special report
GROUND
RULES
WH inves
tigates
When the World He
alth Organization re
leased the results
of a study classifyin
g processed meats
in the same category
as cigarettes, it shoc
ked chorizo lovers th
e world over.
Sausages, the new ca
ncer sticks… serious
ly?
BY A L I C E E L L I S P H OTO G R A P H Y
BY B R E N DA N H O M A N
10 4 wo me ns h e al t hmag .co m.au AP RIL 2 016
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’).
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
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 metaanalysis that looked at the results of
10 6 wo me ns h e al t hmag .co m.au AP RIL 2 016
50G
This much
processed
meat per day
increases the
risk of bowel
cancer by 18
per cent.
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
*KILOGR AMS OF BEEF, VEAL, L AMB, PORK AND POULTRY CONSUMED
PER CAPITA , PER YEAR . SOURCE: OECD-FAO AGRICULTUR AL OUTLOOK 2014
special report
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 COW
Time 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
MEATLOVING
COUNTRIES*
Australia 93kg
United States 91.1kg
Israel 86kg
Argentina 84.7kg
Uruguay 82.9kg
Brazil 78.1kg
New Zealand 73.5kg
Chile 72.5kg
Canada 70.5kg
Malaysia 54.9kg
South Africa 50.7kg
Saudi Arabia 50.5kg
Russia 50.2kg
South Korea 50.2kg
China 48.8kg
special report
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,
10 8
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
PROTEINS
2016 is the International
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.”
CAP IT
OFF
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…
*INCLUDES BEEF, VEAL, L AMB, PORK AND POULTRY
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.
Other
health
benefits
The food
Protein per
100g
Have
them in…
LENTILS
26g
High in magnesium
and fibre; aid
digestion
Stuffed capsicums
SPLIT PEAS
25g
Help stabilise
blood sugar;
very high fibre
Pea & broccoli soup
KIDNEY
BEANS
24g
Help stabilise
blood sugar;
antioxidant rich
Turkish eggs
MUNG BEANS
23.86g
Rich in fibre;
reduces cholesterol
Pilaf
BORLOTTI
BEANS
23g
Help stabilise blood
sugar; rich in B
vitamins, iron,
potassium, zinc
Homemade baked
beans
CANNELLINI
BEANS
22.3g
Help stabilise
blood sugar;
antioxidant rich
Burger patties
TEMPEH
18g
Reduces
cholesterol
San choy bow
AZUKI BEANS
17.3g
Aid digestion;
stabilise
cholesterol; may
help prevent
breast cancer
Brownies
NUTS AND
SEEDS
20-30g
Full of healthy fats
for heart health;
mineral rich
Your hand
A PRI L 2 01 6 wom ens he a l t hma g .co m. a u 1 0 9