What, meat worry?

Whether Neal Barnard is right or wrong, he's certainly got people talking.

Last April, everyone from Newsweek to The New York Times reported on a startling new proposal by Barnard's Physicians Committee for Responsible Machine. The "New Basic Four Food Groups," said Barnard at a Washington, D.C., press conference, should consist of fruits, vegetables, legumes, and whole grains. That's it.

Everything else from French bread to flounder, cottage cheese to chicken, and skim milk to olive oil would end up in the "optional" category. This isn't just a vegetarian diet. We're talking vegan (no meat, fish, poultry, eggs, or dairy).

One press conference isn't enough to convince a nation to give up red meat, not to mention the foods that fill half our refrigerators. But millions of Americans are eating less beef and pork. And many of them are nervous about nutrients they may be missing. They shouldn't be.

Ever wonder why you see so many ads from the Pork Producers and the Beef Industry Council? It's because people are eating less red meat.

Some are cutting back to avoid fat. Others are motivated by ethics. Whatever the reason, in 1990 we ate less than 120 pounds of red meat per person, 12 percent less than in 1980 and 20 percent less than in 1971, our peak year.

But many people fear that eating less red meat is risky. And while some may maintain their composure if a piece of chicken or fish replaces the hunk of beef or pork on their plate, take away all four and they really start to sweat.

As it turns out, the one nutrient that troubles them most--protein--is the last one to fret over.

Protein Panic. "Protein is not a concern at all," says Jeanne Freeland-Graves of the University of Texas at Austin. "That's an old wives' tale."

* The typical adult gets at least 50 percent more protein than the Recommended Dietary Allowance (RDA). Young children average three times the RDA.

* Protein isn't found just in meat and milk. The third largest source of protein in the average American's diet is white bread, rolls, and crackers.

* Lacto-ovo vegetarians (who eat dairy and eggs) needn't worry about mixing complementary proteins. The protein in milk products and eggs has a "complete" array of the amino acids that your body can't make.

* Only vegan [VEE-gun] children (who eat no dairy or eggs) could conceivably be at slight risk, because 35 percent of a child's protein must be complete (it's only 20 percent for adults). But most vegan meals mix complementary foods like beans and rice or bread and peanut butter, so it's rarely a problem...as long as the child is getting enough food.

Iron Overload. If there is any nutrient non-red-meat-eaters should worry about, it's iron, not protein.

Beef is loaded with iron, and nutritionists have long worried that eating too little beef will cause anemia, especially in women of childbearing age (who lose iron during menstrual periods).

But the iron story is not as simple as it sounds. While most nutritionists are eager to tell people what to eat to get enough iron, James Cook of the University of Kansas Medical Center isn't.

"Men, postmenopausal women, and children under 18 don't develop iron deficiency," says Cook. "And the women who have anemia shouldn't rely on diet to alleviate it. They should take an iron supplement."

That's because "there are so many competing effects on iron absorption that, with a varied diet, they cancel each other out," he says.

For example, you might have an iron-rich chicken leg for lunch, but you might also have coffee, tea, a calcium supplement, or some egg yolk, bran, or other foods that interfere with your body's ability to absorb the iron (see page 13).

Cook is also reluctant to give advice on how to get more iron because "a large number of people suffer from too much iron, and the problem may be as bad as for those who suffer from too little."

Cook is talking about a disease called hemochromatosis, which is a genetic defect that affects three to five out of every thousand people. Their bodies accumulate excess iron, and the results can be disastrous.

"I just admitted to the hospital a 32-year-old mother with severe heart failure," says Cook. "I don't know if she'll survive."

Early signs of hemochromatosis are a lack of menstrual periods in women, loss of sex drive in men, and darkened skin in both. Later, victims may develop diabetes, arthritis, or liver or heart failure.

Once it's discovered, the treatment is simple. "We bleed them," says Cook.

The trick is finding who they are. "We're beginning to think it's cost-effective to screen the general population," he says. Men should have their serum iron levels tested at about age 40, while women should wait until after menopause, because most are protected by menstrual bleeding until then.

Iron-Poor Blood. Of course, no one's saying it's good to be low in iron. First there's anemia, which leaves people tired and out of breath. And iron-depleted women may feel cold, sleep poorly, and have poorer memories, according to preliminary studies that need to be confirmed. (1-3)

Are people who eat less red meat that greater risk? Perhaps.

Iron-deficiency anemia is no more common among vegetarians than non-vegetarians, in part because the body adapts. The less iron you eat, the more your body absorbs.

But many women have iron levels that are below normal, (though not low enough to cause anemia), and few studies have examined iron levels in vegetarian women. One small study, by Bonnie Worthington-Roberts of the University of Washington, found that premenopausal women who were lacto-ovo vegetarians or fish-and-poultry eaters had lower iron levels than women who ate red meat. (4)

"The incidence of true anemia is four to five percent of premenopausal women, which is not as high as possible think," says Worthington-Roberts. "But we don't have a good handle on the number of women with low iron stores."

If you want to know if you're getting enough iron, a serum ferritin test is a good measure. Unfortunately, "it can't be analyzed in a doctor's office, so it's not cheap," says Worthington-Roberts.

A less expensive test measures the "zinc protoporphyrin/heme ratio." It evaluates iron stores using only a finger-prick's worth of blood. (3) But so far, few doctors have the equipment to do it.

In the meantime, says Worthington-Roberts, "all women should at least get their hematocrit and hemoglobin analyzed annually."

Inscrutable Zinc. If you're eating less red meat, zinc is another nutrient nutritionists might warn you about. But as far as researchers now know, it isn't much of a problem.

"Adults have an incredible capacity to adapt to marginal intakes of zinc by decreasing excretion and maybe by increasing absorption," says Janet King of the University of California at Berkeley. Exceptions are:

* pregnant women (they have greater needs),

* diabetics whose blood sugar levels are uncontrolled (they lose zinc in their urine), and

* people who have experienced trauma (such as surgery, burns, or gunshot wounds).

Unfortunately, you can't take a test to find out if you're getting enough zinc.

"We don't have a good way to evaluate zinc status," says King. The amount of zinc in your hair or saliva is unreliable, and once the level in your blood drops, you're really deficient. By then, a zinc deficiency may be impairing your immune system, your sense of taste, and your wound-healing ability.

Only in children is it easy to know who is getting enough zinc. Kids who are deficient don't grow.

So what can you do if your doctor is concerned that your child is growing too slowly? "Give them zinc and see if growth improves," says King. To play it safe, stich with the RDA (10 mg per day for children under 11). Don't go overboard.

Fortunately, you don't need red meat to get zinc. There's plenty in seafood, poultry, milk, and legumes (see page 13).

Vegetables in the News. So, non-or-less-red-meat-eaters, cross protein off your worry list. If you're a premenopausal woman, keep iron in mind, and if your child isn't growing well, don't forget zinc.

If you're still concerned, why not take a multi-vitamin-and-mineral supplement that provides 100 percent of the USRDA (15 mg for zinc and 18 mg for iron)? Just make sure it has copper (see page 4), and that you're not at risk for hemochromatosis.

"I know it's against most others in my profession, but I don't see anything wrong with a supplement with RDA levels as a margin of safety," says nutritionist Freeland-Graves.

One thing is certain. Taking a supplement is healthier than loading up on red meat.

(1) Am. J. Physiol. 246: R380, 1984.

(2) Fed. Am. Soc. Exper. Biol. J. 2: A434, 1988.

(3) Am. J. Clin. Nutr. 53: P-16, 22, 28, 1991.

(4) Am. J. Clin. Nutr. 47: 275, 1988.