Swapping red meat for fish like sardines may help prevent early deaths

The researchers constructed distinct scenarios to assess the effects of substituting red meat with forage fish based on anticipated dietary trends in 137 countries by the year 2050.

They used a comparative risk assessment framework to investigate how such substitutions could reduce the global burden of diet-related noncommunicable diseases in adults.

Among the proposed scenarios, prioritizing fish distribution to regions with low fish consumption, particularly in lower and middle-income countries, showed the most promise in diminishing global disease burdens.

Their comprehensive analysis suggested that substituting red meat with forage fish could potentially save between 500,000 to 750,000 lives by reducing diet-related diseases by the year 2050, primarily by lowering the incidence of coronary heart disease.

Implementing this change could also help decrease the years lived with disability by 8 to 15 million, primarily benefiting low- and middle-income nations, according to the researchers.

Noncommunicable diseases are responsible for 41 million deaths annually, accounting for 74% of all deaths worldwide. A staggering 77% of these deaths occur in low- and middle-income countries.

The researchers note that nearly half of the global deaths linked to noncommunicable diseases are attributed to major illnesses such as coronary heart disease, stroke, diabetes, and colorectal cancer.

With studies increasingly linking the consumption of red meat, such as beef, pork, and lamb, and processed meats to a higher risk of these diseases, the present study authors emphasized:

“To reduce the burden of diet-related [noncommunicable diseases] without sacrificing environmental health, by 2050 we need to limit the consumption of greenhouse gas emission-intensive red meat and shift to foods that are both healthy and environment-friendly.”

While forage fish cannot fully replace red meat globally, this study suggests this dietary shift could increase average daily fish consumption to close to the recommended 40 kcal in many countries.

This could potentially reduce the prevalence of coronary heart disease, stroke, diabetes, and colorectal cancer by 2% by 2050, according to the study results.

Thomas M. Holland, MD, physician-scientist at the RUSH Institute for Healthy Aging, Rush University System for Health, who was not involved in the study, highlighted the benefits of transitioning from red meat to forage fish.

“These benefits include improved cholesterol levels, brain health, and cardiovascular health,” he said.

He attributed these benefits mainly to forage fish’s omega-3 fatty acids, such as EPA and DHA, known to reduce inflammation, blood pressure, low-density lipoprotein (LDL) cholesterol, and triglyceride levels.

Eliza Whitaker, MS, RDN, a registered dietitian and medical nutrition advisor at Dietitian Insights, who was not involved in the study, echoed this and told MNT, “Omega-3 fatty acids may also reduce the risk of developing certain types of cancers.”

Whitaker noted that beyond their fatty acid profile, these small fish are rich in other health-promoting essential nutrients, too, including vitamins D and B12, and minerals such as calcium, iron, and zinc.

In contrast, the World Health Organization has classified red meat as possibly carcinogenic to humans, specifically due to evidence suggesting a link between consuming red meat and developing colorectal cancer. This is in addition to links between red meat and other diet-related diseases, including diabetes and ischemic heart disease.

Sophie Lauver, MS, RD, a registered dietitian and owner of Plant-Based Perspective, who was also not involved in the study, suggested another important consideration when comparing the two different protein sources.

Compared to red meat, fish contain lower levels of dietary advanced glycation end products (AGEs), which produce oxidative stress and inflammation in the body and are linked to chronic diseases, she explained.

Overall, forage fish may be more nutritionally beneficial and health-promoting, while red meat, higher in saturated fats and AGEs, may contribute more to disease states.

Plant-based alternatives for omega-3 fatty acids

Individuals who are looking for plant-based sources of omega-3 fatty acids have various options, such as nuts, seeds, and marine microalgae.

Lauver explained that marine microalgae are a direct source of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which is where fish get their omega-3s. Thus, microalgae bypass the need for fish consumption, making them a particularly valuable addition for vegetarians and vegans.

Microalgae can be consumed as a food or supplement and, if grown in controlled environments, “can help to reduce exposure to industrial pollutants often found in fish,” said Lauver.

Although nuts and seeds, such as chia seeds, flaxseeds, and walnuts, do not provide EPA and DHA, they supply ALA (alpha-linolenic acid), which the body can convert into EPA and DHA to some extent, she explained.

Whole food, plant-based omega-3 options also have the added benefit of dietary fiber, absent in forage fish, said Whitaker, making them a nutritious part of a healthy diet.

This research underscores the potential health and environmental benefits of substituting traditional protein sources like red meat with forage fish. However, it does not explore the global feasibility of making these dietary changes.

Dr. Holland explained:

“While transitioning to forage fish from red meat is moderately feasible due to their relatively low cost compared to red meat, there are challenges, particularly in low and middle-income countries where access to nutritious food is limited.”

“Addressing health inequities and promoting dietary shifts must consider economic realities, requiring strategies such as subsidies and education programs to ensure accessibility for all populations,” he said.

The study authors expressed that accessibility remains a primary challenge in regions where seafood is scarce, such as many landlocked areas in Africa and Central Asia.

To this point, Whitaker highlighted that canned fish offers a more budget-friendly and accessible alternative to fresh or frozen fish, especially for those living far from coastlines and concerned about food safety.

Still, cultural preferences for red meat, overfishing, and ecosystem disruption also complicate a global shift to forage fish consumption.

Regarding the feasibility of this dietary shift, Dr. Holland concluded: “While novel ideas for addressing these issues are needed and welcomed, without adequate funding for infrastructure, education, and preventive measures, these ideas remain theoretical.”