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    3 Comments for this article
    Ronald N. Kostoff, Ph.D. | Georgia Institute of Technology
    A recently posted document [1] described prevention and remediation measures for chronic and infectious diseases. Two of the findings are directly relevant to this article on effects of dietary red meat. First, as part of the study [1], I identified 140 major diseases. I then selected twenty of the most prominent, and examined their core literatures for the presence of AGEs articles. Every one of these twenty major disease literatures contained one or more (some very many more) articles associating the presence of large amounts of AGEs to the disease. One can conclude that control of excessive AGEs in body tissues is a foundational requirement for health/healing.
    AGEs are contained in different foods in different amounts, they are increased by high-temperature food processing, and they are produced endogenously by, e.g., reactions of proteins with glucose and ascorbates. In particular, they tend to be increased dramatically with high- temperature food processing, and since red meat tends to be cooked at high temperatures, one would expect adverse impacts on health from increased AGEs alone.
    Second, I showed examples where many clinical trials do not report variables central to the study. In the present case, 'red meat' covers a wide variety of substances. In the USA, most red meat comes from corn/grain-fed cattle, confined in relatively close quarters, and filled with antibiotics and growth hormones. How much of the adverse impacts reported come from the 'red meat' and how much come from the type of feed and additives? How would the results differ if the cattle were free-range grass-fed and not flooded with antibiotics and hormones? Without addressing these missing variables, the results of the study could be misleading.
    While the authors do show that consumption of standard red meat is harmful, and is exacerbated by other harmful substances/practices ((1) sedentary; (2) smoking; (3) drink; (4) obesity; (5) consumption of empty calories; and (6) consuming less fruits, vegetables, and whole grains.)], they do not separate the effects of intrinsic red meat from the effects of processing, additives, and cattle environmental and dietary factors.
    Kostoff RN. Literature-Related Discovery and Innovation - Update. Technological Forecasting and Social Change (2012). doi:10.1016/j.techfore.2012.02.002.
    *Pre-print full text version can be accessed at (http://stip.gatech.edu/wp-content/uploads/2012/02/LRD- UPDATE_TFSC_7_REV.pdf).
    *Journal posting access (http://dx.doi.org/10.1016/j.techfore.2012.02.002).

    Conflict of Interest: None declared
    Does red meat reduce cholesterol levels?
    Margaret Moss | Nutrition and Allergy Clinic
    I ask my patients to consume lower purine lighter meats, salmon and white fish rather than high purine red meat, sardines, mackerel and beer. This is to reduce chronic gut symptoms. I ask them to reduce their fructose intake. Fructose and purines both increase uric acid production, which is associated with mortality. [1] Fish provides useful omega three fatty acids and iodine. Wild or grass-fed meat may well be healthier than intensively reared meat, exposed to growth hormone, antibiotics, and genetically modified feed. Food frequency questionnaires (FFQ) are inaccurate. The correlation between food intake and food diaries was only between 0.5 and 0.6. The participants were asked to give the frequency with which they ate 85g of unprocessed or 45g of processed meat. Did some use raw and others cooked weights? How did the authors distinguish between a large steak and a small turkey sandwich, using only frequency information? Sugars, like galactose and fructose, are involved in glycation. They are hidden in processed foods, and intake is impossible to assess by FFQ. Glycation of LDL leads to oxidation and deposits in artery walls. [2] Fructose makes DNA available, to enlarge tumours or for metastasis. [3] The figures were not controlled for intake of these key sugars. Data for dairy products does not distinguish between low sugar hard cheese and butter, and high sugar fresh and dried milk. Nor were the figures controlled for intake of harmful trans fats or healthy omega three fats. Table 1 shows that the more red meat is consumed, the less fish is eaten. Professionals in the study may have an excessive iron intake from large steaks. An impoverished menstruating woman may benefit from having a little beef rather than a small amount of chicken. L-carnitine can be synthesised in the body, but we might wish to use red meat to increase L- carnitine levels, for example in diabetes. [4] Beef provides much, while chicken and fish provide little. The authors suggest that higher cholesterol may contribute to their findings. Yet Table 1 shows that the percentage with high cholesterol decreases, the more often red meat is consumed. The correlation of percentage with high cholesterol with quintile is –0.94 for the HPFS study and –0.92 for the NHS study. These are surprisingly high correlations for data from FFQs. The data for unprocessed meat was not corrected for processed meat consumption. Do those who consume large amounts of unprocessed meat also consume large amounts of processed meat? Also high temperature methods, like barbecuing, frying and grilling, that cause browning on the surface, are thought to be less safe than making stews or casseroles. Juices from barbecued meat fall onto the heat source, converting to carcinogens, and rise to be deposited on the meat. Red meat consumption is associated with an increased risk of mortality, in these professional Americans. However, substituting other protein sources for red meat may not reduce the risk, depending whether they choose gently cooked fish, or fried chicken and chips, made with hydrogenated oil. References. 1. Heras M, Fernández-Reyes MJ, Sánchez R, Molina A, Rodríguez A, Alvarez- Ude F. Serum uric acid as a marker of all-cause mortality in an elderly patient cohort. Nefrologia 2012; 32(1):67-72. 2. Moss M, Freed D. The cow and the coronary: epidemiology, biochemistry and immunology. Int J Cardiol 2003; 87:203-216. 3. Liu H, Heaney AP. Refined fructose and cancer. Expert Opin Ther Targets 2011; 15(9): 1049-59. 4. Malaguarnera M, Vacante M, Avitabile T, Malaguarnera M, Cammalleri L, Motta M. L-carnitine supplementation reduces oxidised LDL cholesterol in patients with diabetes. Am J Clin Nutr 2009; 89(1): 71-6.
    High content of AGEs and the unhealthy effects of red meats.
    Jaime Uribarri | Professor of Medicine The Mount Sinai School of Medicine New York NY
    This is an interesting epidemiological work, which suggests a relationship between increased consumption of red meats and higher risk of development of type 2 diabetes in human populations.There is extensive in vitro and animal data that support an important causative role for dietary advanced glycation end products (AGEs) in diabetes mellitus (1). An association between circulating levels of AGEs and HOMA-IR, an index of insulin resistance, has been demonstrated in humans (2). More importantly, our group has demonstrated that a low AGE diet was able to reduce HOMA-IR in a group of type 2 diabetic patients with insulin resistance (3). The AGE content in highest in foods of animal origin, especially meats prepared under conditions of dry heat cooking such as grilling and barbecuing. The content of AGE markedly decreases with culinary techniques that apply lower heat and plenty of water such as stewing and poaching (4).Based on the above data, I strongly believe that the association between increased consumption of red meats and the development of type 2 diabetes is mediated by the increased content of AGEs in red meats, as commonly cooked. Simple changes in meat cooking methods might make meat intake healthier.References1) Cai W et al. Oral advanced glycation endproducts (AGEs) promote insulin resistance and diabetes by depleting the antioxidant defenses AGE receptor-1 and sirtuin 1. Proc Natl Acad Sci U S A. 2012; 109:15888-932) Uribarri J et al. Circulating glycotoxins and dietary advanced glycation endproducts: two links to inflammatory response, oxidative stress, and aging. J Gerontol A Biol Sci Med Sci. 2007; 62:427-333) Uribarri J et al. Restriction of advanced glycation end products improves insulin resistance in human type 2 diabetes: potential role of AGER1 and SIRT1. Diabetes Care. 2011; 34:1610-64) Uribarri J et al. Advanced glycation end products in foods and a practical guide to their reduction in the diet. J Am Diet Assoc. 2010; 110:911-16
    Original Investigation
    Apr 9, 2012

    Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies

    Author Affiliations

    Author Affiliations: Departments of Nutrition (Drs Pan, Sun, Bernstein, Stampfer, Willett, and Hu) and Epidemiology (Drs Manson, Stampfer, Willett, and Hu), Harvard School of Public Health, and Channing Laboratory (Drs Sun, Stampfer, Willett, and Hu) and Division of Preventive Medicine (Dr Manson), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Wellness Institute of the Cleveland Clinic, Lyndhurst, Ohio (Dr Bernstein); and Department of Molecular Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany (Dr Schulze).

    Arch Intern Med. 2012;172(7):555-563. doi:10.1001/archinternmed.2011.2287

    Background Red meat consumption has been associated with an increased risk of chronic diseases. However, its relationship with mortality remains uncertain.

    Methods We prospectively observed 37 698 men from the Health Professionals Follow-up Study (1986-2008) and 83 644 women from the Nurses' Health Study (1980-2008) who were free of cardiovascular disease (CVD) and cancer at baseline. Diet was assessed by validated food frequency questionnaires and updated every 4 years.

    Results We documented 23 926 deaths (including 5910 CVD and 9464 cancer deaths) during 2.96 million person-years of follow-up. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) (95% CI) of total mortality for a 1-serving-per-day increase was 1.13 (1.07-1.20) for unprocessed red meat and 1.20 (1.15-1.24) for processed red meat. The corresponding HRs (95% CIs) were 1.18 (1.13-1.23) and 1.21 (1.13-1.31) for CVD mortality and 1.10 (1.06-1.14) and 1.16 (1.09-1.23) for cancer mortality. We estimated that substitutions of 1 serving per day of other foods (including fish, poultry, nuts, legumes, low-fat dairy, and whole grains) for 1 serving per day of red meat were associated with a 7% to 19% lower mortality risk. We also estimated that 9.3% of deaths in men and 7.6% in women in these cohorts could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings per day (approximately 42 g/d) of red meat.

    Conclusions Red meat consumption is associated with an increased risk of total, CVD, and cancer mortality. Substitution of other healthy protein sources for red meat is associated with a lower mortality risk.