True Health Initiative Respectfully Disagrees: A Response to the Annals Of Internal Medicine Reviews on Meat Guidelines

True Health Initiative (THI) urges scientists, nutritionists and consumers to look deeper at a newly published series of systematic reviews and meta-analyses in Annals of Internal Medicine. While the studies that were reviewed show negative health effects of consuming red and processed meat, the authors advise people to continue consuming red and processed meat at current levels.

The Annals of Internal Medicine has just published a series of systematic reviews and meta-analyses. Despite many of the reviews’ data showing negative health effects of consuming red and processed meat, such as increased all-cause mortality, cardiovascular disease, cancer and diabetes, the authors are calling for alternative ‘guidelines’ and advising people to continue consuming red and processed meat at current levels. True Health Initiative(THI) urges scientists, nutritionists and consumers to look deeper.

The Annals analyses are not a new development in science, they are simply using an ill-fitting measuring tool (GRADE), which is built to evaluate pharmaceuticals, and not lifestyle intervention. This is why True Health Initiative, in conjunction with the American College of Lifestyle Medicine, proposed a metric specifically fitted to measure SOE related to lifestyle intervention, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM).

“The authors’ conclusions in no way support the bold claim made in this release,” said David L. Katz, MD, MPH, and President of True Health Initiative. Even using the ill-fitting GRADE measurements, the recommendations put forth by these reports are in direct contradiction to the data reported by the reports themselves. In one study where people simply limited meat, the researchers found a 10% reduction in cardiovascular mortality, 6% reduction in stroke and 10% reduction in type 2 diabetes.

John Sievenpiper, MD, PhD, who worked on one of the published systematic reviews and meta-analyses as a nutritional epidemiology and meta-analysis expert said, “Unfortunately, the leadership of the paper chose to play up the low certainty of evidence by GRADE, as opposed to the protective associations that directly support current recommendations to lower meat intake. I completely oppose this recommendation and worry about the lasting damage to public and planetary health.”

“The recommendation that adults continue current red and processed meat consumption is based on a skewed reading and presentation of the scientific evidence…even with this skewed way of presenting the evidence, the reviews clearly indicate the benefits of reducing red and processed meat consumption,” said Marco Springmann, Oxford Martin Programme on the Future of Food.

Unhealthy lifestyle behaviors are a leading cause of chronic illness, with more than 80% of deaths resulting from noncommunicable diseases. Reports that claim to disprove accepted science, while proving nothing, are an irresponsible threat to progress and a public health concern.

“The panel’s blanket recommendation that adults should continue their red meat consumption habits is highly irresponsible,” said Frank Hu, Chair of the Department of Nutrition, Harvard. “We are facing a growing epidemic of diet-related chronic diseases and a climate change crisis, both of which are linked to high meat consumption.”


“Sadly, the confluence of factors leading to today’s media frenzy directly contributes to the culture of nutrition confusion,” said P.K. Newby, author of Food and Nutrition: What Everyone Needs to Know. “It further erodes the public’s trust in science. And it’s bad for everyone and everything: our health, our environment, and our society.”

In today’s society, a multitude of competing agendas and motivations obscure the fundamental, simple truths of healthy living. “Not all meat is created equal, but the science is clear that overconsumption of red meat and processed meat can be detrimental for both public health and the environment,” said Danielle Nierenberg, Food Tank. If we don’t create enduring, sustainable change, we submit to a world where chronic disease and premature death, along with detrimental climate change, are the norm, not the exception.

Richard Carmona, MD, MPH, FACS, 17th Surgeon General of The United States, said “Nutritional science is an essential part of public health, which therefore requires national leadership to provide clear, concise and thoroughly scientifically-vetted information to providers and the public in order to optimize food choices.”

True Health Initiative has compiled a list of quotes from Council Members and unaffiliated experts in response to these papers, for a full list of quotes and to request and interview please contact Jennifer Lutz:

Email: [email protected]
Phone: +1 412 337 9869

These quotes will also be posted on our website,

True Health Initiative has also issued a letter to Annals of Internal Medicine, recommending that they preemptively retract publication of these papers on the basis of grave concerns about the potential for damage to public understanding, and public health. This letter was signed by David L. Katz, MD, President, True Health Initiative, Founding Director, Yale University Prevention Research Center; Neal Barnard, MD, President, Physicians Committee for Responsible Medicine; Richard Carmona, MD, MPH, FACS 17th Surgeon General of The United States; Christopher Gardner, PhD, Stanford University Prevention Research Center; Frank Hu, MD, PhD Chair, Department of Nutrition Harvard T.H. Chan School of Public Health; David Jenkins, MD, PhD University Professor and Canada Research Chair University of Toronto and St Michaels Hospital; Dariush Mozaffarian, MD, Dean, Friedman School of Nutrition Tufts University; Dean Ornish, MD, Founder & President, Preventive Medicine Research Institute, Eric Rimm, ScD, Professor of Medicine, Harvard Medical School; John Sievenpiper, MD, PhD, Department of Nutritional Sciences University of Toronto; Meir Stampfer, MD, Professor of Medicine, Harvard Medical School Harvard T.H. Chan School of Public Health; Walter C. Willett, MD, Harvard T.H. Chan School of Public Health Professor of Medicine, Harvard Medical School; and Kim A Williams, MD, Chief, Division of Cardiology, Rush Medical College Past President, American College of Cardiology.

ABOUT THE TRUE HEALTH INITIATIVE: We are a global coalition of leading experts, fighting fake facts and combating false doubts to create a culture free of preventable disease, while conjointly safeguarding planetary health using the time-honored and evidence-based practices of lifestyle as medicine. As the authoritative voice on lifestyle as medicine, we are working to change policy, by enlisting leading experts and commissioning a collection of research to fight fake facts and fix a broken system; change minds, by demonstrating and disseminating the global consensus on the fundamental, evidence-based truths of lifestyle as medicine; and improve lives, by working with communities to create a healthier culture that adds life to years and years to life. Learn more at

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The panel’s blanket recommendation that adults should continue their red meat consumption habits is highly irresponsible.