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“Clearly these Guidelines bear the hoof prints of the Cattlemen’s Associations,” Walter Willett, MD, Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health and a member of the Dietary Guidelines Advisory Committee

“In fact, [the World Health Organization] said that the increased risk from red or processed meat is ‘small’ for individuals, though potentially important for public health since so many people eat meat.” John Swartzberg, MD, University of California, Berkeley Wellness Letter, February 2016

Red and Processed Meat Can Be Part of a Healthy Eating Pattern, According to the New Dietary Guidelines

The 5-year update of the official dietary guidelines from the U.S. government adopts many of the changes recommended in the advisory report. It also contains some controversial provisions. It removes the limits on total fat and cholesterol intake, while retaining a 10 percent limit on saturated fat—and adding a 10% limit on added sugar. The guidelines advise Americans to eat less red and processed meats, but disappoints many by not being more specific.

Dr. Dariush Mozaffarian, dean of the Tufts University Friedman School of Nutrition Science and Policy, summarized the recommended dietary pattern as rich in vegetables, fruit, whole grains, seafood, legumes, nuts and dairy products, moderate in alcohol (among adults), lower in red and processed meat, and low in sugar-sweetened foods and beverages and refined grains.

Dr. Mozaffarian’s advice is to “avoid processed meats,” but others are more outspoken in their criticism.

Harvard professor of nutrition Walter Willett, says the primary guidelines should have specified that “consumption of red and processed meat should be reduced for health reasons.”

Dr. Frank Hu, also a professor of nutrition at Harvard and a member of the Dietary Guidelines Advisory Committee, agrees that the committee’s recommendations on the consumption of red and processed meats were watered down. Hu says specific advice to eat less red and processed meat would have been easier for the public to understand than a 10% limit on daily calories from saturated fat.

Be that as it may, the Guidelines do specify the concerns—and the benefits. 

The “Meats and Poultry” section in the body of the Guidelines warns of a strong association with cardiovascular disease and a moderate association with obesity, type 2 diabetes, and some types of cancer. Offsetting this downside is that protein requirements can be met by consuming a variety of lean meats, lean poultry, and eggs. Choices within these patterns may include processed meats and processed poultry “as long as the resulting eating pattern is within limits for sodium, calories from saturated fats and added sugars, and total calories.”

Tom Brenna, a nutrition professor at Cornell University and a member of the Dietary Guidelines Advisory Committee, told NPR that the advisory committee’s recommendation to cut back on red and processed meats “morphed a bit into a different kind of message. A little bit like turning a coin over, in a sense, where if you eat less red meat, one is eating more of other protein foods.” In other words, the guidelines accomplish the reduction by expanding protein foods beyond lean meats and poultry, to include seafood, eggs, legumes, soy products, nuts, and seeds. Dairy products are also a good source of protein.

So red and processed meats and poultry are a mixed bag. If you go there, go with caution.

Heightened concerns include a November 2015 pronouncement from the World Health Organization that the consumption of processed meat is carcinogenic to humans.

Understanding WHO

Dr. John Swartzberg, Editorial Board Chairman of the University of California, Berkeley Wellness Letter, expounded on the World Health Association finding on meat in the February 2016 issue—and in the process revealed why the meat issue remains unclear and may never be settled to everyone’s satisfaction.

WHO concluded that processed meats like hot dogs, bacon, and ham almost certainly increase the risk of colorectal cancer--by 18% per daily serving--and that red meat probably does as well. Dr. Swartzberg explains why that’s not nearly as bad as it sounds. “In fact,” he writes “the increased risk from red or processed meat is ‘small’ for individuals, though potentially important for public health since so many people eat meat.”

While an 18% increase in risk sounds like a lot, it’s really not. That’s because it’s a relative risk. It means in relation to the lifetime risk of developing colorectal cancer, which in the U.S. is about 5%. Swartzberg drives home the point by doing the math:

“An 18% increase does not mean 5% + 18% = 23%, but rather 5% + (18% of 5%) = 6%. That means one extra case of colorectal cancer per 100 meat eaters. In contrast, smoking increases the lifetime risk of lung cancer by roughly 2,000%--from about 1 per 100 people to about 20 per 100.”

The increased cancer risk from eating meat is trivial compared to smoking.

“I don’t think it has been clearly established that meat causes cancer,” Swartzberg adds. “The observational studies upon which the [WHO] classifications were largely based can only find associations—they cannot prove cause and effect.”

Swartzberg does acknowledge that the link between red and processed meat and cardiovascular disease is stronger, but he adds that it’s not clear which compounds in them are the possible culprits.

Dr. Swartzberg’s bottom line is that screening is a “far surer way to reduce the risk of colorectal cancer than tinkering with your diet.”

My Take

I’m with Dr. Mozaffarian that processed meat should be avoided—and red meat should be eaten sparingly.

Carol and I enjoy range fed beef once or twice a month—and processed meat (ham, hot dogs, bacon) once or twice a year, usually on holidays.

It makes sense to me that meat of any kind slows bowel function giving carcinogens—whatever they may be—more time to work their mischief. That can’t be good. It’s all the reason I need to go easy on meat and poultry.

Some vegans put fish in the same category. I don’t buy that, but it does suggest that it’s not a good idea to overload your system with fish. The modest serving of sardines (shown above) included in my breakfast—along with an egg, whole grains, fruit, vegetables, nuts, and organic whole milk—has no effect on my bowel function. If it did I would cut back.

Moderation in all things—including diet—is the ticket to healthy and happy living. I keep that in mind when the dietary zealots come calling.

February 1, 2016

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