Johnston BC, Zeraatkar D, Han MA, et al. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium. Ann Intern Med. 2019 Oct 1. pii: 2752328. doi: 10.7326/M19-1621. (Evidence-based guideline)

Description: Dietary guideline recommendations require consideration of the certainty in the evidence, the magnitude of potential benefits and harms, and explicit consideration of people's values and preferences. A set of recommendations on red meat and processed meat consumption was developed on the basis of 5 de novo systematic reviews that considered all of these issues.

Methods: The recommendations were developed by using the Nutritional Recommendations (NutriRECS) guideline development process, which includes rigorous systematic review methodology, and GRADE methods to rate the certainty of evidence for each outcome and to move from evidence to recommendations. A panel of 14 members, including 3 community members, from 7 countries voted on the final recommendations. Strict criteria limited the conflicts of interest among panel members. Considerations of environmental impact or animal welfare did not bear on the recommendations. Four systematic reviews addressed the health effects associated with red meat and processed meat consumption, and 1 systematic review addressed people's health-related values and preferences regarding meat consumption.

Recommendations: The panel suggests that adults continue current unprocessed red meat consumption (weak recommendation, low-certainty evidence). Similarly, the panel suggests adults continue current processed meat consumption (weak recommendation, low-certainty evidence).

Primary Funding Source: None. (PROSPERO 2017: CRD42017074074; PROSPERO 2018: CRD42018088854).

Discipline Area Score
Family Medicine (FM)/General Practice (GP) 6 / 7
General Internal Medicine-Primary Care(US) 6 / 7
Public Health 6 / 7
Internal Medicine 5 / 7
Comments from MORE raters

Family Medicine (FM)/General Practice (GP) rater

Let the arguments begin! Kudos to the authors for a courageous but objective and dispassionate look at the evidence.

General Internal Medicine-Primary Care(US) rater

The underlying clinical evidence is weak, so the recommendations lack conviction. Not sure this is of huge interest.

Public Health rater

Meta-analysis with relatively weak data.

Public Health rater

An article that has already hit the news.

Public Health rater

A provocative guideline that calls into question the causal effect of lower red meat and lower processed meat consumption in reducing cardiovascular disease and cancer. Instead of saying there is insufficient evidence, they recommend people maintain their current meat consumption.
Comments from EvidenceAlerts subscribers

Dr. Mel Anderson (10/17/2019 2:16 PM)

RCTs are a difficult tool to examine the impact of dietary patterns -- the DASH diet trial required incredible effort to complete but helped us understand that the composition of calories mattered. Observational data across hundreds of thousands of patients across the globe consistently links diets high in fruits, vegetables, whole grains, legumes, nuts and seeds with positive health outcomes in addition to requiring less arable land and water use to sustain. As internists, we must not lose sight of the great balance of data showing that processed, cured, meats are not associated with positive health outcomes.