According to a new review of current evidence regarding the adverse health outcomes of eating red and processed meats, a panel of fourteen members of an international team have concluded that there are no health reasons to cut down on the consumption of these foods. A controversial finding and one that needs exploring.
Prior to discussing their report, I would like to set out the current guidelines on red and processed meat consumption set out by the World Health Organisation (WHO), the NHS and the British Dietetic Association (BDA), as well as recommendations from the World Cancer Research Fund (WCRF). Red meat is classed as beef, lamb, pork, venison, veal, goat; processed meat as meat that has been preserved by smoking, salting, curing or adding preservatives, such as bacon, ham, sausage, pate).
WHO – There is sufficient evidence to class processed meat as cancer causing and red meat as probably cancer causing. The strongest evidence associates red meat with an increased risk of colorectal cancer but also pancreatic and prostate. Processed meat has been classed as “carcinogenic” since 2015. NHS – If you eat more than 90g per day, reduce to 70g: this is equivalent to about 3 slices of ham, or 1 sausage and 1 rasher of bacon BDA – recommendations are in line with NHS guidelines, along with additional guidelines for sustainability which take into account the effects of red meat consumption on the environment. They therefore recommend reducing intake but ensuring it is replaced by suitable plant-based sources. WCRF – the recommendation is to cut out processed meat altogether and keeping red meat intake to no more than three portions weekly.
Current guidelines are the result of over thirty years of thorough research and all the organisations above continue to recommend reducing red and processed meat intakes and that there is an increased risk of developing bowel cancer and possibly other cancers with intakes above 70g per day.
The panel responsible for the new report claim that current recommendations are based on observational studies which are at high risk of bias and which cannot show cause and effect. They also state that those producing current guidelines did not thoroughly review the evidence. They claim that they have produced “rigorous evidence-based nutritional recommendations” following systematic reviews of the current evidence. However, when you look at who makes up the panel of fourteen, alongside health care professionals there are three members “outside the medical and healthcare communities”, which essentially means three members of the public. It is not stated who these community members are, whether they are meat eaters or non meat eaters and how they were selected to join the panel, only that they were contacted and excluded if they had “financial or intellectual conflicts”
The panel states that current evidence showing adverse health outcomes of eating red and processed meats is weak. It is true that nutrition studies are notoriously hard to conduct due to a range of factors, such as participant compliance with the diet, errors in self-reporting, sample sizes and availability of participants for follow up. It is also very difficult to conduct trials which give high quality evidence of cause and effect. However, when you look at the trials the panel were able to review and reference, they were only able to discuss one trial – The Women’s Health Initiative and this did no specifically focus on reducing red and processed meat intake. The main focus was the effects of a low fat diet, and the high fat foods they were looking to reduce included, amongst others, dairy, nuts and oils as well as red meat. In addition the serving size of red meat between the intervention group and the control only differed by 1.4 servings per week, hardly a significant amount.
A major omission by the panel was the effects of red meat consumption on the environment. In fact, they admit that they did not consider animal wellfare and environmental issues and that therefore their recommendations do not apply to those wanting to reduce their red meat intake for environmental reasons. This is a major factor for many people who are concerned about the fact that the production of red meat is responsible for about two thirds of greenhouse gas emissions, as well as deforestation and that a significant reduction is needed to tackle climate change.
The panel go as far as to state that there may be health benefits of eating meat in comparison to non meat eaters on outcomes such as muscle development and anaemia. What they are alluding to here is that by reducing or cutting out red meat, people are depriving themselves of protein and iron sources. However, there are many many plant based alternative sources of protein and iron and there would be no adverse effects on muscle development or iron levels in the body with a well planned vegetarian/vegan diet.
The panel admit to several limitations of their report, such as cooking methods (ie baking versus frying) could not be determined, in addition to other dietary factors aside from meat intake. Not all members of the panel agreed to the recommendations; 3 out of the 14 (21%) disagreed and wanted to recommend reducing red and processed meat consumption. They also state that their report may be “excessively pessimistic”.
While it is true that much of the evidence surrounding adverse health outcomes on red and processed meat consumption is weak, actively encouraging people to continue with their consumption of these foods is dangerous and goes directly against current recommendations. Ongoing research is needed and in fact, results from the European EPIC study, which was published after the studies reviewed in this report, provides further evidence for the benefits of reducing red and processed meat consumption. The Physicians Committee for Responsible Medicine have filed a petition with the Federal Trade Commission to correct the “false statements” in the report, claiming that there is an abundance of evidence linking red and processed meat consumption to an increased risk of heart disease and colorectal cancer and that those who decide to follow the panel’s “dangerous” advice could be caused physical harm.
In summary, I believe that the evidence remains sufficient to continue the current recommendations of reducing red and processed meat intake to 70g or less per day and that it is beneficial to replace it with non processed forms of plant-based proteins, such as nuts and seeds, pulses and legumes (such as chickpeas, lentils, red kidney beans, peanuts and peanut butter), grains (such as brown rice/pasta, wholemeal bread, quinoa, pearl barley).