On September 30, 2019, Annals Of Internal Medicine revealed a brand new set of dietary pointers. The pointers, primarily based on a collection of evaluations, primarily suggested adults to proceed consuming pink and processed meat at present ranges.
This was trumpeted as a significant information story, and media retailers worldwide had been fast to choose up on it, reassuring legions of anxious shoppers that they’ll scarf down their burgers and bacon with out concern about detrimental penalties to their well being. Headlines emerged reminiscent of: “Is Everything We Know About Meat Consumption Wrong? Stunning new recommendation says to keep eating it”, and “There’s no need to eat less red or processed meat.”
The solely hassle is, this conclusion is totally unsuitable, and threatens so as to add a mountain of confusion on the very time we face a public well being disaster which calls for that dietary authorities present clear and constant steerage. In truth, a lot of the info upon which this evaluation was primarily based does present detrimental well being results from consuming pink and processed meat – together with elevated all-cause mortality, heart problems, most cancers, and diabetes.
The researchers put long-established and credible research by means of a brand new measurement software, often called GRADE, which was developed to judge prescribed drugs. GRADE seems to be a deeply flawed methodology for evaluating the impacts of way of life intervention.
Perhaps the individual most accountable for the usage of such a deeply inappropriate statistical methodology is Bradley C. Johnston. He co-authored the report, and says “there may not be any benefit at all” [from] “reducing your intake of red or processed meat.” Johnston beforehand authored a research, additionally revealed within the Annals of Internal Medicine, that challenged the standard of the proof behind the suggestions to restrict sugar. That paper, revealed on-line in 2016, was funded by the International Life Sciences Institute, a nonprofit group funded by giant meals and beverage firms that has come underneath intense scrutiny for its function in shaping meals coverage.
Created 4 a long time in the past by a prime Coca-Cola government, the International Life Sciences Institute has a innocent sounding identify, however based on an in-depth report within the New York Times, “it is almost entirely funded by Goliaths of the agribusiness, food and pharmaceutical industries… and championed tobacco interests during the 1980s and 1990s in Europe and the United States.”
Food Revolution Summit speaker Marion Nestle is Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University. Referring to the Annals of Internal Medicine’s “red meat papers” she mentioned: ”The papers come throughout to me as a concerted assault on dietary pointers (nationwide and worldwide), on diet science on the whole, and on dietary epidemiology particularly.”
Another Food Revolution Summit speaker, Neal Barnard MD, President of Physicians’ Committee for Responsible Medicine, referred to as it “cancer-causing clickbait.”
Dr. Walter Willett, MD, P.H., is Professor of Epidemiology and Nutrition at Harvard T.H. Chan School of Public Health, and was the chair of the division of diet at Harvard Medical School from 1991 to 2017. He mentioned: “This report has layers of flaws and is the most egregious abuse of evidence that I have ever seen.”
Despite the confusion created by all this, the information are truly fairly clear. We now have an awesome many research, revealed in peer-reviewed medical journals, which have discovered compelling associations between pink meat and early loss of life. One of the most important, involving greater than 500,000 folks, was revealed in The British Medical Journal on May 9, 2017. In this monumental research, researchers discovered that consumption of pink meat, each processed and unprocessed, was related to elevated threat of loss of life from each one of many particular causes of loss of life they checked out — together with most cancers, coronary heart illness, stroke, and different cerebrovascular illnesses, respiratory illness, diabetes, infections, kidney illness, and power liver illness.
We have an awesome physique of science telling us that by consuming much less pink meat, folks will dwell longer and more healthy lives. What we don’t want are sensationalized headlines that misrepresent the science, and direct folks towards consuming meals that may clog their arteries, result in sickness and early loss of life, and additionally harm the well being of the planet.
As a member, together with my son and colleague, Ocean Robbins, of True Health Initiative (THI), I’m in search of to right the report on this harmful growth. THI is a world coalition of main specialists who vary from paleo to vegan, in search of to struggle faux information and fight false doubts to create a tradition freed from preventable illness.
True Health Initiative issued a letter to Annals of Internal Medicine, recommending that they preemptively retract publication of those papers on the idea of grave issues concerning the potential for harm to public understanding, and public well being. This letter was signed by, amongst others, David L. Katz, MD, the Founding Director of Yale University Prevention Research Center; Richard Carmona, MD, MPH, FACS, the 17th Surgeon General of The United States; Christopher Gardner, PhD, of Stanford University Prevention Research Center; Frank Hu, MD, PhD, Chair of the Department of Nutrition for Harvard T.H. Chan School of Public Health; Dariush Mozaffarian, MD, Dean of Friedman School of Nutrition for Tufts University; and Kim A. Williams, MD, Chief of the Division of Cardiology for Rush Medical College and Past President of the American College of Cardiology.
In response to this request, Annals of Internal Medicine agreed to alter, barely, the headline of their lead press launch. But they refused to retract or meaningfully modify their complicated and disturbing message.
So True Health Initiative issued a press launch of its personal, which is posted beneath. And underneath that, you’ll discover statements from some notable THI members and colleagues on this matter.
The Center for Science within the Public Interest, the American Institute for Cancer Research, and the Harvard T.H. Chan School of Public Health have additionally issued responses.
Hopefully, this can assist to clear up among the confusion which will ensue from this deeply misguided report.
With a public well being disaster that’s rising deeper by the day, the world wants information, not fiction, as a way to information public well being coverage. And the information are in: If you worth your well being, and you need to reduce your threat of contracting coronary heart illness, most cancers, diabetes, dementia, or different power illnesses, then consuming much less pink and processed meat, or none in any respect, is superb recommendation certainly.
No quantity of confusion stemming from this flawed interpretation of previous research can change this elementary truth.
Press Release from True Health Initiative
True Health Initiative Respectfully Disagrees
A Response to the Annals Of Internal Medicine Reviews on Meat Guidelines
Derby, Connecticut September 30th, 2019:
The Annals of Internal Medicine has simply revealed a collection of systematic evaluations and meta-analyses. Despite lots of the evaluations’ information exhibiting detrimental well being results of consuming pink and processed meat, reminiscent of elevated all-cause mortality, heart problems, most cancers and diabetes, the authors are calling for different ‘guidelines’ and advising folks to proceed consuming pink and processed meat at present ranges. True Health Initiative (THI) urges scientists, nutritionists, and shoppers to look deeper.
The Annals‘ analyses are not a brand new growth in science; they are merely utilizing an ill-fitting measuring software (GRADE), which is constructed to judge prescribed drugs and not way of life intervention. This is why True Health Initiative, together with the American College of Lifestyle Medicine, proposed a metric particularly fitted to measure SOE associated to way of life intervention, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM).
“The authors’ conclusions in no way support the bold claim made in this release,” David L. Katz MD, MPH, and President of True Health Initiative. Even utilizing the ill-fitting GRADE measurements, the suggestions put forth by these stories is in direct contradiction to the info reported by the stories themselves. In one research the place folks merely restricted meat, the researchers discovered a 10% discount in cardiovascular mortality, a 6% discount in stroke, and a 10% discount in sort 2 diabetes.
John Sievenpiper MD, PhD, who labored on one of many revealed systematic evaluations and meta-analyses as a dietary epidemiology and meta-analysis skilled says, “Unfortunately, the leadership of the paper chose to play up the low certainty of evidence by GRADE, as opposed to the protective associations that directly support current recommendations to lower meat intake.”
“The recommendation that adults continue current red and processed meat consumption is based on a skewed reading and presentation of the scientific evidence… even with this skewed way of presenting the evidence, the reviews clearly indicate the benefits of reducing red and processed meat consumption,” Marco Springmann, Oxford Martin Programme on the Future of Food.
Unhealthy way of life behaviors are a number one explanation for power sickness, with greater than 80% of deaths ensuing from noncommunicable illnesses. Reports that declare to disprove accepted science, whereas proving nothing are an irresponsible risk to progress and a public well being concern.
“The panel’s blanket recommendation that adults should continue their red meat consumption habits is highly irresponsible. We are facing a growing epidemic of diet-related chronic diseases and a climate change crisis, both of which are linked to high meat consumption,” Frank Hu, Chair of the Department of Nutrition, Harvard.
“Sadly, the confluence of factors leading to today’s media frenzy directly contributes to the culture of nutrition confusion. It further erodes the public’s trust in science. And it’s bad for everyone and everything: our health, our environment, and our society.” P.Okay. Newby, writer, Food and Nutrition: What Everyone Needs to Know.
In at present’s society, a mess of competing agendas and motivations obscure the basic and easy truths of wholesome residing. “Not all meat is created equal, but the science is clear that overconsumption of red meat and processed meat can be detrimental for both public health and the environment,” Danielle Nierenberg, Food Tank. If we don’t create enduring, sustainable change, we undergo a world the place power illness and untimely loss of life, together with detrimental local weather change, are the norm, not the exception. Richard Carmona, MD, MPH, FACS, The 17th Surgeon General of The United States says, “nutritional science is an essential part of public health which therefore requires national leadership to provide clear, concise and thoroughly scientifically vetted information to providers and the public in order to optimize food choices.”
Critiques From Prominent Authorities
The following is a compilation of quotes in response to the meat papers, revealed within the Annals of Internal Medicine on September 30th, 2019. These quotes come from main professionals within the well being neighborhood – most, however not all are members of True Health Initiative. This is supposed to precise the priority for public well being that would consequence from the misinterpretation of those meat papers.
David L. Katz MD, MPH, President of True Health Initiative:
“The author conclusions in no way support the bold claim made in this release. The authors effectively say: ‘these papers show that when diet quality, dietary pattern, and what is replacing meat is systematically ignored because we don’t have those data – then very small variations in meat and processed meat intake (we mostly were unable to say which) are apparently associated with small differences in health outcomes – in the expected direction, but with extreme lack of certainty because of the data problems noted above. None of these papers report on ‘good health.’ They all compare rates of mortality, cardiometabolic disease, and cancer.’ ‘No Change’ in such outcomes does not mean good health; it means there’s more than one way to get the same, bad health.”
John Sievenpiper, MD, PhD
(co-author on one of many meta-analyses who strongly disagreed with the conclusions and suggestions from the panel):
“Unfortunately, the leadership of the paper chose to play up the low certainty of evidence by GRADE, as opposed to the protective associations that directly support current recommendations to lower meat intake. The signals would be even stronger if one considered substitution analyses with plant protein sources or investigated dose-response gradients which are used to upgrade data by GRADE, both of which I had requested. Unfortunately, I never saw the galley proofs to ensure that these changes had been made.”
Robert McLean, MD, FACP, President, American College of Physicians:
“It needs to be clear that the articles you reference are not suggestions developed by the American College of Physicians. Annals of Internal Medicine is an editorially unbiased, peer-reviewed medical journal with its personal publishing protocols. ACP management doesn’t give course to the editors of Annals of Internal Medicine on what they need to or mustn’t publish.”
Marion Nestle, PhD, MPH:
Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University; visiting professor of Nutritional Sciences at Cornell University by way of www.foodpolitics.com says, “The papers come across to me as a concerted attack on dietary guidelines (national and international), on nutrition science in general, and on nutritional epidemiology in particular. The meat industry and its supporters will love them. Attacks on the quality of nutrition research have been coming from many sources lately: the food industry, of course, but also statisticians (John Ioannidis at Stanford is making a career of this), and some scientists (usually with ties to food companies). The criticisms themselves are not new. What is new is the vehemence and level of effort to discredit observational studies, particularly those based on self-reports of dietary intake. Yes, nutritional epidemiology has flaws, but the methods have been useful in many instances, as argued convincingly by two of its leading practitioners. The way I look at nutrition research is that it is essential to evaluate the totality of information available: laboratory, animal, human epidemiology, and clinical studies – to do this in the context of what people actually eat and the number of calories they consume, and to add in a hefty dose of common sense. Common sense is what’s missing in these studies.”
John Robbins, 2-million copy bestselling writer, and co-founder of Food Revolution Network:
“We have an awesome many research, revealed in peer-reviewed medical journals, which have discovered clear and compelling associations between pink meat and early loss of life. One of the most important, involving greater than 500,000 folks, was revealed in The British Medical Journal on May 9, 2017. In this monumental research, researchers discovered that consumption of pink meat, each processed and unprocessed, was related to elevated threat of loss of life from each one of many particular causes of loss of life they checked out — together with most cancers, coronary heart illness, stroke and different cerebrovascular illnesses, respiratory illness, diabetes, infections, kidney illness, and power liver illness. We have an awesome physique of science telling us that by consuming much less pink meat, folks will dwell longer and more healthy lives. What we don’t want are sensationalized headlines that misrepresent the science, and direct folks towards consuming meals that may clog their arteries, result in sickness and early loss of life, and additionally harm the well being of the planet.”
Danielle Nierenberg, Food Tank:
“Not all meat is created equal, but the science is clear that overconsumption of red meat and processed meat can be detrimental for both public health and the environment.”
Marco Springmann, Oxford Martin Programme on the Future of Food:
“The recommendation that adults continue current red and processed meat consumption is based on a skewed reading and presentation of the scientific evidence… even with this skewed way of presenting the evidence, the reviews clearly indicate the benefits of reducing red and processed meat consumption.”
P.Okay. Newby, ScD, MPH, Author of Food and Nutrition: What Everyone Needs to Know:
“The vast majority of headlines flitting through newsfeeds do not reflect key study details: most showed a small and significant effect of red and processed meat on various health outcomes, for example. They also lack context: a number of results are consistent with the larger body of evidence showing increased risks of various diseases among those consuming a diet with higher meat intakes.”
Helen Harwatt, PhD, Animal Law & Policy Program, Harvard Law School:
“In addition to considering the non-communicable disease impacts of red and processed meats, it is worth noting that the WHO recognizes climate change as the greatest threat to human health – and red meat is a particularly significant contributor to global greenhouse gas emissions and rising temperatures. The authors recommendations are therefore irresponsible for public health in a number of high impact ways.”
“Red meat is a particularly significant contributor to global greenhouse gas emissions and rising temperatures. The author’s recommendations are, therefore, irresponsible for public health in a number of high impact, detrimental ways.”
Dean Ornish, MD, Clinical Professor of Medicine, UCSF and writer of Undo It:
“Having seen what a powerful difference a whole foods plant-based diet low in fat and refined carbohydrates can make in people’s lives, these articles deeply sadden me because they will discourage many people from making changes that can transform their lives for the better.”
“While modest reductions in beef might not have had vastly helpful well being results, eliminating beef and most different animal merchandise can reverse the development of many power illnesses. These embrace even extreme coronary coronary heart illness, sort 2 diabetes, hypertension, elevated levels of cholesterol, and early-stage prostate most cancers—in addition to reversing mobile getting old by lengthening telomeres and turning on a whole bunch of genes that preserve us wholesome and turning off a whole bunch extra that trigger sickness inside simply three months. Many sufferers improved a lot in solely 9 weeks that they not wanted a coronary heart transplant. Most have been in a position to scale back or discontinue medicines underneath their physician’s supervision that they’d have taken the remainder of their lives. Medicare is overlaying this plant-based program for reversing coronary heart illness nationwide.”
“These Annals stories will confuse thousands and thousands of individuals into believing that ‘these damn doctors can’t make up their minds,’ countering a long time of constant analysis exhibiting meat-based weight-reduction plan is unhealthful and undermining the general public’s confidence in scientific analysis.”
Frank Hu, MD, PhD, Chair of the Department of Nutrition, Harvard T.H. School of Public Health:
“The panel’s blanket recommendation that adults should continue their red meat consumption habits is highly irresponsible. We are facing a growing epidemic of diet-related chronic diseases and a climate change crisis, both of which are linked to high meat consumption. Red meat consumption remains high in economically developed countries and is markedly increasing worldwide. In this context, it is unprecedented and unconscionable for a self-appointed panel to issue dietary guidelines that are tantamount to promoting meat consumption, despite their own findings that high consumption is harmful to health.”
Neal D Barnard, MD, FACC, President Physicians Committee for Responsible Medicine:
“The indisputable fact that the World Health Organization has discovered convincing proof that processed meat causes most cancers in people, and that pink meat is a possible human carcinogen, was not disputed in these new “guidelines” somewhat, the “guidelines” encourage folks to proceed their publicity to those harmful merchandise just because their technically weak meta-analysis methodology was unable to detect enough proof of good thing about avoiding these merchandise that outweighed the research authors’ estimation of how a lot folks like persevering with to eat bacon, hotdogs, sausage, and burgers.
Randomized scientific trials by our workforce and others have clearly proven that over the quick and long run, discount or elimination of pink and processed meat and alternative with more healthy meals result in vital weight reduction, enhancements in ldl cholesterol and blood stress, and substantial profit for diabetes administration.”
Christopher Gardner, PhD, Stanford University Prevention Research Center:
“The authors themselves note that their recommendations for people to continue eating unprocessed and processed red meats at current rates are ‘weak recommendations, with low-certainty evidence’. Beyond weak, I believe these are reckless. They will confuse the public & undermine scientific credibility, with potential to harm public health and the environment.”
Eric Rimm ScD, Harvard T.H. School of Public Health:
“We should note that these are primarily health researchers conducting these reviews and they are using terms to assess bias and certainty as if they are systematically reviewing pharma drug trials to determine the effect of a synthetic compound in pill form. The method does not translate to data on dietary patterns.”
Sara Baer-Sinnott, President, and Kelly Toups, MLA, RD, LDN, Director of Nutrition, Oldways:
“The present physique of analysis reveals very sturdy relationships between good well being and sure consuming patterns (extra fruits, greens, legumes, and entire grains, and restricted pink and processed meats).
At Oldways, we are devoted to bettering public well being utilizing the burden of proof from all related analysis strategies. Unfortunately, the Annals of Internal Medicine article seeks to sow confusion, somewhat than consensus. This is very dangerous, as confusion offers us a motive to not change our ingrained habits. We all must take a minute at present to pause and ask ourselves what every of us can change for the sake of our well being and that of the planet.”
Audrey Lawson-Sanchez, Executive Director www.balanced.org:
“When I see recommendations like those made by these authors, I think first of the people who essentially have “no choice” however to believe them. The people and the general public extra broadly, who don’t have the medical or scientific coaching to assessment the precise research and have interaction within the analysis with rigor and experience. I fear concerning the individuals who will learn the headlines, take them at face worth, and don’t have any approach of figuring out that these suggestions are in reality, harmful to their well being and the well being of their households. Recommendations like these are the rationale so many individuals are confused about diet, and they’re a significant a part of the rationale households throughout the nation proceed to expertise pointless and preventable illnesses related to unhealthy, misinformed dietary patterns.”
Tell us within the feedback:
- What do you consider the Annals of Internal Medicine report?
- Do you assume that public well being can be served by consuming much less pink meat and processed meat?
- Should the environmental affect of meat be included within the public well being equation?
Featured Image: iStock.com/Lisovskaya