For decades, health experts have advised us to cut back on red meat to lower cholesterol and reduce the risk of heart disease. But new research suggests the story might be more complicated than that—and good news for meat lovers: cutting out red meat may not be as crucial as once thought.
The warnings against red meat have been a staple in health advice circles for years, but they intensified about a decade ago. This was when a study linked a chemical called TMAO (trimethylamine N-oxide) to an increased risk of heart disease. The hypothesis was that eating red meat raised TMAO levels in the blood, thereby boosting the chances of a heart attack or stroke.
TMAO quickly became the supposed “smoking gun” connecting red meat consumption to heart problems. But is the link really that straightforward? Maybe it’s not time to give up on beef and settle for plant-based alternatives just yet.
Another common argument against red meat is its supposed effect on cholesterol levels. The prevailing theory has been that consuming red meat, which is high in saturated fat, raises blood cholesterol and, subsequently, heart disease risk. However, more recent studies have begun to challenge this notion, suggesting that dietary cholesterol does not directly translate to higher blood cholesterol levels as once believed.
So, let’s take a closer look at the links between red meat, cholesterol, heart disease, and the TMAO hypothesis.
Chris Kresser, M.S., L.Ac., an expert in Functional Medicine and author of “The Paleo Cure,” argues that the red meat-TMAO connection doesn’t hold up under scrutiny. “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,” Kresser explains.
However, a large-scale meta-analysis published in the journal Circulation by Micha et al., which included over 1.2 million participants, found no significant link between fresh, unprocessed red meat and an increased risk of coronary heart disease (CHD), stroke, or diabetes. Furthermore, Kresser points out that if red meat were a significant factor in heart disease, we would see much lower rates of cardiovascular disease (CVD) in vegans and vegetarians, which is not necessarily the case.
Kresser and other experts in Functional and Anti-Aging Medicine suggest that the relationship between red meat and heart disease is not as clear-cut as it seems. Instead of focusing on TMAO, cholesterol, or other usual suspects, they highlight the role of the gut microbiome in influencing overall health and disease risk.
What is the Gut Microbiome?
Our bodies host trillions of bacteria, viruses, and fungi collectively known as the “gut microbiome.” While bacteria and microorganisms are often associated with illness, most of these gut microbes are essential for maintaining a healthy immune system, heart, and even weight. Emerging research reveals that a balanced gut microbiome plays a crucial role in reducing the risk of obesity, metabolic syndrome, and heart disease.
Studies indicate that the balance of bacteria in the gut could be one of the most critical factors in determining overall health. An unhealthy gut—marked by metabolic dysregulation—has been linked to an increased risk of obesity, diabetes, high cholesterol, cardiovascular disease, and digestive disorders.
Even if TMAO is linked to a higher risk of heart disease (a theory Kresser remains skeptical about), he suggests that elevated TMAO levels in red meat eaters are likely due to an imbalanced gut microbiome. This imbalance could result from other dietary factors, such as low fruit and vegetable intake, insufficient soluble fiber, and high consumption of processed foods, refined sugars, and seed oils—not necessarily red meat itself.
A healthy gut can be supported by consuming foods rich in prebiotics and probiotics, such as yogurt, kefir, and plenty of fruits and vegetables. If you maintain a diet that promotes gut health, eating red meat in moderation may not increase your risk of heart disease.
In other words, it’s not the red meat that poses the greatest risk—it’s the processed bun and fries cooked in seed oils that are more likely to be the culprits. So, before you banish steak from your plate, consider focusing on overall dietary balance and gut health instead.