Growing consumption of processed red meat in Asia linked to higher mortality risk, experts flag

13 Mar 2023 --- Women with a high intake of processed red meat had a 32% higher risk of death and men had a 21% higher risk, according to a South Korea-based study. At the same time, the study found that a moderate unprocessed pork belly and beef intake may offer protective benefits against premature mortality. 

Published in Frontiers in Nutrition, the study also found that participants consuming moderate levels of pork belly decreased risk levels for all causes of death by 24% for men and 18% for women.

The authors explain that the Asian region has experienced the third most significant increase in red and processed red meat intake in the past decade. At the same time, traditional dietary patterns in Korea still emphasize a high intake of plant foods and a moderate fat intake. 

The type of meat and preparation methods influenced the mortality risk in the study. Therefore, the authors suggest that Korean public health guidelines on meat intake should consider these aspects. 

The researchers selected 113,568 participants from the Health Examinees cohort, a study with participants over 40 years recruited in Korea between 2004 and 2013. Participants were followed until 31 December 2020. 

Impact on mortality risk 
For female participants, a high intake of pork belly led to an 84% higher risk of death due to cardiovascular diseases (CVD). Moreover, women with a high intake of organ meat had a 21% higher risk for death and a 24% higher risk for cancer mortality. 

Low beef intake decreased the risk of CVD mortality in men by 42%, while roasted pork increased cancer mortality risk in women by 26%.Processed red meat intake was linked to a higher risk of death in men and women.

The study found no association between deaths and white meat. Previous Asian studies found that chicken intake was inversely associated with a reduced risk of all-cause mortality in men. 

Studies in Western countries found that red and processed meats increased the risk of strokes by up to 16% while reducing meat consumption could lower cancer risk. Plant-based foods may help fight disease epidemics. 

Influence of preparation methods 
The authors suggest that meat preparation in Korea influenced the study’s outcomes, where meat is mainly consumed roasted or in soup or stews. 

Pork belly consumed in South Korea is lower in saturated fat than in Western countries, as Korean consumers favor grilled or roasted bellies over cured or processed bacon. Roasted pork belly and ribs increased the risk of cancer mortality in women. 

Moreover, the positive health effects of moderate unprocessed pork belly and beef consumption may also be influenced by the products’ high socio-economic status and social capital in Korea. These are common in social gatherings among middle- and high-income classes. 

Mechanisms that may explain the detrimental health impacts of processed red meat include iron mutagens generated by high-temperature cooking, N-nitroso compounds formed in processed meats and high concentrations of nitrates/nitrite. 

Set-up of the study 
Participants’ average age at the start of the study was 53.5 years and 66% were women. The researchers determined the date and causes of death by death certificate data, distinguishing between total deaths and deaths caused by cancer and CVD. 

All participants completed a food item questionnaire at baseline to assess dietary intake. The questionnaires helped researchers to determine food consumption frequencies and portion sizes, which they translated into energy and macronutrient content per item. 

Meat items included in the questionnaire were different preparations of pork, edible organ meat, processed meat, beef, dog meat and chicken.

The authors point out that as an observational study, it could not confirm causal relationships. Moreover, the focus on old adults limits the findings’ generalizability to young individuals. Different meats and meat preparation influence the mortality risk, with varying outcomes for men and women. 

Meat consumption in Asia 
Asian populations have a lower absolute meat intake than Western populations. The study reports that the average total meat intake was 44.3 g/day for men and 29.7 g/day for women. 

Read meat contributed to over 90% of total meat intake and 98% of red meat intake was unprocessed for both genders. Pork is the most consumed red meat in Korea, where consumers prefer pork belly.

The highest meat consumers were likely to be younger, highly educated and had high incomes. They were also drinkers, less likely to engage in regular exercise and had a higher Body Mass Index (BMI) in men and low BMI in women. 

Although the study excluded participants with a shorter follow-up duration, the authors note that they did not evaluate changes in meat intake over time. Dietary assessment only took place at the start of the study and data were self-reported, which could have resulted in measurement errors.

By Jolanda van Hal