Sorting Out Confusion Over Meat and Cancer Risk
Pamela A. Popper, Ph.D., N.D.
Wellness Forum Health
In 2015, the World Health Organization’s International Agency for Research on Cancer (IARC) issued a report stating that processed meats raise the risk of colon and stomach cancer, and most likely red meat increases the risk too. Red meat refers to foods like beef, veal, pork, lamb, mutton, horse, and goat. Processed meat refers to any animal flesh that has been salted, cured, fermented, smoked or been processed in a way that enhances flavor or presentation.
The IARC charged 22 researchers with evaluating over 800 studies looking at the relationship between various types of meat and 12 types of cancer during the last 20 years. The researchers reported that processed meat was a Group 1 carcinogen and that for every 50 gram portion (1.7 ounces) of processed meat consumed daily, the risk of colorectal cancer increased by 18%. This places processed meats in the same category as smoking and asbestos.
Red meat was reported as “probably carcinogenic to humans” (Group 2A) based on “limited evidence that the consumption of red meat causes cancer and strong mechanistic evidence supporting a carcinogenic effect.” Red meat, according to the IARC, is “probably” linked to colon, prostate, and pancreatic cancers.
The researchers noted that the increased risk of colorectal cancer due to processed meats remains small, but that risk increases with intake – a dose-dependent effect. The researchers also reported that “…red meat has nutritional value. Therefore these results are important in enabling governments and international regulatory agencies to conduct risk assessments in order to balance the risks and benefits of eating red meat and processed meat and to provide the best possible dietary recommendations.”
A flurry of articles and comments followed the report and the news stories about it. Advocates of plant-based diets stated that this report is proof positive that people should eat no meat, no animal foods, and adopt a vegan diet. As expected, agricultural groups, food manufacturers, lobbyists, and promoters of bad diets capitalized on statements such as “…red meat has nutritional value…” and the use of term like “probably” and “small increase in risk,” to reassure carnivores that it really is ok to eat a diet that includes copious amounts of animal food.
The North American Meat Institute issued a statement saying that “…cancer is a complex disease not caused by single foods.” The organization is actually right about this; the totality of the dietary pattern determines health.
Gunter Kuhnle, a food nutrition scientist at the University of Reading said that “Three cigarettes per day increases the risk of lung cancer sixfold, or 500%, compared with the 18 percent from eating a couple of slices of bologna a day. This is very relevant from a public health point of view…But it should not be used for scaremongering.”
John Ioannidis, chairman of disease prevention at Stanford University commented, “I think it’s very important that we don’t terrorize people into thinking that they should not eat any red meat at all. There’s some risk involved, but it’s much less than smoking or alcohol. I think it would be an exaggeration to say based on this that no one should be eating red or processed meat.”
Both sides are wrong about this issue. Advocates of vegan diets exaggerate the risk of eating any animal foods at all in order to justify recommending a vegan diet for everyone, ignoring the fact that all over the world, the populations we all love to refer to as eating optimally and enjoying optimal health are not vegans. They propose an all or nothing solution – either eat a vegan diet or your risk of cancer will be high.
Advocates of animal foods-based diets ignore the fact that people don’t eat pristine, optimal diets with 2 slices of bacon each day. Most people eat terrible diets with much if not most of their calories from animal foods, oils, and processed foods. The cumulative effect of all the bad choices is what causes disease, not the 2 slices of bacon alone.
The bottom line is that dietary choices individually have little meaning. It is the overall dietary pattern that matters most. A person eating a Wellness Forum Health-style diet that includes 2-3 servings of organic animal food or wild caught fish each week, and who has a hot dog on Memorial Day is likely to have a long and healthy life. The vegan who eats no animal food, never touches hot dogs, but eats potato chips, uses oil in cooking, carries extra body fat and does not exercise, is likely to have health issues.
The debate will continue and, just as in politics, the extreme stance of both sides confuses the public and stands in the way of progress.
Bouvard V, Loomis D, Guyton K et al. on behalf of the International Agency for Research on Cancer Monograph Working Group. “Carcinogenity of consumption of red and processed meat.” Lancet Oncology December 2015;16(16):1599-1600
Angela Charlton. “Study: Meats increase risk of cancer.” Columbus Dispatch Oct 27 2015
Anahad O’Connor “Meat Is Linked to Higher Cancer Risk W.H.O. Report Finds.” New York Times Oct 26 2015
Does Intuitive Eating Work?
Pamela A. Popper, Ph.D., N.D.
Wellness Forum Health
The failure rate for weight loss programs – all of them – is very high. Frustrated, overweight and obese people who want desperately to be normal weight enroll in or adopt program after program, hoping for better results, but ending up getting nowhere, or even gaining more weight instead of losing.
Studies can appear to make some programs “work” because most are short-term, and almost anything will work in the short term. Tens of millions of Americans have been successful for 21 day, 30 days, or 90 days at a diet program, or several diet programs, but have not figured out how to change their lives.
Enter intuitive eating, a diet philosophy that teaches people how to develop a healthy relationship with food. So far so good; most overweight people do not have a healthy relationship with food. Proponents rightly state that diets don’t work and that in order to succeed, people should avoid dieting and instead learnt o listen to their body’s cues since”…you were born with all the wisdom you need for eating intuitively.” Participants are taught to “trust themselves” and to “make peace with food” which involves several principles. One is that that you should not tell yourself that any food is forbidden since doing so will “…lead to such intense feelings of deprivation that build into uncontrollable cravings, and often bingeing.” This leads to overeating and guilt. Another principle is to “Challenge the Food Police” who have made the “unreasonable rules” that have led to dieting failure. Overweight people are encouraged to “…eat what you really want in an environment that is inviting and conducive” which will lead you to the place where less food is needed in order for you to have “enough.”
Best-selling books have been written about the concept, health coaches advertise that they specialize in teaching intuitive eating concepts, but there is little research to back up the claims. The “evidence” consists mostly of people telling their stories of failing at dieting and finding “success’ which is usually not measured or quantified in any way, with intuitive eating. Again, almost all programs work in the short-term, and almost all programs, no matter how bad they are, produce a few people who succeed.
What further makes analysis of diet plans confusing and somewhat useless is that they often compare programs that are ineffective with one another, and then declaring that one terrible program is better than the others. The general public and even some health professional don’t necessarily realize this, and conclude that a certain diet is actually superior and “works.”
Such is the case with a small study published in 2015 that compared calorie restricted diets with intuitive eating. Sixteen obese and sedentary men and women were assigned to eat either a diet with 1200-1800 calories (the amount depended on the individual’s metabolic rate), which represented an average reduction of 500 calories per day; or to practice intuitive eating. The intuitive eaters were not given calorie intake targets. All participants were instructed to exercise only in the lab three times per week to avoid increased physical activity, which often accompanies starting a new diet program, from influencing the results. At three weeks and six weeks, participants received additional counseling and encouragement.
At three weeks, the participants eating the restricted calorie diet had lost about 5.3 pounds, and the intuitive eaters had lost slightly more. But at six weeks the restricted calorie eaters had lost an additional 2.5 pounds, while the intuitive eaters had regained their weight. Some were heavier at the end of the 6 weeks than they were before they started.
Since studies have shown that calorie counting and calorie restriction do not result in permanent weight loss for most obese people, this study says more about the lack of efficacy for intuitive eating than how effective calorie restriction is.
People do like to hear good news about their bad habits, so it is not surprising that many overweight people love this program. The idea that eating cinnamon scones in an inviting and conducive setting, combined with no “rules” to guide the eating pattern is very attractive. Intuitive eaters have no dietary guidelines – they just listen to their bodies and eat what they want. If I did that I’d weigh 300 pounds. I want cinnamon scones!
There are many reasons why intuitive eating cannot work. While some people don’t want to hear this, there really are good and bad foods and good and bad dietary patterns. Cow’s milk was designed to help a baby cow grow from 90 pounds to 800pounds in less than a year. It’s a bad food for people who want to be lean (or to avoid chronic infections, breast and prostate cancer, autoimmune diseases, constipation, acne and a host of other conditions). Eating cheese, no matter how inviting or conducive the environment is, will not result in optimal health.
Another issue is that in order to be successful at weight loss or health improvement, prescriptive communication is required. In addition to its dietary guidelines not being science-based, the USDA’s recommendations are delivered with instructions that are so vague as to allow almost anything. “Eat less saturated fat” and “keep sodium low” and “enjoy your food but eat less” “choose whole grains more often” and “Cut back on some foods” are difficult to follow. Terms like “less” and “cut back” mean different things to different people. People tend to interpret them to favor their dietary preferences, and also because they do not know and have never been taught the principles that guide healthful eating.
Prescriptive communication involves giving people directions that are understandable, clear, and actionable. “Eliminate dairy,” “no oils,” and “treats are for holidays and birthdays” are clear directives. Admittedly, these are not as popular as telling people to essentially eat anything the intuit that their bodies want at a certain point in time, but we have never been driven by a desire to tell people what they prefer to hear, or to publish garbage that panders to the public in order to sell books or programs.
So the bottom line is that there is a specific diet that promotes health and ideal weight for humans, just as there is a specific diet for all other creatures on the planet. Intuitive eating is a diet plan presenting itself as a “non-diet” that does not work.
Anglin J, Borchard N< Ramos E, Mhoon K. “Diet quality of adults using intuitive eating for weight loss – pilot study.” Nutr Health Jul 2013;22(3-4):255-264
By Pamela A. Popper, Ph.D., N.D.
Tai Chi means “Grand Ultimate” in Chinese, and the practice is based on the balance between light and dark, stillness and movement, and other phenomena in the natural world. It is practiced as both a martial art and a form of meditative movement, and the meditative movement type is recommended for healing, stress reduction, and improved quality of life.
One of the best therapeutic uses of Tai Chi is for Parkinson’s patients. A growing number of studies show that Tai Chi can improve balance and significantly reduce the number of falls with just 3 sessions per week. Early-stage Parkinson’s patients should start practicing while they are still ambulatory as a means for postponing disability as long as possible. Combined with dietary change, Parkinson’s patients can remain independent for much longer periods of time, which improves their quality of life and the quality of life of their family members too.
A study of 266 older adults with both hypertension and other risk factors such as high cholesterol and high blood sugar levels showed that participating in Tai Chi classes resulted in several positive changes including reduced blood pressure, lower body mass index, and improved health-related quality of life. The classes did not improve fasting blood sugar levels, cholesterol levels or metabolic syndrome, and the authors wrote that future research should look at “…a combination of Tai Chi and nutritional intervention to further reduce the level of biomedical risks.”
Another group that benefits from Tai Chi practice is rheumatoid arthritis patients. Several studies have shown benefit, but one study showed that in just 12 weeks, patients had improved lower limb function, improved overall physical function, better balance and less pain during exercise and daily life, lower stress, increased body awareness and more confidence in moving in general.
Tai Chi is an accessible form of exercise for most people, and can be an excellent first step toward becoming physically active (particularly for those who have diseases that have resulted in impaired function), or an excellent addition to an exercise program.
Sun J, Buys N. “Community-Based Mind–Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension.” Am J Cardiol October 1 2015;116(7):1076-1081
Gao Q, Leung A, Yang y. et al. “Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial.” Clin Rehabil 2014 Feb 11;28(8):748-753
Uhlig T, Fongen C, Steen E, Odegard S. “Exploring Tai Chi in Rheumatoid Arthritis: A Quantitative and Qualitative Study.” BMC Fam Prac 2010;11:43
By Pamela A. Popper, Ph.D., N.D.
Studies consistently show that overweight and obese children have a very high risk of remaining overweight or obese throughout adulthood. Studies also show that people find it very difficult to lose weight and keep it off, which means that while we must continue to look for methods that are effective for weight loss in overweight and obese adults, we also must work at preventing weight gain in children.
Poor dietary habits leading to weight gain often begin early in childhood, and a recent meta-analysis looked at the various factors that contribute to this weight gain. The analysis included 20 studies from the U.S., Europe, and Australia with 1067 participants. Several consistent themes were identified.
The first was that children’s taste preferences, attitudes toward food, and likes and dislikes often determined the foods given to them. Parents of fussy eaters tended to give children what they wanted to eat, but also described strategies that could help children to make better choices, such as negotiation, repeated exposure to healthy food and encouraging children to help with food preparation. I am compelled to comment here; negotiating with preschool-aged children about food, bedtimes, behavior, or anything else is inappropriate – very young children are not equal partners with their parents in making these types of decisions. Some likes and dislikes can be considered, but one way to get children to eat better foods is to serve them and to offer no other alternatives. When they get hungry, they will eat!
Another factor that consistently affected food choices was modeling behavior. Parents, and other family members and peers influenced children’s dietary choices, and parents who preferred fast food and packaged foods admitted that this stood in the way of healthier choices for their children.
Parents’ lack of knowledge about nutrition, lack of support, and lack of cooking skills were an issue. Additionally, parents tended to be more concerned about their children being underweight than overweight and overweight parents tended to have inaccurate perceptions of their children’s weight status.
Lack of time was often an issue and parents stated that they felt that they often had to make a choice between healthy eating and facilitating their children’s activities. Parents also reported resorting to fast food because they worked long hours and did not have time to cook.
Financial considerations influenced food choices, and most studies reported that participants could not afford to purchase healthy food and thought that healthy food was more expensive than unhealthy foods. Many stated that healthier foods should be cheaper and some said that healthy foods should be subsidized by the government.
Ten studies reported using unhealthy foods as reward for good behavior. This is a common practice, particularly in schools, where, with good intentions, some teachers reward students with sweet treats for jobs well done or for good behavior. But I think it is important to establish the idea that good behavior and accomplishment are personal responsibilities, not events requiring constant external rewards, and clearly our kids do not need more reasons to eat junk foods.
Ten studies reported that kids tend to consume junk foods when they are available. On the other hand, controlling the home and school environment was shown to facilitate better choices.
Not surprisingly, advertising, packaging, and food placement in stores influenced choices as well.
The good news here is that all of these impediments to healthy eating are resolvable. It is a myth that healthy eating is more expensive, and also that preparing healthy foods is excessively time consuming. Stores are packed with convenient healthy foods, ranging from pre-washed greens and sliced mushrooms to microwavable packages of rice and vegetables. Clearing homes of junk foods is a powerful way to prevent both children and adults from eating these foods. Educational intervention programs have been proven to result in positive changes in both knowledge about health and in health-promoting habits. The success of a preschool health education program in Madrid Spain in changing children’s attitudes, and eating and exercise habits should encourage more schools and community organizations to help parents and families by offering similar programs.
Paes V, Ong K, Lakshman R. “Fators influencing obesogenic dietary intake in young children (0-6) years): systematic review of qualitative evidence.” BMJ Open 2015;5:e007396 doi:10.1136/bmjopen-2014-007396