@PeterAttiaMD Thinks the Red Meat and Cancer Research is Flawed (RESPONSE)
Dr. Matthew Nagra, ND
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References:
https://link.springer.com/article/10.1007/s10654-021-00741-9
https://www.sciencedirect.com/science/article/pii/S0022316622006289?via%3Dihub
https://academic.oup.com/ije/article/49/5/1540/5894731?login=false
https://academic.oup.com/ije/article/49/1/246/5470096?login=false
https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-12-385
https://pubmed.ncbi.nlm.nih.gov/29367388/
https://pubmed.ncbi.nlm.nih.gov/37264855/
https://bjsm.bmj.com/content/57/15/979
https://pubmed.ncbi.nlm.nih.gov/26092138/
https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-5-56
https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-01078-4
https://pubmed.ncbi.nlm.nih.gov/9989687/
https://academic.oup.com/jnci/article/97/12/906/2544064?login=false
#redmeat #beef #cancer #peterattia #outlive
Full Transcript
Red Meat vs. Vegetarian Comparisons 0:00
You know, the debate on red meat and cancer goes back for for long periods of time. And again, it suffers from all of the usual trappings of nutritional epidemiology. So I don't dispute for one moment that every time you do an epidemiologic survey and you compare people who live on hot dogs and pepperoni to vegetarians, epidemiologists will always tell you that the vegeterians are going to live longer. Now, I don't know if Peter Attia is being disingenuous here, or maybe he's just not that familiar with the research, but I do not see the point of this comparison between hot dog and pepperoni eaters and vegetarians.
For one, we have research on unprocessed red meat specifically, which excludes those processed meats like hot dogs and peperoni, and instead focuses on things like beef, pork, lamb. And second, vegetarians don't only avoid red meat, they don' eat any meat. So looking at that comparison wouldn't tell us much about red meats specifically.
Adjusting for Lifestyle Confounders 0:48
And we actually have research on higher versus lower red-meat intake amongst omnivores, so why don''t we look at it instead? On average, those vegeterians have a much higher socioeconomic status. They are much more health-conscious. they are exercising much, much less likely to be smoking, doing yoga, all these other things. Therefore, how can we disentangle the variable from the effect? Well, studies attempt to remove the influence of those variables through adjustments, and when they do that, we still see associations between unprocessed red meat consumption and colorectal cancer.
And in some studies like the UK Biobank, those who eat more redmeat are actually of higher socioeconomic status yet still have higher risk. Whereas conversely, when you look at the epidemiology of smoking or the Epidemiology Of Exercise, like those are so overwhelming that it factors into what we see as the overall causality. And this is where I think he may hold a double standard. Yes, the relative risk of developing lung cancer amongst smokers compared to non-smokers is very large, but what about coronary heart disease risk?
Smoking, Exercise, and Relative Risk 1:44
It's actually much more comparable to what we see with red meat consumption, particularly at around one to five cigarettes a day. So I'd like to know if he thinks light to moderate smoking is bad for our heart health because I don't see a clear distinction between that research and the research we have on red me. But that aside, I think the bigger sign of a potential double standard here is actually his position on exercise. The risk reductions we see from exercise for outcomes like cardiovascular disease, type 2 diabetes, and certain cancers is actually very comparable to what we can see in much of the nutrition literature.
Now he seems to also have an issue with the surveys that are used in nutrition research, often referred to as food frequency questionnaires. But that's not the only method that is used, and most of the exercise literature also relies on self-reporting. And the accuracy of self reporting for exercise is comparable to the self report for diet, particularly when it comes to red meat consumption. In this study on red and processed meat and colorectal cancer risk, when the researchers corrected for some of those inaccuracies in reporting,
Self-Reporting Bias in Nutrition Studies 2:40
the effect actually got larger, not smaller. So the risk jumped from a 25% higher risk to a 55% risk. So if anything, these inaccuracies may actually lead to an underestimation of risks, not overestimations of risk. But what's most bizarre about him bringing up exercise here is that he criticizes nutrition research because people who eat less red meat are less likely to smoke and may engage in other healthy lifestyle behaviors. And while I already addressed that researchers are aware of this and they take steps to adjust for those variables, I can't think of an example where it's more relevant than in the exercise research.
Think of people who exercise regularly versus those who don't. People who exercised more are less likely to smoke, they drink less alcohol, eat healthier diets, and guess what? The researchers adjusts for all those variable in same way that the researchers behind the red meat studies do. So I do suspect there's some bias here because I don't know how someone can claim that the exercise literature is, in his own words, overwhelming while suggesting that The Red Meat Literature is next to useless by the sounds of it.
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