Does red meat cause heart attack?

Myocardial infarction, commonly known as a “heart attack,” occurs when blood flow to part of the heart muscle is interrupted, usually by blockage of a coronary artery. That blockage most often results from a process called atherosclerosis: the progressive buildup of plaques made of fat, cholesterol and other substances in the inner walls of the arteries. It is in this context that the debate about red meat typically arises, linking its consumption to raised cholesterol due to saturated fat and other effects that could accelerate arterial blockage, without considering the context and variables related to the topic, as shown in this article.

But what do studies specifically say about the relationship between heart attack and red meat consumption? Distinguishing between this and other heart diseases is the first factor that needs to be properly clarified. Available research does not always separate myocardial infarction, stroke and heart failure — conditions often analyzed together because they belong to the group of cardiovascular diseases and share the same biological basis, generally linked to changes in blood circulation such as atherosclerosis.

The difference lies in the organ affected: in myocardial infarction, the problem occurs in the heart’s arteries; in stroke, in the brain’s arteries; and in heart failure, in the heart’s ability to pump blood adequately, often as a consequence of prior damage. Still, results vary depending on the outcome investigated, that is, what happens to the patient at the end of the study or the event evaluated. Therefore, treating all these conditions as if they were a single entity is already a factor that can create noise in communication.

What observational studies say about heart attack specifically

One of the reviews most focused on this subject is the meta-analysis published in Critical Reviews in Food Science and Nutrition, which pooled 13 prospective cohort studies. This type of study follows groups of people over time to observe disease development. In this case, 1.4 million participants and more than 32,600 cases of ischemic heart disease (IHD) were observed, a condition caused by reduced blood flow to the vital organ, usually associated with plaque buildup in the coronary arteries.

The results showed that the association with unprocessed red meat consumption was not statistically significant in the main analysis, while an increase of 50 g of processed meat in daily intake was associated with an 18% higher risk of IHD.

Another widely cited reference in debates on this topic is this review and meta-analysis, which included 20 studies covering 1.2 million individuals. The central finding was similar: unprocessed red meat was not associated with coronary heart disease risk, since the relative risk obtained was 1.00 per 100 g/day serving (which represents a mathematical tie of 1 to 1), meaning there was no difference in risk between those who consumed that amount and those who consumed less or none. Processed meat, in turn, was associated with a 42% higher relative risk of coronary heart disease per 50 g/day serving. The authors partly attributed the difference to the sodium content in processed meats, which is four times higher than in fresh meats, and to the use of preservatives such as nitrites employed to preserve the food, inhibit microbial growth, and maintain characteristics like color and flavor.

More recently, in 2024, a study published in the Journal of Nutrition, with 148,506 participants, followed the occurrence of nonfatal heart attacks and fatal cardiac events. For unprocessed red meat, the relative risk was 1.14, with a 95% confidence interval (0.96–1.36). An interval that includes the null value, 1, indicates an absence of statistically consistent evidence of an association between the food’s consumption and disease development. For processed meat, the risk was 1.29 (1.04–1.60). An interval entirely above 1 indicates a statistically significant association. The results suggest that the relationship between meat consumption and cardiovascular risk is not homogeneous and varies according to the level of food processing, being more robust for processed meats than for fresh red meat.

Why results vary: the limits of observational studies

Healthy elderly man running outdoors in nature, wearing sports clothes — Photo: PeopleImages / Shutterstock

Observational studies identify correlations but do not establish direct causality. People who consume large amounts of red meat may also smoke more, exercise less, drink more alcohol, and have overall less healthy dietary patterns—factors that independently influence heart attack risk. These variables, considered in academic contexts as confounders, are difficult to control completely, even in the best-conducted studies.

How meat consumption is measured also introduces uncertainties: most studies use food frequency questionnaires filled out by participants themselves and subject to memory and estimation errors. Additionally, categories like “red meat” can encompass everything from a lean filet mignon to an ultra-processed hamburger high in sodium and additives—very different nutritional compositions.

What Mendelian randomization studies say

To overcome the limitations of observational studies, researchers have used Mendelian randomization (MR), an approach that uses genetic variants as instruments to estimate causal relationships with less interference from confounding factors.

An MR study published in the European Journal of Preventive Cardiology specifically investigated coronary artery disease (CAD) as an outcome, analyzing genomic data from the CARDIoGRAMplusC4D consortium—one of the largest databases on coronary disease genetics in the world. The result: no significant causal association was found between genetically predicted consumption of red meat (beef, pork, lamb) or processed meat and CAD risk (p > 0.05 for all types of meat evaluated).

Similarly, an MR study published in Clinical Nutrition ESPEN used data from the UK Biobank and the CARDIoGRAMplusC4D and FinnGen consortia and reached the same conclusion for coronary artery disease: genetically predicted beef consumption showed no causal association with CAD (OR = 0.70; 95% CI: 0.28–1.73 in the large consortia).

These results show that, when trying to establish a direct causal relationship between fresh meat consumption and heart attack, isolating it from other factors, the available evidence is not strong enough to support such a claim.

Biological mechanisms: what might be at play

Even without established causality, science identifies mechanisms by which red meat could influence heart attack risk in some contexts:

Saturated fat and LDL cholesterol: the saturated fat in red meat can raise LDL cholesterol, which contributes to the formation of atherosclerotic plaques in the coronary arteries. However, a meta-analysis of randomized clinical trials published in Circulation showed that the effects of red meat on LDL depend on the comparison food. Relative to high-quality plant protein sources such as legumes, soy and nuts, red meat was associated with smaller reductions in LDL cholesterol. When compared to fish, it produced greater reductions in both LDL and HDL, indicating a mixed effect on the lipid profile.

TMAO (trimethylamine N-oxide): L-carnitine from red meat can be metabolized by the gut microbiota into TMAO, a compound associated with vascular inflammation and platelet activation. The Journal of the American College of Cardiology identified that increases in TMAO levels over 10 years were associated with higher coronary heart disease risk. Moreover, the association was influenced by overall dietary patterns: less healthy diets intensified this link, while healthier dietary patterns attenuated it.
Heme iron: heme iron, abundant in red meat, can participate in reactions that generate oxidative stress and contribute to atherosclerosis progression. However, the same heme iron is responsible for the high bioavailability of the mineral in meat, making red meat an important food for preventing anemia, especially in vulnerable populations.

Heart attack is a multifactorial disease

Children and elderly preparing meat skewers, highlighting healthy food preparation and family cooking activities. — Photo: Minerva Foods

Heart attack results from a complex and cumulative process. The main modifiable risk factors—hypertension, smoking, diabetes, dyslipidemia, physical inactivity and obesity—interact with each other and with genetic predisposition.

The American Heart Association (2025) points out that excess weight today contributes to up to 1,300 additional deaths per day in the United States, surpassing the absolute impact of smoking, whose rates have declined in recent years.

In this context, isolating the effect of a single food on heart attack risk is methodologically challenging. Overall dietary pattern, not a specific food, is what the most robust studies point to as the main relevant dietary factor. According to a study published on PubMed, patterns such as the Mediterranean diet, which includes small amounts of red meat within a diet rich in vegetables, legumes, fish and olive oil, show consistent evidence of cardiovascular protection.

So, does red meat cause heart attack?

Science does not support the claim that fresh red meat, consumed in moderate amounts, causes heart attacks. Observational evidence is inconsistent for this specific outcome: while some groups showed modest associations, others found no significant effect.

The distinction between fresh and processed meat is central. For cured, salted and smoked products, the evidence of association with coronary heart disease is more consistent, driven mainly by high sodium content, which raises blood pressure, and the use of nitrites as preservatives.

Consuming fresh red meat in moderation, as part of a balanced dietary pattern combined with physical activity, weight control and not smoking, remains compatible with cardiovascular health. Avoiding or minimizing processed meat consumption is the recommendation with the strongest scientific support.

Learn more: Where do myths about meat come from?

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