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August 26, 2019

Can Plant-Based Meat Alternatives Be Part of a Healthy and Sustainable Diet?

Author Affiliations
  • 1Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 2Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 3Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 4Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
JAMA. 2019;322(16):1547-1548. doi:10.1001/jama.2019.13187

Diets high in red meat, especially processed meat, have been associated with a wide range of health consequences including obesity, type 2 diabetes, cardiovascular disease, and some cancers. Based on a comprehensive review of epidemiologic evidence, the International Agency for Research on Cancer of the World Health Organization classified processed meats such as hot dogs, bacon, and sausages as carcinogenic to humans for colorectal cancer, and unprocessed red meats, such as beef and pork, as “probably carcinogenic.”1 In addition, there is growing concern that industrial meat production can contaminate natural resources, including rivers, streams, and drinking water, with nutrients from animal waste lagoons and runoff. There is also concern that the raising of livestock can lead to the loss of forests and other lands that provide valuable carbon sinks as well as the large amounts of greenhouse gas emissions that contribute to the ongoing environmental and climate-related issues.2

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    3 Comments for this article
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    This Article Misses the Point
    Daniel Hogan, PhD | Biotech Company
    With all due respect, this piece completely misses the point.

    The point of these burgers isn't to be much healthier than animal-analogs. at least for now -- and these companies openly acknowledge that.

    The main point is that they are >10X less impactful on the environment (which you question). Here is the logic:

    1. Animal farming is one of the major contributors of environmental catastrophe.
    2. Humans love/crave meat.
    3. Meat consumption is increasing.
    4. To dramatically reduce meat consumption, you need to replace animal meat with equally tasting and expensive plant meat (there is no
    other way).
    5. If we don't do this we are done for.

    Of course we should eat better, but that's not really important right now. In contrast, you state: "While environmental factors can and should be strong motivators of food choice, it is equally important to consider the effects of PBMAs on human health." No, No, No.

    Also, it is misleading to categorically group PBMAs with " highly processed" junk foods; PBMA products are basically a cooked protein shake. Are you opposed to those? The issue with "highly processed" foods, at least ones made from healthy inputs, in large part seems to be linked to eating more than you would otherwise, as you acknowledge, not the nutrition content per se.
    CONFLICT OF INTEREST: None Reported
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    Commentary Reflects Bias and Lack of Education
    Robert Abbott, MD | University of Virginia
    It has become quite clear that Dr. Hu and colleagues are not fond of red meat and have spent millions in research efforts (not to mention the thought space) seeking to show how destructive it is for human health. I mean for goodness sake, a physicians group recently made a petition against the recent Annals of Internal of Medicine article "Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials" because the conclusions were different and went against much of Hu's and colleagues research. There is no point to waste space here going into the issues with FFQ's, recall bias, absolute vs relative risk in these nutritional studies, so I want to point out a statement from this commentary that stuck out to me and provide some reflections.

    "It is clear that for both human health and the health of natural resources and the planet, a sustainable food system that shifts the global population toward more plant-based foods and less animal-based foods is needed."

    Well I don't care if you cite a research article supporting this statement as was done in the commentary, but this statement is flat out opinion and not fact or science. There are hundreds of innovative groups or farmers, The Savory Institute and Polyface Farms being two, that are seeking to promote sustainable grazing that actually can be net positive in carbon emissions. These organizations also promote and engage in humane slaughtering/processing amidst many other practices that I would guess almost any environmentally conscious individual would support if they were aware of them. The issue is, these organizations and innovative farmers don't get talked about because "meat is the problem and plants are the answer."

    I completely agree that current grain-fed cattle practices along with industrial produce agriculture (let's not forget about all the topsoil being destroyed, irresponsible irrigation, tons of pesticides put onto crops, etc) are not sustainable and must be changed, but the answer to these issues is vastly more complex that eat less meat, eat more plants. Other nutritional professionals have written as well about the concerning possibility that in telling people to eat more plants and forego meat and animal products, potentially hundreds of thousands of Americans will become (more) choline deficient (pregnant woman being the most concerning subgroup).

    When the layperson and even physician goes on the internet to try and become informed about this topic, is it next to impossible as the numbers the "pro-plant" folks share in favor of their views are vastly different than the numbers shared by those seeing this as a more complex problem.

    I agree with you that the promotion of these plant-based meat products as "healthy" is irresponsible and there is no evidence currently supporting them as a healthy option as compared to whole plant foods. The issue, however, is that the discussions and changes we must be implementing are so much bigger and so much more important than trying to fight the companies making these processed plant-based meats.

    Please, I urge anyone reading this to recognize the complexity of these issues and seek out education and resources on all sides and realize that given these complexities, the answer to improving human health and environmental sustainability will never be as easy as eat more plants, eat less meat.

    Thank you
    CONFLICT OF INTEREST: None Reported
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    "Dose" Would Promote Harmony
    Alejandro D Gonzalez, Ph.D. in Physics | Principal Researcher, retired from CONICET Argentina
    The concept of dose is as important in medicine as in radiation physics. A proper dose would do well without harmful effects. I find that the same should be much stressed in the debate about meat- vs plant-based foods. There have been several studies on amounts of meats that would reduce environmental pressure and at the same time the increasing of plant foods benefiting health. Grazing is fine but the yield would be much lower by natural limitations, though by harmonizing the consumption smaller offers may be enough.

    The approach of dose for recommending a range in the
    amounts of meats weekly consumed could be more effective in convincing people to change their customs and cultures, which for foods have shown to be notably strong.

    Thanks JAMA for opening comments and discussions
    CONFLICT OF INTEREST: None Reported
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