The Truth About Red Meat, Cholesterol, and Heart Disease

For years health professionals have been saying to cut out red meat to lower cholesterol. But that may not be the whole story.

We have all heard about the dietary change that one should make to try to live a longer, healthy life. But good news for the carnivores out there – cutting out red meat may not be one of them.

The big cries of “foul” against red meat, which have kind of always been around, reached a fevered pitch when a study was published about ten years ago that suggested that a chemical called TMAO (trimethylamine N-oxide) increases the risk of heart disease. In this study, they hypothesized that eating red meat may increase levels of TMAO in the bloodstream, which would, in turn, ramp up your chances of having a heart attack.

TMAO was the supposed smoking gun linking red meat consumption to an increased risk of stroke or heart attack. But was it? Maybe it’s just not yet time to accept the taste of “impossible burgers.”

Another alleged culprit for why red meat could cause an increased risk of heart disease is because it, like other high fat “no-no’s,” allegedly raises your cholesterol level. But the theory that the cholesterol that you eat has anything to do with the cholesterol in your blood is  — while widely accepted – also flawed. Recent research has shown that dietary saturated fat and cholesterol are not associated with heart disease after all.

But let’s specifically take a look back at red meat consumption, heart disease, and the TMAO hypotheses.

Chris Kresser, M.S., L.Ac., a recognized expert in the field of Functional Medicine and author of the Paleo Cure, says it simply has no basis in reality. Chris says, “If red meat consumption elevates TMAO, and elevated TMAO increases the risk of heart disease, we’d expect to see higher rates of heart disease in people that eat more red meat.”

But a large meta-analysis published in Circulation by Micha et al. covering over 1.2 million participants found that consumption of fresh, unprocessed red meat is not associated with increased risk of coronary heart disease (CHD), stroke, or diabetes.  Furthermore, if eating meat increases heart disease risk, Chris says we should expect lower rates of cardiovascular disease (CVD) in vegans and vegetarians – and this, too, is not necessarily the case.

Chris says that, taken together, these data do not suggest a strong relationship between red meat and heart disease. It’s also crucial to remember that epidemiological evidence does not prove causality. Even if red meat intake is associated with a higher risk of CVD (or any other health problem), such studies don’t tell us that red meat is causing the problem.

Chris, like many others in the fields of Functional and Antiaging Medicine, believes that it’s not TMAO or cholesterol or any of the “usual suspects” that are the cause of heart disease, systemic inflammation, and a wealth of other health problems. It is the gut microbiome.

What is the Gut Microbiome?

Our bodies are home to trillions of bacteria, viruses, and fungi, which are collectively known as “the microbiome” or the “gut microbiome. Most people associate bacteria and other microorganisms with sickness and disease, but the truth is most of the microflora in our guts are actually extremely important to your immune system, heart, and particularly your ability to maintain a healthy weight. More and more medical research is discovering the crucial role that maintaining a healthy gut plays in your risk of obesity, metabolic syndrome, and, yes, heart disease.

Numerous studies suggest that the balance of bacteria in our gut may be one of the most important factors—if not the most important—that determines our overall health. Science has shown that an unhealthy or imbalanced gut – a condition known as metabolic dysregulation – contributes to a greater risk of obesity, diabetes, high cholesterol, cardiovascular disease, and digestive disorders.

If you accept that TMAO is responsible for an increased risk of heart disease (and Chris says the jury is still out on that), Chris suggests that the rise in TMAO levels in the meat-eaters in these studies is likely caused by an imbalanced gut that is the result of other things – not red meat – in their diets, such as lack of fruits and vegetables, and less soluble fiber, and more processed and refined flour, sugar and seed oils.

A healthy gut is maintained by eating foods rich in prebiotics and probiotics. That means foods already rich in bacteria, such as yogurt and Kefir, and like your mom always said – fruits and vegetables!

If you are eating an otherwise “gut-healthy diet,” the consumption of red meat in and of itself should not increase your risk of heart disease. In other words, it’s the processed bun and the French fries fried in seed oil that are more likely to kill you than the burger!