August 20, 2017
How Bad Is Meat, Really?
Be Well

How Bad Is Meat, Really?

by John Swartzberg, M.D.  |  

When I saw the headlines in October 2015 that meat was linked to cancer, I braced myself for the inevitable brouhaha. The news was that the International Agency for Research on Cancer (IARC), part of the World Health Organization (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.

But we’ve heard about this link many times before. Over the past 20 years, many observational studies have found that people who regu­larly eat red or processed meats have higher rates of several cancers, notably of the colon and rectum. And lab studies have shown that com­pounds formed when meat is processed (that is, smoked, salted, or cured) or cooked at high temperatures can cause cancer in animals or cells. All that research served as the basis of the IARC conclusions. But even in 2007 the World Cancer Research Fund, another key group of experts, concluded that there was “convincing” evidence that these meats increase the risk of colorectal cancer. And since 2002, WHO has advised people to moderate their consumption of processed meat, as did the draft 2015 Dietary Guidelines for Americans. (That advice was unfortunately absent from the final version of the guidelines, released in January 2016.)

What elicited the most heated reaction in the press and blogo­sphere and especially from the meat industry was the fact that the IARC put processed meats in its Group 1—“carcinogenic to humans”—which includes tobacco smoking and asbestos. (It put red meats in Group 2A—“probably carcinogenic.”) The IARC clearly explained that this clas­sification merely indicates the strength of the evidence that something causes cancer, not the degree of risk. In fact, it 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.

What about that 18% increase in risk? The IARC estimated that for every serving of processed meat (just under 2 ounces) or red meat (3½ ounces) eaten daily for years, the lifetime risk of colorectal cancer goes up by about 18%. But this is what’s known as relative risk, which can be misleading. For instance, the lifetime risk of developing colorectal cancer in the U.S. is about 5%. 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. So while IARC may clas­sify both processed meat and smoking as Group 1 carcinogens, there’s no comparison in their risks.

In fact, IARC cited estimates that 34,000 cancer deaths per year worldwide can be attributed to diets high in processed meat. In con­trast, tobacco causes nearly 2 million cancer deaths per year.

I should add that I don’t think it has been clearly established that meat causes cancer. Proving that foods cause or help prevent cancer is difficult for many reasons. Notably, the observational studies upon which the IARC classifications were largely based can only find associ­ations—they cannot prove cause and effect.

That said, there are plenty of other reasons to moderate your intake of red meats and limit processed ones. There’s strong evidence linking them to cardiovascular disease and a variety of other disorders, though it’s not clear which compounds in them are the possible cul­prits. What’s more, eating more plant-based foods and less meat is better for the planet, resulting in less greenhouse gas production.

And there’s a far surer way to reduce the risk of colorectal cancer than tinkering with your diet: Get screened.