We are approaching October 26, a day that was a milestone in nutrition science as it was the day in 2015 that the World Health Organization published an analysis that concluded that processed red meat CAUSED colorectal cancer and was listed as a Class 1 carcinogen.
Another milestone that will be remembered is October 1, this time in 2019. This was the date that a flurry of papers were published providing guidelines on meat consumption.
The headlines erupted and the last two weeks have seen a media frenzy that I participated in with an article even before the publication of the papers. Although I recorded a segment on The Doctors that will air this coming week on the topic, it appears that the tsunami of discussion is winding down and I offer a few thoughts overall to digest on the meat debate.
1. Never before on national news has a journal titled the Annals of Internal Medicine been pronounced the Anals.
It seems fitting for the controversy of the editorial wisdom in publishing these papers.
2. The papers confirmed that reducing and limiting meat intake had health advantages but this was largely buried in the conversation. Overall, an analysis confirmed that a diet low in red and processed meat resulted in a:
13 percent lower all-cause mortality
14 percent lower heart mortality
24 percent lower rate of type 2 diabetes mellitus
10 percent lower cancer rates
11 percent lower cancer mortality
56 percent lower pancreatic cancer mortality
64 percent lower gallbladder cancer incidence
59 percent lower extrahepatic cancer incidence
3. The lead author had industry relations in the near past that were not disclosed in the paper but were later reported in the media.
4. One of the authors of one of the papers was very outspoken in his criticism of the decision to emphasize the uncertainty of the meat science versus the potential protection to the public by advising reduced meat intake. This is unusual for sure.
This author wrote that: "As a co-author of one of papers and a physician, I share the concern that the public may view this series of systematic reviews and meta-analyses and resulting clinical practice guideline as commissioned or endorsed by the American College of Physicians.
"Our review of dietary patterns low in red and processed meat showed associated reductions in the most important outcomes to patients and public health: all-cause mortality, cardiovascular mortality, and cancer mortality.
"Despite this finding, the recommendation from the guidelines paper (of which I was neither a part nor was I invited to review as a co-author of one of the reviews) was that adults continue consuming red and processed meat. I completely oppose this recommendation and worry about the lasting damage to public and planetary health.”
5. One of the senior authors, Gordon Guyatt, a respected scientist, was asked by a journalist after the publications were released about nutrition science.
The response is quite revealing as the priority on analysis over sensible advice:
“I asked Guyatt if doctors can advise people on even something such as whether a salad is healthier than a bowl full of sugar. He said I should tell them that 'the quality of evidence is low, so it depends almost entirely on their preferences'."
Bad for the planet - bad for you
6. The decision by the authors to exclude and analysis of the environmental impact of sustained meat consumption was poorly chosen.
The conclusion of an analysis of the meat guidelines was that 'what is bad for the planet is bad for you'.
7. The hypocrisy of many critics was blatant and instructive as to the challenges of nutrition science.
On the one hand, meat proponents like Nina Teicholz, author of The Big Fat Surprise, praised the articles in an opinion piece that afforded no opportunity for reader comments. She welcomed the data as it emphasized the most rigorous of scientific models, the randomized clinical trial (RCT).
On the other hand, many medical practitioners on TV and social media supported the continued consumption of meat by references to their individual patients and practices, a meaningful observation, but the antithesis of RCTs. The pro-meat camp appeared to be speaking out of both sides of their mouths.
Overall, the vast majority of health experts responded by advising that the guidelines be ignored and continuing efforts to reduce meat intake be advanced. The True Health Initiative, formed by over 500 health scientists and practitioners, called for lower meat intake in view potential to save over 300,000 lives a year and support a healthy planet. I agree.