IBC Diabetes Support Group

IBC Diabetes Support Group

Article:

Red and Processed Meats and Health Risks: How Strong Is the Evidence?

  1. Frank Qian1,2
  2. Matthew C. Riddle3
  3. Judith Wylie-Rosett4and 

Corresponding author: Frank B.  Hu

Diabetes Care 2020 Feb; 43(2): 265-271.https://doi.org/10.2337/dci19-0063

 

Based on the cumulative evidence, the majority of existing dietary guidelines, including the Dietary Guidelines for Americans 2015–2020 (14), recommend dietary patterns relatively low in red and processed meats and high in minimally processed plant foods. Similarly, a consensus report of the American Diabetes Association recommends multiple dietary patterns for preventing and managing T2D, most of which emphasize modest or no consumption of red or processed meats (15). These include the Dietary Approaches to Stop Hypertension (DASH) (16), the traditional Mediterranean-style diet (17), and vegetarian/plant-based regimens (2,9,18). The American College of Cardiology/American Heart Association Guideline on the Primary Prevention of Cardiovascular Disease also recommends consuming diets low in red and processed meats (19). In 2015, the International Agency for Research on Cancer (IARC) classified processed meats as a Group 1 carcinogen for human colorectal cancer, and red meat was classified as probably carcinogenic to humans (Group 2A) based on a comprehensive review of epidemiologic evidence, combined with “strong mechanistic evidence supporting a carcinogenic effect” (20). Based on the review, the IARC has recommended reducing consumption of red and processed meats for cancer prevention.

 

However, a recent collection of systematic reviews and meta-analyses and accompanying dietary guidelines by the “Nutritional Recommendations (NutriRECS) consortium,” published in the Annals of Internal Medicine (2125), has challenged these recommendations. This group also systematically reviewed health-related values and preferences regarding red/processed meat consumption (25) and concluded that most people are generally unwilling to alter their current meat consumption habits. Contradicting both the current dietary recommendations and some of the findings of their own analyses, the authors issued “new dietary guidelines” that individuals should be advised to continue their current meat consumption habits due to the “low certainty” of the evidence, the weak associations, and the difficulty of altering meat eaters’ habits and preferences.

 

Conclusions

The “dietary guideline recommendations” by the NutriRECS consortium suffer from multiple methodological limitations and involve misinterpretations of nutritional evidence. These recommendations are not justified by current evidence and have led to considerable confusion among health professionals and the general public. While more evidence regarding the health effects of red and processed meats is needed, the body of epidemiologic data showing their associations with T2D, CVD, and cancer is large and consistent. Meanwhile, short-term randomized intervention trials have demonstrated the benefits of replacing red meat with plant protein sources in reducing LDL cholesterol and other cardiometabolic risk factors (10). For the prevention and management of diabetes and other chronic diseases, it is important to follow current nutritional recommendations by the American Diabetes Association (15) and other professional and governmental organizations that allow for personalized choices but also emphasize dietary patterns high in minimally processed fruits and vegetables, whole grains, nuts, and legumes, while limiting red and processed meats, refined carbohydrates, saturated fats, and sugar-sweetened beverages. Although there is still some uncertainty regarding current evidence, we should not fall into the trap of demanding absolute proof before taking public health actions. As Sir Austin Bradford Hill succinctly articulated nearly half a century ago (47):All scientific work is incomplete—whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have, or to postpone the action it appears to demand at a given time.

 

 

Definition of Diabetes Mellitus:

Diabetes mellitus is a group disease that occurs because of abnormal insulin and glucagon action.  Both insulin and glucagon are made by the pancreas and determine how the body cell uses food.  Abnormal insulin action causes all foods (i.e. carbohydrates, fats, proteins, minerals, vitamins, water and salt, etc.), to be handled poorly by the body’s cells.  If a person has normal red blood cells, an A1C greater than 5.7% is abnormal; greater than 6.4 is Diabetes.

 

Exercise:

For both pre-diabetes and Type 2 Diabetes, recent studies show that eating less and exercising (resistance better than aerobic), 30 minutes a day, 5 days a week or any equivalent time can improve the heart, arterial blood vessels, lungs, brain and kidney function.

 

In addition, if Metformin is added to eating less and exercising, both blood sugar and blood pressure are reduced and stay down for long periods when Metformin is not taken.  Recent findings show that Metformin not only lowers the blood sugar by stopping the liver from making so much sugar, but it also makes the pancreas produce insulin better.

 

New Medicines:

Advances in the treatment of Type 2 Diabetes include the following groups:

  • Medicines that work on enzymes in the small intestines to enhance insulin secretion by the pancreas.
  • Medicines that work on the kidney to enhance the loss of sugar.
  • New and better insulins and better methods of delivering insulin.