Comparison of Two Kinds of Red Meat Regarding Atherogenic Profile After Ingestion: A Crossover Study in Healthy Subjects
Eduardo
Gomes Lima, Whady Hueb*, Jaime Paula Pessoa Linhares Filho,
Desiderio Favarato, Rosa Rahmi, Paulo Cury Rezende, Eduardo Bello Martins,
Diogo Freitas Cardoso de Azevedo, Antonio Casella Filho, Laila Ghtait, Laura
Ines Ventura, Myrthes Emi Takiuiti, Carlos Vicente Serrano Júnior, José Antonio
Franchini Ramires, Roberto Kalil Filho
Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de
São Paulo, SP, Brazil
*Corresponding
author: Whady Hueb, Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de
São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, Sala 114, Cerqueira César,
São Paulo-SP/ Brazil 05403-000. Tel: +55-1126615032; Fax: +55-1126615188; Email: mass@incor.usp.br
Background: Some
studies demonstrated higher levels of atherogenic biomarkers after red meat
ingestion compared with other sources of protein, like fish or poultry.
However, considering that different kinds of red meat contain varied levels of
fat, few studies have compared different types of red meat regarding
inflammation and atherosclerosis.
Objective: Compare
2 kinds of red meat in relation to atherosclerosis-related biomarkers.
Design: This
was a double-blind, crossover, single-centre study. Healthy male subjects were
enrolled in this study at the Heart Institute, Brazil. They ate 2 different
diets in 2 simple meals 1 week apart. Meal 1 was composed of a balanced diet
with rice, juice, and standard red meat. Meal 2 had the same composition as
meal 1 but contained lean meat obtained by the cross between 2 breeds: Rubia
Gallega and Nelore. Blood samples were obtained at baseline, 1 and 2 hours
after ingestion of meal 1 (H1 and H2) and meal 2 (H3 and H4). Serum levels of
IL-6, hs C-reactive protein (CRP), VCAM, ICAM, p-selectin, Apo-A1 and Apo-B
were compared at these prespecified times.
Results
and Discussions: Twenty healthy men participated in
this study. Mean age was 30.5±2.89, and they had normal blood glucose and
cholesterol levels. Apo-A1 mean levels (ng/mL) were higher at 1h after
ingestion of meal 2 (p=0.010). Serum Apo B levels (ng/mL) were also higher 1
hour after ingestion of meal 1 (p=0.003). hs-CRP levels were lower at H3 and H4
compared with those at H1 and H2 (baseline:0.90; H1:0.93; H2:0.86; H3:0.59 and
H4:0.58; p=0.031).
Conclusion: Lean
red meat from a cross of Rubia Gallega and Nelore leads to a less atherogenic
profile after ingestion than standard meat.
Keywords: Atherosclerosis;
Inflammation; Biomarkers; Meat; Diet
List
of Abbreviations
1. Background
Meat is part of human
diet since 2-6 million years ago [1], and the inclusion of meat plays an
important evolutionary role, explaining, in part, the large and complex human
brain [2]. Red meat contains all 8 essential amino-acids for adults and 9 for
children, constituting one of the main sources of protein in the Western diet.
Besides, meat and meat products contribute to 21% of iron intake and 30% of
vitamin D in adults [2]. However, its consumption is often associated with
increased cardiovascular risk [3] and colorectal cancer [4]. This association
is related to consumption of meat with large amounts of Saturated Fatty Acids
(SFA), leading to an increase in postprandial inflammatory response and,
consequently, endothelial dysfunction [5]. These changes, may increase the
incidence of cardiovascular diseases in the long term [6]. Intake of low-fat
red meat could be associated with lower inflammatory activity and lipid levels
[7]. Diets containing kangaroo or bison meat, when compared with meat
traditionally sold in markets, resulted in lower levels of inflammatory
biomarkers, such as high-sensitive CRP (hs-CRP) and Interleukin-6 (IL-6) [8,9].
To date, no study has
compared postprandial inflammatory repercussion of 2 meats of the same species.
Recently, a new beef developed by cross breeding Rubia Gallega and Nelore
Cattle, resulted in a nutritional composition with lower amounts of fats and
carbohydrates, compared with conventional red meat. The objective of this study
was to compare the effects on postprandial inflammatory response of a diet
containing meat originating from crossing of Rubia Gallega and Nelore breeds of
cattle versus a conventional meat diet.
2.
Materials and Methods
2.1.
Design of the Study
This was a
double-blind, crossover, single-centre study designed to compare 2 kinds of red
meat in relation to atherosclerosis-related biomarkers.
2.2.
Population and Compared Groups
Healthy male subjects
were enrolled in this study at the Heart Institute (InCor – HCFMUSP), São
Paulo, Brazil. They ate 2 different diets in 2 simple meals 1 week apart
(Figure 1). Meal 1 was composed of a balanced diet with rice, juice, and
standard red meat. Meal 2 had the same composition as meal 1 but contained lean
meat obtained by the cross between 2 breeds: Rubia Gallega and Nelore (Table
1). Meat was served as hamburger obtained from the same cut of beef for both
types of meat. Blood samples were obtained at baseline, 1 and 2 hours after
ingestion of meal 1 (H1 and H2) and meal 2 (H3 and H4). Serum levels of IL-6,
hs-CRP, VCAM, ICAM, p-selectin, Apo-A1, and Apo-B were compared during these
prespecified times.
2.3.
Statistics
Baseline
characteristics were summarized for all patients as percentages for categorical
variables and as means with standard deviations for continuous variables.
Comparisons between means of the groups used the Student t test
for parametric26 and the Mann-Whitney test for nonparametric variables. The
means of 3 or more groups were compared by 1-way ANOVA, followed by the
Bonferroni multiple comparison test for parametric variables. For nonparametric
variables, we used the Kruskal-Wallis test, followed by multiple comparisons
based on Dunn’s test. Tests were 2-sided. Values of P<0.05 were considered
statistically significant. Statistical analysis was performed by using SPSS
21.0 for MAC.
2.4.
Ethics
Patients gave written
informed consent and were randomly assigned to a specific group. The Ethics
Committee of the Heart Institute (InCor) of the University of São Paulo Medical
School in São Paulo, Brazil, approved the trial, and all procedures were
performed in accordance with the Helsinki Declaration.
3.
Results
Twenty healthy men
participated in this study. Mean age was 30.5±2.89, and they had normal glucose
blood levels (84.7±9.12) and cholesterol levels (LDL 113.1±27.15; HDL
44.6±10.3, and TG 100.28±55) (Table 2).
Apo-A1 mean levels
(ng/mL) varied after ingestion of meal 1 but not after meal 2 (baseline: 1.28;
H1:1.28; H2: 1.21; H3:1.32 and H4:1.22; overall p=0.010; p<0.001 for
baseline versus H1 and H2; p=0.076 for baseline versus H1 and H2) (Figure 2).
Serum Apo B levels
(ng/mL) were also different from baseline for meal 1 and 2 (baseline: 0.81;
H1:0.81; H2:0.75; H3:0.76; H4:0.76; overall p=0.003). Differences were observed
for both meals compared with baseline (p=0.015 for baseline versus H1 and H2;
p=0.004 for baseline versus H3 and H4). Additionally, we observed lower levels
of Apo-B 1h after ingestion of meal 2 compared with meal 1 (p=0.043 for H1
versus H3) (Figure 3).
Levels of hs-CRP were
lower after ingestion of meal 2 compared to meal 1 (baseline: 0.90; H1:0.93;
H2:0.86; H3:0.59; and H4:0.58; overall p=0.031) (Figure 4).
No differences were
observed between meal 1 and meal 2 regarding ICAM, VCAM, p-selectin, or IL-6
serum levels (p=0.054, p=0.580, p=0.671, and p=0.938 respectively) (Figures
5-8).
4.
Discussion
This single-centre
randomized study evaluated the atherogenic profile after ingestion of 2
different kinds of meat of the same species and found a most favourable profile
of genetically selected meat compared with standard meat. Lower levels of ApoB
and CRP after ingestion corroborated this fact. Metabolically triggered
inflammation has been traditionally associated with modifications in levels of
apolipoproteins, hs-CRP, and other inflammatory mediators immediately after
ingestion of a meal. Thus, the degree of inflammation triggered by a specific
kind of food could be objectively measured. A more atherogenic profile has been
associated with higher levels of inflammatory mediators (such as hs-CRP, IL-6,
VCAM, ICAM, and p-selectin) besides higher levels of ApoB, and lower levels of
ApoA1. In fact, non-healthy food ingestion has been related to a more
atherogenic profile [10].
Ingestion of red meat
is traditionally associated with unhealthy habits, and some diets, such as the
Mediterranean Diet, restrict its ingestion favouring intake of fish or poultry
[11] However, some previous trials have demonstrated that red meat is not
uniform in terms of atherogenic profile after ingestion. Type of meat and
amount of evident fat are factors that could interfere with the release of
inflammation mediators after ingestion of meat. It is important to point out
that different kind of red meat contains different proportions of saturated fat
[12] Emerson et al. in a systematic review found consistent evidence for
postprandial elevation of IL-6 after ingestion of a high-fat meal but not for
other markers of inflammation [13].
Recently, Bergeron et
al. [14] conducted a randomized controlled trial to test whether levels of
atherogenic lipids and lipoproteins differed significantly following
consumption of diets with high red meat content compared with diets with
similar amounts of protein derived from white meat or nonmeat sources, and whether
these effects were modified by concomitant intake of high compared with low
SFA. They found that LDL cholesterol and apoB were higher with red and white
meat than with nonmeat, independent of SFA content. However, levels of LDL
cholesterol, apoB, small + medium LDL, and total/HDL cholesterol ratio did not
differ significantly between red and white meat. Besides, independent of
protein source, high compared with low SFA increased LDL cholesterol (p =
0.0003), apoB (p = 0.0002), and large LDL (p = 0.0002). These findings confirm
that most differences after ingestion of source of proteins are related to SFA
content.
Comparing different
kind of meat in relation to race, Arya and colleagues found that postprandial
levels for 1 and 2 h of TAG, IL-6 and TNF-a were significantly higher after
eating wagyu meat compared with kangaroo, concluding that the meta-inflammatory
reaction to ingestion of a ‘new’ form of hybridized beef (wagyu) is indicative
of a low-grade, systemic, immune reaction compared with lean game meat
(kangaroo). Noteworthy is the fact that not only the kind of meat tested was
different but also the amount of fat in both tested meats were very different;
wagyu is one of the fattiest meats currently available, and even the visible
fat of kangaroo meat was removed in this study [8].
In fact, the meat
derived from crossing of Rubia Gallega and Nelore breeds has fewer calories,
total and saturated fat, and sodium compared with standard meat. Thus,
differences in postprandial biomarkers could be explained not only by the kind
of meat itself but also by its nutritional content. Some final considerations
must be made. Different from previous trials with a similar methodology, our
study compared 2 kinds of bovine red meat from the same beef cut offered as hamburger
in a double-blind approach. Thus, differences observed between them would be
explained by the origin of the meat and its constitution in terms of fat and
sodium. However, the current study has limitations. Blood samples were
collected just after a single meal for each kind of meat, and not after a
period of daily ingestion of the meats. Therefore, impact of daily ingestion of
red meat was not assessed in this study.
5.
Conclusions
In conclusion, lean
red meat from a cross of Rubia Gallega and Nelore leads to a less atherogenic
profile after ingestion than standard meat, regarding to Apo-A1, Apo-B, and
hs-CRP levels. These findings are in keeping with the understanding that even
when red meat is obtained from the same species and the same cut, a breed containing
lean meat could be associated to lower inflammation after ingestion.
Disclosure
statement
No potential conflict
of interest was reported by the authors.
6.
Acknowledgments
Financial support for
the present study was provided in part by a research from the Zerbini
Foundation, São Paulo, Brazil and Medical writing support was provided by Ann
Conti Morcos of MorcosMedia during the preparation of this paper.
The authors are solely
responsible for the design and conduct of this study, all study analyses, the
drafting and editing of the paper, and its final contents.
7.
Funding
Funding was provided
by a research grant from the G.M.G. Importação e Exportação Ltda, São Paulo,
Brazil.
Figure 1: Design of the study.
Figure 2:
Levels of ApoA1 (g/L) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Figure 3:
Levels of ApoB (g/L) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Figure 4:
Levels of Hs-CRP (mg/L) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Figure 5:
Levels of ICAM (ng/mL) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Figure 6:
Levels of VCAM (ng/mL) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Figure
7: Levels of p-selectin
(ng/mL) at baseline, 1h and 2h after ingestion of meal 1 (H1 and H2) and meal 2
(H3 and H4).
Figure 8:
Levels of IL-6 (ng/mL) at baseline, 1h and 2h after ingestion of meal 1 (H1 and
H2) and meal 2 (H3 and H4).
Portion of 100g |
Standard Red Meat |
Comparative Red Meat |
Calories |
220 Kcal |
141 Kcal |
Carbohydrates |
1.8 g |
0.7 g |
Proteins |
24.9 g |
22 g |
Total Fat |
13.8 g |
5.8 g |
Saturated Fat |
5.5 g |
2.8 g |
Trans Fat |
0.8 g |
0.3 g |
Fiber |
0.8 g |
0 g |
Sodium |
70.6 mg |
55 mg |
Table 1: Nutritional Facts for Both Kinds of Meat.
Characteristics |
Mean |
SD |
Age (y) |
30.55 |
2.89 |
Glucose (mg/dL) |
84.79 |
9.12 |
Creatinine (mg/dL) |
1.18 |
0.14 |
TC (mg/dL) |
177.89 |
33.27 |
LDL (mg/dL) |
113.11 |
27.15 |
HDL (mg/dL) |
44.67 |
10.3 |
TG (mg/dL) |
100.28 |
55 |
AST U/L |
24.11 |
11.7 |
ALT U/L |
34.95 |
8.69 |
Abbreviations: TC = Total Cholesterol; LDL = low-Density Lipoprotein;
HDL = High-Density Lipoprotein; TG = Triglycerides; AST = Aspartate
Aminotransferase; ALT = Alanine Aminotransferase. |
Table 2: Baseline Characteristics of Subjects.
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