Recently, the World Health Organization (WHO) released its report condemning processed meat as a group 1 human carcinogen — a classification that includes such notorious companions as tobacco smoking, smokeless tobacco, and second-hand smoke. This is not surprising considering that processed meat contains many of the same known or probable carcinogens as cigarette smoke, like heterocyclic amines and N-nitrosamines.
Red meat was labeled in the runner-up category as a “probably causing cancer” — specifically colorectal cancer. The similarities between meat and tobacco also extend to how both of their industries have decried prestigious health organizations as they have issued reports aimed at improving public health and saving lives. Akin to the tobacco industry’s response several decades ago, the meat industry — using many of the tactics of big tobacco — swiftly denounced the WHO report.
The first defense brandished by tobacco industry after the surgeon general declared that cigarette smoking causes lung cancer in 1964 was denial. It was their most important tactic, and it served them well for decades. The industry maintained its position by creating doubt among the public. As a tobacco industry stated after the surgeon general’s indictment on smoking, “Doubt is our product.” By creating controversy, the tobacco industry was able to defer a smoker’s need to quit smoking and preserve profits — at least, until the “controversy” was settled, which took nearly three decades.
In reality, among the public health community, there was never a controversy — only the one fomented by industry. At the time of the surgeon general’s report, the average American smoked a half pack per day. Although smoking rates declined in the ensuing decades, the decline was mitigated by the industry’s aggressive tactics.
Borrowing a precedent set by the tobacco industry, the meat industry categorically denied the WHO’s landmark statement, calling it “dramatic and alarmist overreach.” The North American Meat Institute wasted no time in denying that meat causes cancer, arguing that “numerous studies” have shown “no correlation between meat and cancer.” By “numerous” they mean nine studies. In comparison, the WHO looked at more than 800 studies, from which they concluded that processed meats do cause cancer — a similar conclusion was reached by the American Institute for Cancer Research and the World Cancer Research Fund International after reviewing 7000 studies a few years ago.
Correlation is not causation and other fallacies
The industries’ best strategy to buttress their claims of denial is to argue that correlation is not causation. Simply put, just because both meat consumption and colorectal cancer rates are high doesn’t mean they are related. The industry will say that meat eating countries have a lot of power lines, for example, that could also be a cause. These are half-truths distorting basic statistical concepts to support an a priori claim. The reason the WHO concluded that processed meat cause cancer was because they looked at a wide body of evidence from multiple sources. They looked at evidence from animal studies, basic science research, and, of course, humans to see the whole picture. It was the totality of the evidence that led the WHO to eschew bacon.
It was the same approach that led public health authorities to rethink our relationship with cigarettes, which was made public with the surgeon general’s report in 1964. In order to subvert the medical establishment, the tobacco industry created the “Tobacco Industry Research Committee” and several other decoy organizations with the express purpose of fostering claims that cigarettes do not cause cancer. This organization was filled with for-hire publicists, scientists, and physicians.
In an example of organized knavery, they argued that heavy smoking was unrelated to rising rates of lung cancer and other causes were to blame — like air pollution, smoke, and automobile exhaust. We now know that smokers are 15 to 30 times more likely to get lung cancer or die from lung cancer than nonsmokers.
Examples of overt obfuscation have also occurred after WHO report debuted. House Republican and Agricultural Committee Chair Michael Conaway boorishly stated, “These claims are based on a biased selection of studies performed by an organization notorious for distorting and misconstruing data …” Although Mr. Conaway does not have any formal background in the medical sciences or statistics, he has received more than $350,000 in campaign support from the livestock industry, according to the Center for Responsive Politics.
In reference to the WHO’s report, the North American Meat Institute also did not mince its criticism, stating, “They tortured the data to ensure a specific outcome.” The diction is ironic and distasteful considering that the meat industry itself has been repeatedly accused of torturing animals in the process of making meat, as this PETA exposé narrated by Paul McCartney graphically illustrates.
Benefits outweigh the risks
Perhaps the only endorsement the meat industry can make at this point is one that appeals to popular conception: Meat has a lot of protein (and that protein is good for you). In fact, that is exactly what the meat industry did: “Meat is ‘nutrient-dense’ and vital humans … Meat is a complete protein, meaning it contains all the amino acids our bodies need.” Yet, there are plenty of protein sources that are carcinogen-free, like beans, lentils, and tofu. In a land of plenty, there is no reason to risk cancer for the sake of protein. As a physician, I have yet to see anyone in America with a case of true protein deficiency (known as kwashiorkor).
Hormel, one of the leading meat processors, went on further to state the benefits of these nutrients outweigh any risk, the “very important nutrients in meat far outweigh any theoretical hazard.” This rhetoric of emphasizing value and discrediting the risks is not novel to the meat industry and was pioneered by big tobacco.
The tobacco industry used similarly deceptive advertisements throughout the 20th century to trumpet the benefits of smoking. These advertisements feature physicians wholeheartedly endorsing cigarette smoking. As recently as 1988, the then CEO of Philip Morris, Joseph Cullman III, has been caught on record trying to discredit studies showing hazard to health by stating, “There is only a statistical association. It has never been proven.”
Quantifying the risk
The meat and tobacco industry have a self-interest in preserving their profits, but you have also have an interest in preserving your own health. The choice to smoke or consume processed meat is an individual one, but should be made based on knowing all the facts. With both of these habits, we now can quantify our risk. With smoking, we know that cigarettes cause 1 death for every million smoked. When we consider that trillions of cigarettes are smoked every year, it is no surprise that cigarettes are predicted to cause nearly a billion deaths in the 21st century.
With processed meat, the WHO report estimates an 18 percent increased risk of colorectal cancer for every 50 grams per day of processed meat consumed — the amount of meat in a regular hot dog. In one large summary study reviewed by the WHO, the risk was seen to increase linearly with increasing consumption until one ate 140 grams of processed meat per day.
In America, nearly 5 percent of individuals will develop colorectal cancer over their lifetimes. It is the second leading causes of cancer-related deaths and the third most common type of cancer in men and women. The cancer is so common that the government recommends every adult over the age of 50 to be regularly screened for colorectal cancer. With statistics like this, it is hard to ignore the WHO’s conclusions.
The WHO estimates that 34,000 cancer deaths per year across the globe are attributable to eating processed meat. Although this number is smaller compared to the damage inflicted by cigarettes, it is still a significant issue to those getting colorectal cancer from eating processed meat. Whether it’s cigarettes or bacon, it is prudent to think about what we put in our mouths.
Shivam Joshi is an internal medicine resident who blogs at afternoonrounds.
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