Health Journal Online

Tag: Processed

  • How Big Is the Cancer Risk from Processed Meat?

    How Big Is the Cancer Risk from Processed Meat?

    I quantify the risks of colon and rectal cancers from eating bacon, ham, hot dogs, sausage, and lunch meat.

    In 2018, arguably the most prestigious cancer research institution in the world, the International Agency for Research on Cancer (IARC), part of the World Health Organization, published its report on processed meat, concluding that foods like bacon, ham, hot dogs, lunch meat, and sausage are cancer-causing, classifying processed meat as a Group 1 carcinogen. “These findings,” concluded the director of the agency, “further support current public health recommendations to limit intake of meat.” Critics questioned putting processed meat in the same carcinogenic classification as asbestos and tobacco. Or, as a pesticide company roughly put it, how can eating processed meat be in the same category as mustard gas?

    As I discuss in my video How Much Cancer Does Processed Meat Cause?, the classifications only relate to the strength of evidence that the agent causes cancer or not, not how much cancer. This doesn’t mean they all pose the same level of danger. It’s safer to eat a sandwich filled with pastrami than plutonium, even though they are both Group 1 carcinogens, which means both substances are known to cause cancer in people. So, just how dangerous is meat? The relative risk of colorectal cancer was 18% for every 50 grams eaten a day. But what exactly does that mean?

    Well, 50 grams is about one hot dog, or two breakfast links, or two slices of Canadian bacon or ham. So, a daily sandwich with one or two slices of baloney would increase your colorectal cancer risk by 18%. But a half-pound of pastrami on rye would bump it up more like 80%. Okay, but what does the 18% increased risk really mean? One way to look at it is absolute risk versus relative risk. Assuming that the lifetime risk of colorectal cancer is about 5% (1 in 20), increasing your risk by about 20% would only bump up your absolute risk of getting colorectal cancer from 5% to 6%. Now, on a population scale, an 18% drop in risk could mean about 25,000 fewer cases of colorectal cancer every year in the United States, 25,000 fewer families a year dealing with that diagnosis, if we swapped out the daily baloney sandwich for hummus or if we chose veggie dogs instead. So, it all depends on how you look at it.

    Colorectal cancer is the United States’ second leading cause of cancer death for men and women combined, after lung cancer. So, if you don’t smoke, colon and rectal cancer may be your greatest cancer nemesis. But we can drop the risk of getting it by about a fifth with a single dietary tweak: cutting a serving of processed meat out of our daily diet.

    How does 18% increased cancer risk compare to other risky behaviors? In my testimony before the Dietary Guidelines Scientific Committee, I made what may sound like a hyperbolic metaphor. I asked, “We try not to smoke around our kids, why would we send them to school with a baloney sandwich?” That is not hyperbole. According to the Surgeon General, living with a smoker increases our risk of lung cancer by 15%. So, breathing second-hand smoke day in and day out increases our risk of lung cancer almost as much as eating a serving of processed meat day in and day out increases our risk of colorectal cancer.

    The meat industry responded by saying that we must consider the risks together with the benefits before we tell people what to eat or breathe. Think about all the baloney benefits—lunch meat isn’t just about cancer, but convenience.

    Indeed, processed meat isn’t just about cancer. An article railing against the World Health Organization’s “meat terrorism” cited the Global Burden of Disease studies comparing how many cancer deaths are caused by processed meat consumption compared to tobacco or alcohol use. But if you look at the study they’re referencing, the roughly 37,000 deaths attributable to higher processed meat intake are just the colorectal cancer deaths and don’t also include the 100,000 deaths from diabetes or the 400,000 deaths from heart disease. So, in actuality, we may be talking about half a million deaths attributable to processed meat, as you can see below and at 4:06 in my video.

    And it’s not just colon and rectal cancer. If you look at the science since the IARC decision was published, processed meat may also increase the risk of prostate cancer, breast cancer, and pancreatic cancer.

    Unfortunately, research shows that “despite growing public health concerns about processed meat consumption, there have been no changes in the amount of processed meat consumed by US adults over the last 18 years.” Of course, it would have helped if the last Dietary Guidelines for Americans had happened to mention that processed meat was a carcinogen. Publishing “an explicit and science-based statement on processed meat” in the next Dietary Guidelines would certainly help. But the scientific committee made no such recommendation.

    Sadly, even those with colorectal cancer “hardly improve their overall lifestyle after diagnosis,” though that may be because “70% of cancer patients have never received nutrition advice from their [medical] providers during or after treatment.” That just blows me away.

    An article published in a scientific cancer-research journal stated that “despite the continued obfuscation of the issue by the meat industry—they learned well from the tobacco merchants—meat should continue to be a focus of public health action.” New York City is leading the way, passing legislation to ban processed meats from school meals. Not giving our kids carcinogens? What a concept!

    Meanwhile, the processed meat industry is trying to reformulate its products. It’s kind of like in the pharmaceutical area, where you try to mitigate the potential adverse effects of one drug by prescribing an additional drug. For example, fiber could be added to hot dogs to try to counterbalance the risk, potentially reducing the cancer load by changing how it’s processed instead of by banning processed meat altogether.

    Doctor’s Note

    If you missed the previous video, see IARC: Processed Meat Like Bacon Causes Cancer.

    For my full testimony on the U.S. Dietary Guidelines, check out Highlights from the 2020 Dietary Guidelines Hearing.



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  • Does Processed Meat Affect Our Lung Function? 

    Does Processed Meat Affect Our Lung Function? 

    If the nitrites in foods like ham and bacon cause lung damage, what about “uncured” meat with “no nitrites added”?

    “Recently, the World Health Organization (WHO) classified processed meat as carcinogenic to humans.” Also known as cured meat, such as bacon, ham, hot dogs, lunch meat, and sausage, processed meat is definitively cancer-causing. What’s more, “high processed meat consumption has also been associated with increased risk of all-cause mortality”—that is, dying prematurely from all causes put together—“and is a risk factor for several major chronic diseases, such as type 2 diabetes, coronary heart disease, and stroke.” What about lung issues like asthma?

    As I discuss in my video Does Processed Meat Affect Our Lung Function?, nitrites are added to processed meats as preservatives to preserve their pink hue (so the meat products don’t turn gray), keep them less rancid-tasting, and prevent the growth of diseases like botulism. But, if that same sodium nitrite is put into the drinking water of lab animals, they develop emphysema. Nearly all of them develop emphysema. That was the extent of the scientific knowledge we had on the subject going into 2007, then this study was published: “Cured Meat Consumption, Lung Function, and Chronic Obstructive Pulmonary Disease Among United States Adults.” It found that frequent consumption of cured meat is associated with an increased risk of people developing diseases like emphysema, a form of chronic obstructive pulmonary disease (COPD). As you can see below and at 1:32 in my video, eating it every other day appeared to triple the odds of severe COPD. 

    Since it was a snapshot-in-time study, we don’t know which came first, the sausage or the COPD. For that, we need prospective studies that follow people over time, and the big twin Harvard studies in women and men both found that “the risk of newly diagnosed COPD increased with a greater consumption of cured meats after adjustment for many important confounders.” 

    We now have studies involving hundreds of thousands of people showing that higher consumption of processed meat is associated with a 40 percent increased risk of COPD. It comes out to about an 8 percent higher risk of COPD for each hot dog eaten in a week or each weekly breakfast link sausage. What is going on?

    Yes, there are advanced glycation end-products (AGEs), so-called glycotoxins that “occur naturally in meat and are formed through heat processing,” that may be pro-inflammatory, as well as saturated fat that can also trigger inflammation in the airways. And there’s the high salt content that can present a potential risk for lung inflammation, and the suggestion that processed meat intake may increase systemic inflammation in general. However, the reason attention has focused on the nitrites is because nitrites themselves may be “one of the mechanisms by which tobacco smoke causes COPD” and other diseases like emphysema. “Cured meats are the principal source of dietary nitrites,” but “nitrites are also byproducts of tobacco smoke.” One of the main constituents in cigarettes, besides carbon monoxide and nicotine, are nitrogen oxides that are converted in the lungs to nitrites.

    The way nitrites appear to cause lung damage is by affecting connective tissue proteins like collagen and elastin, which are what help keep the airspaces in our lungs open. But nitrite can modify these proteins in ways that “mimic age-related damage, including elastin fragmentation.”

    With that much lung injury, it’s logical to assume that processed meat consumption could also exacerbate the disease of those who already have it. And, indeed, cured meat consumption increases the risk of people with COPD ending back in the hospital; those eating more cured meat on average have about twice the risk of readmission. It appears the more you eat, the worse it is, as seen here and at 3:56 in my video.

    “Regarding lung health, processed meat intake has been associated with a likely increased risk of lung cancer, decline in lung function and chronic obstructive pulmonary diseases (COPD),” but what about asthma? High consumption of processed meat has also been “associated with higher asthma symptoms.” 

    We know that “higher maternal intake of meat before pregnancy may increase the risk of wheezing” in her children later on, based on a study of more than a thousand mother-child pairs. (And we aren’t talking about aspirating meat into our lungs and getting misdiagnosed with asthma.) In fact, “those who ate the most cured meats were 76% more likely to experience worsening asthma than those who ate the least.” Since obesity is a likely risk factor for asthma, might meat’s influence be indirect, by contributing to weight gain? That may be a small part of it, but the main effect appears to be direct, “suggesting a deleterious role of cured meat independent of BMI,” body mass index, a weight measurement. Put all the studies together, and “processed meat intake appears to be an important target for primary prevention of adult asthma.”

    Even if you don’t have any lung issues, processed meat consumption was negatively associated with measures of normal lung function, while fruit and vegetable consumption and dietary total antioxidant capacity were associated with better lung function.

    Can we just eat all-natural, uncured hot dogs, with “NO NITRATES OR NITRITES ADDED,” like these see here and at 5:35 in my video? 

    If you use a magnifying glass and peer at the small print, it says “except those naturally occurring in sea salt and cultured celery juice.”

    See, to avoid saying “added nitrites,” food manufacturers may add something that has a lot of nitrates, like celery, and also bacteria, “a starter culture to convert the nitrate to nitrite.” So, nitrites are being added and consumers are being duped.

    The European Union doesn’t allow this kind of consumer fraud and “considers the use of plant extracts containing high levels of nitrate with an intended technological purpose of preservation to be a deliberate use of a food additive,” and manufacturers must explicitly label their products as “containing nitrate or nitrite.” You can’t even call it natural. “In the European Union, ‘natural’ claims are also not permitted….”

    When Consumer Reports put it to the test, it found the nitrite levels in all the products were essentially the same, so “‘no nitrites’ doesn’t mean no nitrites.” Consumer Reports and the Center for Science in the Public Interest have petitioned the U.S. Food Safety and Inspection Service of the Department of Agriculture to stop this misleading practice. Nitrites are nitrites, and “their chemical composition is absolutely the same, and so are the health effects.”

    Yes, processed meat is a known carcinogen, but How Much Cancer Does Lunch Meat Cause? 

    I have many videos on both nitrites and nitrates. I know it can be confusing, so be sure to check them out. 



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  • Processed Foods and Obesity 

    Processed Foods and Obesity 

    The rise in the U.S. calorie supply responsible for the obesity epidemic wasn’t just about more food, but a different kind of food.

    The rise in the number of calories provided by the food supply since the 1970s “is more than sufficient to explain the US epidemic of obesity.” Similar spikes in calorie surplus were noted in developed countries around the world in parallel with and presumed to be primarily responsible for, the expanding waistlines of their populations. After taking exports into account, by the year 2000, the United States was producing 3,900 calories for every man, woman, and child—nearly twice as much as many people need. 

    It wasn’t always this way. The number of calories in the food supply actually declined over the first half of the twentieth century and only started its upward climb to unprecedented heights in the 1970s. The drop in the first half of the century was attributed to the reduction in hard manual labor. The population had decreased energy needs, so they ate decreased energy diets. They didn’t need all the extra calories. But then the “energy balance flipping point” occurred, when the “move less, stay lean phase” that existed throughout most of the century turned into the “eat more, gain weight phase” that plagues us to this day. So, what changed?

    As I discuss in my video The Role of Processed Foods in the Obesity Epidemic, what happened in the 1970s was a revolution in the food industry. In the 1960s, most food was prepared and cooked in the home. The typical “married female, not working” spent hours a day cooking and cleaning up after meals. (The “married male, non-working spouse” averaged nine minutes, as you can see below and at 1:34 in my video.) But then a mixed-blessing transformation took place. Technological advances in food preservation and packaging enabled manufacturers to mass prepare and distribute food for ready consumption. The metamorphosis has been compared to what happened a century before with the mass production and supply of manufactured goods during the Industrial Revolution. But this time, they were just mass-producing food. Using new preservatives, artificial flavors, and techniques, such as deep freezing and vacuum packaging, food corporations could take advantage of economies of scale to mass produce “very durable, palatable, and ready-to-consume” edibles that offer “an enormous commercial advantage over fresh and perishable whole or minimally processed foods.” 

    Think ye of the Twinkie. With enough time and effort, “ambitious cooks” could create a cream-filled cake, but now they are available around every corner for less than a dollar. If every time someone wanted a Twinkie, they had to bake it themselves, they’d probably eat a lot fewer Twinkies. The packaged food sector is now a multitrillion-dollar industry.

    Consider the humble potato. We’ve long been a nation of potato eaters, but we usually baked or boiled them. Anyone who’s made fries from scratch knows what a pain it is, with all the peeling, cutting, and splattering of oil. But with sophisticated machinations of mechanization, production became centralized and fries could be shipped at -40°F to any fast-food deep-fat fryer or frozen food section in the country to become “America’s favorite vegetable.” Nearly all the increase in potato consumption in recent decades has been in the form of french fries and potato chips. 

    Cigarette production offers a compelling parallel. Up until automated rolling machines were invented, cigarettes had to be rolled by hand. It took 50 workers to produce the same number of cigarettes a machine could make in a minute. The price plunged and production leapt into the billions. Cigarette smoking went from being “relatively uncommon” to being almost everywhere. In the 20th century, the average per capita cigarette consumption rose from 54 cigarettes a year to 4,345 cigarettes “just before the first landmark Surgeon General’s Report” in 1964. The average American went from smoking about one cigarette a week to half a pack a day.

    Tobacco itself was just as addictive before and after mass marketing. What changed was cheap, easy access. French fries have always been tasty, but they went from being rare, even in restaurants, to being accessible around each and every corner (likely next to the gas station where you can get your Twinkies and cigarettes).

    The first Twinkie dates back to 1930, though, and Ore-Ida started selling frozen french fries in the 1950s. There has to be more to the story than just technological innovation, and we’ll explore that next.

    This explosion of processed junk was aided and abetted by Big Government at the behest of Big Food, which I explore in my video The Role of Taxpayer Subsidies in the Obesity Epidemic.

    This is the fifth video in an 11-part series. Here are the first four: 

    Videos still to come are listed in the related videos below.



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  • FDA Wants To Further Reduce Salt Levels In Packaged, Processed Food

    FDA Wants To Further Reduce Salt Levels In Packaged, Processed Food

    The U.S. Food and Drug Administration has announced a milestone in its voluntary sodium reduction program by completing the Phase I target and issuing draft guidance for Phase II. In this next phase, the FDA plans to further reduce sodium levels in packaged and processed food by 20%, to bring the average intake to about 2,750 milligrams per day.

    According to the U.S. Dietary Guidelines, a person should not consume more than 2,300 milligrams of sodium per day, which is about one teaspoon of salt. The FDA launched its sodium reduction program in 2021, setting a 2.5-year target. The goal for Phase I was to lower the average daily sodium intake from 3,400 milligrams to 3,000 milligrams.

    High sodium intake is linked to health issues such as increased blood pressure, a major risk factor for heart disease and stroke. Studies have shown that reducing sodium intake could prevent hundreds of thousands of premature deaths and illnesses. However, to effectively lower sodium consumption, changes need to be made in the food supply itself, as more than 70 percent of sodium comes from processed and prepared foods.

    “Reducing sodium in the food supply has the potential to be one of the most important public health initiatives in a generation. The early successes we’re seeing with sodium level reduction in certain foods is encouraging and indicative of the impact we believe our overall nutrition approach can have on the wellbeing of society,” FDA Deputy Commissioner for Human Foods Jim Jones said in a news release.

    Phase II will continue to target sodium levels in commercially processed, packaged, and prepared foods in the marketplace.

    “In addition to our sodium reduction efforts, the FDA is also actively working on a forthcoming final rule updating the definition of the claim ‘healthy,’ a proposed rule for front-of-package nutrition labeling and exploring ways to reduce added sugars consumption. The FDA’s sodium reduction and other nutrition initiatives are central to a broader, whole-of-government approach to help reduce the burden of diet-related chronic diseases and advance health equity,” Jones added.

    The American Heart Association (AHA) advises limiting sodium intake to no more than 2,300 milligrams per day, with an ideal limit of 1,500 milligrams for those with high blood pressure. They suggest that reducing daily sodium intake by 1,000 milligrams can significantly improve blood pressure and heart health.

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