Last Updated on June 1, 2021 by Michael Joseph
While many people enjoy steak, the media often flip-flops between telling us how “bad” it is for us and how it is one of the most nutrient-rich foods around.
Is one of these viewpoints correct and one off the mark? Or does the truth lay somewhere in the middle? To accurately answer this question, we need to examine both sides of the story critically.
This article provides an objective guide to the health effects of steak and red meat in general, driven by facts rather than opinion and evidence rather than fearmongering.
First, we will look at some of the beneficial aspects of steak, followed by a look at some potential downsides.
For this article, we will define steak as equal to the nutritional and health properties of unprocessed red meat.
Is steak a healthy choice?
Steak (and Red Meat In General) Is a Rich Source of Nutrients
Steak is one of the most popular forms of meat, and it usually refers to specific cuts of red meat, most commonly beef.
While steak is renowned for its high protein (and often high fat) content, unbeknown to some, it is also a reasonably rich source of vitamins and minerals.
- Vitamin B12: 105% of the daily value (DV)
- Niacin (B3): 91% DV
- Selenium: 90% DV
- Zinc: 73% DV
- Vitamin B6: 71% DV
- Choline: 34% DV
- Phosphorus: 33% DV
- Pantothenic acid (B5): 26% DV
- Iron: 18% DV
- Potassium: 15% DV
- Riboflavin (B2): 15% DV
- Small amounts of most other vitamins and minerals
Thus, steak provides a broad range of essential vitamins and minerals. Despite much debate on the topic, there are no significant differences between grass-finished beef and grain-finished.
The above serving of ribeye steak will also provide 484 calories, 0 grams of carbohydrate, 32.3 grams of fat, and 45.0 grams of protein (1).
Red Meat Is a Significant Contributor of Nutrients In the Human Diet
For example, an interesting paper analyzed the contribution of red meat to vitamin B12, iron, and zinc status among 215,000 people across five ethnic groups in the United States.
These groups included those identifying as African Americans, Caucasians, Japanese, Latino, and Native Hawaiian people. Across these diverse groups of people, red meat contributed between (3):
- 19.7 to 40% of the recommended daily allowance (RDA) for vitamin B12
- 11.1 – 29.3% of the RDA for zinc
- 4.3 – 14.2% of the RDA for iron
Furthermore, extensive research conducted in the United Kingdom made similar findings. The results of the first four years of the cross-sectional National Diet and Nutrition Survey demonstrated that ‘meat and meat products’ contributed (4):
- 32-25% of the UK’s reference nutrient intake (RNI) for zinc
- 28-32% of the RNI for selenium
- 27-29% of the RNI for vitamin B12
- 18-21% of the RNI for iron
- 13-18% of the RNI for potassium
- 12-17% of the RNI for copper
Thus, removing red meat from the diet would clearly remove a large contributor to nutrient status for these vitamins and minerals across diverse populations and age groups.
As with any food in the diet, these nutrients can be obtained from different foods, with poultry and fish, in particular, offering a similar range of nutrients. However, this doesn’t necessarily mean that the nutrients would be adequately replaced if removing red meat from the diet.
Steak Contains a Range of Non-Nutritive Compounds That May Offer Benefits
Besides its provision of macronutrients (carbohydrate, fat, protein) and micronutrients (vitamins and minerals), steak also offers various other potentially beneficial compounds.
- Anserine (5)
- Carnitine (6)
- Carnosine (7)
- Conjugated linoleic acid (CLA) (8)
- Creatine (9)
- Glutathione (10)
- Spermine (11)
- Taurine (12)
The references next to the compounds above will provide further reading for anyone interested in learning more about each one, in addition to a summary of their potential effects.
However, whether a demonstrable health benefit is provided by intaking these compounds from steak, in the concentrations they are present, is less certain, as is their precise concentration in different cuts of meat.
At present, there does not appear to be sufficient evidence to make strong claims concerning human health.
Can You Get An Effective Creatine Dose From Steak?
Perhaps one of the most stand-out non-nutritive compounds that steak provides is creatine.
However, it is difficult to determine the exact amount of creatine in steak accurately. Some studies suggest that beef offers around 10 mg of creatine per gram, equal to around 10 grams per kilogram (15).
Other papers suggest that red meats such as beef and lamb contain approximately 3.9 grams of creatine per kilogram (9).
Thus, a kilogram of cooked steak could potentially provide anything from 2 grams of creatine to 7.5 grams.
While this may seem quite a lot, not many people consume a kilogram of steak per day, and it is equal to 0.2 to 0.75 grams on a per-100-gram basis. Further, the effective dose of creatine for sports performance is widely prescribed as being 3-5 grams per day for athletes of average size (18, 19).
Therefore, in typical portion sizes, the amount of creatine found in steak would not be an adequate substitute for supplemental creatine.
Steak Is a Source of High-Quality Protein
One of the other key benefits of steak is that it provides a complete source of protein, which means it contains a sufficient amount of all nine essential amino acids (20).
Steak tends to offer at least 20 grams of protein per 100 grams, depending on the precise type.
Going back to whether steak is a healthy choice, it would certainly have benefits should one not be consuming an adequate amount of protein. However, absolute protein intake tends to be the most important factor here, and there is nothing unique about the protein in red meat compared to other quality protein sources.
Potential Downsides of Steak
While steak has clear positive aspects, observational research has pinpointed some potential downsides of red meat consumption.
Observational research, otherwise known as epidemiology, is the research design most suitable for examining associations between exposures (e.g. smoking, specific foods, lifestyle habits) and long-term health outcomes.
Other study types, such as randomized controlled trials, are not well-suited for investigating the long-term links between specific foods and outcomes due to the expense and difficulty of running controlled human trials over an extended period.
The most consistently linked adverse outcomes with red meat intake include colorectal cancer incidence and cardiovascular disease.
Before we look at these associations in further detail, it is important to be clear: observational findings do not infer causation. However, this does not mean that we should ignore observational findings.
If an association is strong and consistent across multiple studies, it warrants further investigation.
Let’s take a look.
Red Meat and Colorectal Cancer
In 2015, the World Health Organization (WHO) deemed red meat to be a ‘Group 2A carcinogen,’ which, according to WHO classifications, means that red meat is “probably carcinogenic to humans.”
Explaining their decision, the WHO stated: “In the case of red meat, the classification is based on limited evidence from epidemiological studies showing positive associations between eating red meat and developing colorectal cancer as well as strong mechanistic evidence” (21).
So, what is the current evidence base for a link between red meat and colorectal cancer?
Based on systematic reviews and meta-analyses that appraise the totality of the evidence, here is a summary of findings:
- Zhao et al (2018): A systematic review and dose-response analysis of eighteen studies found that for every 100-gram increase of red meat per day, there was a 14% increased relative risk of colorectal cancer (22).
- Zhao et al (2017): This systematic review and meta-analysis analyzed twenty case-control studies and fifteen cohort studies that stratified red meat consumption into high vs. low intakes. Among the case-control studies, there was a 41% increased relative risk in the high intake group and a 12% increased risk in the cohort group (23).
- Aykan (2015): This systematic review analyzed ten existing meta-analyses on red meat and colorectal risk. There was a statistically significant increased relative risk of colorectal cancer in those with the highest red meat intake in every meta-analysis, with the relative risk ranging from 11% to 35% (24).
- Pham et al (2014): This was a systematic review and meta-analysis of nineteen observational studies in the Japanese population. The result of the meta-analysis demonstrated a 16% increased relative risk of colorectal cancer in the highest versus lowest groups of red meat consumption (25).
- Chan et al (2011): This meta-analysis included a dose-response analysis that found a 17% increased relative risk of colorectal cancer per 100-gram/day increase in intake (26).
- Smolinska et al (2010): This systematic review featured a meta-analysis of thirteen studies that found consuming more than 50 grams of red meat per day increased the relative risk of colorectal cancer by 21% (27).
As we can see, these findings, all of which were statistically significant, are relatively consistent.
But what exactly would a hypothetical 20% increased relative risk actually look like?
According to the National Institutes of Health, there is an estimated 4.1% lifetime risk of developing colorectal cancer in men and women (28).
Thus, based on NIH data, 41 out of every 1000 people will develop the disease. A 20% increased relative risk would increase the individual risk to around 4.9% and the population incidence to 49 people per 1000 – an extra eight cases per thousand people.
While the increased individual risk is low, these relative risk increases can be very significant on a population level when considering millions/billions of people.
Does ‘the Healthy User Effect’ Explain These Associations?
When reading people’s thoughts on red meat’s links with colorectal cancer, we can often see discussions on the ‘healthy user effect.’
The implication here is that, due to public health advice to limit red meat intake, those consuming the highest amounts of red meat are also more likely to ignore other public health guidelines. For example, they may smoke more, drink more alcohol, and follow a less healthy dietary pattern.
While this is probably true to some extent, this does not explain away the associations. For instance, many of the studies on red meat intake account for these variables in their results, adjusting for diet quality, smoking status, alcohol, physical activity level, and more.
One of the most thorough examples of this is a recent umbrella review of 45 meta-analyses on red meat and colorectal cancer. This umbrella review graded the quality of evidence provided by each meta-analysis and adjusted for potential confounding variables that could influence the outcomes (29).
These associations still exist at statistically significant levels after such adjustments.
Why Might Eating Red Meat Increase Colorectal Cancer Incidence?
There are several potential mechanisms through which red meat might increase colorectal cancer risk.
One of these is because cooking steak at high temperatures (particularly barbecuing and grilling) leads to the production of heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs).
These compounds are suspected carcinogens, and based on animal studies, higher exposure to HCAs and PAHs appears to increase the risk of gastrointestinal cancers (29).
The reaction between amino acids (protein), creatine/creatinine, and sugars at high temperatures leads to the production of HCAs. PAHs form when meat fat/juice drips on a flame or a hot surface, leading to smoke, which gets absorbed into the meat (30).
In reviews on the potential carcinogenicity of red meat, other mechanisms, such as the impact of large amounts of heme iron on oxidative stress and production of N-nitroso compounds, are also discussed (31, 32).
On this note, it is worth mentioning that poultry, which differs from red meat in that it contains smaller amounts of heme iron, doesn’t have the same observational links with colorectal cancer.
However, there are no definite answers at this time.
It is also worth pointing out that, in the United States, incidence rates of colorectal cancer have significantly increased within the 20-49yr age group between 1975 and 2013. Based on existing predictions, this increasing trend for colorectal cancer in young adults is set to continue on an upward trajectory through 2030 (33).
During the same 1975 to 2013 time period, red meat intake fell from 80 kg to 64.31 kg per person in the United States (34).
In other words: we shouldn’t ignore the consistent associations between red meat and colorectal cancer, but it is likely that other factors are also influencing colorectal cancer incidence rates. These may include established risk factors such as obesity and declining activity levels (35, 36, 37).
Can These Risks Be Reduced?
Based on the existing evidence, there do seem to be some steps that can reduce these potential risks between red meat and colorectal cancer:
- Cooking methods that use lower temperatures, such as broiling and stewing, can reduce the amount of HCAs and PAHs generated (38).
- According to research, using polyphenol-rich marinades (featuring herbs and spices) may reduce HCA formation by up to 88% (39).
- Frequently turning steak when grilling or using a high-temperature cooking technique can lower the formation of HCAs and PAHs (40).
- Other lifestyle interventions, such as reducing alcohol intake, increasing fiber intake, and increasing physical activity levels, all reduce colorectal cancer risk (41, 42, 43, 44, 45).
- A recent feasibility trial demonstrated that in humans consuming the highest amounts of red meat, adding green vegetables to the diet decreased markers of DNA damage in the colon. However, the study was not adequately designed to test whether the red meat was actually causing this damage or not, and further research on the topic is warranted (46).
Red Meat Is Associated With Increased Cardiovascular Risk
Increased red meat consumption is generally associated with a small to moderately increased risk of cardiovascular and all-cause mortality.
The relative risk is higher with processed red meat, but the associations are still present with unprocessed red meat like steak.
This finding is quite consistent across multiple cohort studies and systematic reviews. The increased relative risk at higher intake levels appears to range from 11% to 29% for cardiovascular disease risk (47, 48, 49, 50, 51, 52).
Once again, these are correlations from observational research, and they are not proof of causation.
However, there are potential mechanisms through which high red meat intake may increase cardiovascular risks. These include the impact of large amounts of saturated fat on LDL cholesterol levels and gut microbiota-mediated metabolism of carnitine in meat. Still, research in this area is not fully understood, and further research is necessary (53, 54, 55).
Randomized Controlled Trials On Red Meat Intake
There have also been numerous randomized controlled trials (RCTs) on the health impacts of red meat intake, with both positive and negative findings.
Here are links to some of these RCTs (and reviews of RCTs) alongside a summary of their findings for those who wish to investigate further.
Note: however useful RCTs might be, they cannot accurately predict long-term outcomes, and they are not designed to do so. Thus, it is difficult to apply the findings of RCTs to long-term health outcomes. However, they can show us the potential impact of different foods in the short term.
- In a meta-analysis of randomized controlled trials, total red meat consumption did not affect inflammatory markers over durations up to 16 weeks (56).
- A randomized clinical trial demonstrated that the substitution of red meat with soybean significantly lowered inflammatory markers in patients with diabetes (57).
Type 2 Diabetes and Insulin Sensitivity
- In the context of a calorie-restricted, low-energy diet, a randomized feasibility trial found no differences in insulin sensitivity between groups consuming a diet featuring high red meat (>150g/d) and low fiber intake and a diet high in fiber with no red meat (58).
- A randomized controlled trial demonstrated that, in the context of caloric restriction, reducing red meat intake had no beneficial effects on glucose tolerance, insulin sensitivity, or weight loss (59).
Chronic Disease Outcomes and Markers of Risk
- A systematic review of twelve randomized trials found that diets restricting red meat may have very little or zero effect on cardiovascular and cancer mortality. However, these findings were not statistically significant; thus, the certainty of the evidence for these statements was very low (60).
- Compared to plant proteins, red meat intake increased levels of LDL cholesterol and apolipoprotein B, both of which are cardiovascular risk markers, in a randomized controlled trial (61).
- A meta-analysis of randomized controlled trials found that plant protein sources led to improved LDL cholesterol levels compared to red meat (62).
- In a randomized trial, a Mediterranean-style diet featuring 476 grams of lean red meat per week did not negatively affect cardiovascular markers of health compared to a Med-style diet with 196 grams of red meat per week (63).
- A systematic review and meta-analysis of randomized controlled trials found no adverse effect on markers of cardiovascular risk from the highest red meat intake (>210g) per day versus the lowest intake (<0.35g) per day (64).
Quality of Life
- Older female adults (mean age: 73) fed a protein-enriched diet based on 160 grams of red meat per day experienced significant improvements to muscle strength and quality of life (65).
- Two randomized controlled trials in older adults with obesity found that a diet combining calorie restriction with a high intake of lean red meat led to significant weight loss. The effectiveness of diets high in meat and other protein sources for weight loss is likely driven by their impact on satiety levels (66).
What Do National Health Guidelines Say About Red Meat Intake?
In the United States, there doesn’t appear to be a set recommended intake level solely for red meat. Instead, the Dietary Guidelines for Americans suggest 26 ounces (737 grams) of meat, poultry, and eggs per week (67).
In the United Kingdom, the National Health Service (NHS) currently recommends no more than 500 grams of red and processed meat per week. This amount is equal to approximately 70 grams per day or two 8-9 oz (250-gram) steaks per week (68).
Is Steak a Healthy Choice?
To conclude: as with most things in nutrition, the answer to this question depends on the context: is steak a healthy choice compared to what? And in what amount?
For example, it is reasonable to suggest replacing a source of red meat with oily fish would likely confer a net benefit. This is because oily fish offers a similar nutrient profile, provides the added benefit of omega-3, and doesn’t flag up the same long-term observational concerns.
On the other hand, consuming steak rather than some ultra-processed, energy-dense food would also confer a benefit.
Focusing on the positives, red meat offers an excellent source of high-quality protein. It contributes important nutrients across diverse population groups, and randomized controlled trials demonstrate that it can have benefits as part of a well-formulated diet.
At the same time, there are understandable concerns over its long-term effect on colorectal cancer and cardiovascular risk. While correlation is not proof of causation, the associations are supported by potential mechanisms and consistent enough to warrant continuing research in the area.
All in all, it is a matter of personal choice: red meat doesn’t have to be included in the diet, and it doesn’t have to be avoided either.
If one chooses to include red meat in their diet, it can fit into an overall healthy dietary pattern. And just like always, the overall dietary pattern is more important than including or excluding specific foods.