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Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat (medscape.com)
40 points by andromaton 10 months ago | hide | past | favorite | 75 comments



One of my favorite books is

https://www.amazon.com/Crime-America-Cambridge-Studies-Crimi...

as it points out the limitations of the social sciences and generally why people don’t find science satisfying, particularly looking at it scientifically as opposed to “here is a paper I can use as a weapon to justify my dogma”.

In that book, researchers analyze just about every theory of the crime drop and got inconclusive results. The one exception was a chapter which was not quantitative at all but rather spun the story the black people in NYC switched from cocaine and heroin to passing around a blunt, sipping from 40s, and having a chill time.


>... to passing around a blunt ...

Hey, whatever it takes to get the sage herb descheduled.


Hey, IQ is 10 points lower in the West than in East Asia, but the West has much nicer societies.


The key sentence most are probably looking for is:

> The median HR was 0.94 (IQR, 0.83-1.05) for the effect of red meat on all-cause mortality — ie, not significant.

However, the article (and the study) are absolutely worth a read. Another main take-away is:

> I hope you read this paper and think about it every time you read an observational study that finds a positive or negative association between two things. Ask: What if the researchers were as careful as Zeraatkar and colleagues and did multiple different analyses? Would the finding hold up to a series of plausible analytic choices?


This approach ought to have been codified as part of an oath, with associated repercussions for the breaking of, but instead that which makes for popular sound bites from talking heads will carry the day.

What researchers chasing popular beliefs fail to realize is that once you chase popular opinion, your science and therefore you are suspect, not to mention the 'content' was never going to be as popular as the latest bowel movement of modern Ben-Hur.

Aesop's fable on the Bat, the Birds and the Beasts comes to mind regarding the fall out of this approach.


For all that prefer their scientific communications to start with the conclusions:

"Of the 48 analyses deemed statistically significant, 40 indicated that red meat consumption reduced early death and eight indicated that eating red meat led to higher mortality."


So many things are lumped into red meat; highly processed meats with nitrates like hotdogs and organic grassfed beef both fit the definition. One is very clearly not healthy (due to nitrates) and the other has health benefits due to nutrients like creatine and b12 that can only be found in beef. I think if they could construct a study where red meat was more strictly defined and compared different types of red meat, that might eliminate some of this noise.


Both can be true at the same time.


> > They cannot both be right.

> You know? You are also right.


All I know is I feel amazing eating lots of leaner red meat. The nutrient content is very high (B-vitamins, zinc, etc.) and hard to get elsewhere. I probably eat 5 lbs of red meat per week. Im in my 50s, fit, and have healthy bloodwork.


I primarily eat vegetarian (eggs, and legumes for protein), but some meat every other day or so. I take supplements and ensure my diet is balanced. Something about meat and red meat in particular does make my body generally just feel significantly better though. More energy, clear headed, etc.

I've thought it might be due to in part to high metabolism. My entire family is quite slender and generally have trouble gaining weight.


How much of that do you ascribe to genetics?


There's red meat and Red Meat.

Boars and pigs are closely related, but meat from the latter has twice the calories of the former - largely due to its extreme fat content.

I had to lay off red meat due to typical sedentary lifestyle induced health issues, but I found that the problem isn't exactly in the species consumed, but in the ridiculous amount of fat that's present in factory farmed animals.

On the flipside game meat is perfectly fine, even if expensive.


you can also buy leaner cuts of meat. for example flank steak, etc. stuff that needs marinated or slow cooked, and has less fat. also grass fed steaks tend to have less fat (they aren't force-fed corn and soy to fatten them up)


Whaaaa? My favorite indulgence is grilling flank steak blue and slicing it cross-grain. You slow cook it? Doesn't it dry out?


Try sous vide. You pre-cook the meat without losing any of the water or fat because it's sealed, then you finish the outside with a pan or grill.

My steak pipeline:

* Buy uncut slabs of USDA Prime grade ribeye from your local butcher or wholesaler like Costco. If possible, avoid blade tenderized meat.

* Individually hand-cut steaks of about a pound each. You quickly learn to eyeball this.

* Individually vacuum seal them while sucking out as much moisture as possible. A FoodSaver or similar can do this cheap and easy. Buy bulk bag rolls from Costco, first-party bags are more expensive for no benefit, while pre-cut bags cost a lot to only save a few seconds.

* Freeze them until needed. With the moisture and air gap removed, they basically become a slab of solid marble with a shiny finish. There will be 0 crystallization or freezer burn if you sealed them properly. You are now set for months of superb steak with minimal further fuss.

* When needed, put one or more of these steak modules into a 137F sous vide for at least 2 hours. Season / fry / grill / etc from there as preferred.


> Buy uncut slabs of USDA Prime grade ribeye

Weird start to making flank steak, but okay?


I did say "My steak pipeline:" but yeah, adjust as needed.


One thing about these red meat studies is that they do not discern those who are on a carnivore diet (no plants - no alcohol, no sugar, no grains, etc) and those who have red meat as part of a mixed diet.

Having been on a carnivore diet for a while, and seeing many medical problems resolve that had not resolved with many medical interventions by doctors, it would be great to see more studies take a look at this.


How do you get fiber?


My dogs have a carnivore diet and their poops are firm and regular. Much better than when they were on premium dog food. Their fur is fuller, they have more energy, and yet they are more at ease.

It's an analogously similar situation with me. Haven't missed the fiber one bit.

The transition takes a bit of planning as there are initial side effects since your body is used to digesting and getting energy from sugar instead of fat. This video is a good start.

https://www.youtube.com/watch?v=r3wzDWW1MdI


"Multiverse Analysis" is a terrible name, that can only introduce confusion, even if it increases readership. This methodology is more about machine learning than it is about covering all possible worlds. I'm also suspicious of the entire approach. In order to compare two different methods of analysis, you have to do some kind of mapping or weighting or meta-analysis that tells you why comparing two numbers makes any sense at all. This result must be tautological, in the sense that every expected value and variance can be computed and compared to another of the thousands of methods employed, and when we pour in the data it has to fall within the expected ranges, otherwise we know we've made a mistake in the original calculation.


They should probably start with defining what "red meat" actually is. Personally I don't believe that fresh meat of various animals is unhealthy but I try to consume less to none of "red meat products", that is processed meat with nitrite curing salt.


lot of these "studies" have included "processed meats" not fresh meat...


Your body isn’t really digesting plants. It’s getting what nutritional value it can out of it and then pooping the rest out. Mostly it becomes fiber, which is good for you, but it is not going to provide real value like meat does. Meat is the key to a healthy diet.


Whole swats of populations go without touching any red meat (or any meat whatsoever) and be absolutely fine, some say faring even better.

Then if someone is personally addicted to meat and/or cannot enjoy other non-animal products providing the same nutrients then it's another topic. But let's not make incorrect statements, red meat is not key to anything.


If I throw a bowl of scraps to my chickens or dog or cats they go for the highest value things first which is meat and fat. Only after everything has been pecked and licked do any of them consider carrots and lettuce.

Meat provides many vitamins and nutrients in a highly bioavailable form. No one is addicted to meat. It’s a great nutrient delivery vehicle and looking at how many ways we have invented to cook it and increase its digestability it must have been useful. Grains and plants seem to be fillers to a main meal, throw in a bunch of vegetable matter in a pot with stringy meat to make it go further is how many poor people eat and the reason for the beans and rice. Any family that can afford to throw in some chicken legs or entrails or even muscle meat is going to do so into those beans and rice.

In one of the third world countries I lived in they would often tease people who could only afford beans rice and plantains because it was noted they were not as intelligent. Anecdotal sure but a common sense wisdom found in different and less affluent areas.

Furthermore, I can take your argument and use it the same. Eg Many people don’t eat vegetables, they only eat meat, and they are doing fine and many say they are doing better than ever. Let’s not make incorrect statements, vegetables are not key to anything.


If you throw food in front of kids they’ll go for the candy. Candy must be the healthiest.


Not "helthy", he said "highest value" and you are right! Candy does have pretty much the most bioavaliable energy, thats why we love it, so you make a very good point and further prove what Salad-Tycoon is saying.


The only nutrient that candy has is added sugar, which is of decidedly low value ( one of the few commonly-consumed ‘nutrients’ of which the ideal amount is probably zero)


You might be confused, the highest value is generally what we call fats. Sugars (aka carbohydrates) have the same calorie density than proteins (broadly speaking, it seems to heavily depend on the metabolism of each individual, the type of food, etc.)

That's why you would rather bring nuts/peanut butter and crisps to a ultralight hike and not a bag of sugar or candies.


> Furthermore, I can take your argument and use it the same. Eg Many people don’t eat vegetables, they only eat meat, and they are doing fine and many say they are doing better than ever. Let’s not make incorrect statements, vegetables are not key to anything

You've lost me here. If you want a short active life then mainly meat might be fine, if you want to live in a different situation than our evolutionary past then you are killing yourself early by skipping vegetables, statistically speaking.

You've completely changed the bar in your argument from what is good for preventing early death by today's standards for expected life time to other things.


I appreciate your reply and argument. I concede that conventional wisdom and knowledge is that vegetables, across the board, are healthy and that meat is classified as carnciogenic by renowned national and international institutions.

However, I disagree with this premise frankly. A lot of the studies which led to these classifications are poor quality, backwards looking, and rely upon people remembering what they ate for the last quarter. Nutrition research is poor for a variety of reasons, sadly, and who hasn’t experienced the seasons of change with one article one day claiming eggs/coffee/wine/whatever are bad one season and the next that they are good and then bad and then good and then…

I’ve taken this up as a hobby, in my studies I have found an extremely wide and deep base of people who point out a dramatic improvement in their mental and/or physical health by cutting out plant matter. Many times these people have had chronic, difficult, conditions and had been told it was incurable.

Personally, I don’t believe vegetables are necessary. I am not a zealot however (just made a bluecheese steak salad for the family) and I think nuance is key here. We’ve all been told to eat the rainbow, vegetables are good, meat is bad, etc. However I think that it should be an individual decision, some don’t do well with vegetables high in oxolates, or lechtins, or glycoalkaloids. I LOVE spicy food [and nicotine] as in nightshades, (thanks to adhd?) and while I think I would do better without it I still eat them. I also think if you are eating highly processed meats like charred burgers or smoked salami with beer and bread and condiments that isn’t great and will lead to shortened life span.

I don’t want to drone on, my point is there is a lot of nuance and individual variability. Also, strict diets tend to cut out ultra processed foods (vegan to carnivore). We should not simply assume that all vegetables are good for all people. Some veggies are better than others. Some people process things differently. Healthy meats are healthy.

For anyone interested in further reading look up: https://www.diagnosisdiet.com/

https://www.amazon.com/Brain-Energy-Revolutionary-Understand...

More on the “carnivore” diet fringe-y side:

Paul Saladino

Shawn Baker podcast for testimonials

Anthony Chaffee

In summary, there is a lot we don’t know but it appears that people eating an alternative diet are doing great. We shouldn’t just discount that because of “settled science.”


Sure, people are happy at the moment with a diet they've been on for up to 2 decades..

Meanwhile, child development under this diet would be child abuse given how little we know.

We know that people who skip certain vegetables have heightened risk of cancers, those vegetables contain chemicals not in meat.

We can conclude from the study that a vegetarian diet is competitive with an omnivore diet, maybe a little better, maybe a little worse.

From this I would assume that vegetables themselves are an important factor that was a free variable in the studies with vegetarians getting more but not necessarily better quality.

Thus vegetables matter a lot to longevity, and meat is filler that may or may not have aspects directly killing you like all the other non vegetable filler and poorer nutrition portion of vegetables.

You can't get to absolutes with the low quality of nutrional studies or meta studies across them.. But you can get to a Bayesian estimate of how poor a gamble people are making on things like excluding a whole category where some reasonable conclusions occurred within the category.


If the nutritional density of the food you are eating is the limiting factor, then prioritizing meat makes sense. But in the USA it's a lot more common to have the opposite problem, people are eating too much. In which case focusing on less dense foods can make a lot of sense from a health perspective. Variety also is important to avoid various micronutrient deficiencies. That's one thing that makes Vegan diets more difficult (but if you're overweight it'll probably still help just by reducing your calorie intake, much like most big diet changes).


“Micronutrient deficiencies” is easily solved by a normal daily multivitamin. If you eat meat you will get all of these nutrients anyway.

I’m not suggesting avoiding vegetables, they are delicious and healthy. It’s just that meat is the most important thing over all.


The difference here is that I never stated they were, unlike OP.

The key, as far as our scientific understanding goes, is to have the right micro/macro nutrient in our diet. Where you get them is not as important.

Also, using chickens and cultural norms of other countries (very often shaped by European colonists and their ideals) is not a strong argument as you might think.

In many countries being overweight is a sign of wealth and hence desired but we know that it's not the best in terms of long-term health.

P.S. You say nobody is addicted to meat? Take any random 3 people and ask them not to eat meat for 1 week. Let's see how that goes.


Getting what nutritional value it can and pooping out the rest is just literally what eating is.


I think the point is in comparison to some animals, we don't extract the full amount of nutrition available in plants (which requires a much larger gut and more energy digesting).


Still an absurd argument. We get a lot of nutritional value from plants and you still take shits after eating meat.


According to the people who are on all meat diets, one’s volume and frequency of poop goes way way down.


We generally don't eat the toughest parts of plants either. Seeds and fruits are not as hard to digest as many stems or plants like grass. Not to mention that we pre-process a lot of the vegetable matter we eat - either by grinding (e.g. flour) or cooking or both.


Yes plant based food is often ultra processed and highly refined, which is typically what foodies argue is bad (except when it comes to their plant food).


Thankfully humanity invented cooking for this very reason. Progress is great, isn't?


Doesn't this depend heavily on the plant? Lots of vegetarians seem to be able to put together a perfectly balanced diet with no meat whatsoever. (Seems like rice and beans are the key here. Mushrooms are also quite tasty, depending on whether your definition of "plant" extends to fungi.)


Vegetarians can eat eggs, milk, yogurt, cheese, &c. It's extremely easy to hit all your macros and nutrients on a vegetarian diet

Vegan diets are another story though


Vegan is certainly harder but still completely feasible, especially after the initial learning period. I’ve been vegan for 20 years and it’s only ever really annoying when travelling abroad.


I watched the Stanford twin study that was made into a Netflix documentary and it was really interesting.

It seemed like the sheer volume of food that vegans had to eat in order to avoid losing healthy muscle was very high. Participants really struggled with it.


> It seemed like the sheer volume of food

30 ml of olive oil is about 300 calories. 50 grams of peanut butter is 250 calories. Edamame / tofu (soy) has about 18 g of proteins per 100g. Beans have about 17 g per 100g. Peanut butter has 25 g of proteins.

Protein daily needs is 0.8 grams per kilogram of body weight.

I dunno boss, doesn't seem like a very high volume of food.


Just relaying what participants in the study were saying.

Don't get me wrong, there were plenty of health benefits as well but just about everybody lost muscle mass for that reason.


Just use pea or soy protein powder.


I remember reading a blog a long time ago by sometime who was vegan talking about the long term (something like 9 years) effects of eating a vegan diet without properly supplementing the nutrients you'd get with red meat.

Apparently you can easily get long term brain damage if you don't supplement with certain b vitamins. There were also other deficiencies like iron and zinc that would effect you as well.

Of course this won't effect people who only do it for a year or 2 so most probably don't ever run into issues.


Vegan for 20 years: I check my blood every other year or so and there hasn’t been an issue. I take a multivitamin, like everybody should, but maybe that counts as “properly supplementing”? AFAIK the only vitamin that’s easily deficient in a healthy vegan diet is B12, and that’s supplemented in most soy milks


Well, I think drinking b12 enriched soy milk counts. I don't think it's a given that just because you're vegan you'd drink soy milk either. I don't drink any milk and try to avoid soy and also don't take multivitamins. So in my case it's really pertinent to understand about these deficiencies in case I decide to go vegan.


What’s hard to get on a vegan diet? The only nutrients I know of that vegans tend to lack are B12 and iron, which are easily supplemented if needed.


Plants do not contain vitamins B12, D3 and K2.

Humans can transform some of the vitamin K1 from plants into K2 (like they can transform beta-carotene from plants into vitamin A), but it seems that the quantity produced thus is not sufficient. The intestinal bacteria can also produce some K2, but it is unpredictable whether that is sufficient. The vitamin K2 is required by humans for purposes in which it cannot be substituted by K1.

Plants do not use iodine and selenium. They may contain some quantities of them, especially of selenium, only when the soil where they have been cultivated happens to be rich in these elements, but it is unpredictable whether they contain enough.

Most humans, especially most males, cannot produce enough DHA and EPA fatty acids from the fatty acids available in plants.

Besides iron, plants do not contain enough calcium and they frequently contain most of their phosphorus in phytic acid that cannot be digested by humans. The vegans who do not take supplements are prone to osteoporosis.

Most humans cannot produce internally enough creatine, choline and taurine to satisfy their needs, so they also need external sources and plants are not among those.

A healthy vegan diet must include about a dozen supplements, which is not really a problem, because they are cheap and easily available, except for the fact that many vegans believe myths like "the only nutrients I know of that vegans tend to lack are B12 and iron", so they eventually tend to have health problems, which make many of them to give up on the vegan diet, instead of taking the right supplements.


Cool, thanks for the research fodder. I wouldn't say I "believed the myth", those were just the only two I was aware of, that's why I asked.


Meh, you can get all you need from a vegetarian diet, it's been prove over and over and over again

The real question if you want to stay healthy is what meat and in what quantities.

300gr of fresh ground beef every other day from the local bio farmer isn't the same as ultra processed bear shaped ham* at every meal.

* https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRkM8VO...


Ground beef wouldn't be usually the best quality, bio or not. Bio category isn't perfect, farmers try to hack around it. We have sometimes really good meat grounded for burgers here in Switzerland, but thats a rare exception.


Even unprocessed red meat increases the all-cause mortality risk by 3%. Refer to https://pubmed.ncbi.nlm.nih.gov/32011623/ which states:

> Intake of processed meat (adjusted HR, 1.03 [95% CI, 1.02-1.05]; adjusted ARD, 0.90% [95% CI, 0.43%-1.38%]) or unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.05]; adjusted ARD, 0.76% [95% CI, 0.19%-1.33%]) was significantly associated with all-cause mortality.


The paper we're discussing based its analysis on a bunch of published reports. Eyeballing its supplement Figure 1, about 4/5 of those reports gave a bottom line in the same direction as yours (increased mortality). But the OP paper arrived at a bottom line in the opposite direction.

I haven't looked further at either of these papers; just saying that telling me there's another paper which agrees with 4/5 of the other papers is not actually much information, in itself.


They're using a very unproven analysis approach, although it's their biased study selection that worries me more. You can prove anything you want if you creatively select mainly the studies that favor your desired conclusions. They didn't even use the 2020 study that I linked. They also didn't use a famous study from 2009 (PMID: 19620159) which showed harm. These are just the two that I could identify quickly.


You may well be right that they got there out of bias; I've only glanced at this.

How'd this bias manifest in their choice of which studies to review? The 4/5 opposite that I mentioned points the other way. (Added: I wrote this before you added an example paper.)

Of course their main point is supposed to be about finding ways to counter this effect of engineering desired results within academic standards. I agree that's a real thing and part of a huge problem.


Rejoice all ye faithful, the yearly flippening of whether red meat is good for you has arrived. Avail yourselves of steak before “scientific consensus” flips again a year from now.


I found this interesting because of its multiverse approach not because it's about red meat. I would have found it even more yet separately interesting if the median HR was 0.1 or 10.


people who consume red meat are likely to be in higher income brackets hence have better access to healthcare and less stressful lives


Do you know that? In western countries the stereotypical confounder on nutritional epidemiology is that people who follow official guidelines like "avoid red meat" also follow other ones like "don't smoke". And this bias would go with your higher income, the opposite of the correlation you give.


This should be a banned topic. There’s never any insight just righteous posturing.


I agree meat is not a topic that draws very interesting comments generally, but the article itself is unusually good. It's funny seeing all the uncited bold assertations on a post about how even many studies in combination are not necessarily strong evidence.


All depends how you feel about observational studies vs randomized trials. Key word = "feel".


Data science should be banned?


Well, in the case of this analysis, the authors creatively left out at least two important studies that show harm from red meat, namely PMID: 19620159 and PMID: 32011623. I don't know the full extent of their bias in study selection, but it's evident to me that it's a creative way of producing any desired conclusion.


No, articles about red meat. Gives the vegans and the manly men a platform to shout at each other.


It's all bullshit, but I don't think bullshit should be banned -- there'd be no content left!


TL;DR:

"Zeraatkar and colleagues have shown that there are thousands of plausible ways to analyze the data, and this can lead to very different findings. In the specific question of red meat and mortality, their many analyses yielded a null result. "




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