Animal sourced protein (meat and poultry) and heart health An Evidence Check rapid review brokered by the Sax Institute for the National Heart Foundation of Australia. December 2018. An Evidence Check rapid review brokered by the Sax Institute for the National Heart Foundation of Australia. December 2018. This report was prepared by: Rhoda Ndanuko, Matti Marklund, Miaobing Zheng, Clare Collins, David Raubenheimer, Jason Wu. December 2018 © Sax Institute 2018 This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusions of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the copyright owners. Enquiries regarding this report may be directed to the: Principal Analyst Knowledge Exchange Program Sax Institute www.saxinstitute.org.au [email protected] Phone: +61 2 91889500 Suggested Citation: Ndanuko R, Marklund M, Zheng M, Collins C, Raubenheimer D, and Wu JH. Animal sourced protein (meat and poultry) and heart health: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the National Heart Foundation of Australia, 2018. Disclaimer: This Evidence Check Review was produced using the Evidence Check methodology in response to specific questions from the commissioning agency. The conclusions in this report are those of the authors and do not reflect the position of the Heart Foundation or the Sax Institute. It is not necessarily a comprehensive review of all literature relating to the topic area. It was current at the time of production (but not necessarily at the time of publication). It is reproduced for general information and third parties rely upon it at their own risk. Animal sourced protein (meat and poultry) and heart health An Evidence Check rapid review brokered by the Sax Institute for the Heart Foundation of Australia. December 2018. This report was prepared by Rhoda Ndanuko, Matti Marklund, Miaobing Zheng, Clare Collins, David Raubenheimer, Jason Wu. Contents Glossary.......................................................................................................................................................................................................... 5 Executive summary.................................................................................................................................................................................... 6 Background / Purpose of the review............................................................................................................................................. 6 Review questions ................................................................................................................................................................................... 6 Summary of methods .......................................................................................................................................................................... 6 Key findings and discussion .............................................................................................................................................................. 7 Quality and gaps in the evidence ................................................................................................................................................... 7 Applicability ............................................................................................................................................................................................. 8 Conclusion ............................................................................................................................................................................................... 8 Background .................................................................................................................................................................................................. 9 Review questions ................................................................................................................................................................................... 9 Methods ..................................................................................................................................................................................................... 10 Data sources ......................................................................................................................................................................................... 10 Eligibility criteria ................................................................................................................................................................................. 10 Study selection .................................................................................................................................................................................... 13 Data synthesis and evaluation of study quality ..................................................................................................................... 16 Findings....................................................................................................................................................................................................... 17 Findings relevant to research Questions 1 and 2 .................................................................................................................. 17 Findings relevant to research Question 3 ................................................................................................................................ 25 Discussion/synthesis of findings ....................................................................................................................................................... 29 Unprocessed red meat and poultry intake and risk of clinical CVD .............................................................................. 29 Unprocessed red meat intake and risk of heart failure ...................................................................................................... 31 Unprocessed red meat and white meat intake and weight gain.................................................................................... 31 Unprocessed red meat intake and effect on lipid profile and blood pressure ......................................................... 31 Cardiovascular effect of including unprocessed red meat and poultry as part of healthy dietary patterns 32 Conclusion ................................................................................................................................................................................................. 33 Applicability .......................................................................................................................................................................................... 34 Appendices ................................................................................................................................................................................................ 35 Appendix 1 ............................................................................................................................................................................................ 35 Appendix 2 ............................................................................................................................................................................................ 37 Appendix 3 ............................................................................................................................................................................................ 63 Appendix 4 ............................................................................................................................................................................................ 73 Appendix 5 ............................................................................................................................................................................................ 77 ANIMAL SOURCED PROTEIN AND HEART HEALTH | SAX INSTITUTE 4 Appendix 6 ............................................................................................................................................................................................ 78 Appendix 7 ............................................................................................................................................................................................ 79 References ................................................................................................................................................................................................. 80 Glossary BOLD Beef in an Optimal Lean Diet CHD Coronary heart disease CVD Cardiovascular disease DASH Dietary Approaches to Stop Hypertension DBP Diastolic blood pressure GI Glycaemic index GL Glycaemic load HDL-C High density lipoprotein cholesterol HF Heart failure LDL-C Low density lipoprotein cholesterol MI Myocardial infarction RCT Randomised controlled trial SBP Systolic blood pressure TC Total cholesterol TG Triglycerides ANIMAL SOURCED PROTEIN AND HEART HEALTH | SAX INSTITUTE 5 Executive summary Background / Purpose of the review Cardiovascular disease