Why is the World Health Organisation Anti-Meat?

Limited evidence

The WHO’s definition of limited evidence is the following,

‘Limited evidence means that a positive association has been observed between exposure to the agent and cancer but that other explanations for the observations (technically termed chance, bias, or confounding) could not be ruled out.’

‘Observations’ means data received from observational studies. These are a type of research, including epidemiology, that sits below randomised control trials (RCTs) in the hierarchy of evidence, as seen in the image below, grouped together under the term ‘cohort studies’.

Observational studies do not show causation and were never designed to. Partly because data collection for this type of research is unreliable. Scientists leave it up to individuals to tick boxes about their diets. Collectively, conscious or otherwise, people are not honest about they’ve eaten.

The IARC summary tells us:

‘The Working Group assessed more than 800 epidemiological studies that investigated the association of cancer with consumption of red meat.’

Impressive. From this huge pile the working group dumped most of the papers, leaving just fourteen cohort studies for analysis. Only half of which showed a ‘statistically significant association’ between the consumption of red meat and colorectal cancer (CRC). Not so impressive. By the way, the score for processed meat was twelve associations out of eighteen. Helpfully, this world changing analysis adds:

‘Consumption of red meat was also positively associated with pancreatic and with prostate cancer.’

Unhelpfully, they decided not to give us the references for this statement. But hey, they mentioned cancer forty-five times and red meat thirty-four times in under five columns, which is something Derren Brown, famed London-based illusionist, is hard pressed to beat when hypnotising an entire theatre full of people.

Once you’ve recovered from their mentioning over 800 studies and realise that their ratio for and against red meat is one to one, then consider that observational research is not capable of showing causation, it kind of takes the spring out of your step, doesn’t it?

Let’s look at their other evidence.

Relative risk

The IARC report states boldly:

‘..a 17% increased risk [of colorectal cancer] per 100 g per day of red meat and an 18% increase per 50 g per day of processed meat.’

It’s critical to note that these are relative risk numbers. Presuming the data is accurate, these percentages represent the difference between those people studied that eat the least red or processed meat, versus those people in the study that eat the most.

Cancer research UK remind us that even the actual risk numbers, seen in the infographic below, may not accurately reflect your chances of developing colorectal cancer due to the myriad variables at play in cancer development.

Strong mechanistic evidence?

The IARC summary report tells us that they have ‘strong mechanistic evidence’ that red meat causes cancer in humans. They state:

‘In three intervention studies in human beings, changes in oxidative stress markers (either in urine, faeces, or blood) were associated with consumption of red meat or processed meat.’

This was actually a single human intervention study of eighteen volunteers, plus two rodent studies rolled into one paper, hence the misleading statement of ‘three intervention studies in human beings’.

The brave humans were fed processed meat, not fresh red meat, with the catchy name of DCNO which stands for ‘dark cooked meat with nitrite, oxidized’. This laboratory ‘food’ is excessively processed to increase both reactive nitrites and oxygen molecules. The next time you buy some salami have a look at the back, you’ll see an antioxidant like vitamin C (ascorbic acid) on the ingredients list. This useful addition reduces the oxygen and nitrogen reactivity by quenching the reactive molecules that can cause damage to the food and potentially our guts.

In the rodent part of the research, scientists used a luckless group of rats who had just had their gut-protective mucosal layer wiped out with a poison. Sounds fair. Unsurprisingly, the researchers discovered high levels of reactive molecules in their rodent samples. These molecules are damaging if left unquenched by the bodies antioxidant system. The combination of deliberately injured guts and excessively reactive food, devoid of other nutrients meant the rats didn’t stand a chance.

Despite the gut injuries, a luckier group of rats were able to mitigate the reactivity and proposed carcinogenic effect of the DCNO when the scientists included vitamin E and calcium to their diet. What’s the take away from this? Avoid eating DCNO if you’ve just been poisoned and, if for any reason you can’t, eat some calcium and vitamin E to mitigate the effects.

The next IARC referenced paper spawned this sentence:

‘Red and processed meat intake increased lipid oxidation products [reactive molecules that degrade fats] in rodent faeces.’

I had a look at this paper too and couldn’t help reading the second sentence in the abstract over a few times:

‘Puzzlingly, meat does not promote carcinogenesis in rat studies[…]Here, we tested the hypothesis that heme-rich meats promote colon carcinogenesis in rats treated with azoxymethane and fed low-calcium diets (0.8 g/kg).’

‘Puzzlingly, meat does not promote carcinogenesis in rat studies’. That is until they poisoned them with azoxymethane, a carcinogenic neurotoxin used specifically in research to induce colon cancer, and then made sure there was no calcium in their diet. Bravo!

You may think I’m being flippant, and I am, but this is how mechanistic papers are used to prove something can happen under a set of very specific circumstances; the combination of being poisoned and removing vital micronutrients from the diet.

Does this mean that including red or processed meat in your diet — that should also include the very micronutrients shown to mitigate the issue — is a danger to you? Of course not, and it’s irresponsible to say otherwise.

The IARC paper now moves on to another couple of papers cited after this sentence:

‘Substantial supporting mechanistic evidence was available for multiple meat components (NOC, haem iron, and HAA).’

These chemicals are out to get you — ignore the fact that haem iron is essential for life — and the IARC have produced two papers to prove it. The first, studied twenty-three subjects over four weeks, the second, twenty-five subjects over three weeks. I shall address each of the so-called problematic chemicals one at a time.

NOCs

NOCs are converted from nitrites (the stuff they topped up in the processed meat study mentioned earlier). Eighty to eighty-five per cent of nitrites in the body are converted from nitrates in foods. I’m going to refer to nitrates to keep it simple. Now, you could be forgiven for thinking that all the nitrates we eat come from processed meats, and you’d be wrong.

Actually, eighty per cent come from vegetables, just five per cent from meats. As with most things nutrition research, conclusions are conflicted as a review published in the journal Aging & Disease (2018), demonstrates:

‘Normal dietary nitrate and nitrite showed no harm to human health and no confirmed evidence stated the explicit association of dietary nitrate and cancer. Most existing research on nitrite and tumors ignored the complicated compounds in target foods, resulting in contradictory conclusions among researchers.’

Zooming into a single chemical in a food doesn’t tell you about the overall health benefits of that food. Hopefully, you’re eating whole foods, that come with synergistic chemicals that may mitigate any negatives. You know, like the fact that calcium and vitamin E mitigated the carcinogenic affects of the reactive molecules in pre-poisoned rats, discussed a little earlier.

It’s worth knowing that the level of nitrates in our vegetables are increasing due to chemical fertilisers, and decreasing in processed meats. In fact, some leafy greens (grown hydroponically) actually contain more than is recommended to eat. And whilst we’re here, the widely accepted DASH diet, for the treatment of high blood pressure, may be as much as 550% too high in nitrates.

The puzzle of whether or not nitrates—and the inevitable nitrites and NOCs produced within us after eating any foods that contain them—has not sufficiently taken shape. If you want my two cents it’s this; it depends on the environment into which the nitrates find themselves. Your digestive processes and intestinal flora must be in good order so they can disarm those harmful substances by just going about their business.

When scientists added resistant starch to the meal, the mechanistic paper used by the IARC shows a mitigation of the issue supposedly caused by red meat. We can’t digest resistant starch, hence its name, so we outsource this job to our commensal gut flora, in return for this provision of food and housing, they help keep us healthy.

Haem Iron

Haem iron is the most bioavailable form of iron. It only comes from animal products, red meat is a great source. Iron is one of the most common nutrient deficiencies in the world, with vegetarians more likely to be lacking in it versus omnivores. It’s absolutely essential for life. Overdosing is possible if you supplement it, have a rare genetic disorder or cook with iron pans often. Iron plays a role in the formation of NOCs, but because we can’t live without it, and getting too much from real foods has not been demonstrated, this is not a reason to stop eating red meat.

Heterocyclic aromatic amines (HAA) and polycyclic aromatic hydrocarbons (PAH)

HAA and PAH form when protein rich foods, including red meat, are cooked at high temperatures. They’re also found in roasted coffee, alcoholic beverages, food flavouring and breast milk. They too have been classified as ‘probable carcinogens’ by WHO. Their report says this about them:

‘These chemicals cause DNA damage, but little direct evidence exists that this occurs following meat consumption.’

Such a small amount of evidence it seems, that the IARC haven’t bothered to reference the statement about DNA damage. The take-away here is that eating burnt food may not be a sensible strategy for health. Let’s have a look at some better quality research.

Better evidence

In September 2019, a group of nineteen scientists published in the Annals of Internal Medicine their summary of four review studies designed to look closely at the Nutritional Recommendations and accessible Evidence summaries Composed of Systematic reviews (NutriRECS).

The first three papers (1, 2, 3) assessed the observational research and the fourth looked at the invention studies (meta-analysis of randomised control trials) available on both red meat and processed meat. Please refer back to the hierarchy of evidence diagram shown earlier, you’ll notice this type of evidence is the best available to us. The group of scientific researchers produced a fifth paper to look specifically at people’s values and preferences around meat consumption.

The hypothesis that prompted these comprehensive investigations was, in their own words:

‘…that if red meat and processed meat were indeed causally related to adverse health outcomes, we would find stronger associations in studies that specifically addressed red meat and processed meat intake..’

Their findings

These papers tell us that the evidence against red and processed meat is so weak that people may as well go on as they are, because the findings are not strong enough to provide guidance. Also, when you consider the nutrients lost by avoiding red meat this makes recommending its reduction folly, especially for those people who do not live yards from a supermarket with a hundred different types of plants to choose from all year round. The researchers state in their conclusion:

‘In terms of how to interpret our weak recommendation, it indicates that the panel believed that for the majority of individuals, the desirable effects (a potential lowered risk for cancer and cardiometabolic outcomes) associated with reducing meat consumption probably do not outweigh the undesirable effects..’

Further, a randomised control trial of 1060 people between the ages of forty-seven and seventy-four, published in the Asian Pacific Journal of Cancer Prevention (2018), found no association between meat consumption and carcinogenic faecal biomarkers. They write:

‘No significant associations were noted with any of the variables, except for being aged 60–74 years […] Borderline significance was observed for high consumption of vegetables[…]and being male.’

So, if evidence of a much higher standard now exists, and the research used in the IARC report is not sufficient to label red meat as a ‘probably carcinogenic’, this begs the question; what’s happening down at WHO?

If you can’t beat them, join them

In 2003 WHO published their independent Expert Report on diet and chronic disease. This paper recommended under ten per cent of our daily calories should come from added sugar. Guess which companies didn’t enjoy reading that? The good old sugar industry of course, and all their clients in junk food manufacturing plus some influential people in Congress (USA). Getting wind of the under ten per cent recommendation, the Sugar Association exerted its hefty weight and threatened to have WHOs funding pulled by their primary sponsor, the United States.

The Sugar Association had taken exception to the ten per cent number because their own stooges reckoned twenty five per cent of daily calories could safely come from added sugar; from their member’s products, no doubt. At the time, an article published in the Guardian includes this snippet from a letter sent by the foaming at the mouth Sugar Association to WHO’s director-general:

‘Taxpayers’ dollars should not be used to support misguided, non-science-based reports which do not add to the health and well-being of Americans, much less the rest of the world[…]If necessary we will promote and encourage new laws which require future WHO funding to be provided only if the organisation accepts that all reports must be supported by the preponderance of science.’

The fact that a conglomerate of food manufacturers think they can “promote and encourage new laws” is astounding and despicable, but let’s stay on track.

The Guardian article reveals the Sugar Association has a history of threatening institutions. So, in line with the universal truth that is, if you can’t beat them join them, WHO decided to have an Arthurian sit down with the companies that just weeks before had been spitting chips about their batshit crazy advice on sugar.

On the day of this infiltration, WHO released this appeasing statement akin to, ‘peace in our time’.

‘Director-General Dr Gro Harlem Brundtland, MD, today hosted the first formal Roundtable meeting between World Health Organization (WHO) and senior executives from the food and associated industries. The meeting, in Geneva, discussed ways the food industry could work with WHO to encourage healthier diets and increased physical activity worldwide.’

Ah yes, ‘increased physical activity’, that old chestnut. Eat less and move more fatty! If you’re overweight it’s because you haven’t moved enough, not because you’re consuming calories all day long brought to you in a carefully formulated, chemically addictive package that’s as easy, nay, easier to drink than water and devoid of satisfying nutrients. Your fault, just get moving!

Let’s have a look at which companies were present at this ground-breaking Rommel versus Montgomery, if you show me your battle plan, I’ll show you mine, get together:

‘The Roundtable was attended by about a dozen CEOs and senior executives from companies including Nestle, Unilever, The Coca-Cola Company, The Kellogg Company, PepsiCo Inc., Cadbury Schweppes plc, Compass Group, McDonald’s, Yum! Brands Inc., Mizuno Corp, Pentland Group Plc and Royal Ahold N.V.’

I wonder who brought the biscuits? Here’s what WHO (2016) write about this bunch of easy-going executives:

‘The International Food & Beverage Alliance (IFBA) is a group of eleven global food and non-alcoholic beverage companies[…]that share a common goal of helping people around the world achieve balanced diets, and healthy lifestyles. Formed in response to the World Health Organisation’s (WHO) call to action in the 2004 Global Strategy on Diet, Physical Activity and Health, CEOs of the founding members of IFBA voluntarily committed to work together to implement a set of actions — on product reformulation and innovation, nutrition information, responsible marketing and the promotion of healthy lifestyles — recognised by the WHO and the public health community as crucial to improving public health.’

It seems that WHO’s ‘call to action’ was more them falling to their knees and begging these powerful companies not to have their funding pulled via political puppeteers.

If WHO sitting down to discuss how the manufacturers of much of the junk food in the world can help ‘people[…]achieve balanced diets and healthy lifestyles’ isn’t selling out, then how about the health organisation actually taking money from them?

A Reuter’s investigation

The influence of WHO on dietary guidelines around the globe, and therefore the spending choices made by individuals daily, is gargantuan. An investigative team from Reuters dug deep, uncovering some disturbing facts.

Rather than just accepting a wad of cash directly from these companies — which runs counter to WHOs' own policies — Reuters discovered the one-step-removed way in which they take money. The Pan American Health Organisation (PAHO), the American arm of WHO, have taken:

‘$50,000 from Coca-Cola, the world’s largest beverage company; $150,000 from Nestle, the world’s largest food company; and $150,000 from Unilever, […]whose brands include Ben & Jerry’s ice cream and Popsicles.’

According to the evidence gathered by Reuters, WHO have taken money from some of the companies that bullied them into, erm, working together. WHO regularly gets together to discuss global food policies with those companies selling the very foods that are responsible for the obesity epidemic. It’s in the interests of these companies to remind everyone that if they’re overweight it’s because they haven’t got off their arses regularly enough, not because they’re eating high energy, low nutrient foods every few hours.

Blaming red meat, a food eaten by our ancestors for millions of years, for the modern epidemics of obesity and related diseases doesn’t make any sense, but takes the heat off sugar. Today, bashing meat has become en vogue, a dangerous fashion that will break the health of many and further damage our environment whilst we look away from anything plant-based.

Idealistic bias

Dr. David Klurfeld, was one of the twenty-two experts on the IARC panel that produced the report at the heart of this article. Recently, he was interviewed on the ‘Peak Human’ podcast where he revealed his concerns about the number of vegetarians on the panel. He considers this a conflict of interest; something that should be declared. The medical doctor and researcher mentions the IARC panel experience was the most frustrating of his professional career, especially when he discovered the report had failed to include two human intervention studies of low-fat, low-meat diets that showed no benefit to cancer risk.

The IARC report is one-sided, failing to present any evidence contrary to its message. What are WHO trying to achieve by ignoring research that would have added critical depth to their paper?

What is WHO trying to achieve?

Since the 1990s WHO has been trying to reduce global obesity, a noncommunicable disease (NCD) affecting us all, directly or indirectly. NCDs are estimated to kill more than forty-one million people each year, or seventy-one per cent of all deaths globally. These premature deaths are caused in large part by diet and lifestyle choices causing obesity and its related diseases. An unfair proportion of these, eighty per cent, occur in low to middle income countries (LMIs).In bold, three out of four of the world’s worst NCDs can be directly caused by obesity.

‘Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.0 million), respiratory diseases (3.9million), and diabetes (1.6 million).’

WHO is concerned about LMI countries, and mentions them in the Q&A follow up of the IARC report:

‘Although these risks are small [cancer association & meat consumption], they could be important for public health because many people worldwide eat meat and meat consumption is increasing in low- and middle-income countries.’

It has been shown that micronutrient deficiencies (MNDs) worsen diseases of many kinds and affect those in LMI countries at a higher rate with women and children most at risk. Iron, iodine, folate, vitamin A, and zinc are the most prevalent MNDs with protein deficiency also a serious problem. Let’s have a look at what red meat, processed meat and a popular fizzy drink can offer in terms of nutrients:

I’ve chosen an approximate portion size for each, the cut of beef I chose is cheap, and about half as nutritious as a ribeye. As you can see ‘liver sausage’ provides high amounts of vitamin A which is vital for the immune system, a deficiency of which makes infectious disease more deadly. So, processed meats not all bad then. Cola, what I see as the epitome of junk food and drink, offers only one thing, sugar.

Sugar, not meat, is at the heart of the obesity epidemic, especially sugar sweetened beverages (SSBs), go back and see which drinks companies sit down with WHO if you need to be reminded here. SSBs are easy to over consume without being in the least bit satisfying. This dangerous combination paves the way for an excess of energy whilst many nutrients go wanting. Red meat on the other hand comes with protein, some of the most deficient nutrients in the world, and satisfaction.

In my opinion, satisfaction is an under utilised tool in the world of health and nutrition. Being satisfied allows people effortlessly exist from one nourishing meal to the next without having to snack—which is all about junk foods if we’re honest. Satisfaction comes easily with real, nutritious foods, especially red meat. It comes hard from ultra-processed, high energy, low nutrient, junk foods that need to be overeaten for the slightest whiff of a balancing effect. See the problem?

Who’s accomplishments

WHO’s most recent advice on diet can be seen here. It recommends keeping saturated fat (SFA) low and therefore to keep meat lean and trim the fat. It also recommends eating fish and low fat dairy as a way to reduce SFA. Interestingly, it seems to have upped the anti on added sugars:

‘Limiting intake of free sugars to less than 10% of total energy intake is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits.’

WHO’s press office released a statement in answer to the Reuters article I have referred to denying any wrong doing. They tell us:

‘…the Organization [WHO] takes all possible measures to ensure its work to develop policy and guidelines is protected from industry influence[…]For this reason the Organization does not accept funding from the food and beverage manufacturers for work on NCD prevention and control.’

They make it clear that PAHO is a separate legal entity and:

‘in its capacity as PAHO, food and beverage manufacturers have contributed financially as part of a multi-sector forum to address NCDs.’

Since the union of WHO and International Food and Beverage Association (IFBA) in 2004 they have, in their own words:

‘…made substantial progress in addressing nutrition-related concerns. Tens of thousands of products have been reformulated or developed with less fat, sugar, salt and calories and ingredients considered beneficial for good health have been added — whole grains, fibre, fruits and vegetables, low-fat dairy.’

Further, IFBA members have reduced their marketing to children as per the recommendations made by WHO in a 2010 report.

My unbridled conclusion

The appeal to authority is a tactic I face often. It’s akin to saying, ‘speak to the hand’ and a tool used by those who haven’t done their own research to stop the debate in its tracks. It works often too. People would rather appeal to authority than take the time to critically appraise the documents coming from lofty towers.

However, a more discerning eye would notice the words in the initial quote, ‘probably, limited, mechanistic, association, observed’, that tell us more about the type of research used to construct the narrative that has been the focus of this article. Further, if you’re willing as I am, to read the papers citied, you’ll get a much better picture of the evidence used and the real strength of the report as well as a window into those biases that created it.

IARC uses a one to one, for and against, ratio of observational research to claim that red meat is a probable carcinogen. But this ratio is evidence of no carcinogenic effect because showing no association is a stronger predictor than showing a weak one. The working group then takes a single human trial and two rodent studies to convince us of ‘strong mechanistic evidence’ in support of their corrupted advice.

These studies created the circumstances to form reactive molecules. Despite evidence within the same research that showed perfectly normal aspects of diet (vitamins, minerals and fibre) mitigating the proposed carcinogenic effects, these were not discussed at all by the IARC. Nor was the fact that the rodents were given a proven carcinogenic poison, used to induce colon cancer in other animal trials. This kind of critical discussion doesn’t feature in the IARC paper because it would unsettle the beliefs of most of the scientists involved in producing it.

The strength of feelings, revved up by divisive social media within the vegetarian and vegan world, means that identifying as either is indeed a conflict of interest and should be declared, especially when party to producing something so influential.

WHO, like all entities that require money, is pushed and pulled by the same forces. Their attempt in 2004 to bring sugar consumption down was admirable, but their instant capitulation and union with the very forces that threatened them is Vichy. The resultant ‘teaming up with industry’ is a thinly veiled attempt to make this capitulation look like something we can all benefit from. This is absurd. To see straight through it, nothing more is required than a look at those companies invited to sit around the round table with WHO.

WHO’s denial of any wrong doing after the investigation by Reuters amounts to this: PAHO are a different legal entity, so there. Great. Well, the proof is in the pudding. What has this false union achieved other than pathetic reformulations, platitudes and industry self regulation?

In WHO’s (2020) own words:

• Worldwide obesity has nearly tripled since 1975.
• In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.
• 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.
• Most of the world’s population live in countries where overweight and obesity kills more people than underweight.
• 38 million children under the age of 5 were overweight or obese in 2019.
• Over 340 million children and adolescents aged 5–19 were overweight or obese in 2016.
• Obesity is preventable.

‘Obesity is preventable’. Their advice conceived in a room that is utterly compromised hasn’t worked. Of course it hasn’t. WHO have failed categorically to prevent obesity from continuing to shorten lives and the quality of them. It’s failed because it’s allied to companies that sell nutrient deficient, junk foods which are usurping people’s relationships with real foods, especially red meat, that require preparation but repay in nutrient dividends that protect from diseases of all kinds, including obesity.

People are not obese because they eat too much red meat. Be realistic! It is almost impossible to over eat red meat day in day out until you become obese. Try it. It’s too satisfying and too expensive for most people. However, it’s the easiest thing in the world to over eat junk foods, especially when they’re high in sugar. Sugar-sweetened beverages are at the heart of this.

Are WHO going to start recommending to people in LMI countries they should reduce the amount of nutritious red meat in their diets because of an imagined risk conjured from poor quality research, lack of critical thinking and possible conflict of interest? I hope not considering that as Africans able to eat more meat see their health and longevity improving.

WHO has boxed themselves into a corner to the point now where they cannot even mention the word ‘protein’ on their new healthy diet page because to do so leaves them at a loss of what to recommend. A hangover from Ancel Keys who, paid by the sugar industry to take the heat off them, cherry-picked his way around the globe to blame saturated fat for what sugar and junk foods were doing; causing disease and premature death. This fatty scapegoat, found in all foods that contain fat by the way, including fish, but higher in red meat, became the focus of the nutrition world.

The belief that will not die; that animal fats and specifically saturated fat is bad for health, has been nothing but destructive since careful conception. It has allowed a decades long anti-meat narrative to permeate nutrition research and education. All the while chronic disease, obesity at its molten core, sky rockets and affects almost every household and every economy in the world.

By accepting weak evidence, by allowing ideology to take the lead on their IARC paper, by refusing to discuss evidence to the contrary, by capitulating to powerful industries, and worst of all by sitting down with them to discuss influential global diet policies, WHO has allowed chronic disease free reign over us.

Will we ever have an institution that is untouchable? One that is able to deliver the best available information, free from ideology and vested interests? I doubt it, so I guess I’ll just have to keep spending my time looking at references, applying a common sense filter, putting my ego to one side and trying to do the best I can.

I’ll leave you with this sentence from the IARC’s Q&A session in response to their paper:

‘Eating red meat has not yet been established as a cause of cancer.’

Of course it hasn’t.