidence, eating one serving per day of processed meats was associated with a 42%-higher risk of CHD and a 19%-higher risk of diabetes mellitus. In contrast, eating unprocessed red meat was not significantly associated with risk for either disease. We also demonstrated that unprocessed red and processed meats in the US differed mainly in their content of preservatives, including salt and nitrates/nitrites which were higher in processed meats, suggesting that such preservatives could account for the different relations with disease risk.

Dr Bryan claims that nitrates/nitrites actually have multiple cardiovascular benefits and protect against CHD and stroke. We agree with Dr Bryan that epidemiological findings such as ours require appropriate perspective, context, and recognition of limitations. Yet, he forgets his own advice in his buoyant description of the far more limited evidence for potential benefits of nitrates/nitrites, including a handful of animal experiments and a few small short-term trials on intermediate risk factors (eg, blood pressure).2,–,4 Such evidence has enormous limitations for causal inference relative to clinical events in humans, even notwithstanding other conflicting experimental findings, summarized in our report,1 that support the harms of nitrates/nitrites.