https://ama.com.au/ausmed/processed-meats-need-closer-look

Processed meats need a closer look

The time for compassionate action and leadership on this important issue by the Australian medical profession has arrived
04 Aug 2017

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OPINION
By Dr Alphonse Roex and Dr Heleen Roex-Haitjema

In October 2015, the authoritative International Agency for Research on Cancer (IARC) confirmed that processed meat causes cancer and red meat is a probable carcinogen (Table 1.^1,2 ).

IARC Carcinogenic Classification Groups	Likelihood to cause cancer in humans	Type of meat	Examples
1	Causes cancer	Processed meats	Bacon, ham, sausages, hot dogs, hamburgers, ground beef, mince, corned beef, beef jerky, canned meat, offal and blood
2a	Probably causes cancer	Red meats	Meat from mammals: pork, veal,  beef, bull meat, sheep, lamb, horse meat and,Meat from hunting: wild boars, deer, pigeons, partridges, quail and pheasants

Table 1. Based on the IARC’s data on the carcinogenicity of processed meat and red meat.^1,2

The IARC assessed more than 700 epidemiological studies regarding red meat and more than 400 provided data on processed meat. The IARC estimates that worldwide the consumption of diets high in processed meat results in approximately 34,000 deaths annually and diets high in red meat in 50,000 avoidable cancer deaths per year. Eating an extra portion of 50 grams of processed meat daily increases the relative risk of colorectal cancer by 18 per cent.

The strength of evidence that processed meat is a carcinogen is comparable with tobacco smoking and asbestos.^3,4

Diets high in animal protein show a 75 per cent increase in total mortality, a 500 per cent increase in diabetes, a 400 per cent increase in cancer risk, and produce significantly higher levels of IGF1, a potent cancer-promoting hormone.⁵

Chronic diseases are responsible for considerable human suffering and contribute heavily to the burden of disease nationally. Australia’s ever increasing total healthcare expenditure has in 2016 for the first time surpassed 10 per cent of its Gross Domestic Product. It is estimated that 55-60 per cent of this total is spent on chronic disease management.

Nearly two years have passed since the World Health Organisation’s report on the categorisation of processed animal products as carcinogenic. The time has come that we doctors take the initiative to inform our citizens and create systems, processes and policies to protect our patients and communities from further harm from such known carcinogens. We were finally moved to show united leadership 60 years ago in regards to smoking. Ultimately, after roughly 7000 scientific publications showing the relationship between smoking and lung cancer, healthcare providers became advocates for the best available medical evidence trumping the lures of a treasured habit for many of their patients (and indeed, fellow colleagues).

The American Medical Association in the USA has led the way by calling on hospitals there to improve the health of patients, staff and visitors by (1) providing a variety of healthful food, including plant-based meals that are low in fat, sodium and added sugars, (2) eliminating processed meats from menus and (3) providing and promoting healthful beverages.^6,7,8

Springmann et al. estimated the effects of consuming less – or no – animal products on global population health should a transition to a more plant-based diet be made leading up to 2050. Conclusions reached were a reduction in premature deaths, abundant economic benefits and reduced greenhouse gas emissions. Table 2.⁹

Healthier diets compared to present omnivorous diet	Characteristics diets	Human health benefits:millions of premature deaths avoided	Economic valuation: value-of-statistical life approach.Trillion of AUD saved per year
Healthy Global Diet (WHO)	Less meat and sugar; More vegetables and fruit	5.1	27.6
Vegetarian	Minimal animal products: dairy and eggs only	7.3	36.8
Vegan	No animal products: plant-based only	8.1	39.4

Table 2. Human lives and money saved in 2050 if the world population would adapt more healthful diets. Based on publication M Springmann et al.⁹

We understand that our AMA is aware of the issue and we are engaging with its Public Health team.

The time for compassionate action and leadership on this important issue by the Australian medical profession has arrived. All medical administrators, procurement officers, caterers and doctors (in association with registered dietitians) should then feel encouraged, empowered and supported to play a role in implementing the elimination of processed meats in medical institutions.

Views expressed in the above Opinion piece are those of the authors and do not reflect official policy of the AMA.

The authors’ credentials are listed below:

Dr Alphonse Roex MD PhD, FRANZCOG

Senior Consultant Obstetrics and Gynaecology The Lyell McEwin Hospital South Australia
Senior Lecturer, The University of Adelaide
Medical degree: Utrecht University, the Netherlands
Specialist degree and PhD: Free University Amsterdam, The Netherlands
Member PCRM (Physicians Committee for Responsible Medicine (Washington DC USA)
International presenter on Nutrition and Health

Dr Heleen Roex-Haitjema, Paediatrician (not practising)
Certificate in Plant-Based Nutrition, Cornell University, New York
Certified Food for Life Instructor, The Physicians Committee for Responsible Medicine, Washington DC
Medical degree: Utrecht University, The Netherlands
Specialist degree: Free University Amsterdam, The Netherlands.
Member PCRM (Physicians Committee for Responsible Medicine (Washington DC USA)
International presenter on Nutrition and Health.

References

1. Bouvard V, Loomis D, Guyton KZ et al. on behalf of the IARC Monograph Working Group. Carcinogenicity of consumption of red and processed meat. Lancet Oncology 2015.
2. http://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Evaluation-Of-Carcinogenic-Risks-To-Humans. Volume 114 (2015).
3. IARC Monographs on the Evaluation of Carcinogenic Risks to humans. Volume 83 (2004) Tobacco Smoke and Involuntary Smoking.
4. IARC Monographs on the Evaluation of Carcinogenic Risks to humans. Volume 100C. (2012) Asbestos.
5. Levine ME et al. Low Protein Intake is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metabolism 2014;19:407-17.
6. https://janeunchained.com/2017/06/23/ama-comes-out-against-serving-processed-meats-in-hospitals/
7. http://www.pcrm.org/nbBlog/american-medical-association-passes-healthy-food-resolutions
8. https://wire.ama-assn.org/ama-news/ama-backs-comprehensive-approach-targ…
9. Springmann M. et al. Analysis and valuation of the health and climate change co-benefits of dietary change PNAS doi:10.1073/pnas. 2016; 1523119113.

Article available at: https://ama.com.au/ausmed/processed-meats-need-closer-look