What is wrong with the new study about eating meats?

What is wrong with the new study about eating meats?

so much

On September 30, Annals of Internal Medicine published what many are calling the “red meat papers”, advising Americans that there’s no need to cut down on consumption of red and processed meats (even if they come from factory farms).

Media outlets worldwide were quick to pick up on it, reassuring legions of anxious consumers that they can scarf down their burgers and bacon without concern about negative consequences to their health. Headlines emerged such as: “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.”

What’s the truth? Does this mean that decades of research, regulations by international bodies, and common sense are all wrong?

If you want the facts, check out this article from the Food Revolution Network.

What’s all wrong about annals of internal medicine red
and processed meat advice,

By John Robbins

On September 30, 2019, Annals Of Internal Medicine published a
new set of dietary guidelines. The guidelines, based on a series of reviews,
essentially advised adults to continue consuming red and processed meat at
current levels.

This was trumpeted as a major news story, and media outlets
worldwide were quick to pick up on it, reassuring legions of anxious consumers
that they can scarf down their burgers and bacon without concern about negative
consequences to their health. Headlines emerged such as: “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 only trouble is, this conclusion is utterly wrong, and
threatens to add a mountain of confusion at the very time we face a public
health crisis which demands that nutritional authorities provide clear and
consistent guidance. In fact, much of the data upon which this analysis was
based does show negative health effects from consuming red and processed meat –
including increased all-cause mortality, cardiovascular disease, cancer, and
diabetes.

The researchers put long-established and credible studies through
a new measurement tool, known as GRADE, which was developed to evaluate
pharmaceuticals. GRADE turns out to be a deeply flawed methodology for
evaluating the impacts of lifestyle intervention.

Perhaps the person most responsible for the use 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
previously authored a study, also published in
the Annals of Internal Medicine, that challenged the quality of the
evidence behind the recommendations to limit sugar. That paper, published
online in 2016, was funded by the International Life Sciences Institute, a
nonprofit group funded by large food and beverage companies that has come under
intense scrutiny for its role in shaping food policy.

Created four decades ago by a top Coca-Cola executive, the
International Life Sciences Institute has a harmless sounding name, but
according to an in-depth report in
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 said: ”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.”

Another Food Revolution Summit speaker, Neal Barnard MD,
President of Physicians’ Committee for Responsible Medicine, called 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 department of nutrition at Harvard Medical School from 1991 to 2017. He
said: “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 facts are
actually quite clear. We now have a great many studies, published in
peer-reviewed medical journals, which have found compelling associations
between red meat and early death. One of the largest, involving more
than 500,000 people, was published in The British Medical Journal on
May 9, 2017. In this enormous study, researchers found that consumption of red
meat, both processed and unprocessed, was associated with increased risk of
death from every one of the specific causes of death they looked at — including
cancer, heart disease, stroke, and other cerebrovascular diseases, respiratory
disease, diabetes, infections, kidney disease, and chronic liver disease.

We have an overwhelming body of science telling us that by
eating less red meat, people will live longer and healthier lives.
What we don’t need are sensationalized headlines that misrepresent the science,
and direct people toward eating foods that will clog their arteries, lead to
illness and early death, and also damage the health of the planet.

As a member, along with my son and colleague, Ocean Robbins,
of True Health Initiative (THI),
I’m seeking to correct the record on this dangerous development. THI is a
global coalition of leading experts who range from paleo to vegan, seeking to
fight fake facts and combat false doubts to create a culture free of
preventable disease.

True Health Initiative issued a letter to Annals
of Internal Medicine
, recommending that they preemptively retract
publication of these papers on the basis of grave concerns about the potential
for damage to public understanding, and public health. This letter was signed
by, among 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 change, slightly, the headline of their lead press
release. But they refused to retract or meaningfully modify their confusing and
disturbing message.

So True Health Initiative issued a press
release
 of its own, which is posted below. And under that, you’ll find
statements from some notable THI members and colleagues on this topic.

The Center
for Science in the Public Interest
, the American
Institute for Cancer Research
, and the Harvard
T.H. Chan School of Public Health
 have also issued responses.

Hopefully, this can help to clear up some of the confusion
that may ensue from this deeply misguided report.

With a public health crisis that is growing deeper by the
day, the world needs facts, not fiction, in order to guide public health
policy. And the facts are in: If you value your health, and you want to
minimize your risk of contracting heart disease, cancer, diabetes, dementia, or
other chronic diseases, then eating less red and processed meat, or none at
all, is very good advice indeed.

No amount of confusion stemming from this flawed
interpretation of past studies can change this fundamental fact.

A Response to the Annals Of Internal Medicine Reviews
on Meat Guidelines

Derby, Connecticut September 30th, 2019:

The Annals of Internal Medicine has just
published a series of systematic reviews and meta-analyses. Despite many of the
reviews’ data showing negative health effects of consuming red and processed
meat, such as increased all-cause mortality, cardiovascular disease, cancer and
diabetes, the authors are calling for alternative ‘guidelines’ and advising
people to continue consuming red and processed meat at current levels. True
Health Initiative (THI) urges scientists, nutritionists, and consumers to look
deeper.

The Annals‘ analyses are not a new development
in science; they are simply using an ill-fitting measuring tool (GRADE), which
is built to evaluate pharmaceuticals and not lifestyle intervention. This is
why True Health Initiative, in conjunction with the American College of
Lifestyle Medicine, proposed a metric specifically fitted to measure SOE
related to lifestyle 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 using the ill-fitting GRADE measurements, the
recommendations put forth by these reports is in direct contradiction to the
data reported by the reports themselves. In one study where people simply
limited meat, the researchers found a 10% reduction in cardiovascular
mortality, a 6% reduction in stroke, and a 10% reduction in type 2 diabetes.

John Sievenpiper MD, PhD, who worked on one of the published
systematic reviews and meta-analyses as a nutritional epidemiology and
meta-analysis expert 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 lifestyle behaviors are a leading cause of chronic
illness, with more than 80% of deaths resulting from noncommunicable diseases.
Reports that claim to disprove accepted science, while proving nothing are an
irresponsible threat to progress and a public health 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.K. Newby,
author, Food and Nutrition: What Everyone Needs to Know.

In today’s society, a multitude of competing agendas and
motivations obscure the fundamental and simple truths of healthy living. “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 submit to a world where chronic disease and premature death, along
with detrimental climate 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, published in the Annals of Internal Medicine on
September 30th, 2019. These quotes come from leading professionals in the
health community – most, but not all are members of True Health Initiative.
This is meant to express the concern for public health that could result from
the misinterpretation of these 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 the meta-analyses who strongly
disagreed with the conclusions and recommendations 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 should be clear that the articles you reference
are not recommendations developed by the American College of Physicians. Annals
of Internal Medicine
 is an editorially independent, peer-reviewed
medical journal with its own publishing protocols. ACP leadership does not give
direction to the editors of Annals of Internal Medicine on
what they should or should not 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 via 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 author, and
co-founder of Food Revolution Network:

“We have a great many studies, published in peer-reviewed
medical journals, that have found clear and compelling associations between red
meat and early death. One of the largest, involving more than 500,000 people,
was published in The British Medical Journal on May 9, 2017.
In this enormous study, researchers found that consumption of red meat, both
processed and unprocessed, was associated with increased risk of death from
every one of the specific causes of death they looked at — including cancer,
heart disease, stroke and other cerebrovascular diseases, respiratory disease,
diabetes, infections, kidney disease, and chronic liver disease. We have an
overwhelming body of science telling us that by eating less red meat, people
will live longer and healthier lives. What we don’t need are sensationalized
headlines that misrepresent the science, and direct people toward eating foods
that will clog their arteries, lead to illness and early death, and also damage
the health 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.K. 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
author 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 may not have had hugely
beneficial health effects, eliminating beef and most other animal products
can reverse the progression of many chronic diseases. 
These include even severe coronary heart disease, type 2 diabetes, high blood
pressure, elevated cholesterol levels, and early-stage prostate cancer—as well
as reversing cellular aging by lengthening telomeres and turning on hundreds of
genes that keep us healthy and turning off hundreds more that cause illness
within just three months. Many patients improved so much in only 9 weeks that
they no longer needed a heart transplant. Most have been able to reduce or
discontinue medications under their doctor’s supervision that they would have
taken the rest of their lives. Medicare is covering this plant-based program
for reversing heart disease nationwide.”

“These Annals reports will confuse millions
of people into believing that ‘these damn doctors can’t make up their minds,’
countering decades of consistent research showing that a meat-based diet is
unhealthful and undermining the public’s confidence in scientific research.”

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 fact that the World Health Organization has
found convincing evidence that processed meat causes cancer in humans, and that
red meat is a probable human carcinogen, was not disputed in these new
“guidelines” rather, the “guidelines” encourage people to continue their
exposure to these dangerous products simply because their technically weak
meta-analysis methodology was unable to detect sufficient evidence of benefit
of avoiding these products that outweighed the study authors’ estimation of how
much people like continuing to eat bacon, hotdogs, sausage, and burgers.

Randomized clinical trials by our team and others have
clearly shown that over the short and long term, reduction or elimination of
red and processed meat and replacement with healthier foods lead to significant
weight loss, improvements in cholesterol and blood pressure, and substantial
benefit for diabetes management.”

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 current body of research shows very strong
relationships between good health and certain eating patterns (more fruits,
vegetables, legumes, and whole grains, and limited red and processed meats).

At Oldways, we are dedicated to improving public health
using the weight of evidence from all relevant research methods. Unfortunately,
the Annals of Internal Medicine article seeks to sow confusion,
rather than consensus. This is especially harmful, as confusion gives us a
reason not to change our ingrained habits. We all need to take a minute today
to pause and ask ourselves what each of us can change for the sake of our
health 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” but to
believe them. The individuals and the public more broadly, who don’t have the
medical or scientific training to review the actual studies and engage in the
research with rigor and expertise. I worry about the people who will read the
headlines, take them at face value, and have no way of knowing that these recommendations
are in fact, dangerous to their health and the health of their families.
Recommendations like these are the reason so many people are confused about
nutrition, and they’re a major part of the reason families across the country
continue to experience unnecessary and preventable diseases associated with
unhealthy, misinformed dietary patterns.”

 

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.

Rod Stone
Author,
Publisher and Supplier of Healthy Living information and products to improve
your life.

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