Is Red Meat Bad for Your Health?

At the very top of the new inverted food pyramid is a giant rib-eye steak. Depending on who you talk to, this is either sending a terrible message to Americans to eat more red meat, sending a wonderful message to Americans to eat more red meat, or just a really odd design choice.

Beyond the picture, the rhetoric around the new food guidelines has raised the simple question again: Is red meat bad for you? On the one side, we see claims from organizations like the American Heart Association, which encourage people to choose lean meats, fish, or plant protein. On the other side, proponents of the health benefits of diets that are high in protein and fat — like the keto diet — argue that red meat is unfairly maligned.

What does the data actually say, on both sides? And — more importantly — how much could this actually matter for you?

A note before we get started: one reason some people oppose consumption of red meat is because of the possible impacts on climate change; others oppose on moral grounds. Although these are both important considerations for many people, they aren’t ones we will consider here. This is squarely focused on the direct health question, which is an important input — if not the only one — for many people.

Take me to the bottom line

What do we mean by “health”?

The question is red meat bad for your health? is not specific enough to actually answer. We have to get more specific. For example, one thing you could mean by this is conditional on the same number of total calories and the same exact macro and micronutrient profile, does it matter for your health if you consume red meat or something else? The answer to this must be no. When your body processes food for fuel, it doesn’t care what the source is, beyond these macro and micro nutrients.

Another thing you could mean is if I add 15 ounces of rib-eye steak on top of my current diet every day, will that be bad for my health? The answer to this is probably yes. This would add another 1,000 to 1,200 calories a day to your diet, which for most people is likely to lead to weight gain, which can contribute to metabolic disease.

In practice, I think the question we mostly have in mind is more narrow: does it matter for our health if we get a greater share of our protein from red meat, as opposed to having chicken or tofu as the main protein sources in our diet? We know having enough protein is necessary for health, so you have to get it from somewhere. Is one source better than another?

The reason this might matter is that a protein-equivalent amount of steak contains more calories, in the form of fat, than something like chicken breast. Three ounces of sirloin steak has 26 grams of protein and 8 grams of fat (3 grams of which are saturated) for a total of 180 calories. Three ounces of chicken breast also has 26 grams of protein, but with only 3 grams of fat (1 saturated) for 140 calories.

This narrows to what I think are the two reasons why adding red meat to the diet could impact health. The first is that it could cause people to simply eat more calories, since this is a calorically dense food. This wouldn’t have to happen if people ate fewer calories elsewhere, but it’s an empirical question. The second possibility is that the move toward more fat in the diet could have health impacts (in principle, these could be positive or negative).

I start with this because it will help us frame how we look at the data below, and what kind of data we could bring to bear here.

Why diet is so hard to study

We do not have very clear answers about the impact of red meat consumption on long-term health. The primary reason for this is that it is extremely difficult to do large-scale, long-term experiments on individual diets. The gold standard science would be to take a large set of people, randomize them to different diets — matched in most ways, but with some diets higher in red meat and others higher in other sources of protein — and follow them for decades to see how their health evolves.

Such a study would be incredibly expensive, and it would be difficult to get people to sign up for it and to adhere to the prescribed diet. In addition, if you want to evaluate outcomes like mortality, you have to follow people for a very long time. By the time the subjects in the experiment are dead, the researchers will probably be dead too. This makes the professional value of such a study more limited.

In lieu of this, we have either very problematic observational data, which confuses correlation and causation, or randomized data, which looks at only intermediate outcomes. I’ll discuss both below; nothing will be ideal.

What evidence do we have about red meat and health?

The evidence for the impacts of red meat consumption on disease or mortality comes from observational studies. One large example is a 2012 study that used two large datasets with a combined total of over 100,000 people in the U.S. These studies surveyed individuals about their diets and followed them over time so they could observe (among other things) mortality. The paper argues that substituting one serving of red meat for other protein sources per day increases mortality risk by 13%.

The problem with this study is that the individuals who eat more red meat are different in many other ways, as the study points out. They are much, much more likely to smoke and more likely to be overweight. They exercise much less and are more likely to have diabetes. They eat many more total calories, which could be a part of why red meat matters, but it complicates the interpretation. The authors adjust for some of these differences in their analysis, but the vast observed differences across groups should make us very worried about differences we cannot observe, which might drive these results.

There are many other large studies like this — in Europe, there are studies focusing on separating processed and unprocessed meat — but they all have this same core problem. In my view, we simply cannot learn anything concrete from this type of study, and it alone should definitely not be used to dictate what is a healthy behavior.

These studies also generally indicate more concern about processed meat than unprocessed. This finding likely reflects the fact that the people who consume a lot of unprocessed meat are even more different than those who consume less. It may also reflect that we know (from good, randomized data) that people tend to eat more calories when offered ultraprocessed foods. Either way, it does not seem likely that this is about the meat.

There is some better-quality evidence on red meat from randomized trials, but it is focused on short-term outcomes, which are easier to study. A 2019 meta-analysis of trials that looked at cholesterol and other heart measures found overall small and inconsistent impacts of red meat on these outcomes. They argue that when red meat is substituted for high-quality plant protein sources, heart measures get worse; however, substituting to other meats, fish, or carbohydrates does not show this effect. And all of the changes are quite small.

The upshot: we have minimal evidence of direct impacts of red meat per se on health.

What evidence do we have about fat and saturated fat?

Even without data on red meat per se, if we had strong evidence of health impacts of fat or saturated fat on health, that would be a strike against red meat, since it is relatively higher in these items.

In the case of fat, the best evidence we have on disease is a landmark 2006 study called the Women’s Health Initiative, which was a randomized trial of a low-fat diet. Women in the study, ages 50 to 79, were randomly assigned to a low-fat diet or a comparison diet and followed for an average of eight years. These diets weren’t forced on them, but the treatment group was encouraged to consume a smaller share of calories in fat and eat more fruits and vegetables.

The low-fat diet group consumed less fat and slightly fewer calories than the comparison group (by year six, they reported 100 fewer calories per day). They also ended up a bit lower in BMI than the control group by year three. This would support, possibly, the view that consuming more saturated fat causes people to consume more calories overall. However, the low-fat diet did not improve mortality, stroke, or cardiovascular disease rates and caused only small changes in a couple of heart-health biomarkers. There was also no change in colon cancer risk or breast cancer risk.

Those papers focus on cardiovascular disease and cancer. Another question often asked about fat is whether lower-fat diets contribute meaningfully to weight loss. Basically, no. Weight loss is very similar in low-fat versus low-carbohydrate diets; if anything, weight loss is slightly lower in low-fat diets. Low-fat diets seem to lower LDL (“bad”) cholesterol, and higher-fat diets raise HDL (“good”) cholesterol. No diet is especially effective for weight loss in the long term, and if that is the primary goal, GLP-1s are likely to be much more effective.

Finally, for people at higher risk of cardiovascular disease, lowering consumption of saturated fat is often highly emphasized. This makes sense given the impacts on cholesterol levels and the role of high cholesterol in heart disease. However, the most recent meta-analyses of data on this question show no significant impact on mortality, cardiovascular mortality, or cardiac events. One suggestion is that with the widespread availability of statins, these dietary changes impacting cholesterol are not as important.

The upshot: there is simply very little evidence that a diet higher in fat is worse for your health than a diet lower in fat.

Okay, but is red meat good for you then?

Although much of the health discussion is that red meat is bad, there are also some claims that red meat may have health benefits. Some of these come out of the idea of the paleo diet — basically, the idea that we evolved to eat some combination of berries and meat we hunted ourselves on the plains. There is no solid evidence of health benefits of this diet, and it is worth noting that life expectancy in this period was extremely low, so it’s not obviously comparable.

A more credible set of claims surrounds the possible impacts of a ketogenic diet on health, including epilepsy and mental health. Most of this evidence is small-scale and very early-stage. In addition, a medical ketogenic diet is extremely restrictive — it’s not just adding some red meat to what you’re already doing or eating keto bread with your jam. A medical keto diet is 85–90% of calories from fat, most of which will come from oils, butter, nuts, avocados, etc. Fatty meats are also involved. This might sound great, but, actually, a big challenge is that a strict keto diet is very hard for people to stick to.

This is all pretty interesting from a medical and scientific standpoint, but also fairly irrelevant for most people. And to the more narrow question of whether red meat is healthy in the kind of moderation you might consume it in, I’d refer you to the sections above — basically, it’s neutral.

How much does all this matter?

Here’s the question I think most people are grappling with. Let’s say you have red meat three times a week in some form. Would you be better off substituting in chicken or tofu or fish for one of those meals? Or, conversely, would you be better off adding more red meat beyond this?

What the data tells us is that it doesn’t matter. The evidence suggesting that more red meat leads to more heart issues and higher mortality is hopelessly confounded by other differences across people. And even there, the effects are quite small. When we look at better evidence, either on red meat directly or on saturated fat in general, the effects are either very small, inconsistent, or zero.

Put simply: if you’re looking to make health-related changes to your diet, this isn’t it.

The bottom line

Because it’s very difficult to do large-scale, long-term experiments on individual diets, it’s difficult to assess whether red meat is “good” or “bad” for you.
Although red meat is higher in fat and saturated fat, there’s little strong evidence that higher-fat diets are worse for health.
Ultimately, based on the best data we have, it doesn’t matter how much red meat you do or do not eat — it doesn’t have a meaningful impact on your health.