The Lone Star Tick: What to Know About the Tick

that Causes a Red Meat Allergy

An expert explains how a tick bite can cause a meat allergy and what to
watch for if you’ve been bitten by the lone star tick.

Many people associate ticks with Lyme disease, but one particular tick that has become
more prevalent in the Northeast — the lone star tick — transmits bacteria that could
lead to another condition: a meat allergy.

Previously a southern-state dweller, this species of tick has moved north in recent years
thanks to warming temperatures. The lone star tick is unique in that it can transmit a
molecule that causes alpha-gal syndrome, a food allergy to red meat. An analysis of
test results from 2010 to 2018 found over 34,000 documented cases of alpha-gal
syndrome in the United States.  

Health Matters spoke with Dr. Brian Fallon, director of the Lyme and Tick-Borne
Disease Research Center at Columbia and a psychiatrist with
NewYork-Presbyterian/Columbia University Irving Medical Center, to discover more
about the lone star tick, as well as how to detect and treat alpha-gal syndrome.

What ticks are most prevalent in the Northeast?

There are three main species of ticks to be aware of in the New York area. The black-
legged tick, also known as the deer tick, and the dog tick are the most common. The
lone star tick, which until recently was primarily found in the South and moves three
times faster than the black legged tick, is becoming more common and can carry a
substance called alpha-gal that, after a bite, triggers a delayed allergic reaction to red
meat (but not to chicken or fish).
Distinguishing between each tick with the naked eye is challenging, but knowing which
ones are predominant in the area is helpful if you have been bitten.

Where is the lone star tick typically found in the Northeast?

They’re quite prevalent in coastal areas, such as along New Jersey and Long Island.
Eastern Long Island in particular has seen a huge increase in the lone star tick.

How did a tick seen mostly in the South end up in the Northeast?

As weather has gotten warmer, the lone star tick has been able to survive and thrive in
new environments.

How does the lone star tick cause a red meat allergy?

Alpha-gal is a sugar molecule that humans don’t have in their system, but a lot of
animals do. This includes cows, bison, deer, pigs, sheep, and lambs. If a person is
bitten by a lone star tick and it transmits the alpha-gal molecule, the person may
develop an antibody reaction to the molecule. In other words, they could develop an
allergy. This means the next time the person eats red meat such as beef or venison, or
something made with beef gelatin, they could break out in hives or have a more serious
allergic reaction.

How is this allergy diagnosed and treated? Can it be cured?

Unlike most allergic reactions, the alpha-gal reaction is delayed, usually appearing
several hours after exposure to red meat. Typical allergic reactions include hives,
swelling, wheezing. Some people may also experience abdominal symptoms such as
cramping, pain, diarrhea, and nausea, and new research shows some people may only
experience abdominal symptoms. Your doctor can do a blood test to see if you have
alpha-gal antibodies to confirm this is what’s causing your allergy.
For most people, over-the-counter antihistamines may be sufficient as treatment. If the
allergic reaction is more intense, the person should seek immediate medical care and
may need to carry a device to inject epinephrine, commonly known as an EpiPen.
Unfortunately, there isn’t a cure, but the allergy does appear to wane over time, lasting
anywhere from one to five years. So the good news is people who have alpha-gal may
be able to go back to eating red meat.

Is the best treatment then to simply avoid eating red meat?

Yes. There are people with alpha-gal who find they can eat red meat because the
reaction is tolerable, maybe just itchiness, while other people will have a much stronger
and potentially life-threatening allergic reaction that would require going to the
emergency room, such as shortness of breath, abdominal pain, diarrhea, and vomiting.
But like with any allergy, it’s best to avoid the cause.

What other diseases can all of these ticks spread?

Ticks, which are very small and hard to detect, can carry a variety of microbes that
cause human diseases. Black-legged ticks are the carriers of the microbes that cause
Lyme disease. Lyme disease is rarely fatal, but if left untreated, the microbe causing
Lyme disease can spread to the joints, the heart, the connective tissue, and the nervous
system, and can lead to debilitating long-term pain, cognitive problems, and fatigue that
persists among some patients even after antibiotic therapy. (Though less frequent,
black-legged ticks may also cause serious illnesses such as babesiosis, anaplasmosis,
ehrlichiosis, and Powassan virus disease.)

The dog tick, much larger than the black-legged tick, is also endemic in the Northeast. It
carries microbes that cause tularemia and Rocky Mountain spotted fever, two bacterial
infections which are concerning but also far less frequent than Lyme disease.

In addition to alpha-gal, the lone star tick may carry the microbes that cause the
bacterial illness ehrlichiosis, as well as Southern Tick–Associated Rash Illness, which
causes a circular rash similar to the rash of early Lyme disease, fatigue, headache,
fever, and muscle pains. Less commonly, the lone star can cause tularemia or two rare
viral illnesses, the Heartland virus disease and Bourbon virus disease.
Processed Meat Consumption Linked To
Cardiovascular Disease and Death
Health and Nutrition News Apr 1, 2021

Consumption of processed meat is linked to cardiovascular disease and death,

according to a study published online in the American Journal of Clinical Nutrition.
Researchers reviewed food intake records from more than 100,000 participants in the
Prospective Urban Rural Epidemiology (PURE) Study and compared heart disease and
mortality with meat consumption. Those who ate more than 150 grams (e.g., one hot
dog is about 50 grams) of processed meat per week increased their risk of heart
disease and death by 46% and 51%, respectively, when compared to those who did not
eat processed meat. These results support limiting processed meat intake for heart
disease prevention.

References
Iqbal R, Dehghan M, Mente A, et al. Associations of unprocessed and processed meat
intake with mortality and cardiovascular disease in 21 countries [Prospective Urban
Rural Epidemiology (PURE) Study]: a prospective cohort study. Am J Clin Nutr.
Published online March 31, 2021. doi: 10.1093/ajcn/nqaa448

Meat and Fish Intake: PURE

31 March 2021

Meat and fish intake: PURE

Publications this month analyze data from PHRI’s PURE study to reveal new insight into
the association of fish intake, and of processed and unprocessed meat, with major
cardiovascular disease and mortality. In both cases, the global study is the first to so
widely include health outcomes from low-, middle- and high-income countries.

The PURE study team published Associations of unprocessed and processed meat
intake with mortality and cardiovascular disease in 21 countries in the American Journal
of Clinical Research today. During 9.5 years of followup of a cohort of almost 135,000
people in 21 low-, middle- and high-income countries, the study did not find significant
associations between unprocessed red meat and poultry intake and mortality or major
CVD. Conversely, a higher intake of processed meat – salted, cured, or treated with
preservations and/or food additives – was associated with a higher risk of major CV and
mortality.
“Evidence of an association between meat intake and cardiovascular disease is
inconsistent. We therefore wanted to better understand the associations between
intakes of unprocessed red meat, poultry, and processed meat with major
cardiovascular disease events and mortality,” says Romaina Iqbal, first author of the
study and an associate professor at the Aga Khan University in Karachi, Pakistan.

Consumption of processed and unprocessed meat

Mahshid Dehgha

“The totality of the available data indicates that consuming a

modest amount of unprocessed meat as part of a healthy dietary
pattern is unlikely to be harmful,” corresponding author Mahshid
Dehghan, PHRI investigator.

After following for almost a decade, the researchers found

consumption of 150 grams or more of processed meat a week was associated with a 46
per cent higher chance of cardiovascular disease and 51 per cent higher chance of
death than those who ate no processed meat. However, moderate levels of
consumption of non processed meats had a neutral effect on health.

“The PURE study examines substantially more diverse populations and broad patterns
of diet, enabling us to provide new evidence that distinguishes between the effects of
processed and unprocessed meats,” says senior author and PHRI Executive Director
Salim Yusuf.

Fish intake and CVD risk

Meanwhile, an analysis of four international cohorts – PHRI’s PURE, ONTARGET,

TRANSCEND and ORIGIN – indicated that a minimal fish intake of 175 g
(approximately 2 servings) weekly is associated with lower risk of major CVD and
mortality among patients with prior CVD but not in general populations.

Andrew Mente

The pooled analysis of individual participant data involved

147,645 people (139,827 without CVD and 7,818 with CVD) in 21
countries from the PURE study, and 43,413 patients with
vascular disease from 40 countries in the other three prospective
studies.

“This is by far the most diverse study of fish intake and health
outcomes in the world and the only one with sufficient numbers with representation from
high-, middle- and low-income countries from all inhabited continents of the world,” said
PHRI Scientist Andrew Mente, coauthor of Associations of fish consumption with risk of
cardiovascular disease and mortality among individuals with or without vascular disease
from 58 countries in JAMA Internal Medicine. (Deepa Mohan, Madras Diabetes
Research Foundation, India is first author.)

Processed Meat Linked To Higher Risk Of

Mortality And Cardiovascular Disease
March 31, 2021 by ASN Staff

Multinational study published in The American Journal of Clinical

Nutrition suggests that consumption of moderate amounts of
unprocessed meat is okay, but processed meats should be avoided

Summary: Results of a multinational study published in The

American Journal of Clinical Nutrition suggest that individuals
who eat processed meat are at higher risk of mortality and major
cardiovascular disease events compared with individuals who do
not eat processed meat.  In contrast, the consumption of unprocessed red meat and
poultry was not associated with higher mortality and cardiovascular disease risk.  This
study gathered and analyzed data from subjects in low-, middle-, and high-income
countries.

 The PURE study is the first multinational study exploring the association between
unprocessed and processed meat intakes with health outcomes in low-, middle-,
and high-income countries.
 The consumption of unprocessed red meat and poultry was not found to be
associated with mortality nor major cardiovascular disease events.
 In contrast, higher processed meat intake was associated with higher risks of
both total mortality and major cardiovascular disease.

Rockville, MD – Red meat is a major source of medium- and long-chain saturated fatty
acids, which may lead to an increased risk of cardiovascular disease.  Processed meat,
which has been modified to improve taste or extend its shelf-life, has also been
associated with an increased risk of cardiovascular disease.  Dietary guidelines
therefore recommend limiting the consumption of both red and processed meat based
on studies that have linked them to higher risks of cardiovascular disease.  These
studies, however, have come primarily from populations in North America and Europe,
limiting their global applicability.

Published in The American Journal of Clinical Nutrition (AJCN), “Associations of

Unprocessed and Processed Meat Intake with Mortality and Cardiovascular Disease in
21 countries (PURE): A Prospective Cohort Study,” has helped to rectify a major
research gap, helping us better understand the global health impact of meat and meat
product consumption.  Dr. Romaina Iqbal, first author of the study noted, “evidence of
an association between meat intake and cardiovascular disease is inconsistent.  We
therefore wanted to better understand the associations between intakes of unprocessed
red meat, poultry, and processed meat with major cardiovascular disease events and
mortality.”

In order to conduct their research, the authors of this study worked with data from the
Prospective Urban Rural Epidemiological (PURE) study, a long-term study launched in
2003 by Dr. Salim Yusuf, Director of Population Health Research Institute, Canada, and
Principal Investigator of the PURE study.  The PURE study has tracked the dietary
habits and health outcomes of more than 164,000 participants from 21 low-, middle-,
and high-income countries across five continents.

According to Dr. Mahshid Dehghan, one of the study’s authors and Investigator at the
Population Health Research Institute of McMaster University and Hamilton Health
Sciences, “the PURE study is the first multinational study that provides information on
the association between unprocessed and processed meat intakes with health
outcomes from low- and middle-income countries.  Moreover, the PURE study
examines substantially more diverse populations and broad patterns of diet, enabling us
to provide new evidence.”

Participants’ dietary habits were recorded via the use of food frequency questionnaires. 
In addition, data was collected on participants’ mortality and major cardiovascular
disease events, enabling the study authors to determine the associations between meat
consumption patterns and cardiovascular disease events and mortality.

Upon completing their analysis, the study authors “did not find significant associations
between unprocessed red meat and poultry intake with mortality or major cardiovascular
disease.”  By contrast, processed meat intake was associated with higher risks of total
mortality and major cardiovascular disease.

The authors believe that additional research may enhance our current understanding of
the relationship between meat consumption and health outcomes.  For example, it isn’t
clear what study participants with lower meat intakes were eating instead of meat, and if
the quality of those foods differed between countries.  These substitutions may have
implications in further interpreting the associations between meat consumption and
health outcomes.  Nonetheless, the authors believe their findings “indicate that limiting
the intake of processed meat should be encouraged.”

###

Reference

Iqbal R, Dehghan M, Mente A, Rangajaran S, Wielgosz A, Avezum A, Seron P, AlHabib

KF, Lopez-Jaramillo P, Swaminathan S, et al. Associations of unprocessed and
processed meat intake with mortality and cardiovascular disease in 21 countries
[Prospective Urban Rural Epidemiology (PURE) Study]: a prospective cohort study. The
American Journal of Clinical Nutrition, nqaa448, https://doi.org/10.1093/ajcn/nqaa448.
About The American Journal of Clinical Nutrition

The most highly rated peer-reviewed, primary research journal in nutrition and dietetics,
The American Journal of Clinical Nutrition (AJCN) publishes the latest research on
topics in nutrition such as obesity, vitamins and minerals, nutrition and disease, and
energy metabolism. Visit us online at academic.oup.com/ajcn or follow us on
Twitter @AJCNutrition #AJCN.

About the American Society for Nutrition

ASN is the preeminent professional organization for nutrition research scientists and
clinicians around the world. Founded in 1928, the society brings together the top
nutrition researchers, medical practitioners, policy makers and industry leaders to
advance our knowledge and application of nutrition. ASN advances excellence in
nutrition research and practice through its publications, education, public affairs,
membership programs, and annual meeting, Nutrition. Visit ASN online at nutrition.org.
Red Meat Consumption and All-Cause and
Cardiovascular Mortality: Results From The
UK Biobank Study.
European journal of nutrition Pub Date : 2022-02-27 , DOI: 10.1007/s00394-022-02807-
0
Mengying Wang,Hao Ma,Qiying Song,Tao Zhou,Yonghua Hu,Yoriko Heianza,JoAnn E
Manson,Lu Qi

PURPOSE To investigate the prospective associations between red meat consumption

and all-cause and cardiovascular diseases (CVD) mortality, and to assess the
modification effects of lifestyle and genetic risk factors. METHODS 180,642 individuals
free of CVD or cancer were enrolled from 2006 to 2010 and followed up to 2018 in the
UK Biobank. Information on demographics, lifestyles, and medical history was collected
through a baseline touchscreen questionnaire. The information on diet was collected
through a single touchscreen food-frequency questionnaire. A total of ten single-
nucleotide polymorphisms were used to calculate the genetic risk score (GRS) of
trimethylamine N-oxide (TMAO), a gut microbiota metabolite from red meat. Adjusted
Cox proportional hazard regression models were used to assess the association of red
meat consumption with mortality. RESULTS We documented 3596 deaths [655 CVD
deaths, 285 coronary heart disease (CHD) deaths, and 149 stroke deaths] during
median 8.6 years of follow-up. Compared with the lowest red meat intake (< 1.5
times/week), the highest red meat intake (≥ 3.0 times/week) was associated with a 20%,
53%, and 101% elevated risk for CVD, CHD, and stroke mortality (P for trend = 0.04,
0.007, and 0.02, respectively), but not all-cause mortality. We found that the
associations between red meat intake and mortality were not modified by dietary and
lifestyle factors, as well as TMAO GRS. In addition, substitution analyses showed that a
decrease in red meat consumption and an increase in the consumption of poultry or
cereal was significantly associated with 9%-16% lower CVD or CHD mortality risk.
CONCLUSION Our results indicated that red meat consumption was associated with
higher risks of CVD, CHD, and stroke mortality, and the associations were not modified
by lifestyle and genetic risk factors. Replacing red meat by poultry or cereal was related
to lower risks of CVD and CHD mortality.

 riginal Contribution
 Published: 27 February 2022
Red Meat Consumption and All-Cause and
Cardiovascular Mortality: Results From The UK
Biobank Study
 Mengying Wang, Hao Ma, Qiying Song, Tao Zhou, Yonghua Hu, Yoriko Heianza, JoAnn
E. Manson & Lu Qi 

European Journal of Nutrition (2022)

Abstract
Purpose

To investigate the prospective associations between red meat consumption and all-
cause and cardiovascular diseases (CVD) mortality, and to assess the modification
effects of lifestyle and genetic risk factors.

Methods

180,642 individuals free of CVD or cancer were enrolled from 2006 to 2010 and
followed up to 2018 in the UK Biobank. Information on demographics, lifestyles, and
medical history was collected through a baseline touchscreen questionnaire. The
information on diet was collected through a single touchscreen food-frequency
questionnaire. A total of ten single-nucleotide polymorphisms were used to calculate the
genetic risk score (GRS) of trimethylamine N-oxide (TMAO), a gut microbiota metabolite
from red meat. Adjusted Cox proportional hazard regression models were used to
assess the association of red meat consumption with mortality.

Results

We documented 3596 deaths [655 CVD deaths, 285 coronary heart disease (CHD)
deaths, and 149 stroke deaths] during median 8.6 years of follow-up. Compared with
the lowest red meat intake (< 1.5 times/week), the highest red meat intake (≥ 3.0
times/week) was associated with a 20%, 53%, and 101% elevated risk for CVD, CHD,
and stroke mortality (P for trend = 0.04, 0.007, and 0.02, respectively), but not all-cause
mortality. We found that the associations between red meat intake and mortality were
not modified by dietary and lifestyle factors, as well as TMAO GRS. In addition,
substitution analyses showed that a decrease in red meat consumption and an increase
in the consumption of poultry or cereal was significantly associated with 9%–16% lower
CVD or CHD mortality risk.
Conclusion

Our results indicated that red meat consumption was associated with higher risks of
CVD, CHD, and stroke mortality, and the associations were not modified by lifestyle and
genetic risk factors. Replacing red meat by poultry or cereal was related to lower risks of
CVD and CHD mortality.

This is a preview of subscription content, access via your institution.

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Funding

This work was supported by grants from the National Heart, Lung, and Blood Institute
(HL071981, HL034594, HL126024), the National Institute of Diabetes and Digestive and
Kidney Diseases (DK115679, DK091718, DK100383, DK078616), and the Fogarty
International Center (TW010790). LQ is a recipient of the American Heart Association
Scientist Development Award (0730094 N). LQ is also supported by NIGMS
P20GM109036. MW is supported by China Postdoctoral Science Foundation
(BX2021021).
Author information
Affiliations

1. Department of Epidemiology and Biostatistics, School of Public Health, Peking

University Health Science Center, Beijing, China

Mengying Wang & Yonghua Hu

2. Department of Epidemiology, School of Public Health and Tropical Medicine,

Tulane University, New Orleans, LA, 70112, USA

Mengying Wang, Hao Ma, Qiying Song, Tao Zhou, Yoriko Heianza & Lu Qi

3. Department of Maternal and Child Health, School of Public Health, Peking

University, Beijing, China

Qiying Song

4. Channing Division of Network Medicine, Department of Medicine, Brigham and

Women’s Hospital and Harvard Medical School, Boston, MA, USA

JoAnn E. Manson & Lu Qi

5. Department of Epidemiology, Harvard T.H. Chan School of Public Health,

Boston, MA, USA

JoAnn E. Manson

6. Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital

and Harvard Medical School, Boston, MA, USA

JoAnn E. Manson

7. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,
USA

Lu Qi

Corresponding author

Correspondence to Lu Qi.
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Conflict of interest All authors declare no competing interests.

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Wang, M., Ma, H., Song, Q. et al. Red meat consumption and all-cause and
cardiovascular mortality: results from the UK Biobank study. Eur J Nutr (2022).
https://doi.org/10.1007/s00394-022-02807-0