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No consistent evidence of ‘convincing’ red meat/cancer link, says US expert

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There is no consistent evidence of a ‘convincing link’ between colorectal cancer and red meat, according to one leading US epidemiologist who visited New Zealand recently.

With extensive experience in health research methodology and interpretation of epidemiological studies, particularly nutritional epidemiology, Dr Dominik Alexander is based in Boulder, Colorado, where he works for engineering and science consultancy firm Exponent Inc in its Health Sciences Centre for epidemiology, biostatistics and computational biology.

As an epidemiologist, he’s involved with examining exposure and outcome.
“Food is a necessary exposure. All people have to eat,” he says, adding that the result of over-exposure leads to higher Body Mass Index (BMI) rates, where there is an established increased risk for cancers such as colorectal, the most common cancer affecting the alimentary tract.

Last year, the World Cancer Research Fund released the second expert report on a continuous update project on diet and colorectal cancer. This was a comprehensive study, carried out by a panel of scientific experts, which reviewed 567 nutrition-cancer studies from all around the world (see Food New Zealand, July 2011).

The panel’s conclusion was that physical activity and foods containing dietary fibre convincingly reduced the risk of colorectal cancer and, the consumption of garlic, milk and calcium probably also helps to decrease the risk.  However, the report stated that there was a ‘convincing link’ between the consumption of fresh red meat – defined as beef, pork, lamb and goat from domesticated animals – and processed meat and an increased risk of colorectal cancer. This fact was picked up by media around the world and has been used to guide Department of Health nutritional guidelines here and overseas.

However, Dr Alexander points out, it is an ongoing appraisal, which, in his view, has overstated the conclusion that there is a link. “The scientific evidence does not support the ‘convincing link’. In fact, it’s getting weaker over time as more studies are published,” he says.

In addition, the report separated out fresh red meat and processed meats, like salami and jerky. However, he says, there’s actually very little difference between the two in terms of associations.

In the US, he has found the consumers with the highest intake of red meat tend to also smoke, have a higher alcohol consumption rate, do little exercise and are generally unhealthier. There’s also genetics and age to take into account as more people in developed, and increasingly in developing countries, are reaching senior years – one of the strongest risk factors for cancer.

“It’s very challenging to disentangle the factors.”

On recommended portion-sizes (intake values), he argues that they are difficult to quantify as every person is a different size and, therefore, difficult to quantify their risk. He calls it ‘heterogeneity’, where there is no uniform pattern: “75g might work for a small person, for example, but not for a large man involved in physical activity all day.”
In his work, he has looked at a range of intake values and sees no range of patterns for increased risk, with increased consumption.

In Dr Alexander’s view, the focus should be on cancer prevention. He says, “It all starts with physical exercise and maintaining a healthy body weight. In addition you need a well-balanced diet.”

Dr Dominik Alexander PhD MSPH visited New Zealand and Australia in September in a programme organised by Beef + Lamb NZ Inc and the Australian Meat & Livestock Association.

This article appeared in Food NZ magazine (October/November 2012).

Let the science speak for itself

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As epidemiologists go, Dr Dominik Alexander, is a surprise. He’s young, 39, doesn’t wear glasses or a white coat and is a previous professional kickboxer. However, the leading US epidemiologist also knows his stuff about cancer and nutrition research and he’s been over here in New Zealand sharing his expertise.

With extensive experience in health research methodology and interpretation of epidemiological studies, particularly nutritional epidemiology, Alexander is based in Boulder, Colorado, where he works for engineering and science consultancy firm Exponent Inc in its Health Sciences Centre for epidemiology, biostatistics and computational biology.

He delivers the sobering estimation that one in three people will be diagnosed with cancer in their lifetime. The strongest risk factor for cancer, generally, is age.

“With increasing numbers of older people, we are seeing higher rates of cancer and also diabetes and heart disease. This is also the case in developing countries, where the elimination of certain infectious diseases – which would have killed off more of the population early on – and lower infant mortality rates, means a higher rate of cancer and other age-related diseases in the population.”

Relating to nutrition, the types of cancer of concern are those associated with digestion, absorption and elimination such as the most common type, colorectal, through stomach/gastric to the less common oesophageal, pancreatic, liver and other cancers.

As an epidemiologist studying the patterns, causes, and effects of health and disease in defined populations, he’s involved in examining exposure and outcome.

“Food is a necessary exposure. All people have to eat,” he says, adding that the result of over-exposure leads to higher Body Mass Index (BMI) rates – overweight to obese – where there is an established increased risk for cancers such as colorectal, the most common cancer affecting the alimentary tract.

In his view, cancer prevention is all about control. The key is a health lifestyle. “It all starts with physical exercise and maintaining a healthy body weight.  In addition you need a well-balanced diet,” he says.

Opinions + assumptions + perception = confusion

Trouble is, as everyone eats, every single person has an opinion on it and the perceptions of the general public, the medical fraternity and the media vary. That’s why the ‘study of the moment’ is leapt on, over-hyped, over-analysed and consequently gets a lot of airtime leading to consumer confusion.

But, you can’t view a single study in isolation, he notes. “Every study needs to be viewed in the context of the available body of scientific views, otherwise it can be misinterpreted.”

Good science is at the heart of good communication, he believes. Dr Alexander’s advice for those communicating with the public is: “Don’t say anything that can’t be backed up by science. Let the science speak for itself and don’t make an interpretation outside the bounds of the scientific results. Given the complexity with this type of product, there needs to be a cautious approach.”

What media get hung up on sometimes is the people funding the research and conflicts of interest. That can negate the worth of the science itself, he believes. “It’s very important to get to the heart of the issue with science and then focus on the science and the scientific basis for comments.”

In his opinion, what makes good evidence is transparency, objectivity, justification for doing the research, rationale and a clear and open basis for research.

“A lot of problems come in when the research is not open and transparent. Say what you’re going to do, do it and show what you learned,” he advocates.

Looking to the future

Looking to the future, we have a long way to go on the preventative side, he says, and continuous updates of cohort studies, don’t always shed light.

“We also lack long-term evidence of differences between organic versus conventional products, for example.

“This all takes us back to the holistic approach and concentrating on the healthy body weights and lifestyle elements.”

Dr Alexander’s articulate delivery comes with a sense of humour and the surprising revelation that he was once a professional kickboxer in the 1990s, before he moved straight to science at the University of Alabama in Birmingham (UAB).

“You could call me the toughest epidemiologist in the world,” he laughs.

At UAB, he was awarded a National Cancer Institute Fellowship for Cancer Prevention and Control and worked closely with the Department of Pathology where he designed and implemented epidemiological studies pertaining to colorectal survival. He is also the 2010 recipient of the UAB School of Public Health Alumnus for scientific excellence.

Dr Dominik Alexander PhD MSHP was invited to Australia and New Zealand in September in a visit jointly organised by Meat & Livestock Australia and Beef + Lamb NZ Inc.

This article appeared in Pen & Palate (October 2012), the NZ Guild of Food Writers’ ezine.

Telling the story

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The meat industry needs to market itself better and tell its story, according to several presenters at the Red Meat Sector Conference.

Marketing of industry is all about building trust in the integrity of the brand, Meat and Livestock Australia’s managing director Scott Hansen told delegates.

“We’ve learned the best defence against attacks on the industry is  the farmers themselves to become advocates for their industry and their own businesses.”

“Not only do we have to sell a product, we have to sell the industry.”

Keeping consumers informed, however, has become way more complex. Consumer-driven US company Agri Beef has identified that, in the US, the 28-45 year age group – the “Digital Moms” – go online first to make decisions.

They don’t want to know how animals are slaughtered, but they do want to know the animals are treated well and that the product is safe to eat, said the company’s executive vice-president Rick Stott.

Blogs and videos are two weapons in the armoury. Three young US farmers produced a low-cost home-produced rap video about their work on the family farm that went viral after being posted on You Tube and, at the time of his speaking, Stott said had received over 4.5 million views.

The rapid rise and uptake of social media and the use of smartphones around the globe in the past couple of years is changing the way businesses communicate with consumers and was remarked on by several of the presenters.

New communication channels that retailer Progressive Enterprises is using here in New Zealand to directly interact with its consumers include Facebook, You Tube, smartphone applications and QR Codes alongside tailored emails and promotions aimed at loyal consumers, according to its general manager for merchandise Murray Johnston. This all runs alongside print and TV advertising.

Through the use of interactive technology, for a consumer, “brands are now yours. You make them,” he said.

Pinterest’s bulletin boards were also pointed to by Stott and MLA’s Scott Hansen, while B+LNZ Inc chief executive Rod Slater talked of PLUCK, which smartphone-enabled consumers can use in conjunction with television advertisements.

This article appeared in Food NZ magazine (August/September 2012).

Delivered: second Red Meat Sector Conference

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Delivered, as promised: Excellent, inspirational and thought-provoking speakers, all appearing in a packed programme for the 250 delegates attending the second Red Meat Sector conference.

Congratulations must go to the Meat Industry Association (MIA) and Beef + Lamb NZ Ltd (B+LNZ), joint organisers of this year’s well-attended Red Meat Sector Conference at Rydges Lakeland Resort hotel in Queenstown.

Alongside heartening optimism for future demand for red meat, recurrent themes were the massive potential for New Zealand of emerging markets in Asia, especially China, water issues, the need to utilise best practice, the need for all links in the chain to tell the industry’s story to the public, plus the rapid emergence of social media as a tool for communicating with consumers.

In his opening comments, MIA chairman Bill Falconer also noted that, while not as quickly as some would like, encouraging progress is being made on the Red Meat Sector Strategy and that “small starts are being made across the board.” Later in the day Rob Davison, from the B+LNZ Economic Service, outlined a number of matrices that the Economic Service is developing that will help to track progress against the strategy, and these matrices will “focus conversations, thinking and actions to drive the future”.

The Conference also saw the announcement of new Primary Growth Partnership (PGP) funding for the red meat sector, for a project to develop high-value grass-fed marbled beef, using Waygu genetics.

All the presentations were a veritable smorgasbord of information, packed with facts, statistics and views from many facets of the industry, enabling delegates to pick out what was relevant for their part of the value chain. While every single one of the speakers was passionate and eloquent about their topic, from an export food manufacturing perspective the highlights were excellent presentations from McDonald’s Arron Hoyle and vertically integrated meat processor Agri Beef’s Rick Stott from the US.

Besides the serious business, there was entertainment and laughter too. Lunch – finger food featuring B+LNZ Ambassador chef Ben Battersbury’s speciality “alternative cuts, not cheap cuts” like lamb riblets –  was amusingly heralded with witty comments from him. After dinner speaker Davey Hughes of Swazi Apparel gave an hilarious account of hunting expeditions in Africa and shared a few (tongue-in-cheek) items from his latest collection, including a new ‘mankini’.

Also noteworthy, was a significant Australian presence at the conference in the form of representatives from Meat & Livestock Australia and Aus-Meat. This put physical form to MLA’s managing director Scott Hansen’s opening comment in his presentation that “Australia sees a close collaboration with New Zealand.”

There was positive feedback from delegates, who came from all parts of the sector, including farmers, processors, equipment suppliers, researchers and media.

This article appeared in Food NZ magazine (August/September 2012). Copies of most of the conference presentations are available at www.mia.co.nz or redmeatsector.co.nz.