GROUND RULES

104 womenshealthmag.com.au APRIL 2016

WH investigatesWhen the World Health Organization released the results of a study classifying processed meats in the same category as cigarettes, it shocked chorizo lovers the world over. Sausages, the new cancer sticks… seriously? BY ALICE ELLIS PHOTOGRAPHY BY BRENDAN HOMAN

special report

106 womenshealthmag.com.au APRIL 2016

special report

Before you skip the bacon aisle of the supermarket for eternity, here’s the background: the October 2015 conclusions were the results of a meta-analysis, an investigation of existing studies, in which a World Health Organization (WHO) subsidiary, the International Agency for Research on Cancer (IARC), evaluated more than 800 published reports. It led the WHO to label processed meat as a Group 1 carcinogen – along with asbestos and UV rays – meaning there’s strong evidence linking bowel cancer to the consumption of processed meat (that’s meat that has been ‘transformed through salting, curing, fermentation, smoking or other processes to enhance flavour or improve preservation’). They put red meats in Group 2A: foods or substances that probably cause cancer, a category that includes the pesticide DDT and the insecticide malathion. Not great company. (Oh, and sorry pork belly fans: despite being known as ‘the other white meat’, for the study’s purposes, pork is considered red.)

Newsflash: none of this is news! As mentioned, the IARC study was a meta-analysis that looked at the results of

many studies, so the link between meat and cancer has been becoming obvious for a while, and WH health expert Dr Ginni Mansberg started taking it seriously a couple of decades back: “My eldest son Sam is turning 24 this year; I was still giving him cured meats when he was about two years old, and then I stopped because the data started coming out.” No ham for Sam.

WHAT’S BAAA-D ABOUT MEAT?To clarify: the IARC study did not establish red meat as a cause of cancer, despite strong mechanistic evidence supporting a carcinogenic effect, mainly because it considered the evidence to be limited. On the other hand, processed meat landing in with the Group 1 carcinogens means the majority of the IARC Working Group considered the evidence consistent enough to conclude that consumption of it causes cancer.

So what puts bacon up there with ciggies? That part’s not entirely clear yet. Professor Bernard Stewart, chair of the WHO committee that made the meat and cancer ruling, as well as scientific advisor to Cancer Council Australia, says the link between processed

meat and bowel cancer (aka colorectal cancer), as well as stomach, pancreatic and prostate cancer, is not as obvious as those between smoking and lung cancer or UV rays and melanoma. But let’s take a look at what they know...

Preservatives called nitrites and nitrates tend to take the blame. They are salts from either natural or synthetic sources that are added to many packaged foods – also cheese, tinned legumes, dips – to keep them fresh for longer. (They’re usually listed on food packaging as preservatives 250 or 251.) In our digestive tract, nitrites form nitrosamines, carcinogenic compounds. According to research by Food Standards Australia New Zealand (FSANZ), our largest dietary source of nitrites is actually fruit and veg, but when nitrites occur naturally, they don’t turn carcinogenic during digestion.

Before you start overloading your bin with your pantry’s tinned food, the FSANZ research also concluded that our dietary nitrite exposure from all food sources is ‘not considered to represent an appreciable health and safety risk’, and Stewart backs this up: “Fifty years ago, nitrite was used [in high concentrates] as a preservative – when you bought bacon or ham, for example, you could leave it on the shelf, you didn’t need to refrigerate it, that was the whole point of bacon and ham, it lasted before there was refrigeration. Now [we need to] put bacon and ham in the fridge because there’s virtually no nitrite added to it. The formation of nitroso compounds was recognised 50 years ago, and that’s why [the addition of] nitrite was decreased.” Good-o.

Stewart says there are various categories of nitroso compounds (unpronounceable word alert): “Polycyclic aromatic hydrocarbons, heterocyclic amines and heme iron – they are all of concern yet none of them is the proven culprit.” So why consumption of processed meat can lead to cancer is not yet completely understood – at least not in a way that’s easy to communicate to the public. “It’s

very high-level science,” says Stewart. “The simple scenario of processed meat being contaminated by some type of carcinogen is simply not true, it’s much more complicated than that. Although some carcinogens in very small quantities can be identified [in processed and red meat], they can be identified in other foods too. It may well be a combination of [things] – not just the nitroso compounds, nitrate compounds and the presence of hetrocyclingamines or heme iron.”

This all sounds like a lack of cold hard facts, but Stewart points out the focus of the meta-analysis was not so much to find out how consuming processed and red meat can lead to cancer, but instead to resolve if they cause cancer. “It’s all very well to emphasise the complexity [of the link between meat and cancer], but the data did allow us to reach a clear conclusion,” says Stewart. That conclusion was classifying processed meat as a Group 1 carcinogen and red meat as Group 2A. “You cut out processed meat, you decrease the risk of cancer – from a public health point of view, it doesn’t matter if eating processed meat causes cancer directly or causes cancer because you get obese and you get cancer for that reason.”

Kathy Chapman, chair of the Cancer Council’s Nutrition and Physical Activity Committee, adds, “It might be [meat’s] high fat content, the charring in the cooking process, or big meat eaters missing out on the protective benefits of plant-based foods – or a combination of these factors.” Regardless, she says, red and processed meats are associated with around one in six bowel cancers diagnosed in Australia.

DON’T HAVE A COWTime to turn down those alarm bells – while processed meat sits alongside ciggies in the Group 1 carcinogens list, this doesn’t actually mean eating bacon is as dangerous as smoking. Phew. The IARC says the cancer risk

TOP MEAT-

LOVING COUNTRIES*

50GThis much processed

meat per day increases the risk of bowel cancer by 18

per cent.

Australia 93kgUnited States 91.1kg

Israel 86kgArgentina 84.7kgUruguay 82.9kg

Brazil 78.1kgNew Zealand 73.5kg

Chile 72.5kgCanada 70.5kg

Malaysia 54.9kgSouth Africa 50.7kgSaudi Arabia 50.5kg

Russia 50.2kg South Korea 50.2kg

China 48.8kg

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associated with meat consumption is not as high as tobacco and sunshine, and is, importantly, related to how much you consume.

Let’s put bowel-cancer risk in context: about one million deaths result from tobacco-related cancers each year, globally – while only about 34,000 cancer deaths per year worldwide are attributable to diets high in processed meat. We should point out that bowel cancer is the second most common cause of cancer death in Oz, where the lifetime risk of a woman developing bowel cancer is one in 14. Fifty grams of ham (about two slices) per day would raise that risk by 18 per cent – giving you about an 8.4 per cent overall risk. Of course, the risk rises more if you eat more meat. And some people are at a higher risk than the general population – risk factors include a family history of the disease, a history of colon polyps or conditions like Crohn’s disease or ulcerative colitis. You can help counteract the risk with physical activity, maintaining a healthy weight and not smoking, says Chapman.

LESS IS MORE Every day we do lots of dicey things: flying, radiating ourselves with mobile phones, breathing in pollution, drinking from plastic bottles. Alcoholic drinks are also classified as a Group 1 carcinogen, but that doesn’t stop us from popping a bottle of bubbly – instead, we (try to) limit our intake. We take risks because we weigh them up against the benefits and decide they’re worth taking. So let’s just remind ourselves why we eat meat – and not only because… mmm… bacon. “Red meat, such as beef and lamb, is a critical natural source of iron and zinc, vitamin B12 and omega-3 – essential nutrients needed to keep your body and brain functioning well,” says Meat and Livestock Australia spokesperson Clair Cameron. “The iron and zinc in beef and lamb are well absorbed by the body, better than the iron and zinc in plant-based foods. And vitamin B12 is only found in animal foods, so if you don’t eat meat, chicken, fish, eggs and dairy products […] a supplement is required.” The Dietitians Association of Australia agrees: “Lean red meat has a valuable place in the Australian diet,

providing an important source of iron, zinc and vitamin B12. However, regular consumption of greater than 100-120g/day of cooked red meat has been linked with an increased risk of colorectal cancer, so it’s a bit like sunlight – a little bit is good for you, but don’t overdo it; 455g per week of cooked lean red meat represents the ideal amount for Australian adults.” Australia’s National Health and Medical Research Council recommends that people limit their intake to even less than that – no more than 65 to 100g of lean red meat, three to four times a week. This means a few palm-sized fillets, not a porterhouse on Monday, osso bucco on Wednesday, Massaman curry on Friday and roast lamb on Sunday. Plus bacon at Saturday’s brunch and ham a few days for lunch. This meaty menu seems reflective of our actual intake, because Australians eat more meat, per capita, than any other country*. Yep, even more than burger-scoffing Yanks and

beef-obsessed Argentinians. According to 2013 Organisation for Economic Co-operation and Development (OECD)data, each of us puts away 93kg of meat each year – about 1.8kg per week. Even someone with C-minus maths skills would see that’s a lot more than the guidelines recommend.

So sub that meat with vegies (hello, Meat-Free Monday, Tuesday, Wednesday...) and, bonus, you reap their cancer-preventing effects. “Eating more fruit, vegetables and whole grains can help you to moderate your intake of processed and red meats and can also help to protect against cancer,” says Chapman. Of course, seafood’s still on the menu – we could probably all do with more omega-3s in our lives. And when we do eat meat, try to make it the high-quality, lean, grass-fed stuff. Treat prosciutto, meatballs and Reuben sandwiches as just that – treats. That way you can have your health and eat meat too. Oh, and while we’ve whet your appetite for vegetables, turn the page for a whole lot of cutting-veg recipes. WH

BEST GREEN PROTEINS2016 is the International Year of Pulses (ie, lentils, beans, peas and chickpeas). Get your finger on these pulses, as well as legumes, with this breakdown thanks to Fern Green, author of Green Proteins…

WHAT ABOUT

CHICKEN?The study

didn’t look at fresh poultry – apparently

because public health experts

don’t believe it’s a concern. “Chicken

consumption consistently comes

up as being not really linked to any diseases,” says WH

health expert Dr Ginni Mansberg.

“There’s also nothing really for

fish, seafood.”

The food

LENTILS

SPLIT PEAS

KIDNEY BEANS

MUNG BEANS

BORLOTTI BEANS

Homemade baked beans

CANNELLINI BEANS

TEMPEH

AZUKI BEANS Brownies

NUTS AND SEEDS

Protein per 100g

26g

25g

24g

23.86g

23g

22.3g

18g

17.3g

20-30g

Other health benefits

Have them in…

High in magnesium and fibre; aid digestion

Stuffed capsicums

Help stabilise blood sugar; very high fibre

Pea & broccoli soup

Help stabilise blood sugar; antioxidant rich

Turkish eggs

Rich in fibre; reduces cholesterol

Pilaf

Help stabilise blood sugar; rich in B vitamins, iron, potassium, zinc

Help stabilise blood sugar; antioxidant rich

Burger patties

Reduces cholesterol

San choy bow

Aid digestion; stabilise cholesterol; may help prevent breast cancer

Full of healthy fats for heart health; mineral rich

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