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Red meat and cancer: dumbing down the science

At this morning’s session on Diet and Cancer, Dr. Marji McCullough gave an epidemilogist’s-eye view of the relationship between cancer and diet. Her main point was that focusing on overall dietary patterns (such as higher fruit and vegetable intake) rather than individual nutrients and foods (such as broccoli sprouts or soy) appears to be the most effective way to reduce cancer risk.

Throughout her talk, she was careful to point out the limitations of the research and how hard it is to collect and intepret data in the extremely messy experimental model known as “free living humans.”  So I was a little disappointed to hear her single out “red and processed meats” as one of the only food groups for which there is consistent evidence of a link with cancer.

First of all, it always irritates me to hear “red and processed meat” discussed as a single food group. My friends, there is a world of difference between a hot dog and a bison steak.

Cured meats and cancer

There does appear to be a link between cancer and high consumption of processed (i.e. cured) meats like hot dogs, sausages, salami, and cold cuts–most likely due to nitroasamines formed from the nitrates used to cure these meats. Incidentally, nitrosamines are deactivated by vitamin C and the link between cured meat consumption and cancer risk disappears in those who eat a lot of vegetables. That’s right: Those who eat the most cured meats but also the most vegetables have no increased risk of cancer.

But, I digress.  Back to (uncured) red meat.

Cooking methods and cancer

McCullough suggested that red meat consumption might contribute to cancer because heat-heat cooking methods (such as grilling) create harmful compounds. Hang on a minute. Maybe the problem isn’t red meat. Maybe the problem is charred meat.   After the talk, I had a chance to chat with Dr. McCullough and she admitted that from the existing data, most of which was collected 20 and 30 years ago, researchers can’t really distinguish between the type of meat and how it was cooked. Nor can they separate Big Macs from flank steak…nor beef from bison…nor grass-fed from corn-fed. It’s all just “red meat.” And what kind of red meat were Americans eating most of in the 80s and 90s?

Dumbing down the science?

For folks who eat most of their red meat in the form of char-grilled, high-fat, fast-food burgers, telling them that they can cut their cancer risk by cutting back on “red meat” may be good public health policy.  But in over-simplifying the prescription this way, we may be throwing the baby out with the bathwater.

Is there any evidence to suggest that lean, grass-fed red meat, prepared in a way that minimizes formation of HCAs and PAHs increases your risk of cancer? No, there is not. (Click for tips on how to reduce harmful compounds)  In fact, compared with poultry, red meat is higher in monounsaturated fats and lower in omega-6 fats–two qualities that red meat has in common with the cancer-protective Mediterranean diet pattern.

Industry opposes BPA ban (of course)

I hate to be cynical but I think I can see where this is going.

A food safety bill with broad bipartisan support and poised to become law is suddenly being opposed by food industry and business groups. Why? Because of a recently added amendment to ban BPA from food packaging. (More from the Washington Post)

Food packagers think we should wait two more years for the FDA to complete its investigation before deciding whether or not to remove BPA from the food supply. They argue that the evidence against BPA is based on a small number of flawed, biased studies.  Read more from the International Food Information Council.

Consumer advocates and health researchers argue that when there is as much reasonable cause for concern as there is for BPA, the substance should not be “innocent until proven guilty” but rather “off the shelf until proven innocent.”

Should the food industry control food safety legislation? Of course not.  Yet I predict the amendment will ultimately be removed.  But perhaps this is something the market can take care of for itself.

Consumer concern over high fructose corn syrup has led manufacturers to begin removing HFCS from their products and replacing it with cane sugar.  (Personally, I don’t think this accomplishes very much but that’s a different post.) Some manufacturers are similarly responding to the BPA concern with BPA-free packaging.  And whether or not the amendment goes through, a lot of consumers are already voting with their dollars.

See also: BPA: Which foods are safe?

Fructose: Poison, Nutrient, or Both?

Given the escalating rhetoric on fructose, I think it’s time to revisit a couple of basic facts and try to regain some perspective.

Fructose is not a toxin. It is not a man-made “chemical.” The fact that is it metabolized in the liver does not mean that it is a poison.

Fructose is a naturally occurring mono-saccharide (sugar) found in fruits, vegetables, nuts, grains, eggs, dairy products and other whole foods. It has been part of the human diet since the beginning. Presumably, our bodies are well-adapted to it.  In fact, there might be an evolutionary advantage to the ability to metabolize sugars through multiple pathways–including one that does not lead to an immediate rise in blood sugar.

All nutrients are potentially toxic

As the National Academy of Sciences states: “All nutrients can have adverse effects when intakes are excessive.”  That’s why tolerable upper limits (ULs) have been established for many nutrients. The NAS recommends that you don’t exceed 45mg per day of iron, for example. But no-one is suggesting that iron is a poison or that it should be avoided at all costs. Maybe if we had a tolerable upper limit for fructose, we could all relax a little bit.

How much fructose is too much?

According to a recent analysis, Americans are now consuming somewhere between 38 and 73g of fructose a day. A third of that comes from sweetened beverages. The rest comes from other processed foods as well as grains, fruits, vegetables, eggs, cheese, and other whole foods.

It seems clear that current sugar intake is excessive and making us sick. Many argue that it’s fructose, specifically, that’s doing most of the damage. Fine: For the sake of argument, let’s just say that the current average intake of 55g of fructose (or around 10% of total calories) is enough to overload the liver and contribute to obesity and other ills. That suggests that somewhere between 0 and 55g per day is a threshold at which fructose ceases to be a useful (or at least harmless) nutrient and starts to be a problem.

Seeing as it doesn’t seem possible, necessary, or even desirable to reduce fructose consumption to zero, I think it would be useful to start looking for that threshold.

What is the tolerable upper limit for fructose?

Are Your Veggie Burgers Toxic?

ND_Blog_SoyScandal_0410_fin I’ve gotten several emails asking me to comment on the recent soy-burger scandal.  Here’s the background if you’re just tuning in:

A report published by the Cornucopia Institute (which describes itself as a “progressive farm policy research group”) revealed the “dirty little secret” of the soy industry, namely, that a solvent called hexane is commonly used in the processing of soybeans.  Hexane is widely used in food processing to extract oil from vegetables and nuts. Not surprisingly, traces of hexane have been detected in some soy foods leading to over-wrought headlines like “Veggie Burgers Contain Poisonous Chemicals” and “Which Veggie Burgers contain Neurotoxins?

Cause for concern but not panic

Hexane gas is indeed highly toxic. Breathing hexane fumes can cause nerve damage. Industrial use of hexane contributes to air pollution and is potentially hazardous to workers who work with it. But the whole “neurotoxins in your burgers” thing is pretty sensational.  There is a big difference between breathing hexane fumes and ingesting trace amounts. The amounts found were tiny (well within allowable limits) and no adverse effects have been detected–despite decades of use in food production.

I’m not saying hexane is harmless or that we shouldn’t be concerned. But the reaction has been out of proportion. For a concerned but less hysterical response to this issue, see Eric Michael Johnson’s post on his Primate Diaries blog.

We’re shocked, SHOCKED!

For better or worse, hexane in the food supply is nothing new. But the natural-foods crowd seems to feel uniquely betrayed over the possibility of chemicals in veggie burgers. Why are they so surprised?

This is what soybeans look like when I harvest them from my garden:

Soybeans

And here’s one of the “natural” foods that everyone is upset about:

Boca

How shocked can we be that chemicals were involved?  Processed food is processed food. If you want to avoid chemicals in your food (whether it’s hexane or the one we’ll be worried about tomorrow), consider making your own veggie burgers.

Here are some recipes to try.  See also this article for a a list of processed soy foods made without hexane.

 

Nutrition and Health Conference 2010

[Archival: Originally published on my (discontinued) NutritionData.com blog]

The 2010 Nutrition and Health Conference is coming up May 10 – 12 in Atlanta. This annual conference, presented by Andrew Weil and the University of Arizona’s Center for Integrative Medicine, is one of the best I’ve ever attended. The presentations and speakers are terrific and the general approach is rigorous and evidence-based.

If you’ve been reading this blog for a while, you may remember that I wrote a series of posts from the conference two years ago.  I’ll be blogging from the conference again this May. In particular I’m looking forward to hearing  Arthur Agatston, MD (Author, The South Beach Diet) and David Kessler, MD (former Commissioner, U.S. Food & Drug Administration) as well as sessions on environmental contaminants in the food supply, nutrition for sports performance, and latest research in cancer, obesity, food allergies, and more.

For those of you in the nutrition or health professions, consider joining me in Atlanta for this great conference. For non-professionals in the Atlanta area, there will be a Public Forum on May 11th featuring Weil, Kessler, and Sanjay Gupta of CNN.

If you’re going, drop me an email at monica@nutritiondata.com and we’ll coordinate a meet-up!

 

Even bad guys deserve a fair trial

If all the high fructose corn syrup on the planet were to disappear tomorrow, you wouldn’t find me shedding a tear. Thanks to government subsidies and a glut of cheap corn, HFCS is produced in massive quantities. As a result, our food supply has been flooded with cheap, empty calories and we’re fatter and sicker as a result.

But I was disappointed by the latest research on HFCS and the way it’s being reported.

In an effort to put the last nail in the HFCS coffin, Princeton researchers have hit the newswires with a sensational research result: Rats fed high fructose corn syrup gain significantly more weight than rats fed sucrose, even when both groups eat the same amount of calories.  That sounds pretty damning.  But if you read the entire study, I think you’ll be left with a lot more questions than answers.

Weird Science

The authors are making a big deal out of the fact that rats given HFCS gained more weight than rats given sucrose. They don’t mention that they actually had two groups of rats eating HFCS and only one of them gained more weight. The second HFCS group–which ate the same amount of HFCS as the first–gained exactly as much weight as the sucrose group (and, for the record, the same as a fourth group of mice that weren’t given sucrose OR HFCS).   You’d think that would deserve a comment.

In a second long-term experiment using female rats, they gave one group chow plus HFCS and another group chow plus sucrose. The sucrose group actually gained slightly more weight than the HFCS group, but the differences were not statistically significant. Seeing as this result directly contradicts (one of) the results from the short-term study, you would think that would have deserved a comment–if not equal billing in the press release.

But in fact, in the part of the paper where they discuss their results, the authors make what appears to be a blatant misstatement. They say that in the long-term experiment, “HFCS caused an increase in body weight greater than that of sucrose in both male and female rats.” In fact, according to their paper, none of the males in the  long-term experiment were given sucrose and the females given HFCS gained less weight than the comparable group of females given sucrose.  The only females that showed a statistically significant increase in weight gain were a group who were given 24-access to both food and HFCS…a group that had no comparable control in the study.

The Corn Refiner’s Association has raised several questions about study design. But because they are the “bad guys,” no-one seems to take their criticisms seriously. For the record, I am not supported by nor do I support the CRA. (Please re-read the first paragraph of this post).

As I see it, making unhealthy food cheaper doesn’t benefit consumers. The only ones benefiting from HFCS are corn growers and junk food manufacturers. But in a court of law, the rules of evidence are upheld even when we’re all sure that the guy on trial is a bad guy. And the same should apply to research–and journalism.

Weird conclusions

Aside from the problems with the study design and the misleading reporting of the results, the authors also make some odd speculations about the possible mechanisms behind the results (such as they were). For example,  the authors suggest that it is the increased percentage of fructose that makes HFCS more damaging than sugar. (HFCS is typically 55% fructose, sugar is 50%). But using their numbers, if we were to replace all the HFCS in today’s typical diet with sucrose, it would reduce the amount of fructose by 3 g per day.Honestly, it’s a little hard to believe that 3 g of fructose a day is responsible for all of our woes. (The 100% increase in refined sugar intake…now that I could buy.)

They also speculate that HFCS might suppress leptin and insulin release, which might fuel over-eating. Yet their own results don’t support this. The rats given HFCS ate the same number of calories as the rats given sucrose–even though they had unlimited access to more food.

Despite the headlines on the press release, the findings on HFCS vs. sucrose are actually so sketchy they’re not even mentioned in the “conclusion” section of the journal article. Ultimately, the only valid conclusion from this study is that if you give rats food and sweetened water, they will get fatter than if you only give them food and water. I think we knew that already.

It’s the quantity not the quality we should be worrying about

Research is research. But in the real world, I think we’ve got our priorities backward. Let’s first focus on reducing the outrageous quantity of sugar being consumed, and then worry about the quality.  I’ve said this before (to howls of protest) but I’ll say it again: If you were to reduce your intake of sugar to the levels recommended by the AHA or WHO, I haven’t seen one shred of evidence to suggest that ingesting HFCS (or sucrose) at those levels would lead to obesity or disease.
 

Note to industry advocates: No fair quoting from this post out of context. At least include a link to the entire post!

 

Is saturated fat back on the hook?

That pain in your neck? It might be a case of nutrition-advice whiplash.

Saturated fat, long blamed for heart disease, seemed to be exonerated last month by a large study which found no connection between saturated fat intake and heart disease. People who ate less saturated fat were just as likely to have heart disease as people who ate more. Conclusion: Saturated fat does not cause heart disease. Cue rejoicing (not to mention “I told you so’s”) from Atkins and Paleo dieters.

But now the Harvard School of Public Health is throwing a bucket of ice-water on the whole party. They did their own analysis of the relationship between fat and heart disease and found that it all depends on what you replace the saturated fat with.

The Harvard authors note that previous clinical trials aimed at reducing saturated fat had “very mixed” results, “with most showing no significant effect.”   But, they note, when health authorities started to recommend reducing saturated fat, they didn’t offer much guidance in terms of what to replace it with. Some replaced those calories with hydrogenated fats.Others replaced them with refined carbohydrates. In both cases, the benefits of reducing saturated fat may have been canceled out by the negative impact of trans fats and refined carbs.

But when saturated fats were replaced with polyunsaturated fats (yes, the much maligned PUFAs), heart disease risk declined 20%.  (Read summary of research and interview with lead authors.)

This story isn’t over yet. Those who never let go of the notion that saturated fat contributes to heart disease will now get their chance at the “I told you so’s.” Those who are wedded to the idea that saturated fat is the ideal fat or that PUFAs are the source of all evil will find grounds to question this latest analysis. (Post them below–but not before reading the rest of the post.)

Where does this leave the non-ideologue who is just trying to figure out what to eat today?  Let me try to save you some neck pain.  These ground rules are unlikely to change:

1. I think everyone can agree that too many refined carbohydrates is a big problem. Limit them.

2. Trans fats (from hydrogenated oils) are bad news. Avoid them.

3. In the context of a typical Western diet, shifting some of your fat intake from saturated fats (from animals) to polyunsaturated fats (from vegetable oils) appears to have some advantages in terms of heart health. But I would argue that monounsaturated fats (olive oil) and omega-3 fat (fish and flax) are even better replacements.

For my Paleo and Weston Price folks who are about to pop a vein (but NOT from atherosclerosis!!) let me add:

For those who have made a more radical departure from the typical Western diet, by (say) eliminating all or most grains, sugars, processed foods, etc., it may be that reducing saturated fat offers no further benefits in terms of protecting your heart. Party on.

Fresh vegetables? Think again

frozen veggiesWhat could be more nutritious than fresh vegetables? Frozen ones, quite possibly.

A new study finds that frozen vegetables, which are usually processed within hours of being harvested, may contain more of certain nutrients than “fresh” vegetables, which may be weeks old by the time they’re consumed. This latest study was funded by Birds-eye, but it’s actually nothing we didn’t already know. According to the USDA, fresh vegetables can lose up to 50% of their nutritional value after just one or two days of room temperature storage or one to two weeks of cold storage.

This is not a nutritional emergency. Even at half strength, vegetables are still among the most nutritious foods you can choose. And many valuable nutrients, such as fiber, minerals, and fat-soluble vitamins like E and K, are fairly stable in storage. In other words, the kale that’s been sitting in my fridge since last weekend’s shopping trip is still going to make a great, nutritious side dish for tonight’s dinner.

But the study is a good reminder. Scoring extra-fresh produce from the garden or farmer’s market is a good way to maximize the nutritional value–but eating it promptly is just as important. And if you are stocking up for more than a week or so at a time, frozen veggies may be the best bet for long storage.

See also: Is all processed food bad?