We all know that eating too many hot dogs and too few salads isn’t a healthy thing. But which food choices make the most difference in whether we’ll be cut down by the big killers—heart disease, stroke and diabetes?

Skipping bologna, bacon, hot dogs and other cured meats is the best move, it turns out. But eating steak occasionally? Pretty safe, according to new research.

Background: A zillion studies have looked at relationships between specific foods and nutrients and the risks for specific diseases. But there hasn’t been enough research into the big picture. Which foods and nutrients play the biggest roles? Investigators created a way to figure that out.

Study: Tufts University started with major dietary guidelines to determine optimal amounts of 10 key nutrients and/or foods. Then they used high-quality diet/health studies to create a statistical risk model capable of determining the portion of deaths from cardiometabolic disease—those due to heart disease, stroke or type 2 diabetes—that could be prevented if people followed those recommendations.

Results: Overall, a suboptimal diet was related to nearly half—45%—of deaths due to heart disease, stroke and/or diabetes. Not surprisingly, if people followed dietary guidelines to eat enough fruits, vegetables, seafood rich in omega-3 fats and whole grains—while skipping sugar-sweetened beverages—death rates from those diseases would drop significantly. But the biggest contributors to increased mortality were actually consuming too much sodium, too few nuts and seeds and processed meats.

Eating unprocessed meat—beef, chicken, pork—was relatively insignificant. In fact, over the period that these studies covered, even people who had a high consumption of unprocessed red meat such as beef and pork increased their risk of dying from the three cardiometabolic diseases by only 0.4%. While the lowest risk was associated with a daily maximum of no more than one-half ounce a day—one 3½-ounce portion a week—eating more than this, even a lot more, didn’t substantially increase risk in this study.

Processed meats were much bigger dangers. People who ate a diet high in processed meats—defined as meats preserved by smoking, curing, salting or adding chemicals, including bacon, salami, sausages, hot dogs and deli/luncheon meats—faced an 8% increased risk for death. While those who ate the most processed meat were at higher risk than those who ate less, the researchers note that the ideal amount of processed meats for longevity is…none.

The same goes for sugar-sweetened beverages—less is better, but none is best.

Here are all the numbers showing which eating habits—either eating too much or too little of certain foods—seemed to lead to cardiometabolic death…


You’ll increase your risk of dying from cardiometabolic disease by…

  • 5%…if you consume too much sodium. (Goal: Less than 2,000 mg a day).
  • 5%…if you eat too few nuts and seeds. (Goal: At least two ounces of nuts/seeds a day).
  • 2%…if you eat too much processed meat. (Goal: None.)
  • 6%…if you eat too few vegetables. (Goal: At least four servings a day.)
  • 5%…if you eat too little fruit. (Goal: At least three servings a day.)
  • 4%…if you consume too little omega-3-rich seafood. (Goal: Enough to supply an average of 250 mg of omega 3 fatty acids a day. That’s about one 3½-ounce serving of salmon a week.)
  • 4%…if you drink a lot of sugar-sweetened beverages. (Goal: Drink none.)
  • 9%…if you eat too few whole grains. (Goal: At least 4½ ounces a day).
  • 4%…if you eat too much unprocessed red meat. (Goal: No more than 3½ ounces a week.)

Surprising finding: Over the 10 years of the study (2002 to 2012), Americans have been eating better—more nuts and seeds, whole grains, fruits and polyunsaturated fats and fewer sugar-sweetened beverages.

Bottom line: A study such as this cannot prove cause and effect, but it most likely helps us figure out which diet changes are most likely to improve our health. One key take-away is the importance of eating healthful foods more frequently—not just eating unhealthful foods less frequently. To be sure, watching sodium and skipping processed meats is a good idea, but eating more “good” stuff is at least as powerful a way to protect your health. See Bottom Line’s article, “The Mediterranean Diet Protects Your Heart…Even if You Cheat.”