Long-Term Intake of Red Meat in Relation to Dementia Risk and Cognitive Function in US Adults
Abstract
Background and Objectives
Previous studies have shown inconsistent associations between red meat intake and cognitive health. Our objective was to examine the association between red meat intake and multiple cognitive outcomes.
Methods
In this prospective cohort study, we included participants free of dementia at baseline from 2 nationwide cohort studies in the United States: the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). Diets were assessed using a validated semiquantitative food frequency questionnaire. We ascertained incident dementia cases from both NHS participants (1980–2023) and HPFS participants (1986–2023). Objective cognitive function was assessed using the Telephone Interview for Cognitive Status (1995–2008) among a subset of NHS participants. Subjective cognitive decline (SCD) was self-reported by NHS participants (2012, 2014) and HPFS participants (2012, 2016). Cox proportional hazards models, general linear regression, and Poisson regression models were applied to assess the associations between red meat intake and different cognitive outcomes.
Results
The dementia analysis included 133,771 participants (65.4% female) with a mean baseline age of 48.9 years, the objective cognitive function analysis included 17,458 female participants with a mean baseline age of 74.3 years, and SCD analysis included 43,966 participants (77.1% female) with a mean baseline age of 77.9 years. Participants with processed red meat intake ≥0.25 serving per day, compared with <0.10 serving per day, had a 13% higher risk of dementia (hazard ratio [HR] 1.13; 95% CI 1.08–1.19; plinearity < 0.001) and a 14% higher risk of SCD (relative risk [RR] 1.14; 95% CI 1.04–1.25; plinearity = 0.004). Higher processed red meat intake was associated with accelerated aging in global cognition (1.61 years per 1 serving per day increment [95% CI 0.20–3.03]) and in verbal memory (1.69 years per 1 serving per day increment [95% CI 0.13–3.25], both plinearity = 0.03). Unprocessed red meat intake of ≥1.00 serving per day, compared with <0.50 serving per day, was associated with a 16% higher risk of SCD (RR 1.16; 95% CI 1.03–1.30; plinearity = 0.04). Replacing 1 serving per day of nuts and legumes for processed red meat was associated with a 19% lower risk of dementia (HR 0.81, 95% CI 0.75–0.86), 1.37 fewer years of cognitive aging (95% CI −2.49 to −0.25), and a 21% lower risk of SCD (RR 0.79, 95% CI 0.68–0.92).
Discussion
Higher intake of red meat, particularly processed red meat, was associated with a higher risk of developing dementia and worse cognition. Reducing red meat consumption could be included in dietary guidelines to promote cognitive health. Further research is needed to assess the generalizability of these findings to populations with diverse ethnic backgrounds.
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References
1.
Rapp SR, Gaussoin SA, Sachs BC, et al. Effects of intensive versus standard blood pressure control on domain-specific cognitive function: a substudy of the SPRINT randomised controlled trial. Lancet Neurol. 2020;19(11):899-907.
2.
Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7(3):280-292.
3.
Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271-2283.
4.
Jiang X, Lewis CE, Allen NB, Sidney S, Yaffe K. Premature cardiovascular disease and brain health in midlife: the CARDIA study. Neurology. 2023;100(14):e1454-e1463.
5.
Barbiellini Amidei C, Fayosse A, Dumurgier J, et al. Association between age at diabetes onset and subsequent risk of dementia. JAMA. 2021;325(16):1640-1649.
6.
Gu X, Drouin-Chartier JP, Sacks FM, Hu FB, Rosner B, Willett WC. Red meat intake and risk of type 2 diabetes in a prospective cohort study of United States females and males. Am J Clin Nutr. 2023;118(6):1153-1163.
7.
Granholm AC, Bimonte-Nelson HA, Moore AB, Nelson ME, Freeman LR, Sambamurti K. Effects of a saturated fat and high cholesterol diet on memory and hippocampal morphology in the middle-aged rat. J Alzheimers Dis. 2008;14(2):133-145.
8.
Freeman LR, Haley-Zitlin V, Rosenberger DS, Granholm AC. Damaging effects of a high-fat diet to the brain and cognition: a review of proposed mechanisms. Nutr Neurosci. 2014;17(6):241-251.
9.
Li D, Ke Y, Zhan R, et al. Trimethylamine-N-oxide promotes brain aging and cognitive impairment in mice. Aging Cell. 2018;17(4):e12768.
10.
Buawangpong N, Pinyopornpanish K, Siri-Angkul N, Chattipakorn N, Chattipakorn SC. The role of trimethylamine-N-Oxide in the development of Alzheimer's disease. J Cell Physiol. 2022;237(3):1661-1685.
11.
de la Monte SM, Neusner A, Chu J, Lawton M. Epidemilogical trends strongly suggest exposures as etiologic agents in the pathogenesis of sporadic Alzheimer's disease, diabetes mellitus, and non-alcoholic steatohepatitis. J Alzheimers Dis. 2009;17(3):519-529.
12.
Quan W, Xu Y, Luo J, et al. Association of dietary meat consumption habits with neurodegenerative cognitive impairment: an updated systematic review and dose–response meta-analysis of 24 prospective cohort studies. Food Funct. 2022;13(24):12590-12601.
13.
Mohan D, Yap KH, Reidpath D, et al. Link between dietary sodium intake, cognitive function, and dementia risk in middle-aged and older adults: a systematic review. J Alzheimers Dis. 2020;76(4):1347-1373.
14.
Faraco G, Brea D, Garcia-Bonilla L, et al. Dietary salt promotes neurovascular and cognitive dysfunction through a gut-initiated TH17 response. Nat Neurosci. 2018;21(2):240-249.
15.
Zhang H, Hardie L, Bawajeeh AO, Cade J. Meat consumption, cognitive function and Disorders: a systematic review with narrative synthesis and meta-analysis. Nutrients. 2020;12(5):1528.
16.
Dalile B, Kim C, Challinor A, et al. The EAT–Lancet reference diet and cognitive function across the life course. Lancet Planet Health. 2022;6(9):e749-e759.
17.
Zhang H, Greenwood DC, Risch HA, Bunce D, Hardie LJ, Cade JE. Meat consumption and risk of incident dementia: cohort study of 493,888 UK Biobank participants. Am J Clin Nutr. 2021;114(1):175-184.
18.
Fischer K, Melo van Lent D, Wolfsgruber S, et al. Prospective associations between single foods, Alzheimer's dementia and memory decline in the elderly. Nutrients. 2018;10(7):852.
19.
Barberger-Gateau P, Raffaitin C, Letenneur L, et al. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology. 2007;69(20):1921-1930.
20.
Nurses' Health Study. Accessed November 16, 2023. nurseshealthstudy.org/.
21.
Health Professionals Follow-Up Study. Accessed March 16, 2024. hsph.harvard.edu/hpfs/.
22.
Gu X, Wang DD, Sampson L, et al. Validity and reproducibility of a semiquantitative food frequency questionnaire for measuring intakes of foods and food groups. Am J Epidemiol. 2024;193(1):170-179.
23.
Stampfer MJ, Colditz GA, Willett WC, et al. Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the nurses' health study. N Engl J Med. 1991;325(11):756-762.
24.
Julayanont P, Nasreddine ZS. Montreal Cognitive Assessment (MoCA): concept and clinical review. In: Larner AJ, ed. Cognitive Screening Instruments: A Practical Approach. Springer International Publishing; 2017:139-195.
25.
Yeh TS, Yuan C, Ascherio A, Rosner BA, Blacker D, Willett WC. Long-term dietary protein intake and subjective cognitive decline in US men and women. Am J Clin Nutr. 2022;115(1):199-210.
26.
T.H. Harvard Chan School of Public Health Nutrition Department's Food Composition Table. Accessed November 24, 2023. regepi.bwh.harvard.edu/health/nutrition/.
27.
Pan A, Lucas M, Sun Q, et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med. 2010;170(21):1884-1891.
28.
DeVille NV, Iyer HS, Holland I, et al. Neighborhood socioeconomic status and mortality in the nurses' health study (NHS) and the nurses' health study II (NHSII). Environ Epidemiol. 2023;7(1):e235.
29.
Lindström S, Loomis S, Turman C, et al. A comprehensive survey of genetic variation in 20,691 subjects from four large cohorts. PLoS One. 2017;12(3):e0173997.
30.
Ma C, Li Y, Mei Z, et al. Association between bowel movement pattern and cognitive function: prospective cohort study and a metagenomic analysis of the gut microbiome. Neurology. 2023;101(20):e2014-e2025.
31.
World Cancer Research Fund/American Institute for Cancer Research. Recommendations and Public Health and Policy Implications. 2018.
32.
Wang M, Spiegelman D, Kuchiba A, et al. Statistical methods for studying disease subtype heterogeneity. Stat Med. 2016;35(5):782-800.
33.
Dietschy JM, Turley SD. Cholesterol metabolism in the brain. Curr Opin Lipidol. 2001;12(2):105-112.
34.
Wu A, Molteni R, Ying Z, Gomez-Pinilla F. A saturated-fat diet aggravates the outcome of traumatic brain injury on hippocampal plasticity and cognitive function by reducing brain-derived neurotrophic factor. Neuroscience. 2003;119(2):365-375.
35.
Sartorius T, Ketterer C, Kullmann S, et al. Monounsaturated fatty acids prevent the aversive effects of obesity on locomotion, brain activity, and sleep behavior. Diabetes. 2012;61(7):1669-1679.
36.
Kim SH, Reaven GM. Insulin resistance and hyperinsulinemia: you can't have one without the other. Diabetes Care. 2008;31(7):1433-1438.
37.
Kamal MA, Priyamvada S, Anbazhagan AN, Jabir NR, Tabrez S, Greig NH. Linking Alzheimer's disease and type 2 diabetes mellitus via aberrant insulin signaling and inflammation. CNS Neurol Disord Drug Targets. 2014;13(2):338-346.
38.
Rajan KB, Wilson RS, Weuve J, Barnes LL, Evans DA. Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia. Neurology. 2015;85(10):898-904.
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© 2025 American Academy of Neurology.
Publication History
Received: July 15, 2024
Accepted: November 14, 2024
Published online: January 15, 2025
Published in print: February 11, 2025
Disclosure
The authors report no relevant disclosures. Go to Neurology.org/N for full disclosures.
Study Funding
This study was supported by research grant R01AG077489, RF1AG083764, R00DK119412, R01NR019992, and P30DK046200; the NHS was supported by UM1 CA186107, and the HPFS was supported by U01 CA167552 from the NIH.
Authors
Author Contributions
Yuhan Li: drafting/revision of the manuscript for content, including medical writing for content; study concept or design; analysis or interpretation of data. Yanping Li: study concept or design; analysis or interpretation of data. X. Gu: drafting/revision of the manuscript for content, including medical writing for content. Y. Liu: drafting/revision of the manuscript for content, including medical writing for content. D. Dong: drafting/revision of the manuscript for content, including medical writing for content. J.H. Kang: drafting/revision of the manuscript for content, including medical writing for content. M. Wang: drafting/revision of the manuscript for content, including medical writing for content. H. Eliassen: drafting/revision of the manuscript for content, including medical writing for content. W.C. Willett: drafting/revision of the manuscript for content, including medical writing for content. M.J. Stampfer: drafting/revision of the manuscript for content, including medical writing for content; study concept or design. D. Wang: drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; analysis or interpretation of data.
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Cited By
- Red Meat Amino Acids for Beginners: A Narrative Review, Nutrients, 17, 6, (939), (2025).https://doi.org/10.3390/nu17060939
- Large US study links processed red meat to dementia risk, BMJ, (r126), (2025).https://doi.org/10.1136/bmj.r126
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We appreciate your patience during this time and apologize for any inconvenience.
We sincerely thank Drs. Hirani and Etienne for their comments on our study on red meat intake and cognitive health outcomes.1
Regarding the suggestion to stratify participants based on vegetarian/vegan status, we agree that examining vegetarian/vegan status and adherence to plant-based dietary patterns could offer additional valuable insights. The inclusion of plant-based dietary patterns in future studies is indeed of great interest to us, especially as we expand our research on dietary factors, dementia, and cognitive function.
We also appreciate the readers’ comments on our proposed pathway involving host-microbe co-metabolism and the role of trimethylamine N-oxide (TMAO), a metabolite derived from L-carnitine in red meat, which has been implicated in cognitive aging.2,3 This area is an exciting direction for further research, and we hope to explore this mediator in greater depth in future studies to provide a comprehensive understanding of red meat’s role in neurodegenerative processes.
Last, we agree with the readers’ point about the limitations on the generalizability of our findings due to our predominantly White health care professional cohorts. As noted in our paper’s Discussion section, including more diverse populations in future studies will be crucial for further confirming our findings.
References
Author disclosures are available upon request ([email protected]).
We read with great interest the recent article by Li et al.; we commend the authors for their analysis of the relationship between red meat consumption and cognitive health outcomes.1 This study provides valuable insights into dietary impacts on cognition. While comparing lower and higher red meat intake is crucial, stratifying participants based on vegetarian/vegan status could enhance the interpretability of findings. Although the regression analysis included some dietary patterns, data on individuals who do not consume meat remain absent. Expanding future cohorts to capture these populations may reveal unique cognitive health benefits associated with plant-based diets.2 However, we recognize the challenges of such stratification in a decades-long longitudinal study.
Additionally, we were particularly intrigued by the study’s mention of trimethylamine N-oxide (TMAO) as a gut microbiome marker. Future research could further investigate how red meat influences gut microbiota composition and its downstream effects on brain health. Exploring the microbiome as a mediator could offer a nuanced understanding of red meat’s role in cognition.
Lastly, we note the study’s limited racial and ethnic diversity; participants were predominantly White. We encourage future work to examine whether these findings generalize to other populations and to consider the potential intersectionality of race, ethnicity, and sex in dietary impacts on cognition. By addressing these areas, future studies could further refine dietary recommendations for promoting cognitive health.
References:
Author disclosures are available upon request ([email protected]).