Claudia Valli, MSc; Montserrat Rabassa, PhD; Bradley C. Johnston, PhD; Ruben Kuijpers, MSc; Anna Prokop-Dorner, PhD; Joanna Zajac, PhD; Dawid Storman, MD; Monika Storman, MD; Malgorzata M. Bala, MD, PhD; Ivan Solà, MSc; Dena Zeraatkar, MSc; Mi Ah Han, MD, PhD; Robin W.M. Vernooij, PhD; Gordon H. Guyatt, MD; Pablo Alonso-Coello, MD, PhD; for the NutriRECS Working Group *
Acknowledgment: The authors thank Kate Ghezzi-Kopel for helping with the search strategy, Ray Zhang for helping with the risk-of-bias assessment, and Gerald Gartlehner for reviewing the assessment of certainty of the evidence.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1326.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Claudia Valli, MSc, Centre Cochrane Iberoamericà, Hospital de la Santa Creu i Sant Pau, Pavelló 18. (Planta baixa) – despatx 15, C/Sant Antoni M. Claret, 167, 08025 Barcelona, Spain; e-mail, email@example.com.
Current Author Addresses: Ms. Valli and Drs. Rabassa, Solà, and Alonso-Coello: Iberoamerican Cochrane Centre, Instituto de Investigación Biomédica de Sant Pau (IIB Sant Pau-CIBERESP) C/Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain.
Dr. Johnston: Centre for Clinical Research, Dalhousie University, 5790 University Avenue, Room 404, Halifax, Nova Scotia B3J 0E4, Canada.
Mr. Kuijpers: Wageningen University, Droevendaalsesteeg 4, 6708 PB Wageningen, the Netherlands.
Drs. Prokop-Dorner, Zajac, Dawid Storman, and Bala: Jagiellonian University Medical College, 7 Kopernika Street, Kraków 31-034, Poland.
Dr. Monika Storman: Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.
Ms. Zeraatkar and Dr. Guyatt: McMaster University Health Sciences Center, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada.
Dr. Han: Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea.
Dr. Vernooij: Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, Utrecht 3511DT, the Netherlands.
Author Contributions: Conception and design: C. Valli, M. Rabassa, B.C. Johnston, M.M. Bala, D. Zeraatkar, R.W.M. Vernooij, G.H. Guyatt, P. Alonso-Coello.
Analysis and interpretation of the data: C. Valli, M. Rabassa, B.C. Johnston, R. Kuijpers, A. Prokop-Dorner, M. Storman, I. Solà, D. Zeraatkar, M.A. Han, P. Alonso-Coello.
Drafting of the article: C. Valli, B.C. Johnston, P. Alonso-Coello.
Critical revision of the article for important intellectual content: C. Valli, B.C. Johnston, A. Prokop-Dorner, M. Storman, M.M. Bala, I. Solà, D. Zeraatkar, M.A. Han, R.W.M. Vernooij, G.H. Guyatt, P. Alonso-Coello.
Final approval of the article: C. Valli, M. Rabassa, B.C. Johnston, R. Kuijpers, A. Prokop-Dorner, J. Zajac, D. Storman, M. Storman, M.M. Bala, I. Solà, D. Zeraatkar, M.A. Han, R.W.M. Vernooij, G.H. Guyatt, P. Alonso-Coello.
Administrative, technical, or logistic support: B.C. Johnston, D. Zeraatkar.
Collection and assembly of data: C. Valli, M. Rabassa, R. Kuijpers, J. Zajac, D. Storman, M. Storman.
A person's meat consumption is often determined by their values and preferences.
To identify and evaluate evidence addressing health-related values and preferences regarding meat consumption.
MEDLINE, EMBASE, Web of Science, Centre for Agriculture and Biosciences Abstracts, International System for Agricultural Science and Technology, and Food Science and Technology Abstracts were searched from inception to July 2018 without language restrictions.
Pairs of reviewers independently screened search results and included quantitative and qualitative studies reporting adults' health-related values and preferences regarding meat consumption.
Pairs of reviewers independently extracted data and assessed risk of bias.
Data were synthesized into narrative form, and summaries were tabulated and certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Of 19 172 initial citations, 41 quantitative studies (38 addressed reasons for meat consumption and 5 addressed willingness to reduce meat consumption) and 13 qualitative studies (10 addressed reasons for meat consumption and 4 addressed willingness to reduce meat consumption) were eligible for inclusion. Thirteen studies reported that omnivores enjoy eating meat, 18 reported that these persons consider meat an essential component of a healthy diet, and 7 reported that they believe they lack the skills needed to prepare satisfactory meals without meat. Omnivores are generally unwilling to change their meat consumption. The certainty of evidence was low for both “reasons for meat consumption” and “willingness to reduce meat consumption in the face of undesirable health effects.”
Limited generalizability of findings to lower-income countries, low-certainty evidence for willingness to reduce meat consumption, and limited applicability to specific types of meat (red and processed meat).
Low-certainty evidence suggests that omnivores are attached to meat and are unwilling to change this behavior when faced with potentially undesirable health effects.
None. (PROSPERO: CRD42018088854)
Evidence search and selection.
AGRIS = International System for Agricultural Science and Technology; CAB = Centre for Agriculture and Biosciences; FSTA = Food Science and Technology Abstracts.
Table 1. Characteristics of the Included Studies
Table 2. Review Finding Table and Certainty of Evidence
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Valli C, Rabassa M, Johnston BC, et al, for the NutriRECS Working Group. Health-Related Values and Preferences Regarding Meat Consumption: A Mixed-Methods Systematic Review. Ann Intern Med. 2019;:. [Epub ahead of print 1 October 2019]. doi: https://doi.org/10.7326/M19-1326
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Published: Ann Intern Med. 2019.
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