Slicing The Salami (and calling it steak).

I am taking a brief respite from the 'Loss of Innocence' saga, to excoriate about the publicity for the study about the intake of meats causing Cancer. Much was made of this in the print and broadcast media with precious little criticism or adverse comment from, well anyone. But in truth it was like most of these proselytising studies, that attempt to steer us from the path of our demise by feeding us the results from 'scientific' research that is not really scientific at all.

The study, published in the Archives of Internal Medicine is an observational study, which means it is not presenting any evidence, merely drawing conclusions from data provided by food frequency questionnaire's filled in by the cohort every four years! I can't even remember what I had for dinner last Tuesday, except to know it would have had meat in it; probably lots of it. These epidemiological type studies are really the starting point of a hypothesis to test it's credibility. They are not the end point, merely the beginning of a journey that should encompass all of the checks and balances that science should pursue to ensure that any statement made about anything should at least be founded in proven fact. So, is it likely that the cohort from whom the data was drawn, reported the facts of their diet without telling a few little lies? I really think not, but that's a side issue really.

Let us then look a little deeper. Firstly we see that all meat, processed or otherwise so long as it's red, is alarmingly 'lumped' together, although they do within the study provide some separation of the two and indeed indicate that 'processed' meats are more harmful than other types. But looking further we find that the actual questionnaire lists hamburger meat as 'unprocessed'. You can read about the reliability of Food Frequency Questionnaires here. This highlights the tendency for the cohort to over report socially acceptable foods rather than those they have been 'brainwashed' to reject, but nonetheless still consume. It may also not escaped your attention, that it is the same Institution that also produced this study. Ironic? I could not comment.

So 'hamburger' meat passes for red meat in the US. And to some extent, if you want to give credence to any of this rubbish then remember that the cohort is entirely comprised of US citizens. There is meat, and then there is American meat most of which is 'lot fed' in corrals most of it's life and fed on concentrates of soy protein, cattle corn and antibiotics. It's no longer meat as we know it! Europeans although consuming meat of this type in small amounts, generally eat grass fed beef and lamb, the latter of which is a large part of their 'red meat' diet.  So if this study proves anything (and I don't think it does) it proves that eating US meat and all the other elements of the diet, of those who filled in the Questionnaire, could possibly, maybe, cause Cancer. Of course there are numerous confounding factors that go unreported such as, what other elements of the diet examined might be contributory to the conclusions about Cancer? All of the cohort may have also drunk vast amounts of alcohol or worse, coke! They may have all been drug addicts for all we know, because it is unreported.

Looking then at the science, about the higher reported incidence of Cancer in those who ate lots of processed meats. There is a mechanism that could be responsible, and again it's something that predominates more in the US than Europe or the UK, and that's nitrites. They are an additive used in the preservation of hams, sausages, bacon and continental sausage. Sodium Nitrite (E250) is used to add colour but more to prevent the growth of the bacteria Clostridium Botulinum, the cause of botulism.

When man started to preserve meat, natural sea or rock salt and air drying were the main agents, but as we became frightened of salt and to speed up processing we began using chemicals. Preserving salts today have the addition of 0.6% sodium nitrite or the potassium version to guard against botulism because we now turn around the processing of meats so quickly that it is much more probable, well not really (anymore) but it does make the product nice and pink. Many long matured air dried 'artisan' sausages do not need it and it's a good idea to avoid it if possible. It is not much of a poison the Lethal Dose 50% (LD50) is 71mg per kilo for humans but nitrites form nitrosamines, which are carcinogens, if they are heated in cooking at high temperature. The highly acidic environment of the human stomach can also bring about the same condition. So it is usual, and a legal requirement in the US, to add ascorbic acid (Vitamin C) at 550 ppm to preserved meat or any meat treated with nitrites. The acid inhibits the formation of nitrosamines and in fact the incidence of stomach cancer fell significantly in the US after its addition to preservation methods.

It is a good idea not to roast ham or fry bacon so that it is charred or too crisp, or to limit intake. If one does eat bacon crisp, which is the way most like it, then take a Vitamin C supplement, it helps to prevent Cancer anyway and is rarely harmful. Alternatively eat high quality processed meats that do not have nitrites, although you may have to go to some lengths to find them. Nitrites can also be found in many green vegetables and root vegetables especially, so you do not want to overload on these either. Lettuce, Spinach and Radishes contain the most and a significant proportion of this can be attributed to the use of nitrate fertilisers. The more mature the plant the lower the level of nitrite. Organic vegetables are usually lower in nitrites than those grown by the multinational growing cartels.

A rare result of over consumption can bring about methaemoglobinaemia, which robs the haemoglobin of its oxygen absorption capabilities and causes hypoxia (oxygen starvation). But one would have to consume vast amounts of nitrites for this to come about and most cases are due to other causes. Again an intake of Vitamin C is both the treatment for this rare disorder and is protective against nitrosamine being formed from nitrite ingestion. Most animals produce their own Vitamin C to combat this but a few, including man lost this ability at some time in the evolutionary chain. And to get enough of this vitamin, drinking orange juice will not cut it I'm afraid. Orange juice is flavoured with err... orange flavouring, because natural orange flavour only lasts hours. So, the processors have to add it back to the packs and bottles it comes in, otherwise it's orange water. Man cannot get enough from diet of this vitamin in today's nutritional environment unless we supplement or eat targeted foods high in its content with watercress being one of the best. However, most green leafy vegetables including cauliflower provide substantial amounts, but yes are also high in.....nitrites! Oh, just take a pill!

 So eating preserved meats does have a mechanism that could be causative of some cancers, because it does actually exist, but frankly you would have to eat really large amounts, on a regular basis. And, the bun surrounding the 'unprocessed' burger meat (sic) is likely to be more harmful. And what country is renowned for it's consumption of burgers and barbecued meats? Might that be the country of origin of the cohort of this study, the USA? Always remember, long suffering reader, that observation (and correlation) does not prove causation.

Loss of innocence (part four) continues shortly.

Nullias in Verba

Much has been made of the view that red meat, including processed and preserved meats, causes Colon Cancer, in the press and television this week. The advice from the DH, is that we should reduce our intake to take account of this. This is based on the recommendation of the Scientific Advisory Committee on Nutrition (SACN). But this report is on Iron and Health, so what's that got to do with it? Moreover this report has been in gestation since 1998, yet was only published in February of this year. So it was pretty urgent then?

When you get to the report itself you will see it's pretty long and full of data, all 374 pages of it! But hang on, this report refers back to the Committee On Medical Aspects of  Food and Nutrition Policy called COMA, and is likely what you will get trying to follow this trail! However let's persevere. We then find that data used by the SACN, was that provided by COMA for the survey of the Food Standards Agency (yes, that lot again!). And the data used, was from the 2000/2001 survey. Pretty up to date then!

Now we're getting somewhere! So the report on Iron and Health from the SACN, based on data from COMA via the FSA, from the  2000 National Diet and Nutrition Survey, recommends we reduce intakes of red and processed meat.  OK, but where's the evidence? All the SACN say is, there is a "possible link" between high intakes of this food group and Colerectal Cancer (CRC). This report from the BBC, links the 'scare' to the World Cancer Research Fund data from 2007 and at the same time casts doubt, both on that report and on the evidence both utilised in the compilation of the advice and more importantly that ignored! Nothing like 'cherry picking' the data that supports your preconceptions then?

Most of the information about CRC and meat actually stems from the EPIC report of 2005. This is a longitudinal study and it's fourth from the top of the list with regards to evidence, the Randomised Control Trial being the 'gold standard'. EPIC is also observational and 'observation does not prove causation' as I have said many times before. If you actually look at the data, it can be seen that there are some anomalies, not supporting the view of the authors, of CRC being positively associated with red meat intake (they talk like that in 'science'). In the hazard ratios reported, and 1.00 equals no effect, we see that Italian meat eaters are in fact protected (0.96) and we in the UK have an increase in risk of about 3% (1.03). 

Remembering of  course all of the data is self reported, it is spread across ten EC countries with many different cultures, types of meat with both traditional and modern methods of preservation and cooking, all intermingled with other nutrients. Thus I do find it difficult for any real credence to be given to the view, that meats causes CRC. The authors seem at a loss as well to explain the mechanism, but there is allusion to excessive iron or nitrosamines (from the preservatives) which are carcinogens. I would hazard that they have far too many confounding factors, within the diet of the cohort to draw any real conclusions. There are no details of which meat (beef primarily) was fed on grass, silage or corn and wheat. What you feed to animals is critical to the meat you produce, with considerable difference in the fatty acid constituent as well as micro nutrients. So grass fed Angus Beef, has much higher n-3 than n-6. Omega 3's are said to protective against cancer, and it is certainly better to ensure that the 3's are higher than 6's, both for human intake generally, or in the meat we eat.

Is it likely as well that the meat we have consumed for thousands of years, lamb, beef, pork and game, has suddenly become toxic in the last forty years? Except perhaps by man's intervention in the form of feeding animals unnatural diets, preserving it with various chemicals that were never used  traditionally, or mincing it up with other products. There are I would suggest far too many variables, to have any certainty as to whether meat consumption is the sole positive indicator for CRC.

I am not the only one with a sceptics view of this. From the Netherlands we have a study that has a contrary view. A number of scientists were unhappy about conclusions as can be seen here. This Japanese study found no connection, but also came out strongly in favour of  n-3 as protective. And they were very honest in their interpretations and about the cohort size. I found many studies that did not support the view that red meat caused CRC, but found much that supported the view that processed meat and sausage did have a slight association. So what to believe then for self protection?

Well going back to EPIC, the overall risk was only increased by 1%, which is a small risk, and is not borne out by other studies, or even commonsense. Quality meat with a good content of saturated and other fats enables humans to keep their carbohydrate intake low and their level of satiety high for a given calorific load, without getting fat. To suggest that this is going to give them cancer, when we almost never had any cancers at all when society consumed a diet almost completely of meat is perverse. It is backed by the recorded good health and lack of disease in every study of 'hunter gatherers' undertaken. I posit that any association that has any foundation would be the intake of processed meats from animals that are 'lot fed', steeped in preservatives and cooked in hydrogenated oils. These can usually be found in eatery's with Scottish or Royal elements to their name and that are on every high street in the land.

So what then is the average citizen to make of all this? Constantly harangued to eat this but not that, most of which is changed somewhere down the line and then often reinstated. The bulk of this is not 'scientific' in it's true sense, because most of the research is too poor, inconclusive, or perverse. And for many years directives from Governments and it's Agencies seems to be founded in the view, that the 'proles' are too thick to have any idea of what's best for them. The scientists have held a similar view about the politicians (can't say I blame them).

Scientists in fact, are often dogmatic in their views, even in the face of contrary evidence that bursts the bubble of their hypothesis. They will biasly select that which does not confound a theory and conceal data that does. This is not peculiar just to 'Big Pharma', but to many individuals within science especially medicine, who are prepared to dance to the tune of the master or of their own ill founded dogma, for what ever motivates them. They are intolerant and even abusive to colleagues who are sceptics, about views often held for no other reason than laziness or stupidity. So at the end, we arrive at the beginning; the motto of the Royal Society; it means "on the word of no one". And so it should be.