If the newspapers are to be believed, you take your life in your hands every time you indulge in a steak.
‘To optimise both human nutrition and planetary health, the EAT-Lancet Commission recommends consuming no more than 98g a week of red meat and very low intakes of processed meat,’ writes Katherine Livingstone, an Australian nutrition researcher, in The Conversation.
The Daily Maverick thought it fit to republish for a South African audience.
Ninety-eight grams. Per week.
That is just under half of what we probably should no longer call a ‘ladies’ steak’ – the 200g alternative, for smaller appetites, to the more common 300g steak.
That is a beef burger about 15% smaller than one of those thin McDonald’s patties, and just over half the size of the perfect burger.
Not that I would recommend mistaking the Daily Mail as an authority on anything, but it claims this steak, about as thick as a deck of cards, weighs 100g.
That’s your weekly ration of red meat. Any more, and you’ll die a horrible death of… let’s see… oh, ass-cancer. Great.
‘Research shows that regularly eating red meat can increase your risk of developing type 2 diabetes, heart disease and certain cancers.’
Note the weasel-word ‘can’. Research does not show that it ‘will’, or ‘does’. Just that it ‘can’. May. Might. In some cases. Perhaps. Under certain circumstances. Perhaps not.
‘Weak evidence’
The article starts with treating saturated fats as if anyone still believed the CDC’s Dietary Guidelines of 1977. In fact, it has become clear that replacing saturated fats with refined carbohydrates like sugar, which is exactly what happened when the ‘low-fat’ label on food became de rigeur, is far worse for heart disease-related outcomes, and the association between saturated fat and heart disease is actually rather weak.
Speaking of which, then there’s ‘weak evidence’, to quote the article, ‘of an association between eating unprocessed red meat and heart disease and type 2 diabetes’.
‘Weak evidence’, of ‘an association’. If we had to stop eating something because of ‘weak evidence’ of ‘an association’, we could likely eat nothing at all.
There’s pretty strong evidence of an association between consuming water and mortality. Everyone who has ever died, started by drinking water.
The author admits that one cannot draw causal conclusions from observational studies but proceeds as if that weren’t true.
‘…but for processed meat, a recent review showed that for each additional 50g of processed meat consumed per day, the risk of heart disease increased by 26% and the risk of type 2 diabetes increased by 44%, on average.’
Cherry-picked risks
Let’s assume that these increased risks really were caused by meat consumption (which, remember, we ought not to do). The percentages indicate by how much your risk increases. (It’s complicated.)
Note that the base case in the study is 50g of processed meat per day, which is 350g per week, which is far more than the dietary recommendation in the article.
Here’s the problem with those risk numbers. Let’s use the 26% for ‘heart disease’ (which actually refers to cardiovascular disease, or CVD) as an example. It is not explained what the base risk is, or over what period it is calculated, in what kind of person, but let’s take me as an example.
The 10-year risk for artherosclerotic CVD in an otherwise healthy, 52-year-old white male former smoker is 1.7%. That means, out of every 1 000 people with my exact profile, 17 would be diagnosed with some CVD-related event in the next 10 years.
A 26% increase from eating an additional 350g or processed meat per week would make my risk 2.1%. So the actual increase in absolute risk is 0.4%, which sounds a lot less scary than 26%.
The review study goes on at some length about the inconsistency of the papers under review, and all the confounding factors they didn’t consider. So, the 26% is just an average of a pretty noisy set of results.
It is also cherry-picked. The study notes that unprocessed red meat is positively associated with coronary heart disease (CHD), with a risk increase of 17%.
It neglects to note, except in a summary chart, that processed red meat appears to reduce the risk of CHD in men (but not in women) by half! This suggests that the basis for these numbers is rather flimsy.
It also neglects to account for the curious fact that all these negative risks emerge only in Western populations, and not in Asian people. (African people weren’t even considered.)
And we don’t know whether it could be something else in the lifestyle of someone who eats more processed meat – such as lack of exercise, or drinking alcohol, for example – that causes the observed changes.
Weak evidence, indeed.
Colorectal cancer
Let’s consider the cancer risk, then. Ass-cancer, in particular.
Apparently, ‘[l]eading international organisations have declared there’s strong evidence consumption of red and processed meat increases the risk of colorectal cancer.’
The authority cited here is an NGO named the World Cancer Research Fund (WCRF).
Once you dig deep enough to get to actual numbers, it seems your increased risk of ass cancer is 27%. Again, this is from observational studies, not clinical trials, so we can’t really conclude anything from it.
Also, the risk increase is based on 100g of red meat per day instead of per week. That’s seven times the dietary recommendation in the article.
The other study cited says that each additional 50g of red meat consumed per day increased the risk of colorectal cancer by 18%. So, the numbers are not even consistent (an increase of twice 18% is 39%, not 27%).
The lifetime risk of colorectal cancer is 4.3% in men and 3.8% in women. Assuming – generously – that the 27% increase is correct, the new risk would be 5.5% in men and 4.9% in women. So, in a group of 100 people, one additional person would get colorectal cancer if all of them ate an additional 100g of red meat per day, which is probably beyond the mean South African family budget.
Moreover, in a South African population, most of the group would be black, and black people have a far lower risk of colorectal cancer than white people. More than 90% lower, in fact. So, the cancer threat from eating meat, to the majority of the population, is negligible.
Scare tactic
The words ‘strong evidence’ also makes for a good scare tactic.
The International Agency for Research on Cancer (IARC), a body of the World Health Organisation (WHO), classifies red meat as probably carcinogenic to humans, along with night shift work, indoor fireplaces, and hot beverages above 65°C, but below alcoholic beverages, which are definitely carcinogenic.
The problem with these classifications is that it considers only the strength of the evidence, and not the degree of risk that this evidence reveals. So, strong evidence of a small increase in risk is classified exactly like strong evidence of a large increase in risk. That’s how alcoholic drinks, leather dust, nuclear fission products, hormone replacement therapy, and tobacco smoking all end up with the same classification.
It is also worth noting that the IARC has reviewed 1045 agents in total. Remarkably, this is only two more than the 1043 it had classified the last time I checked, in 2015.
Of those, 500 (48%) were dismissed as ‘non-classifiable’. Every single one of the rest were described as possibly, probably or definitely carcinogenic.
The lone agent that used to be classified as not carcinogenic (caprolactam; a classification I once described as ‘probably an error’) has indeed been reclassified as possibly carcinogenic.
The IARC hasn’t found a single substance yet that is known to be not carcinogenic, to some degree.
The article notes that the browning effect of grilling produces compounds that can be carcinogenic ‘in very high doses in animal models’. Note: it does not say ‘in typical doses in humans’.
Even so, we shouldn’t char our meat, the author says. Braais, presumably, are right out.
EAT-Lancet Commission
Now, about those dietary recommendations.
Livingstone, the intrepid author of our expedition into the bowels of the red meat scare, chooses to cite the EAT-Lancet Commission recommendations of 98g of red meat per week.
The WCRF, however, from where she pulls the scary ass-cancer claims, recommends otherwise: ‘If you eat red meat, limit consumption to no more than about three portions per week. Three portions is equivalent to about 350–500g (about 12–18oz) cooked weight. Consume very little, if any, processed meat.’
That is up to five times more than the EAT-Lancet Commission will let you eat. So, who exactly are these scaredy-cat commissioners that daren’t touch more than a small weekly medallion of ultra-lean filet?
Well, the EAT Foundation was founded by Norwegian billionaire and animal rights activist, Gunhild Stordalen. This may explain the hostility to eating meat.
The leader of the EAT-Lancet Commission, Walter Willett, is also a lifelong advocate of vegetarianism, and has numerous financial ties to the vegetarian/vegan food industry, every one of which is a conflict of interest.
The rest are a group of 36 self-appointed ‘experts’. This bunch of vegetarian handwringers decided to construct ‘a global planetary health diet that is healthy for both people and planet.’
Heavens forbid that people make their own choices, based on their own local circumstances and tastes.
The commissioners produced a report, which they peer-reviewed themselves.
‘Disturbing’
‘This report is disturbing on a number of fronts,’ wrote Nina Teicholz, an investigative science journalist specialising in nutrition reporting. ‘Most importantly, its diet lacks the backing of any rigorous science. Indeed, it does not cite a single clinical trial to support the idea that a vegan/vegetarian diet promotes good health or fights disease. Instead EAT-Lancet relies entirely on a type of science that is weak and demonstrably unreliable, called epidemiology. This kind of science has been shown to be accurate, when tested in rigorous clinical trials, only 0-20% of the time. One wouldn’t bet on a football team with such poor odds, so why bet on the public health this way?’
She added that the report was one-sided, and resembled the macro-diet fads of the 1970s, which caused severe protein and nutritional deficiencies. It recommends insufficient protein in the diet for many people, including children, overweight individuals and most people over 40.
If only we were all fit and healthy and in our 20s.
Georgia Ede, a medical doctor, also lays into the report, assailing its scientific credibility on 10 different points.
Notably, she writes: ‘The authors admit that it [the report] falls short of providing proper nutrition for growing children, adolescent girls, pregnant women, aging adults, the malnourished, and the impoverished – and that even those not within these special categories will need to take supplements to meet their basic [nutritional] requirements.’
Lack of scientific rigour
Soon, the WHO dissociated itself from the EAT-Lancet diet, pulling out of a launch events following criticism from an Italian official, Gian Lorenzo Cornado, about the report’s lack of scientific rigour and the impact of the diet on people’s health, livelihoods and culture.
The initiative ‘urging for a centralised control of our dietary choices’ risked ‘the total elimination of consumers’ freedom of choice,’ he said.
This sounded a bit hysterical, so I found the full report, and indeed, it says ‘a full range of policy levers, from soft to hard’ will be needed, up to and including ‘eliminate choice’.
The EAT-Lancet Commission wants a complete transformation of our food system, centrally planned and dictated by their own designated experts.
If that sounds Soviet, that’s because it is. A totalitarian technocracy of this sort is exactly what the Soviets had in mind.
Unaffordability
Then, the criticism spread.
‘The shift from low-price, cheap, and not-so-good food to healthy food that internalizes all these costs [of sustainability] will inevitably make food more expensive,’ Jean Balié, platform leader on agrifood policy for the International Rice Research Institute, told the global development news site, Devex. ‘But magically, people will not become richer in these countries [of the global south].’
It wasn’t long before a paper was published (in The Lancet, ironically) saying that even the most affordable EAT-Lancet compliant diet cost more than the entire household per-capita income for at least 1.58 billion people. Trying to adopt it would make global malnutrition much worse.
And that 1.58 billion number is a conservative lower-bound estimate. Nobody can afford to spend their entire income on food, so many more people than that will be unable to afford the EAT-Lancet diet.
Not only that, but another paper found that the EAT-Lancet Commission diet may not prevent non-communicable disease mortality after all. ‘As our findings call into question the global conclusions of the EAT-Lancet report, futher independent validation is needed before it can be used to inform dietary guidelines,’ the authors wrote.
I don’t know about you, but I’m not about to take the ill-founded dictates of would-be vegetarian fascists very seriously.
So, if you’ll excuse me, I’ll risk the ass-cancer and go braai myself a big, juicy steak. I’m going to die of something, anyway, and I might as well be fed and happy when that time comes.
The views of the writer are not necessarily the views of the Daily Friend or the IRR
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Steak on a grill, by Denys Gromov, used under a Creative Commons licence