Here we go again. No doubt you’ve seen on T V or read in the news that meat causes colon cancer. At least that’s the take home message you got if you saw any of these ‘news’ reports or read any of the articles about a new study published in the Journal of the American Medical Association (JAMA) this past week. Let’s take a look at what is really going on.
The study was pretty simple. Researchers looked at the diets of over 1000 subjects who had stage III colon cancer and who were enrolled in a chemotherapy trial. These subjects filled out food frequency questionnaires (FFQ) during their chemotherapy then again six months after. Researchers then stratified the data from the FFQs into what they called a Western dietary pattern and a prudent dietary pattern. After a little over 5 years of follow up about a quarter of these subjects had died from their colon cancer. Significantly more of the patients following the Western dietary pattern died than did those who followed the prudent dietary pattern. Therefore, say these researchers, those who have advanced colon cancer should avoid a Western dietary pattern in favor of a prudent dietary pattern in order to reduce their chances of dying from their disease. And the implication is that all of us should follow the prudent diet rather than a Western diet to maybe avoid getting colon cancer at all. And, as you shall see, what these researchers really want us to avoid is red meat.
Nice and tidy. Problem is that it’s all BS. And it’s the kind of BS that infuriates me because of the dishonesty involved. Let me show you what I mean.
The statistics involved in this paper are convoluted beyond belief. Very few people are going to go through the charts and tables and analyze these statistics as presented. I’m a pretty fair hand at statistics, and I didn’t want to spend the time to laboriously go through these to see if they were correct. I didn’t spend the time because it doesn’t matter if they are correct or not, so why bother. And that’s not to even mention that the nutritional data making up these statistics was derived from FFQs, which are the most notoriously inaccurate way to get nutritional data imaginable. The entire study is an observational study, and as such is absolutely worthless in determining whether the Western diet or the prudent diet or any other kind of diet causes colon cancer or anything else. But before we get into what an observational study really is and why it’s worthless, let’s look at a couple of other factors.
First, the researchers themselves cleverly defined the Western dietary pattern and the prudent dietary pattern so they could determine what made up each one. The prudent dietary pattern was filled with fruits, leafy vegetables, cruciferous vegetables, tomatoes, fish, poultry, wine, tea, and legumes. The Western dietary pattern was dairy, refined carbohydrates, red meat, sweets, desserts, margarine, processed meat, potatoes, French fries, snacks, beer, liquor, eggs, and sugar beverages among others.
Now this divvying up of all these foods into Western and prudent dietary patterns would be okay with me if that’s the way they reported it. I mean all the crap they put in the Western dietary pattern category is pretty much what makes up the typical American diet, and I, of all people, certainly wouldn’t be surprised to find that people following such a diet had their cancers worsen, but that’s not what the researchers reported. They focused on the red meat part of the Western diet in all their reports. It was made to sound like the red meat in the Western dietary pattern was the cause of all the woes, not the sugar, potatoes, sweets, high-fructose corn syrup sweetened beverages, margarine, and all the rest of the crap. Just the red meat. But before we get into examples of that, let’s look at what an observational study is and why these studies are worthless for determining the cause of anything.
Let’s say I come up with the idea that eating ice cream causes multiple sclerosis (MS). To study this I recruit 10,000 subjects and follow them for 5 years. Over this 5 year period I take nutritional surveys by having these subjects fill out detailed food diaries for 3 days every three months, and I have trained interviewers go over these food diaries with the subjects to make sure they included everything. I gather all this data for 5 years, then I look at the amounts of ice cream eaten by all the subjects, and I divide the subjects into quintiles (fifths) depending upon how much ice cream they ate. The top quintile would be the 2000 subjects who ate the most ice cream; the bottom quintile would be the 2ooo who ate the least; and the other three quintiles of 2000 subjects each would fall in the middle.
Now that I’ve got this data, I look to see how many of the subjects in each quintile developed MS during the course of the study. Let’s assume that 100 subjects in the top quintile of ice cream consumption developed MS and only 30 people in the bottom quintile developed MS. The number of cases of MS from the middle quintiles were between 90 and 4o with the higher quintiles developing MS at greater rates than the lower ones.
I could then put out a press release proclaiming that ice cream causes MS, which would be picked up by the press, and, before you know it, I’m on CNN and all the networks talking about my study. Life is great. I’m on TV. But hold on. Whoa, there, Bozo. Let’s take a few steps back and look a this study just a little closer.
The study I did was what is called an observational study. I didn’t give these subjects ice cream, placebo, medications, anything, I simply observed and tabulated their diets over a 5 year period. Those that ate the most ice cream had higher rates of development of MS, but the MS can’t be laid at the doorstep of ice cream consumption because there are too many other factors involved.
Maybe those who are prone to MS are, for whatever reason, driven to eat more ice cream. Maybe those who ate the most ice cream also ate the most cake, and we didn’t even look at cake. Maybe cake is the cause. Maybe those who ate the most ice cream also smoked the most. Maybe those who ate the most ice cream were the least active, and maybe lack of activity predisposes to MS. Maybe those who ate the most ice cream ate the fewest tomatoes, and maybe tomatoes are protective against MS. I could go on and on with the maybes coming up with countless scenarios showing that it isn’t really the ice cream that causes MS even though those who ate the most developed the most MS. The point is that in an observational study like this fictitious one I just came up with – which is no different than the JAMA study on the Western dietary pattern/prudent dietary pattern and death from colon cancer observational study – is meaningless in terms of what causes anything.
What observational studies are good for is creating hypotheses. For example, let’s say I did the above study and I was just looking to see which subjects developed what after 5 years. At the end of the study I discovered that a bunch of people had developed MS. I looked at all the different foods all the subjects ate and I noticed that the ones who ate the most ice cream seemed to develop MS at the greatest rate. So, I come up with a hypothesis that ice cream causes MS, then I get together the funds to test this hypothesis.
To determine if this hypothesis is valid I recruit 10,000 more subjects. This time I randomize them into two groups so that the ages, sexes, heights, weights, and any other thing I can think of are the same in both groups. Then I create a placebo that looks like ice cream, tastes like ice cream, but has no calories and isn’t really ice cream. (Actually, if I could come up with this placebo I would abandon the study, get filthy rich, and move to my own island.) I would then box the placebo and the real ice cream in identical cartons. I would have a staff of people who gave the ice cream or placebo to the subjects at regular intervals. The subjects would be instructed to never eat ice cream on their own, but to only eat the ice cream they were provided during the study.
I would then have a double-blind, placebo-controlled study. It’s double blind because the people administering the ‘ice cream’ don’t know whether its ice cream or placebo and the subjects receiving the ‘ice cream’ don’t know if it’s real ice cream or placebo.
After 5 years I could again determine how many subjects had developed MS and could compare it to the amount of real ice cream eaten by those subjects. If this time the results were the same, then I would have some reason to say that ice cream may indeed cause MS. But this would be a real, double-blind, placebo-controlled study, not an observational study.
Typically when hypotheses arise from data provided by observational studies, these hypotheses are destroyed when they are evaluated using a real study.
For the JAMA study to be able to say that the Western dietary pattern causes recurrence and death to a greater degree than does the prudent dietary pattern, the researchers would have had to randomize the patients into two groups, then give one group the Western diet and the other the prudent diet. And keep both groups on their respective diets for the 5 years, then see what happens.
And the authors of this study indeed know and understand that these observational studies don’t mean squat in terms of causality and admit as much. They write these words buried in the back of this study:
Because this was a observational study, causality cannot and should not be drawn from these data. [my italics]
So, the authors know and admit that no conclusions in terms of causality can or should be drawn from this study. But they go ahead and do just that with this statement that is the very next sentence after the one above:
Nonetheless, the data suggest that a diet characterized by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains increases the risk of cancer recurrence.
So, you fess up that the study doesn’t legitimately say squat, then you say in the very next sentence that, well, we don’t care about the truth, we think it really does matter. Because, after all, no one cares about a meaningless study. You can’t issue a press release about a meaningless, observational study. Can you? The authors and the folks at JAMA apparently think so.
Here is the press release from JAMA.
DIET HIGH IN MEAT, FAT AND REFINED GRAINS ASSOCIATED WITH INCREASED RISK FOR COLON CANCER RECURRENCE AND DEATH
Patients treated for colon cancer who had a diet high in meat, refined grains, fat and desserts had an increased risk of cancer recurrence and death compared with patients who had a diet high in fruits and vegetables, poultry and fish, according to a study in the August 15 issue of JAMA.
Previous research has indicated that diet and other lifestyle factors have a significant influence on the risk of developing colon cancer. However, few studies have assessed the influence of diet on colon cancer recurrence and survival, according to background information in the article.
Jeffrey A. Meyerhardt, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, and colleagues examined the influence of two distinct dietary patterns on cancer recurrence and survival in a group of 1,009 stage III colon cancer patients (cancer present in the colon and lymph nodes) enrolled in a clinical trial of postoperative chemotherapy in addition to other treatment. Patients reported dietary intake using a food frequency questionnaire during and six months after supplemental chemotherapy. Two major dietary patterns were identified, prudent and Western. The prudent pattern was characterized by high intakes of fruits and vegetables, poultry, and fish; the Western pattern was characterized by high intakes of meat, fat, refined grains, and dessert.
Patients were followed up for cancer recurrence or death. During a median (midpoint) follow-up of 5.3 years, 324 patients had cancer recurrence, 223 patients died with cancer recurrence, and 28 died without documented cancer recurrence.
The researchers found that a higher intake of a Western dietary pattern after cancer diagnosis was associated with a significant increase in the risk of cancer recurrence or death. Compared with patients in the lowest Western dietary pattern quintile (bottom 20 percent), those in the highest quintile (top 20 percent) experienced a 3.3 times higher risk for cancer recurrence or death. Patients in the highest quintile of Western dietary pattern were 2.9 times more likely to have cancer recur than those in the lowest quintile. Similarly, a significantly higher overall risk of death with increasing Western dietary pattern was observed. In contrast, the prudent dietary pattern was not significantly associated with cancer recurrence or death.
âStudies have shown an improved disease-free survival among patients who receive adjuvant chemotherapy following the surgical resection of stage III colon cancer. This is the first study, to our knowledge, in a potentially cured population of colon cancer survivors to address the effect of diet. Because this was an observational study, causality cannot and should not be drawn from these data. Nonetheless, the data suggest that a diet characterized by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains increases the risk of cancer recurrence and decreases survival. Further analyses are under way to better delineate specific nutrients or food groupings that may have the strongest association,â the authors write.
Do you see anything in this press release that says no conclusions can or should be drawn from this study since it is an observational study? I didn’t see anything like that. And did you notice how it is no longer a Western dietary pattern, but is now a meat, fat and refined grains diet. And note what is listed first: meat. Most analyses of the Western diet show that the single largest contributor of calories is sugar, which I’m sure is the case in this Western dietary pattern, but the authors and the press release writers for JAMA single out and lead the press release with meat. Not sugar. Not high-fructose corn syrup. Meat.
What’s even worse than the press release is the video that goes along with it. In this video a survivor (so far) of stage III colon cancer, John, is shown cycling and going about his life. A voice over announcer talks about the diagnosis and treatment of John’s colon cancer. Then the announcer says
As you’d imagine, after that, John would do a lot to stay healthy. Turns out what he eats, or doesn’t eat, could really help.
This while John is shown putting fish on the grill. Then cut to Dr. Jeffrey Meyerhardt, the lead author of the study, who says:
Itâs not really increasing the amount of fruits and vegetables but really trying to reduce the amount of red meat intake and fatty foods and sugary, âdessertyâ foods, that seems to be protective for colon cancer recurrences and survival.
Note the emphasis on red meat and fatty foods. As Dr. Meyerhardt finishes his line the video cuts to a steak on a grill, then to someone cutting a steak. The announcer then says:
That higher fat diet Dr. Jefery Meyerhardt describes is called a Western pattern diet. He and colleagues at Dana-Farber Cancer Institute studied that pattern in colon cancer patients. Their findings appear in JAMA, Journal of the American Medical Association.
While the announcer is talking there is more footage of red meat on a grill.
There is some more blather, then the announcer says:
Stage III colon cancer patients who ate high amounts of a Western pattern diet were about three times more likely to have recurrent cancer, or to die, compared to patients who ate less of those types of foods.
More footage of John and his wife eating fish and vegetables. Then the announcer again:
The study says improved outcomes are more likely if stage III cancer patients eat the way John does…lots of fish, chicken, brown rice, and less Western pattern foods, like red meat.
Actually the study says no such thing. The study says that “causality cannot and should not be drawn from these data.”
John finally speaks. He is eating his ‘healthful’ non-Western pattern diet along with his wife, and he says:
To cut down from one steak a week to one steak a month is not a big deal.
As you watch the video you notice that right at first the overall Western pattern diet is described as being filled with red meat, fatty foods, sweets, and desserts. Then as the video rolls on the Western pattern diet transmogrifies into the red meat diet. Anyone watching this video would come away thinking that eating red meat will cause colon cancer to worsen. And that if anyone who has colon cancer eats meat, they’re going to die.
And all this from a study whose authors tell us that the data cannot and should not be used to determine causality. This entire episode is an education in how this nonsense spreads. And another reason to never, ever believe anything you see on television or read in the papers about medical studies. Most of it is pure hogwash.
Why, you may ask yourself, do these highly trained scientists buy into all this when it’s so patently false? Because they want to. Remember the post about the book Stumbling on Happiness? It takes very little evidence to persuade someone of something he/she already believes is true. All of these people believe red meat is bad for us despite there being absolutely no evidence showing such. So it doesn’t take much to prove to them that it really is bad. In this case, it takes no data at all. Merely the suggestion of data. Pitiful.
Here is a link to the JAMA video from which I quoted above. Warning. It takes forever to download this thing, which is why I quoted from it instead of merely linking to it. It took me about 5-6 minutes, so don’t give up if you really want to see it. It is a masterpiece of anti red meat propaganda.
I’ve come to the conclusion, after years in HC, that that single most important factors in surviving colon cancer (or any solid mass tumor) is the quality of your surgeon and the aggressiveness of your oncologist. You need a surgeon that’s thorough and removes all the primary tumor. You need a clever oncologist that really knows how to figure out how much chemo you can take, what combos work for you and how to minimize the damage it does while squeezing out the benefit. I wouldn’t even trust an RCT if those two factors weren’t controlled for. How the hell do I know that the greatest number of survivors had Surgeon A and the failures were operated on by Surgeons B and C?
In that case – I much rather know that data than what the patients had for dinner.
Still eating that T-bone without guilt – these guys are going to have to do better than that.
Glad you could see through the BS.
I’ve given up trying to correct this misconception that “western diet = meat and fat ” and “red meat causes health problems.”
There are other memes out there that are equally impossible to correct. One is that fat causes type 2 diabetes. Another is that type 2 diabetes is preventable. Some examples.
In that huge “diabetes prevention” trial, they put prediabetics on low-fat diets and exercise programs. Those who lost about 7 pounds had 58% lower rates of conversion to type 2 diabetes. The conclusion reported in the press: going on a low-fat diet will prevent diabetes.
First, it was the weight loss, not the low fat that was probably important. Losing weight on a low-carb diet would have had the same effect. Second, reducing diabetes conversion by 58% is not the same as preventing it; 41% still got diabetes despite the massive lifestyle changes. You can reduce your risk; you can’t totally prevent type 2.
Another example is the recent study showing that neurons in the brain that are sensitive to glucose are impaired in obese mice. Mice are very susceptible to becoming obese when given free access to fatty chow. So they made the mice obese this way and they became diabetic and showed defects in certain neurons in the brain.
The conclusion reported in the press: fat causes diabetes.
As long as these memes are stuck to people’s brains (probably by too much starch paste), they’re not going to listen.
Hi Gretchen–
Right you are. The problem is that these memes are already stuck to the brains of most people in the media so they’re all to eager to misreport studies such as the ones you mentioned without reviewing them critically.
Cheers–
MRE
From a purely academic view, there is nothing wrong with their statements. And there in lies the rub. Academics writing for other academics know that correlation does not imply causation, and are familiar with the terminology used in statistics. The terms “associated” and “suggest” have very precise meanings in research circles regarding data, and when they speak with each other, they know what is being implied or not. These terms, however, have very different meanings to lay people. The issue here to me is main stream media misrepresenting the study and using the public’s ignorance of science and math to scare them or try to further some political agenda.
Hi Kevin–
I agree for the most part. But in this case it wasn’t just the mainstream media, it was the staff at JAMA in collaboration with the lead author who spread the bogus, slanted reports.
Cheers–
MRE
Thanks for your analysis. Even it it’s true that the “Western diet” raises cancer risk, lumping red meat with the other junk is a gross distortion. Seems they are discovering that cancer feeds on glucose and some forms of cancer have been linked to a high glycemic load. Fat MAY be part of the problem, but only because the high glucose & insulin levels cause it to turn to the dark side.
We need a study that isolates red meat from the rest of the junk mentioned, which is not likely from the medical establishment. Know any low carb billionaires who could help us out? đ
Hi Dan–
Unfortunately, I don’t know any low-carb billionaires period.
Cheers–
MRE
I know this doesn’t exactly apply to this discussion but it’s along the same meme lines. On “the Peoples’ Pharmacy”, a weekly NPR health discussion, the guest speaker was PRESIDENT-ELECT OF THE AMERICAN DIABETES ASSOCIATION. He discussed mainly medications to treat Type II, then open forum began inviting questions which naturally included questions about nutrition and his reply was typical fruits whole grain blah blah. One of the hosts asked about the benefits of FISH OIL and this guy says that there are 5 CALORIES PER DOSE OF FISH OIL AND THAT’S FIVE POUNDS GAINED OVER A YEAR SO HE DOESN’T RECOMMEND IT.
I figured you’d say Jesus wept and is now banging his head against a table.
By the way I’m reading Stumbling on Happiness and it’s the most fascinating (and funny book)I’ve ever read.
Hi Dawn–
Incredible! And this guy is the president-elect of the ADA. With such buffoons as he at the top of major scientific organizations, there appears to be very little hope for any kind of meaningful change. The bit about fruits, vegetables, and whole grains is to be expected, but his fish oil answer takes the cake for idiocy. Even if the 5 calories added to his weight, they would add up to only a half pound a year anyway, not 5 pounds. The depths of this guy’s nutritional dumbth is astounding.
Glad you’re enjoying Stumbling on Happiness.
Cheers–
MRE
One of your lines struck me as the issue in a nutshell: such surveys are useful for generating hypotheses only. You can’t prove theories when there are a million variables.
Can we get access to the raw data? I’d like to see how survival correlated with predicted insulin level (carb intake), for instance. Or getting colon cancer in the first place related to insulin levels.
Hi seyont–
As far as I know none of that data is available because this was an observational study, and what the researchers chose to ‘observe’ was the rate of death in those following a Western dietary pattern (as defined by them) compared to the prudent dietary pattern (again, as defined by them). I’m sure the data from the FFQs obtained from this group of subjects is available and can be evaluated from any number of perspectives. For example, total carb consumption could be divided into quintiles or quartiles and and compared to deaths. Same for red meat or anything else. Problem is that once one goes through this exercise, no matter what the outcome, it’s still an observational study, and consequently can’t be used to determine causality.
Another big problem with these studies in which researchers arbitrarily place certain foods in certain categories then use these categories to determine which is best is that there is room for a ton of hanky panky. For example, in the colon cancer study fruit juice ended up in the prudent dietary pattern category. Why? Because the researchers volitionally put it there. Many studies have shown fruit juice to be little better than sugary sodas in terms of what they do to one’s metabolism, so fruit juice could just as easily have been placed in the Western dietary pattern category. Ditto for a number of the other foods categorized. What this means is that the researchers could have (and I’m not making this accusation; I’m simply pointing out the possibility) fiddled with the data to get it to come out how they wanted it to come out. Let’s say that fruit juice was first in the Western dietary pattern, and when it was there the overall outcome changed. There was no difference in rates of death between the two categories. So one simply moves fruit juice to the other category and runs the program again, and Viola! there are more deaths in the Western pattern. With all the variables from which to chose, it’s easy to manipulate these kinds of studies to get the results one wants.
Cheers–
MRE
Geez Dr. Mike, these authors and the media must be right. They have their collective heads so far up their butts they can see the polyps!
On a more serious note, I see medical news almost every day that just wants to make me scream. The media no longer checks facts they just go for hype.
That’s why I always have plenty of material.
Cheers–
MRE
“Actually, if I could come up with this placebo I would abandon the study, get filthy rich, and move to my own island.’
Always great to read your analysis of current health and nutrition studies. But also great to get a good laugh in along with the info. Thanks for the excellent laugh.
Jen
Hi Jen–
I’m glad to see someone reads the parentheticals.
Cheers–
MRE
My sister-in-law passed away from cancer this June. It started in her colon and then spread to her liver. She was 44 and just one week shy of her 45th birthday when she died. Her initial surgery to remove the cancer from her colon was successful (it was detected fairly early) and she did a round of chemo. All should have been well but then they discovered that it was in her liver. While on chemo for that, it got worse instead of better. She really went through hell the last 7 months of her life with one type of treatment after another being tried. So it really, really angers me when stuff like this comes out which is so misleading and tries to get the finger to point to the same old tired culprits instead of where it really belongs. I can’t say what she ate on a day-to-day basis before and after she got sick but if the food that was in the house while we were there for the funeral was any indication, all the usual standard American diet crap was there. In fact, by the next day of picking around it, trying to find something that I could eat, I was ready to drive to Omaha and find one of those famous steaks. Thank goodness hubby and I found a little cafe that served a decent breakfast so that we could at least start the day off right.
Sorry to hear about your SIL.
I’m pretty certain that diet does play a role in colon and other cancers, just not the diet the researchers who did this study are trying to blame.
Best–
MRE
The president-elect of the ADA is a good fundraiser for these kinds of groups. That’s why he got the job, so he can raise money. One could argue that the $ is important for research (the ADA and other “disease” groups do provide seed grants for young researchers or ideas that need fleshing out before they qualify for larger NIH grants) but the ADA’s focus is primarily about drugs, not prevention, early detection, or how to achieve truly normal blood sugar levels for those with diabetes, thereby avoiding complications of diabetes (it is possible for many people with the right advice).
Following ADA recommendations is a fast track to complications, IMO.
Jenny at Diabetes Update ( http://diabetesupdate.blogspot.com/ )has a great commentary about the poor choice of this man to head the ADA.
Great accurate info on diabetes is at her other site, What They Don’t Tell You About Diabetes, too (www.phlaunt.com/diabetes/ ).
Hi Anna–
Thanks for the info.
Cheers–
MRE
Excellent post.
It reminds me of a study I saw recently on how people always underestimate and under report how much sugar they eat. I put it here:
http://conditioningresearch.blogspot.com/2007/08/you-are-eating-more-sugar-than-you.html
Hi Chris–
Thanks for the link. The study looks interesting. I’ll retrieve the full paper and give it a look.
Cheers–
MRE
Great post, Dr. Mike. I’ve been reading your blog for several months now, but have never commented before. This time I felt compelled to let you know that thanks to your clear, logical, rational, and very well laid-out analyses, I now feel incredibly more educated and aware of what information I am fed.
I know this to be true since I read the same JAMA study you are discussing a few weeks ago. And, I basically came to the same conclusion that you so eloquently explain. This would not have happened last year, when I would have included myself in the group of “average” people who naively follow the recommendations of such studies.
So, I just wanted to offer my appreciation to you and your fine blog. Your efforts have convinced at least one person to question the printed word and stay alert to hidden agendas!
BTW – I have also completely adopted the high-protein, low-carb lifestyle with amazing results. Too bad more people aren’t willing to even test the hypothesis.
Keep up the good work!
Hi Kelly–
Thanks very much for the kind words; I really appreciate them.
And I’m happy to hear you’re doing so well on the lifestyle. Keep it up.
Cheers–
MRE
Hi Dr. Mike. I posted this response on my Web site after an article linking breast cancer to red meat consumption came out back in March. I thought it might be relavent to the current discussion.
Judy Barnes Baker
“Carb Wars; Sugar is the New Fat”
http://www.carbwarscookbook.com
Red Meat and Cancer
March 30, 2007
âBreast Cancer is another reason to limit beef,â reads the headline on an MSNBC story dated March 16, 2007. Similar headlines were featured in various newspapers in response to the release of a study analysis that suggested a link between red meat consumption and breast cancer. Researchers found no link between overall cancer rates, but when they looked at only those cancers that were dependent on estrogen and progesterone, they found that women who ate one to one and a half servings of red meat a day doubled their risk of developing breast cancer when compared to those who ate three servings or
less per week. Most of the news articles advised replacing meat with plant foods in light of the findings.
The researchers offered several possible explanations to explain the link between red meat and cancer: high-heat cooking methods, high fat, and, of course, the universal scapegoat, saturated fat. Conspicuously missing from the list of suspects: the fact that meat producers routinely implant animals with hormones. Since it was only hormone-dependent cancers that
showed a relationship to red meat, it seems like a no-brainer to check out that connection before pointing the finger of blame.
It is illegal to use hormones in pork or poultry, but cattle can be implanted with natural and synthetic estrogen and progesterone from the time they are weaned until the day they are slaughtered. The pharmaceutical companies advertise that hormone use will provide a return of five dollars for every dollar spent by promoting faster weight gain on less feed. Dairy cattle are injected with rBGH, a genetically engineered hormone, to boost milk production. (Donât read the next two sentences if you are squeamish.) This is a question from the Q&A page of the PosilacÂŽ (rbST) Web site: âWhat about the increased “pus” in the
milk from cows treated with rbST?â The answer: âThese cells are necessary to fight infection, and the increase noted in some POSILAC-treated cows likely reflects the slight increase in mastitis incidence and mammary cells which slough off during infection.â (OK, you can come back now.) The European Union refused to allow the use of rBGH because of health concerns about breast and prostate cancer. Most other countries have banned its use. The EU has also banned the importation of American beef since 1988 because of concerns that the extra estrogens would cause an increase in breast cancer and that
hormone-laden animal waste in the run-off from farms would pollute streams and damage wildlife.
Although little research has been done on the effects of hormone use in meat and dairy products, one recent study discovered a correlation between hormones in beef and infertility. The sperm count of a group of young men was found to be inversely related to the amount of beef eaten by their mothers when they were pregnant. Read about the study from the March 28th Journal of Human Reproduction here:
http://humrep.oxfordjournals.org/cgi/content/full/dem068v1.
A second article in the same issue, titled Could hormone residues be involved?,
http://humrep.oxfordjournals.org/cgi/content/full/dem092v1, brings up some troubling possibilities. The US and Canada based their approval of the use of such hormones primarily on research about the mutagenic activity of the hormones. The author suggests that exposure to hormonally active chemicals could work epigenetically rather than by DNA mutation to cause disruptions at much lower concentrations. Such changes could be inherited by future generations.
The FDA has actively sided with the pharmaceutical industry to prevent label disclosure of hormone use in dairy products. You may have noticed that when a label says âNo artificial growth hormones,â it will also say: âFDA states: No significant difference has been shown between milk derived from rbST-treated cows and non-rbST-treated cows.â
Label disclosure of hormone use in meat is not required. The FDA has taken the position that labels only have to tell us what we need to know; and they get to decide what that is. It has been estimated that hormones are used in 80% of the beef raised in the US. If the package doesnât say âno artificial hormones,â you must check with the company to find out if they were used. For now, if you like your position at the top of the food chain but donât want a side serving of sex hormones, you must look for packages marked âNo artificial hormonesâ or âUSDA-certified organicâ on beef, lamb, and dairy products.
Hi Judy–
Thanks for the excellent discussion. The links to the studies didn’t work for me, though.
Best–
MRE
“Iâm pretty certain that diet does play a role in colon and other cancers, just not the diet the researchers who did this study are trying to blame.”
Exactly. I feel the same way which is why when I read about studies such as this one, I really see red.
Thnak you so much for taking the time to post about studies like this and pick them apart for your readers. To say that I’m a math dunce would be an understatement, but you make it easy for me to understand what’s going on with the numbers involved. Since I’ve started reading your blog, I’ve really learned what to look for when news blurbs about the results of studies are published. Sadly, those around me swallow them hook, line and sinker without pausing to think about what is actually being said. A previous reader commented about the lack of critical thinking skills that most people have these days. So very true.
by the way, Barry Groves did a similar critique of an earlier study of colon cancer and red meat here:
http://www.second-opinions.co.uk/red-meat-colon-cancer.html
Hi Chris–
Thanks for the link.
Cheers–
MRE
We should not forget that the Warburg hypothese (established in the 1920s) was recently confirmed on different levels. Cancer, by this theory, is a metabolic disorder in the respiratory chain of the cells and trying to stop tumor grow, while eating many carbs is like trying to stop a fire by pouring gasoline on it.
True. This is one of the reasons a ketogenic diet is being looked at so seriously as an anti-cancer diet.
Cheers–
MRE
Hi again Dr. Mike. Sorry about the nonfunctioning links in the comment I sent earlier. I think it was the punctuation after the addresses that caused the problem. I’m resending the whole thing again without the punctuation marks. Hope it works this time. (The post had some extra spaces that were not in what I sent. I don’t know why that happened.)
Original Comment:
Hi Dr. Mike. I posted this response on my Web site after an article linking breast cancer to red meat consumption came out back in March. I thought it might be relavant to the current discussion.
Judy Barnes Baker
Carb Wars; Sugar is the New Fat
http://www.carbwarscookbook.com
Red Meat and Cancer
March 30, 2007
âBreast Cancer is another reason to limit beef,â reads the headline on an MSNBC story dated March 16, 2007. Similar headlines were featured in various newspapers in response to the release of a study analysis that suggested a link between red meat consumption and breast cancer. Researchers found no link between overall cancer rates, but when they looked at only those cancers that were dependent on estrogen and progesterone, they found that women who ate one to one and a half servings of red meat a day doubled their risk of developing breast cancer when compared to those who ate three servings or less per week. Most of the news articles advised replacing meat with plant foods in light of the findings.
The researchers offered several possible explanations to explain the link between red meat and cancer: high-heat cooking methods, high fat, and, of course, the universal scapegoat, saturated fat. Conspicuously missing from the list of suspects: None of them mentioned the fact that meat producers routinely implant animals with hormones. Since it was only hormone-dependent cancers that showed a relationship to red meat, it seems like a no-brainer to check out that connection before pointing the finger of blame.
It is illegal to use hormones in pork or poultry, but cattle can be implanted with natural and synthetic estrogen and progesterone from the time they are weaned until the day they are slaughtered. The pharmaceutical companies advertise that hormone use will provide a return of five dollars for every dollar spent by promoting faster weight gain on less feed. Dairy cattle are injected with rBGH, a genetically engineered hormone, to boost milk production. (Donât read the next two sentences if you are squeamish.) This is a question on the Q&A page of the PosilacÂŽ (rbST) Web site: âWhat about the increased “pus” in the milk from cows treated with rbST?â The answer: âThese cells are necessary to fight infection, and the increase noted in some POSILAC-treated cows likely reflects the slight increase in mastitis incidence and mammary cells which slough off during infection.â (OK, you can come back now.) The European Union refused to allow the use of rBGH because of health concerns about breast and prostate cancer. Most other countries have banned its use. The EU has also banned the importation of American beef since 1988 because of concerns that the extra estrogens would cause an increase in breast cancer and that hormone-laden animal waste in the run-off from farms would pollute streams and damage wildlife.
Although little research has been done on the effects of hormone use in meat and dairy products, one recent study discovered a correlation between hormones in beef and infertility. The sperm count of a group of young men was found to be inversely related to the amount of beef eaten by their mothers when they were pregnant. Read about the study from the March 28th Journal of Human Reproduction, here:
http://humrep.oxfordjournals.org/cgi/content/full/dem068v1 .
A second article in the same issue, titled Could hormone residues be involved?,
http://humrep.oxfordjournals.org/cgi/content/full/dem092v1 , brings up some troubling possibilities. The author suggests that exposure to hormonally active chemicals could work epigenetically rather than by DNA mutation to cause disruptions at very low concentrations. Such changes could be inherited by future generations. The US and Canada based their approval of the use of such hormones primarily on research about the mutagenic activity of the hormones.
The FDA has actively sided with the pharmaceutical industry to prevent label disclosure of hormone use in dairy products. You may have noticed that when a label says âNo artificial growth hormones,â it will also say: âFDA states: No significant difference has been shown between milk derived from rbST-treated cows and non-rbST-treated cows.â Any dairy that makes such claims must make a plan and maintain records available for inspection by regulatory agencies to document the accuracy of the label.
Label disclosure of hormone use in meat is not required. The FDA has taken the position that labels only have to tell us what we need to know; and they get to decide what that is. It has been estimated that hormones are used in 80% of the beef raised in the US. If the package doesnât say âno artificial hormones,â you must check with the company to find out if they were used. For now, if you like your position at the top of the food chain but donât want a side serving of sex hormones, you must look for packages marked âNo artificial hormonesâ or âUSDA-certified organicâ on beef, lamb, and dairy products.
I have a friend who did his Master’s thesis on the use of data mining techniques to determine characteristics of pancreatic cancer outcomes. (http://web.cs.wpi.edu/~ruiz/KDDRG/dm_for_medical_analysis.html for the abstract on the research) His research was presented more than a year ago, and did in fact conclude that using more advanced methods provided better answers that traditional regression. With that in mind, these researchers can’t claim that their slipshod statistical methods are the best available for interpreting the data. Really, in my eyes they have failed to even qualify for Hanlon’s Razor; this is malice on their part.
I agree. And I love Hanlon’s Razor. I had forgotten about it until you mentioned it. It will again become part of my armamentarium to be used to savage these kinds of studies.
Cheers–
MRE
Hi, Mike…I know I’m commenting on an older blog post, but I’ve been pretty slammed lately at work. CRC is one of those topics that always catches my eye–after all, I’m one of the fraction of 1 percent (it’s 150,000 people btw) diagnosed each year. Worse, when diagnosed, I was already in stage IV with extensive mets to my liver, and everyone expected that I’d be one of the 58,000 who die each year from the disease. Maybe CRC gets more play because those of use who have it and have lived to tell the tale are talking about it more and more–because while it’s nearly completely preventable by early screening, most people aren’t screened early enough or often enough.
Anyway–I never ate red meat more than a couple of times per week, even after I started controlling carbs in 2002. I’m more of a fish and poultry girl–and I was a vegetarian for years. Still, as a Stage IV CRC survivor, I can promise you that even when you think you *know* what you should eat, studies like the one you’re examining here make you doubt everything that you know. You’re staring death in the face, and unfortunately with CRC, death wins a *lot.* You question everything. And studies like this one, BS or not, are still scary in some small part of your brain.
Sept. 1 was my 18-month anniversary in complete remission–after 39 cycles of chemo, two surgeries, and all kinds of recovery time. I am a statistic…but the good kind. People who survive to the point I have aren’t even a whole number percentage in the stats for this disease. One of the vets I work with has always maintained that I’m too ornery to let cancer kill me without a fight. Maybe.
At one point I’d gained back all of the weight I’d lost controlling carbs–and more–because of the steroids given as part of one of my chemo regimens. I’m down 40 lbs of that weight, but still am 37lbs away from what I weighed in 2004 when I was diagnosed. Exercise after two abdominal surgeries, liver resection, a permanent ostomy and the development of two hernias isn’t and can’t be the same as it was B.C. (before cancer.) We aren’t all Lance Armstrong… đ
And for that matter, my diet can’t be quite the same Protein Power that it was B.C., although I still focus on getting adequate protein and controlling carbs. Now, however, many low carb veggies and most raw veggies and fruits are things I can’t tolerate at all. Fat consumption (except mayonnaise) doesn’t bother me–but I can only eat small quantities of most proteins at one time. Protein shakes are my friends. đ And I can’t eat at all within two hours of doing any type of exercise, because of the hernias.
Anyway…glad to see you reviewing this research, and exposing it for what it is.
Hi Gaelen–
What a nightmare time you’ve had of it. I’m really glad to hear you’re doing so well. Thanks very much for all your work and help with the bulletin board group.
Thanks for writing.
Best–
MRE
Bravo, bravo. What a brilliant analogy of the rampant problems caused by incorrectly identifying cause-and-effect relationships from observational studies (ice cream and MS). I greatly enjoyed the article.
Now if only we could teach the fallacies behind such reasoning strategies to all the “global warming” nuts running amuck…
Glad you enjoyed the post.
Cheers–
MRE