Environmental co-benefits of health policies to reduce meat consumption: A narrative review.

Global meat consumption has risen steadily in recent decades, with heterogeneous growth rates across regions. While meat plays a critical role in providing essential nutrients for human health, excessive consumption of meat, particularly red and processed meat, has also been associated with a higher risk of certain chronic diseases. This has led public authorities, including the World Health Organization, to call for a reduction in meat consumption. How governments can effectively reduce the health costs of meat consumption remains a challenge as implementing effective policy instruments is complex. This paper examines health-related policy instruments and potential economic mechanisms that could reduce meat consumption. Health-related taxation could be the most effective instrument. Other policy instruments, such as informational and behavioral instruments, along with regulations, could discourage meat consumption depending on the policy design. We also provide evidence on the link between meat consumption and the environment, including climate, biodiversity, water use, and pollution. Promoting healthy behaviors by reducing meat consumption can then have environmental co-benefits and promote broader sustainable development goals. We also discuss the policy-related challenges that need to be addressed to meet environmental co-benefits.

Global burden of diabetes mellitus from 1990 to 2019 attributable to dietary factors: An analysis of the Global Burden of Disease Study 2019.

AIMS: To analyse spatial and temporal changes in the global burden of diabetes mellitus (DM) attributable to dietary factors from 1990 to 2019. MATERIALS AND METHODS: The burden of DM was analysed in terms of age-standardized disability-adjusted life-year (DALY) rates and age-standardized death rates (ASDRs), which were obtained from the Global Burden of Disease Study 2019, and their corresponding estimated annual percentage changes (EAPCs). RESULTS: The ASDR exhibited a decreasing trend (EAPC = -0.02), while the age-standardized DALY rate exhibited an increasing trend (EAPC = 0.65). Forty-four percent of the burden of DM was attributable to dietary factors, with the three largest contributors being high intake of red meat, high intake of processed meat, and low intake of fruit. Residence in a region with a high sociodemographic index (SDI) was associated with a diet low in whole grains and high in red meat and processed meat, while residence in a low-SDI region was associated with a diet low in whole grains and fruits, and high in red meat. CONCLUSIONS: The age-standardized DALYs of DM attributable to dietary factors increased between 1990 and 2019 but differed among areas. The three largest dietary contributors to the burden of DM were high intake of red meat, high intake of processed meat, and low intake of fruit.

Global burden of ischemic heart disease associated with high red and processed meat consumption: an analysis of 204 countries and territories between 1990 and 2019.

BACKGROUND: Multiple studies have indicated an association between red and processed meat consumption and the incidence of ischemic heart disease (IHD). In this study, we aimed to assess the burden of IHD caused by a diet high in red and processed meat in 204 countries and territories between 1990 and 2019, using data from the Global Burden of Disease (GBD) 2019. METHODS: We extracted data from the GBD 2019, which included the number of deaths, age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and age-standardized DALYs rates (ASDR) attributed to IHD caused by a diet high in red and processed meat. We then calculated the burden of IHD attributable to a high intake of red and processed meat in each country and territory, stratified by age, sex, and socio-demographic index (SDI). RESULTS: Globally, a high intake of red meat was responsible for 351,200 (95% uncertainty interval (UI): 559,000-642,700) deaths from IHD in 2019, while a high intake of processed meat was associated with 171,700 (95% UI: 30,100-320,000) deaths from IHD. Between 1990 and 2019, while the corresponding age-standardized rates declined, the numbers of deaths and DALYs increased. China had the highest number of deaths [98,386.9 (95% UI: 14,999.3-189,812.7)] caused by a high intake of red meat, while United States of America [33,129.6 (95% UI: 7,150-59,593.8)] was associated with the highest number of deaths caused by high intake of processed meat for IHD in 2019. Males experienced a greater burden of IHD caused by a high intake of red and processed meat than females. The ASMR and ASDR of IHD attributed to a high intake of red meat decreased in countries with high SDI, high-middle SDI and low SDI, while the ASMR and ASDR of IHD attributed to a high intake of processed meat decreased only in countries with high SDI and high-middle SDI. CONCLUSION: Although there is a decline in the ASMR and ASDR of IHD caused by a high intake of red and processed meat, there is also an increase in deaths and DALYs number globally. Additionally, there is a heterogeneous burden of IHD related to a high intake of red and processed meat across regions and countries, with males experiencing a greater burden than females. Implementing targeted policies and interventions is required to reduce the burden of IHD caused by a high intake of red and processed meat.

The current and future costs of colorectal cancer attributable to red and processed meat consumption in Brazil.

BACKGROUND: Compelling evidence supports the association between red and processed meat consumption and increased risk of colorectal cancer. Herein, we estimated the current (2018) and future (2030) federal direct healthcare costs of colorectal cancer in the Brazilian Unified Health System attributable to red and processed meat consumption. Considering reduced red and processed meat consumption, we also projected attributable costs of colorectal cancer in 2040. METHODS: We retrieved information on red and processed meat consumption from two nationally representative dietary surveys, the Household Budget Survey 2008-2009 and 2017-2018; relative risks for colorectal cancer from a meta-analysis; direct healthcare costs of inpatient and outpatient procedures in adults ≥ 30 years with colorectal cancer (C18-C20) from 2008-2019 by sex. RESULTS: Attributable costs of colorectal cancer were calculated via comparative risk assessment, assuming a 10-year lag. In 2018, US$ 20.6 million (8.4%) of direct healthcare costs of colorectal cancer were attributable to red and processed meat consumption. In 2030, attributable costs will increase to US$ 86.6 million (19.3%). Counterfactual scenarios of reducing red and processed meat consumption in 2030 suggested that US$ 2.2 to 11.9 million and US$ 13 to 74 million could be saved in 2040, respectively. CONCLUSION: Red and processed meat consumption has an escalating economic impact on the Brazilian Unified Health System. Our findings support interventions and policies focused on primary prevention and cancer.

The association between meat and fish intake by preparation methods and breast cancer in the Carolina Breast Cancer Study (CBCS).

PURPOSE: We examined the associations between intake of meat and fish by preparation methods and breast cancer in the Carolina Breast Cancer Study, a racially diverse population-based case-control study. METHODS: African American (AA) and European American (EA) women aged 20-74 years with a first diagnosis of invasive or in situ breast cancers were frequency matched by race and age group to controls identified through the North Carolina Division of Motor Vehicles and Medicare lists [AA: 548 cases, 452 controls; EA: 858 cases, 748 controls]. Participants self-reported meat preparation methods and intake frequencies. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression adjusted for age, race, alcohol intake, body mass index, family income, lactation, marital status, use of oral contraceptives, postmenopausal hormone use, smoking status, and offsets. RESULTS: Positive associations with breast cancer were observed for intakes of grilled/barbecued hamburger (≥ once/week, OR: 1.28; 95% CI 1.01, 1.63), and pan-fried/oven-broiled beef steak (≥ once/week, OR: 1.36; 95% CI 1.08, 1.72). Inverse associations were observed for pan-fried fish (≥ once/week, OR: 0.77; 95% CI 0.60, 0.98), and for grilled/ barbecued pork chops (> 0 time/week OR: 0.81, 95% CI 0.68, 0.97). Associations tended to be stronger among EA women than among AA women. CONCLUSION: More frequent consumption of beef prepared with high temperature methods was associated with higher odds of breast cancer while more frequent consumption of pan-fried fish or grilled/barbecued pork chops was associated with lower odds of breast cancer.

Towards refining World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations for red and processed meat intake: insights from Alberta's Tomorrow Project cohort.

Current cancer prevention recommendations advise limiting red meat intake to <500 g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red v. non-red meats with cancer risk in a prospective cohort of 26 218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median follow-up of 13·3 (interquartile range (IQR) 5·1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and sex. The median consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat was 267·9 (IQR 269·9), 53·6 (IQR 83·3) and 11·9 (IQR 31·8), respectively. High intakes (4th Quartile) of processed meat from red meat were associated with increased risk of gastrointestinal cancer adjusted hazard ratio (AHR): 1·68 (95 % CI 1·09, 2·57) and colorectal cancers AHR: 1·90 (95 % CI 1·12, 3·22), respectively, in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggest that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence towards refining cancer prevention recommendations for red and processed meat intake.

Arsenic and toxic metals in meat and fish consumed in Niger delta, Nigeria: Employing the margin of exposure approach in human health risk assessment.

This study provides information on the health risk of As, Cd, Hg, Pb and V exposure from Nigerian foods consumption (fish, cow, goat and chicken meat) in different age-groups (children, adolescent, adult, senior) and six areas of Niger Delta, Nigeria (Choba, Khana, Eleme, TransAmadi, Uyo, and Yenogoa). The health risk assessment was performed by estimating the weekly or monthly intake of metals from foods and Margin of Exposure (MOE) approach by using established benchmark dose levels (BMDLs). Regarding As, cow and chicken meat products contributed to As exposure intake especially in children resulting in values higher than BMDL0.1 for cancer risk in TransAmadi and Uyo areas. Cadmium exposure was due to cow, chicken and goat meat ingestion mostly in adolescent above the tolerable monthly intake limit in TransAmadi and Uyo areas. Concerning Hg and V, the exposure from Nigerian food did not constitute a potential health hazard. Lead exposure in children were above or close to BMDL0.1 for developmental neurotoxicity by ingestion of cow and goat meat in all the Nigerian areas. In adult and senior the Pb dietary exposure were above the BMDL10 providing a low to negligible risk for kidney effects. The potential concern for health effects in Niger Delta population needs further efforts to decrease As, Cd and Pb dietary exposure especially for children and adolescent, who are more vulnerable to adverse life events.

The Future of Meat: Health Impact Assessment with Randomized Evidence.

Massive animal farming for meat production poses major problems in terms of resource use, environmental impact, and biodiversity. Furthermore, excessive meat consumption has been associated with multiple deleterious health consequences. However, more and better-designed randomized trials are needed to increase the level of evidence on the health impacts of meat. Novel meat alternatives, such as plant- and cell-based meat, are much less impactful to the environment and might replace traditional animal meat in the future, but, despite promising early data, the health consequences of these novel products need further study. This manuscript focuses on the health impacts of meat over 3 main sections: 1) overview of the evidence highlighting the association of meat consumption with health; 2) novel alternatives to meat, including plant-based and cell-based alternatives; and 3) examine the rationale for randomized studies to evaluate the effects of the novel meat alternatives compared with the standard animal meat.

Health Risk Assessment for Human Exposure to Trace Metals Via Bushmeat in Ghana.

Consumption and trade in bushmeat are entrenched in sub-Saharan Africa amid growing land degradation and environmental pollution that raise safety concerns, yet sustainability of bushmeat extraction and zoonoses considerations have been the focus of bushmeat research. Here, we evaluated the health risk of trace metals in the skeletal muscle, bone, liver, and skin of the black duiker (Cephalophus niger), brush-tailed porcupine (Atherurus africanus), bushbuck (Tragelaphus scriptus), cane rat (Thryonomys swinderianus), and Maxwell's duiker (Cephalophus maxwelli) being the five most hunted and consumed species of bushmeat in Ghana. Sample tissues of the five species were analyzed for Cu, Zn, Se, Cd, As, Pb, and Hg. Targeted hazard quotient (THQ) of Se for black duiker, bushback, and Maxwell's duiker as well as that of Pb for black duiker, Brush-tailed porcupine, and Maxwell's duiker were concerning (> 1) for individuals foraging daily on bushmeat. Thus, cane rat was the only species that recorded both estimated daily intake (EDI) and THQ of Se and Pb within safe limits for daily consumption. In respect of Cu, Zn, Cd, As, and Hg, EDI and THQ values indicated no perceived risk to consumers for all five species. Lifetime cancer risk (CR) of As was negligible for all species. At the rate of bushmeat consumption in sub-Saharan Africa (0.104 kg per day), the cane rat was the only species considered safe for daily consumption among the five species.

Pink slimed: Media framing of novel food technologies and risk related to ground beef and processed foods in the U.S.

In March 2012 ABC World News Report aired a series of reports on lean finely textured beef (LFTB) that resulted in a 10-year low for beef prices and the bankruptcy of a major firm that produced LFTB. Using a random sample survey, we tested the effects of the media frame "pink slime" and industry frame "lean finely textured beef," alongside media use, food-related knowledge, trust in food-related institutions and preference for local, fresh, organic and GMO-free foods on perceptions of risk related to ground beef containing pink slime/LFTB, processed foods and red meat. The "pink slime" frame was strongly and positively associated with risk related to ground beef, but not risk related to red meat or processed foods. Attention to news stories about pink slime/LFTB was strongly associated with risk related to ground beef and processed foods, but not red meat. We found varying effects of food values, knowledge and trust on all three dependent variables. Implications are discussed.

Gauging attitudes and behaviours: Meat consumption and potential reduction.

The present study focused on adding to the understanding of meat consumption and potential drivers for its reduction in New Zealand. Using the Theory of Planned Behaviour (TPB) and the recently developed Meat-Attachment Questionnaire (MAQ), this study investigated New Zealand consumers' attitudes, motivations and behaviours in regards to meat consumption. Results derive from a questionnaire sent across New Zealand in March 2017, in which 841 responses were obtained from representative consumer panels. Consumer awareness of the severity of meat's environmental impacts was found to be quite low in comparison to other sustainable food behaviours. Motivations for reduction seem to shift across consumer groups, with different considerations rising and falling in importance depending on current meat consumption habits. Among the TPB components, only attitudes were found to accurately and consistently predict willingness and intentions to reduce personal meat intake, while both attitudes and subjective norms predicted agreement with proposed structural measures that would promote meat reduction and/or plant-based food consumption. In addition, the MAQ was found to provide explanatory power above and beyond that of the TPB components alone and this research supports its use as a tool to further understand meat consumption and potential motivations for reduction. The authors believe these results could be useful for governments or organizations wishing to implement meat reduction strategies, as well as providing a stepping stone for further research inquiry into motivations behind meat consumption and its potential reduction.

Rabbit meat production and consumption: State of knowledge and future perspectives.

Since the 1970s, in some European countries rabbit meat production has progressively become a highly specialized industry, which has made Europe the second (after China) largest rabbit meat producer in the world. However, the industry is currently facing a critical period due to structural weaknesses, progressive and constant reductions in consumption, and raising criticism related to welfare conditions and other ethical issues. This trend is questioning the future of the rabbit meat industry, which could lead to the loss of knowledge and technical expertise acquired over decades of major investments and research efforts (a valuable cultural and professional heritage for future generations). In the present review, we provide an overview of the rabbit meat industry, market and value chain, we depict consumer's attitude towards rabbit meat, highlighting strengths and weaknesses, and factors driving their current purchase behavior. Finally, we will attempt to outline possible strategies to ensure a sustainable future for the production of rabbits for commercial meat purposes.

The Influence of Dietary Habits and Meat Consumption on Plasma 3-Methylhistidine-A Potential Marker for Muscle Protein Turnover.

SCOPE: 3-Methylhistidine (3-MH) as a potential biomarker for muscle protein turnover is influenced by meat intake but data on the impact of meat on plasma 3-MH are scarce. We determined the association of plasma 3-MH, 1-methylhistidine (1-MH), and creatinine with dietary habits and assessed the impact of a single white meat intervention during a meat-free period. METHODS AND RESULTS: Plasma 3-MH, 1-MH, and creatinine concentrations of healthy young omnivores (n = 19) and vegetarians (n = 16) were analyzed together with data on anthropometry, body composition, grip strength, and nutrition. After baseline measurements omnivores adhered to a meat-free diet for 6 days and received a defined administration of chicken breast on day four. At baseline, omnivores had higher plasma 3-MH and 1-MH concentrations than vegetarians. White meat administration led to a slight increase in plasma 3-MH in omnivores. The elevated 3-MH concentrations significantly declined within 24 h after white meat intake. CONCLUSION: 1-MH concentrations in plasma seem to be suitable to display (white) meat consumption and its influence on 3-MH plasma concentration. 3-MH in plasma may be used as a biomarker for muscle protein turnover if subjects have not consumed meat in the previous 24 h.

A summary of meat intakes and health burdens.

This review summarizes published meta-analysis outcomes on the associations between meat intakes and burden of diseases. A novel assessment process was developed, combining selected Cochrane Review measures, AMSTAR checklist, and other quality measures identified by authors during preliminary phases of the review process. Meat intakes have been found to be statistically significant associated with 21 burden of diseases. A total of 37 risk-outcome best dose-response estimations were identified, all were positively associated, and 21 of them with low to moderate, or insignificant heterogeneity. The highest dose-responses per 50 g increases in processed meat intake at 95% confident levels were 1.81 (1.32, 2.48) for esophageal cancer, 1.71 (1.34, 2.19) for stomach cancer, 1.42 (1.07, 1.89) for CHD, 1.32 (1.19, 1.48) for diabetes, and 1.24 (1.13, 1.35) for colon cancer incidences, and 1.24 (1.09, 1.40) for CVD mortality. The highest dose-responses per each 65 g increases in total red meat intake were 1.36 (1.16, 1.58) for endometrial cancer, 1.25 (1.10, 1.41) esophageal cancer, and 1.22 (1.16, 1.23) for lung cancer incidences. In addition, 14 statistically significant associations in terms of high vs low meat intake relative risks were also identified. Total red meat intakes were found negatively associated with CVD and cancer mortalities, and poultry meat intakes were found negatively associated with all-cause and cancer mortalities, and rectal cancer incidences in low meat consumption Asian countries. Current global and dietary Comparative Risk Assessments may underestimate burden of diseases attributed to meat intakes. More investigation is needed in low-meat consumption countries.

Dietary patterns, overweight and obesity from 1961 to 2011 in the socioeconomic and political context of Argentina.

To analyse the changes in eating patterns in Argentina from 1961 to 2011, and to assess changes in overweight and obesity in their socioeconomic and political context, we performed a hierarchical cluster analysis. We used the information from Food Balance Sheets of the United Nations Food and Agriculture Organisation to identify dietary patterns of apparent consumption. Years were grouped into five patterns. The food group with the highest apparent consumption was cereals (30% of total kcal/person/day) although this decreased slightly. Meats were second and their contribution decreased by 12%. The following foods contribution increased during the period: Sugar and milk by 2% and vegetable oils by 6%. The changes observed in the number of kcal/person/day were in line with changes in real wage, and coincided with economic and political crises that Argentina experienced during that period. Changes in eating patterns allow us to interpret that they relate to the increase in overweight and obesity.

Red and processed meat consumption and purchasing behaviours and attitudes: impacts for human health, animal welfare and environmental sustainability.

OBJECTIVE: Higher intakes of red and processed meat are associated with poorer health outcomes and negative environmental impacts. Drawing upon a population survey the present paper investigates meat consumption behaviours, exploring perceived impacts for human health, animal welfare and the environment. DESIGN: Structured self-completion postal survey relating to red and processed meat, capturing data on attitudes, sustainable meat purchasing behaviour, red and processed meat intake, plus sociodemographic characteristics of respondents. SETTING: Urban and rural districts of Nottinghamshire, East Midlands, UK, drawn from the electoral register. SUBJECTS: UK adults (n 842) aged 18-91 years, 497 females and 345 males, representing a 35·6 % response rate from 2500 randomly selected residents. RESULTS: Women were significantly more likely (P60 years) were more likely to hold positive attitudes towards animal welfare (P<0·01). Less than a fifth (18·4 %) of the sample agreed that the impact of climate change could be reduced by consuming less meat, dairy products and eggs. Positive attitudes towards animal welfare were associated with consuming less meat and a greater frequency of 'higher welfare' meat purchases. CONCLUSIONS: Human health and animal welfare are more common motivations to avoid red and processed meat than environmental sustainability. Policy makers, nutritionists and health professionals need to increase the public's awareness of the environmental impact of eating red and processed meat. A first step could be to ensure that dietary guidelines integrate the nutritional, animal welfare and environmental components of sustainable diets.

Evaluation of the Balanced Menus Challenge: a healthy food and sustainability programme in hospitals in Maryland.

OBJECTIVE: The Balanced Menus Challenge (BMC) is a national effort to bring the healthiest, most sustainably produced meat available into health-care settings to preserve antibiotic effectiveness and promote good nutrition. The present study evaluated the outcomes of the BMC in the Maryland/Washington, DC region. DESIGN: The BMC is a cost-effective programme whereby participating hospitals reduce meat purchases by 20 % of their budget, then invest the savings into purchasing sustainably produced meat. A mixed-methods retrospective assessment was conducted to assess (i) utilization of the BMC 'implementation toolkit' and (ii) achievement of the 20 % reduction in meat purchases. Previous survey data were reviewed and semi-structured interviews were conducted. SETTING: Hospitals located in the Maryland/Washington, DC region, USA, that adopted the BMC. SUBJECTS: Twelve hospitals signed the BMC in the Maryland/Washington, DC region and six were available for interview. RESULTS: Three hospitals in the Maryland/Washington, DC region that signed the BMC tracked their progress and two achieved a reduction in meat procurement by ≥20 %. One hospital demonstrated that the final outcome goal of switching to a local and sustainable source for meat is possible to achieve, at least for a portion of the meal budget. The three hospitals that reduced meat purchases also received and used the highest number of BMC implementation tools. There was a positive correlation between receipt and usage of implementation tools (r=0·93, P=0·005). CONCLUSIONS: The study demonstrates that hospitals in the Maryland/Washington, DC region that sign the BMC can increase the amount of sustainably produced meat purchased and served.

Health risk assessment of zinc, chromium, and nickel from cow meat consumption in an urban Nigerian population.

BACKGROUND: Meat consumption is increasingly becoming a larger part of diets worldwide. However, the bioaccumulation of toxic metals from anthropogenic pollution is a potential health risk to human health. OBJECTIVE: To measure the daily intake of zinc, chromium, and nickel from cow meat consumption and assess the possible health risks in an urban population in Nigeria. METHODS: Dried meat samples were digested with 3 : 2HNO3 : HClO4 v/v. Zinc, chromium, and nickel concentrations were determined with atomic absorption spectrophotometer. Daily intakes of meat were obtained using a food frequency questionnaire (FFQ). RESULTS: The estimated daily intakes (EDI) (µg/person/day) ranges were: zinc (10 496-13 459), chromium (310·90-393·73), and nickel (26·72-34·87). Estimated daily intake for zinc was 15-30% of provisional maximum tolerable daily intake (PMTDI) and for nickel it was 8-15% of tolerable daily intake (TDI). CONCLUSION: Chromium intakes were above recommended daily intake (RDI). Target hazard quotient (THQ) for nickel and zinc were within WHO/FAO limit. There was no evidence of possible health risk to consumers with regard to zinc and nickel. However, chromium intake should be of utmost concern, while disposal of tanning waste should be checked.