Bringing Home the Bacon – I’m a Cancer Survivor with Meat on the Menu.

baconThis week, the World Health Organisation (WHO) classified processed meat as being carcinogenic to humans and red meat as a probable carcinogen. Bacon has become the darling of the foodie world over the past couple of years, with bacon-flavoured popcornmilkshakes and lollipops on the market, so does this new labelling mean that a package of bacon will be slapped with a warning sticker, and every hotdog will come with a side of medical advice?

Although the overall risk of developing colorectal cancer is small, headlines citing an 18% increase in colorectal cancer risk from consuming one 50 g serving of processed meat per day (approximately one hotdog) have led to consumer concern – including the (incorrect) assumption that eating 5 portions of processed meat would therefore lead to a 90% certainty of developing colorectal cancer.

Let’s examine the real risk.  The average person’s risk of developing colorectal cancer is approximately 5%. If the WHO data suggesting an 18% increase in risk is correct, a daily 50 g serving of processed meat increases that risk to 5.9 % (an increase slightly less than 1 people per 100), of which between 0.65 – 5.4 people will survive for 5 years or more (depending on cancer stage at diagnosis). Despite the increase in meat consumption over the past century (and therefore assumed increase in processed meat consumption due to changes in dining habits and food availability), the death rate from colorectal cancer has dropped over the past 20 years. Moreover, in media articles discussing the WHO announcement, there is no mention of mitigating factors such as fruit and vegetable consumption. What happens if I eat 50 g of bacon within a huge salad with a side of oat bread, a meal high in dietary fibre, which is cited as having a protective effect against colorectal cancer? Or if I eat bacon after running five miles, given the role of exercise in preventing cancer? As with so many other health risks, it’s almost impossible to assess the impact of meat consumption in isolation.

Both alcohol and cigarettes are already listed as carcinogens by the WHO, yet how many people have actually forgone a glass of wine or pint of beer based upon the fear of cancer? By contrast, how many have cheerfully raised a glass to headlines stating that red wine may have beneficial health effects? Rather than health benefits, this announcement may reduce meat consumption by people who are most vulnerable to health complications from nutrient deficiencies (e.g. growing children, pregnant women and elderly people); not to mention the undoubted glee of anti-animal agriculture groups who will welcome the gift of further ammunition against meat consumption.

As a cancer survivor, I am the last person to downplay the importance of minimising cancer risk. However, ultimately we will all die and almost everything we do, from driving a car to choosing salad ingredients, carries some risk to health. Rather than the continuing mass of conflicting evidence, where every week a new article warns us about the latest cancer-causing drug/chemical/food; we need a balanced assessment of all cancer risks in order to make the best choices. I don’t smoke and I have had less than 10 alcoholic drinks in the past 2.5 years, but bacon remains on my dinner menu tonight.

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Hyperbole, Hysteria, and a Sample Size of One – Where’s the Science?

IMG_9219I often describe this blog as a place where I write about things that irritate me. Today, is a case in point. There’s a new princess of technology paranoia on the block: move over Jenny McCarthy, because Modern Alternative Mama (MAM) is out to smother your crown with homemade liver pills and tweak it off your head. Billed as “a community of supportive people and well-researched information” the site is full of useful hints and tips on how to keep your children healthy – which in this case means unvaccinated, with unbrushed teeth and breast milk squirted up their noses to cure congestion. I wish this were my hyperbole – it’s not.

One of the common themes in the litany of anti-vaccination posts is the fact that vaccine scientists need funding to do experiments  (gasp!) and that such funding comes from companies that manufacture vaccines (gasp!). Obviously these scientists are the epitome of corporate shilldom and would sell their first-born child for a microscope and box of latex gloves. Best not to trust their pesky peer-reviewed science.

Don’t worry though, MAM is here to do the research for you and write about in a balanced and fair way. This translates roughly as: “Science (pesky corporate shills) shows there is no harmful effect of X, but if you allow the dastardly medical profession to force it on your defenseless bundle of joy they have a 756% increased risk of <insert scary disease here>, will be in therapy (blaming YOU) till they’re 45, and will never pass third-grade algebra. Oh, and did we mention that X has been linked to leukemia/childhood obesity/autism/type II diabetes/ADD/teenage pregnancy/atheism/voting Republican (delete as appropriate)“. They helpfully highlight the scary messages on the website in bold, so that you don’t miss them.

As with so many anti-technology sites, science is the enemy…unless it’s happy touchy feely science that backs up whatever theory is being propounded this week. Which is why it’s so funny to see them reporting that Baltic amber necklaces “really work” for preventing teething issues in babies.

One of the bloggers was sent a necklace by an amber company. She put it on her baby at 3 months of age (too early to teethe). 5 months and 5 teeth later  – no loss of sleep, no cranky baby, no teething problems whatsoever. Hooray! It’s a miracle! In her words: “Baltic amber is a win!” For the moment, let’s gloss over the fact that the necklace was provided free of charge and that the blogger was compensated for her post (ahem, Baltic amber shill).

So let me compare this to my experience. My baby is now 8.5 months old and also has 5 teeth. We’ve had no loss of sleep, no crankiness, no problems whatsoever with teething….and no amber necklace! Hooray! It’s a miracle! Wearing stripy Rainbow Brite-style leggings and pointing excitedly at next door’s dog (my daughter’s current favorite activity) are a win! Or maybe it’s the cucumber that she often eats for dinner! Or the fact that she can see the mountains from her crib! Or… some babies just teethe better than others.

Billions of children have been given vaccines that prevent disease with no ill-effects whatsoever, which the anti-vaccination activists appear to consider irrelevant. Yet one child given an amber necklace, with no control group or latin-square experimental design to test it’s efficacy – it’s a win! Baltic amber works! For goodness sake, try and be consistent MAM – you wouldn’t consider a sample size of one (my daughter for example, who has experienced no adverse effects from vaccines to date) to be proof that vaccines are ok – why do it with other issues that affect children’s health and wellbeing?

I’m not suggesting that teething pain is on the same scale of importance as the provision of vaccines, but let’s be realistic. If you’re going to this site (or others like it) for unbiased, sound information about vaccines or child health, just take a look at the other posts and products that are being promoted. Would I take cardiac advice from a surgeon who offered me three leeches and a tincture of wormwood to cure cancer*? No – and neither should you.

*Or eating tumeric and avoiding wearing a bra to avoid getting breast cancer, as MAM suggests

How Long is Long-Term? Are We in Danger of Sacrificing Food Security to Satisfy GMO Paranoia?

FrankenfoodsMy Twitter feed is being taken over by two things: 1) arguments and 2) comments that are going to cause arguments. Almost every tweet appears to draw a contrary comment – I’m tempted to post “Elephants have four legs and one trunk” just to see how many people reply “No, there’s an elephant in South Africa called Minnie who only has three legs but has two trunks…”

The latest discussions (debates? arguments? long drawn-out 140-character battles?) have related to the safety of GMOs. Without exception, the argument from the nay-sayers comes down to “We don’t know what the long-term effects are, so we should ban them until we can conclude that they’re safe.”

In other words, we’re trying to prove a negative – show me that there’s no adverse effects whatsoever and I’ll believe it’s ok. Utterly impossible. Can you be absolutely sure that the screen you’re reading this on isn’t causing constant, minute but irreparable damage to your eyes? Water, that essential nutrient without which humans, animals and plants would die, can kill through drowning or intoxication. Even oxygen, without which brain cells are irretrievably damaged in just 10 minutes,  causes seizures and death when inhaled at high pressures. Should we ban these, just in case?

Perhaps we should take a long-term approach to all new technologies. iPhones were only introduced seven years ago, yet many of us spend considerable amounts of time typing on them, or holding them to our ears when they’re not in our pockets – what health-damaging consequences could these shiny new toys confer? What about the now-ubiquitous hand sanitizer? Once only the province of hospitals and germophobes, it’s now sloshed around by the gallon. Touted to kill 99.9% of harmful bacteria – what harm could those chemicals be doing to our fragile physiology?

I’ve yet to meet anybody who, when scheduled for quadruple bypass surgery, demanded that the surgeon only used techniques developed in 1964; or a type I diabetes sufferer who would only use insulin produced from pigs, as it was originally in 1923. When I was treated for breast cancer, I jumped at the chance to be part of a clinical trial involving a new monoclonal antibody treatment, regardless of the very slight risk of heart damage. In medicine, we seem happy to trust that science has the answers – not surprisingly, we prefer to survive today and take our changes with side-effects tomorrow.

With regards to food however, the opposite appears to be the case. The first commercial GMO (the Flavr Savr tomato) was introduced in 1994, GM corn and soy were commercialized in 1996, and not one death or disease has been attributed to any of these crops. Yet the “what are the long-term effects?” concern still persists. So how long-term is long enough? 10 years? 20? 50? Should we keep researching and testing these crops for another 80+ years before allowing them onto the market around the year 2100?

If your answer is yes, just pause for a moment and ask your parents, grandparents or even great-grandparents what life was like during the Great Depression in the USA, or World War II in Europe. Consider what life was like when food was scarce or rationed, when, for example, a British adult was only allowed to buy 4 oz of bacon, 8 oz ground beef, 2 oz each of butter and cheese, 1 fresh egg and 3 pints of milk per week. Those quantities of meat and cheese would only be enough to make two modern bacon cheeseburgers.

By 2050, the global population is predicted to be over 9 billion people. I don’t relish the idea of explaining to my grandchildren that they live with food scarcity, civil unrest (food shortages are one of the major causes of conflict) and malnutrition because public paranoia regarding GMOs meant that a major tool for helping us to improve food production was removed from use. In the developed world we have the luxury of choosing between conventional, natural, local, organic and many other production systems. However, we’re in danger of forgetting that not everybody has the same economic, physical or political freedom to choose. If you gave a basket of food to a family in sub-Saharan Africa subsisting on the equivalent of $30 per week, would they refuse it on the basis that the quinoa wasn’t from Whole Foods, the meat wasn’t organic and the tofu wasn’t labeled GMO-free?

When we have sufficient food being supplied to everybody in the world to allow them to be healthy and productive, we can then start refining the food system. Until then, the emphasis should be on finding solutions to world hunger, not forcing food system paranoia onto those who don’t have a choice.

Correlation vs. Causation – The Gluten-Free Example

My gluten-free tweetI’ve just been involved in that most pointless of activities – a Twitter argument. Entirely without value as neither side will admit defeat (or even concede ground) and it’s difficult to make rational, lucid points using words like “hereafter” and “whither” when the 140 character limit turns scientific discussion into a sea of “u r misinformed re: assoc w/glutfree diet” gobbledegook.

This debate was caused by me posting the photo to the left relating to the use of  “gluten-free” as a marketing term associated with supposedly healthier food. However, in the tweet below, the arguer (arguee?) demonstrated the commonly confused correlation vs. causation which appears to be the poster child for populist bandwagon-jumping science.

Coeliac tweetTheir follow-up tweet cited this website, which claims that 55 diseases can be caused by eating gluten, and there’s a link to a peer-reviewed New England Journal of Medicine paper to prove it. Excellent use of scientific literature to support the adoption of a gluten-free diet.

55 diseasesJust one tiny problem… the 55 diseases* listed in the table to the left are indeed associated with cœliac** disease in that people who are cœliac (0.3-0.8% of the population) often also suffer from a range of other conditions. However, this does not mean that anybody suffering from short stature, diarrhea, rheumatoid arthritis or congenital heart disease will have their symptoms relieved by adopting a gluten-free diet. Heck, if it did, we’d all be 6 feet tall and heart-healthy, right?

To put it another way, all penguins are black and white. Does that mean that all black and white objects are penguins? I have utmost sympathy for sufferers of cœliac disease as it must be a very difficult and painful condition. However, when a gluten-free diet is not only promoted being more healthy for the general population, but backed by willful misinterpretation of peer-reviewed data, it’s just another indication that we need better scientific education. Correlation not causation – rinse and repeat.

*Note that these are not all diseases per se, but that was how they were defined by the website 
** An autoimmune disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. As a Brit, I’m using the English spelling as I find it too grammatically painful to omit the ligature (œ)