Dietary sources and intake. Red meat (i.e., ruminant and pork meat) provides high-quality protein, monounsaturated fatty acids, iron (with high bioavailability), zinc, and vitamins B1 (thiamine), B2 (riboflavin), B6 and B12 in a regular diet, but it is also a source of saturated fatty acids and ruminant trans-fatty acids. Processed red meat is a source of sodium. The reporting of red meat and meat products differs among the Nordic and Baltic countries. Therefore, the intake estimates of red meat and products are rough and ranges from 50 to 150 g/d (Lemming & Pitsi, 2022).
Health effects. Three qSRs are available on the role of meat and meat products and health outcomes (Fogelholm et al., 2012; Lescinsky et al., 2022; WCRF/AICR, 2018e).
The WCRF/AICR demonstrated strong evidence for a significant, largely linear relationship between red meat and risk of colon cancer. For colorectal cancer, stratified analyses by geographic location showed especially a significant increased risk in studies with European populations. The report also concluded that intake of processed meat is a convincing cause of colorectal cancer. Processed red meat includes red meat preserved by smoking, curing, or salting, or by the addition of preservatives (WCRF/AICR, 2018e). A separate dose-response meta-analysis of 15 studies showed a linear dose-response relationship between red and processed meat and risk of colorectal cancer (12 % increased risk per 100 grams increase in red and processed meat consumed per day). The relative risk of colon cancer is increased by 10% per 50 grams intake of unprocessed red meat per day (WCRF/AICR, 2018e). The International Agency for Research on Cancer (2018) classifies processed meat as carcinogenic for humans, and red meat as probably carcinogenic, based on observational, animal and mechanistic data.
Using a more conservate interpretation of the total body of evidence, the “Burden of Proof” study, conducted for the Global Burden of Disease (GBD) project, concluded that there is a weak association between unprocessed red meat consumption and colorectal cancer, breast cancer, ischemic heart disease and type 2 diabetes (Lescinsky et al., 2022). Despite their conservative methodology, the collaboration between GBD and the NNR2023 project observed that a diet high in red meat is the fourth-highest dietary risk factor for Disability Adjusted Life Years (DALYs) in the Nordic and Baltic countries. It is ranked second highest in Denmark and Iceland, and the third highest in Norway, Sweden and Finland (Clarsen, in press). In addition, a diet high in processed meat is the second highest contributor to disease burden in five of eight countries and among the top-4 dietary risk factors in all countries (Clarsen, in press).
Also of relevance to red and processed meat is that numerous qSRs on dietary patterns have found that adhering to diets characterized by lower amounts of red and processed meats are compatible with beneficial health effects, including strong and consistent evidence for lower risk of all-cause mortality (Boushey et al., 2020), cardiovascular disease (2020 Dietary Guidelines Advisory Committee, 2020), and moderate evidence for lower risk of type 2 diabetes (Boushey et al., 2020f) and favourable body weight-related outcomes (Boushey et al., 2020a).
As discussed by Meinilä and Virtanen (2023), red meat can be a good source of nutrients, in particular protein, iron, zinc and vitamin B12. However, regular high intake of red meat and processed red meat, may increase the risk of colorectal cancer, cardiovascular diseases and type 2 diabetes due to several mechanisms (IARC, 2018; Meinilä & Virtanen, 2023; WCRF/AICR, 2018e). The risk increase appears to be linear with most outcomes (Meinilä & Virtanen, 2023; WCRF/AICR, 2018e).
Based on all available evidence, considering both beneficial effect of nutrients and the dose-response curves demonstrating adverse effects for several chronic diseases, NNR2023 recommends that the intake of red meat should be limited to maximum 350 grams/week (cooked or ready-to-eat weight). The Committee notes that a clear-cut level of intake that minimizes risk is difficult to set, as the associations are often linear.
Environmental impacts. High production and consumption of ruminant meat is a major contributor to GHG emissions, especially methane (Harwatt et al., 2023; Poore & Nemecek, 2018), in total being approximately 4- and 7-fold higher on protein basis compared with pork and poultry, respectively (FAO, 2013). Meat from dairy cows has lower GHG emissions than meat from suckler cows. Nordic/European beef production has lower GHG emissions per kg meat produced compared to other regions of the world (FAO, 2013; Poore & Nemecek, 2018; Trolle et al., 2023). However, the high consumption of red meat is the most important contributor to GHG emissions from the diet in the Nordic and Baltic countries. Feed ingredients contribute to environmental impacts through fertilizer, pesticide, water and land use. Their ability to utilize grass make ruminants important for resource utilization (including outfields). If well managed and avoiding overgrazing, grazing ruminants contribute to biodiversity and keeping cultural landscapes open in some settings in the Nordics (Harwatt et al., 2023; Meltzer et al., 2023; Trolle et al., 2023). If we are to consume milk and dairy, a certain amount of beef from milk producing cattle needs to be consumed in order for the food system to be resource efficient. The largest proportions of overall environmental impacts from pig meat production tend to come from feed production and manure management (Harwatt et al., 2023). Feeds for pigs compete for land with food for direct human consumption. However, pigs can also make use of residual products which can contribute to an efficient food system. Free-living game contributes to food consumption based on local natural resources and has a lower climate impact per kilogram of meat than farmed or fenced game. The amount of animal waste should be minimized to reduce its environmental impact. To efficiently use meat and meat products without unnecessary waste, the inclusion of some processed meat products is justified from an environmental perspective.
Main data gaps. We lack studies on the health effects of different types of red meat, especially game meat. Little is known about the nutritional impact of how they are reared, e.g., fatty acid profile of meat from feedlot cows versus grassland herds. Data are still lacking on the health effects of substances formed when meat is processed. There is a lack of comparative environmental data and on studies covering environmental impacts other than climate impact, such as biodiversity aspects.
Risk groups. High consumers of red meat, especially processed red meat, have an increased risk of several chronic diseases, including colorectal cancer, type 2 diabetes and cardiovascular disease. Small amounts of red meat, especially beef, supply iron, zinc and other nutrients with high bioavailability and are important contributors of iron, especially for children and women of fertile age who are at increased risk of developing iron deficiency. Low- or non-consumers have an increased risk of vitamin B12 inadequacy.
Science advice:
Based on health outcomes: Red meat is nutrient dense and a provider of iron and zinc in the diet. Based on meta-analyses of RCTs and observational studies on red meat and health outcomes, it is recommended to consume a limited amount of red meat in the diet, with a maximum intake of 350 grams of red meat (including red meat in products and processed foods) per week. The choice of meat should comply with the recommendations for fatty acids.
Based on environmental impacts: High environmental impact. The high consumption of red meat is the most important contributor to GHG emissions from the diet in the Nordic and Baltic countries. Negative environmental impact is related to methane emissions from ruminants, and feed which contribute through fertilizer, pesticide, water and land use. Positive environmental impact may be related to grazing and biodiversity. GHG emission from pigs is lower than ruminants but there are environmental issues related to feedproduction.
Overall science advice: For health reasons, it is recommended that consumption of red meat from cattle, sheep, goats and pigs (including red meat in products and processed foods) should be low and not exceed 350 gram/week ready-to-eat (cooked) weight. Processed red meat should be as low as possible. For environmental reasons the consumption of red meat should be considerably lower than 350 grams/week. The choice of meat should comply with the recommendations for fatty acids. The reduction of red meat consumption should not result in an increase in white meat consumption. To minimize environmental impact, meat consumption should be replaced by increased consumption of plant foods, such as legumes and fish from sustainably managed stocks.