Lifestyle as Medicine

We have a great many studies, published in peer-reviewed medical journals, that have found clear and compelling associations between red meat and early death. One of the largest, involving more than 500,000 people, was published in The British Medical Journal on May 9, 2017. In this enormous study, researchers found that consumption of red meat, both processed and unprocessed, was associated with increased risk of death from every one of the specific causes of death they looked at — including cancer, heart disease, stroke and other cerebrovascular diseases, respiratory disease, diabetes, infections, kidney disease, and chronic liver disease. We have an overwhelming body of science telling us that by eating less red meat, people will live longer and healthier lives. What we don’t need are sensationalized headlines that misrepresent the science, and direct people toward eating foods that will clog their arteries, lead to illness and early death, and also damage the health of the planet."

The recommendation that adults continue current red and processed meat consumption is based on a skewed reading and presentation of the scientific evidence... even with this skewed way of presenting the evidence, the reviews clearly indicate the benefits of reducing red and processed meat consumption.

Unfortunately, the leadership of the paper chose to play up the low certainty of evidence by GRADE, as opposed to the protective associations that directly support current recommendations to lower meat intake.

The vast majority of headlines flitting through newsfeeds do not reflect key study details: most showed a small and significant effect of red and processed meat on various health outcomes, for example. They also lack context: a number of results are consistent with the larger body of evidence showing increased risks of various diseases among those consuming a diet with higher meat intakes.

Having seen what a powerful difference a whole foods plant-based diet low in fat and refined carbohydrates can make in people’s lives, these articles deeply sadden me because they will discourage many people from making changes that can transform their lives for the better. While modest reductions in beef may not have had hugely beneficial health effects, eliminating beef and most other animal products can reverse the progression of many chronic diseases. These Annals reports will confuse millions of people into believing that “these damn doctors can’t make up their minds,” countering decades of consistent research showing that a meat-based diet is unhealthful and undermining the public’s confidence in scientific research

The papers come across to me as a concerted attack on dietary guidelines (national and international), on nutrition science in general, and on nutritional epidemiology in particular. The meat industry and its supporters will love them. Attacks on the quality of nutrition research have been coming from many sources lately: the food industry, of course, but also statisticians (John Ioannidis at Stanford is making a career of this), and some scientists (usually with ties to food companies). The criticisms themselves are not new.What is new is the vehemence and level of effort to discredit observational studies, particularly those based on self-reports of dietary intake.

The panel’s blanket recommendation that adults should continue their red meat consumption habits is highly irresponsible. We are facing a growing epidemic of diet-related chronic diseases and a climate change crisis, both of which are linked to high meat consumption. Red meat consumption remains high in economically developed countries and is markedly increasing worldwide. In this context, it is unprecedented and unconscionable for a self-appointed panel to issue dietary guidelines that are tantamount to promoting meat consumption, despite their own findings that high consumption is harmful to health.

The fact that the world health organization has found convincing evidence that processed meat causes cancer in humans, and that red meat is a probable human carcinogen, was not disputed in these new “guidelines.” Rather, the “guidelines” encourage people to continue their exposure to these dangerous products simply because their technically weak meta-analysis methodology was unable to detect sufficient evidence of benefit of avoiding these products that outweighed the study authors’ estimation of how much people like continuing to eat bacon, hotdogs, sausage, and burgers.

The author conclusions in no way support the bold claim made in this release. The authors effectively say: "these papers show that when diet quality, dietary pattern, and what is replacing meat is systematically ignored because we don't have those data- then very small variations in meat and processed meat intake (we mostly were unable to say which) are apparently associated with small differences in health outcomes- in the expected direction, but with extreme lack of certainty because of the data problems noted above. None of these papers report on 'good health.' They all compare rates of mortality, cardiometabolic disease, and cancer. "No Change" in such outcomes does not mean good health; it means there's more than one way to get the same, bad health.

We should note that these are primarily health researchers conducting these reviews and they are using terms to assess bias and certainty as if they are systematically reviewing pharma drug trials to determine the effect of a synthetic compound in pill form. The method does not translate to data on dietary patterns.

The approach the authors have taken is: You study cohorts that you class as low GRADE ( Guyatt). You get results You say the studies are low GRADE and therefore of no consequence. Then you come to your own irresponsible conclusions ( climate change??) You feel justified in doing so on the basis of GRADE (despite your all cause mortality cvd, diabetes and cancer findings- a full house of evidence against meat!