An Israeli study has linked consumption of processed and red meat with increased risk of developing chronic liver disease, heart disease and diabetes – especially for people who like their steak well done. 

While red and processed meat has long been tied to increased risk of diabetes, certain cancers and heart disease, evidence regarding the connection to liver disease has until now been mixed.

Researchers at the University of Haifa found that people who ate more processed and red meat were 47 percent more likely to develop a condition known as non-alcoholic fatty liver disease (NAFLD), often associated with obesity, and 55% more likely to have insulin resistance.

Both NAFLD and insulin resistance are also among the symptoms and traits that make up so-called metabolic syndrome, which raises risk for heart disease and diabetes, the researchers note.

During the study conducted between 2013 and 2015, which will be published in the Journal of Heptology in June, the researchers examined data on 789 adults who answered questions about their eating and cooking habits and also underwent liver ultrasound scans and lab tests for insulin resistance. The Israeli research team was led by Shira Zelber-Sagi, a nutrition researcher at the University of Haifa.

Participants were 59 years old on average and typically overweight, with about 15% suffering from diabetes.

Overall, 39% of the participants were found to have NAFLD and 31% had insulin resistance, which occurs when the body is less effective at using insulin to convert sugars in the blood into energy for cells.

The study also found that cooking meat at high temperatures for longer periods of time was also associated with a higher risk of both conditions than eating more rare meat.

Cooking meat until it is “well done” forms compounds known as heterocyclic amines (HCAs) tied to both liver disease and insulin resistance, Zelber-Sagi said.

“In order to prevent insulin resistance and NAFLD, [people should consider] choosing fish, turkey or chicken as an animal protein source,” she told Reuters. “In addition, steaming or boiling food (is better than) grilling or frying meat at a high temperature until it is very well done.”

The study wasn’t controlled and the researchers relied on participants to accurately report their consumption habits. However, the results add to a growing body of evidence suggesting that people should limit how much red and processed meat they eat.