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Processed Meat & Cancer Risk For Children

So the verdict is in, processed meats cause cancer. To me this is not necessarily new news. Whilst I was studying human nutrition at the University of Otago over 10 years ago, I remember learning about the potential link between cancer and processed meats.   However the recent announcement from the  World Health Organisation's International Agency for Research on Cancer (IARC) is significant, as it will make many people sit up and take notice, and perhaps have a think about their family's diet.

There has been quite a lot of commentary on this topic in the media. I have heard views that range from "Panic Stations: Eating a sausage will kill you" to skepticism "Here we go again...yet another thing that may kill me...everything causes cancer!"

Should we be skeptical?

No, I don't think we should be. The IRAC are a reputable professional body (part of the WHO no less)  and the evidence used to make this decision is strong. The IRAC working group was made up of 22 scientists from 10 countries. During the assessment process they evaluated and scrutinised more than 800 epidemiological studies. The evidence is clear processed meats do cause cancer.

Should we panic?

 If we have given our child a ham sandwich or a sausage have we condemned them to cancer?  Again, I think the answer is no, but lets delve a little bit deeper and have a look at the evidence.

First things first: What is processed meat?

Processed meat is meat which is not sold fresh, It has been cured, salted, smoked or preserved in some way. Processed meats can be made from red meats,  fish and poultry.  (However from the studies it would appear processed meats made from red meats, lamb, beef and pork may be worse, than those from fish and poultry) This would include:

• Sausages
• Ham, bacon,salami and other deli meats
• Tinned meats
• Chicken nuggets and fish fingers
• Smoked fish

Fresh mince is not considered a processed meat. 

What type of cancer does processed meat cause? 

Carcinogens  (cancer causing substances) typically link to specific cancer types.  For example tobacco is a known risk factor for lung cancer, and solar radiation for melanoma.  The consumption of processed meat is now known to be a cause of bowel cancer. The evidence is very strong for this type of cancer. There is also emerging evidence for processed meat as a cause of stomach cancer, but at this time the link is not as strong. 

Bowel Cancer in NZ: Some Numbers

New Zealand has the highest rates of bowel cancer and bowel cancer death in the world.

• Kiwi men have the third highest rate of bowel cancer in the OECD
• Kiwi women hive the highest rate of bowel cancer in the OECD
• Approximately 7% of New Zealanders will develop bowel cancer during their lifetime. 
•  In a typical year, approximately 3000 New Zealanders are diagnosed with bowel cancer and approximately 1200 people die due to bowel cancer (2011 Data). 

If you are an Australian reading this, you are not far behind us in the statistics, and also have very high rates compared to our OECD peers.

How does processed meat cause cancer?

Although researchers and professional bodies are now 100% confident that processed meats cause cancer, they are not 100% sure of the mechanism behind it.

It is likely that during the processing and cooking of processed meat cancer causing substances (carcinogens) are formed. These substances then cause damage to cells in our body/bowel which leads to the development of cancer.

It is thought that the following carcinogens may be implicated. But more research is required.

• N-nitroso compounds. These are formed during the  normal digestion of haemoglobin found in red meat. 
• Heterocyclic amines (HCAs) which are caused when cooking meat at high temperatures. Think sausages being charred on the barbecue. HCAs are caused by cooking any type of meat at high temperatures, but processed and red meats usually create more when cooked than white meats.
• Nitrite and nitrate preservatives used in processed meat manufacture
• The high salt content of processed meat and the smoking of some processed meats are thought to be more likely linked to stomach cancer rather than bowel cancer.
• Or perhaps another mechanism which hasn't been hypothesised yet.

One thing to be aware of,  even 'high quality' organic processed meats are still going to have carcinogenic potential. So we can't escape the processed meat risk just be choosing more expensive processed meats in the supermarket.

How much impact does processed meat have on bowel cancer risk?

A 2011 analysis by the World Cancer Research Fund (WCRF) determined there was a dose response, i.e. how much processed meat you eat impacts your risk.  The WCRC found that people who eat the most processed meat have a 17% higher risk of developing bowel cancer than those who eat the least amount of processed meat.

For a typical New Zealander the absolute risk from eating a lot or a little processed meat looks like this:

• An average New Zealander has a 7% chance of developing bowel cancer in their lifetime. (70 in 1000 people)
• New Zealanders who eat the highest amount of processed meat will have a higher risk approximately 7.6% (76 in 1000 people)*
• New Zealanders who eat the lowest amount of processed meat will have a lower risk approximately 6.5% (65 in 1000 people)*
• The absolute increase in risk of eating a high intake of processed meat is likely to be less than 1%

*I am not a statistician these are approximate numbers I calculated, based on applying NZ data to calculations published by Cancer Research UK. 

What is a high processed meat intake?

Within the studies that the WRCF looked at for the highest vs lowest intake analysis, there was quite a large range of intakes that were classified as high intakes. The range was 26-122g per day. The WRCF concluded for every 50g of processed meat eaten your risk  for bowel cancer rises by 18%.

How much is 50g of processed meat?

• 2 rashers of bacon
• 1 sausage
• 3 Chicken nuggets

So in essence 50g of processed meat is not a great deal, especially not if we consider 50g per day is enough to increase the risk for an adult. 

What would our children be missing out on if we removed processed meat all together?

Truthfully, the answer is absolutely nothing. If you remove processed meats from your family's diet your children aren't going to miss out on anything from a nutrition perspective. Nutritionally there  would be no losses only gains, as eating no processed meats would likely mean a lower intake of salt and saturated fats.

As a parent you may lose some meal time convenience. Processed meats are easy to prepare, cost effective and typically liked by kids.  In my house, if I am really and truly honest my 3 year old has probably been eating too much ham. If he could have his way he would have ham sandwiches everyday. If he has ham sandwiches in his lunch box, they never come home uneaten. He doesn't get to have ham sandwiches every day however, as  I am a mum who knows how to say no. But even so he probably has had too much ham of late, as quite simply it is an easy option. While I have been busy with my brood of 3 under 3 years I have probably taken a few too many 'easy' options but this recent IARC announcement has made me re think processed meats in our house.

What do the current guidelines and professional bodies say?

• ANZ Food and nutrition guidelines for healthy children and young people 2-18 yrs "The intake of processed meats needs to be limited"
• WCRF "eat processed meats like ham, bacon and salami as little as possible"
• American Cancer Society "limit how much processed meat you eat"
• NHS High intake eaters (90 g or more per day of processed and red meats combined) to reduce to a maximum of 70g per day of processed and red meats combined.
• NZ Cancer Society: "Limit consumption of processed meat or swap processed meat for other healthier food choices like salads and vegetables"

The key words from all current guidelines and professional bodies when it comes to processed meat appear to be LIMIT and REDUCE.

To summarise so far

• Processed meats definitely do cause bowel cancer
• The amount of cancer caused by processed meat is not a huge number when we look at it as absolute risk
• Processed meats do not offer any nutritional benefits in our children's diets
• Professional bodies and current guidelines recommend limiting our intake of processed meats

Therefore I think you will have made a sensible parental decision if you either choose to:

• Remove all processed meats from your children's diet

Or

• Limit the amount of processed meat your children eat,
  • processed meat should be an occasional food not an every day food.
  • When you have processed meats it should be in small amounts.

For me at this stage, based on my reading and my comfort level that we are taking other cancer prevention precautions. (Physical activity and High fruit and vegetable Intake). I will be going with the later, and will endeavour to limit the amount of processed meat my children eat. 

4 Rules I have to limit my family's processed meat intake

None of these rules are earth shattering in their brilliance or creativity. They are just simple things that I used to be good at doing, but unfortunately have slipped to the way side as I have became busier and busier. 

1. Bring back the Sunday Roast

We will be having a roast every Sunday.  It will be a large roast so that there are heaps of left overs. The left over meat will then be perfect for lunches for the following 3 days (cooked roasted meat can stay in the fridge for up to 3 days before being discarded).

2. The 100g rule

If we do buy ham during our weekly supermarket shop I will have a 100g rule. If we buy less, then we will eat less. Easy. In general though the plan will not be to buy ham for sandwiches on  a regular basis.

3. In a meal, not as a meal

There will be times when I will still use processed meats at meal times. I have decided that I am comfortable to use processed meats sparingly within a meal but not as the meal. By this I mean I am comfortable to keep making recipes where small amounts of processed meats encourage my kids to eat nutritious options.  Such as Zucchini/Courgette slice, or a small amount of bacon/smoked salmon in a vegetable packed pasta sauce. 

4. One is more than enough

Kids love sausages on the BBQ. But in actuality kids love anything off the BBQ. If we have sausages on the BBQ I will (actually it will be my husband) will only cook enough for one sausage each. One is enough, after that they can fill themselves up with other options (Vegetables, salads or other fresh meat, fish, chicken)

So there we have it, my thoughts as a practical, busy mum with a background in human nutrition on processed meat in the family diet. 

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Sugar is another controversial nutrition topic. For my take on it click here

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Processed Meat and Cancer Risk | A review of the evidence and 4 practical guidelines when it comes to processed meat for children

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