Risk, sausages and your health
This week, the World Health Organisation (WHO to their friends) released a report that caused a bit of a stir. After a long look at the existing research, and doubtless months of deliberation, the WHO’s International Agency for Research on Cancer said that cured and processed meats are carcinogenic. Moreover, red meat (like beef, lamb or pork) was deemed to be ‘probably carcinogenic’. Long story short, processed meats like bacon, ham and sausages are now in the same category as other things which are established causes for cancer, like alcohol, tobacco and asbestos. These meats are particularly associated with colorectal/bowel cancer, but also linked to pancreatic and prostate cancer.
Cue great uproar amongst various newspapers, argument between contrary health experts, and beleaguered individuals in the middle staring wanly at their half-eaten sausage roll. In fairness, the WHO has been very clear in its report about their evidence and what it means. The WHO’s report is controversial, but a few clarifications are in order.
Firstly, eating a slice of bacon won’t give you cancer, just like one puff of a cigarette is not going to put you into intensive care. Secondly, clearly if you eat nothing but processed meats, cancer is going to be just one of your varied and interesting health problems. Surely the fact that eating processed meats is unhealthy is not news. Thirdly and most important of all, while bacon now rubs its greasy shoulders with cigarettes in the WHO’s ‘Group 1’ category of carcinogens, this is not because it’s as dangerous as cigarettes. While some commentary on the report had this mixed up. Actually, foods or other materials are placed into this ‘Group 1’ based on the strength of evidence that they can cause cancer, not because they are all equally dangerous. Let’s be clear, processed meats are now on the same list as plutonium. So, this story is not about sausages being as dangerous for you as nuclear materials. Instead, the news is simply that the WHO researchers are sure that processed meats ARE a cancer risk.
The story raises a big issue about our perception and understanding of risk. Cancer is not just one disease, but a whole horrible host, so it’s understandable why many people fear it. But we need to bear in mind that health risks are (a) variable, (b) complex and (c) something we usually have some control over.
One of the biggest problems in our understanding of health risks is a confusion between your absolute risk of a disease, and increases in that risk as a result of doing something unwise or unhealthy. Taking a simple example, according to Bowel Cancer UK, a man’s risk of developing bowel cancer in their lifetime is 1 in 14; i.e. about 7%. Bowel cancer is a horrible disease, but while that risk is significant, clearly most men will not get bowel cancer. Let’s put this information together with the news stories on the WHO report. Depending on the amount you eat, processed meat could increase your risk of bowel cancer by 18%. Sounds scary. But hang on, we’re talking about an 18% increase in the lifetime risk. We won’t make you get out your calculator, but factoring that increase would leave men who eat lots of processed meat with a lifetime risk of a bit over 8%. A higher risk? Sure. Much higher? No.
We are simplifying this situation (and the maths!) greatly, as an individual man’s risk of bowel cancer will depend on a wide range of factors, particularly age. But vitally, we must be clear on whether risks reported are absolute risks, or just potential increases on that risk. After all, on a long enough timeline, we all have a 100% probability of death.
This should not prevent us from taking positive steps with our lifestyle and healthy living, to ensure we get both the most and best time out of our lives. Let’s return to the WHO report. They are saying is that while the overall risk of developing cancer from eating processed meat is small, the more you eat, the higher your risk will be. The WHO’s report also recommended eating no more than 500g of red meat (e.g. pork, lamb or beef) per week. So, if you don’t eat red or processed meats for religious, cultural or personal reasons already, then congratulations, you are ahead of the game on that specific health risk. It follows that if you eat meat but mainly stick to white meat (poultry or fish), your risk of bowel cancer should be lower than someone who eats nothing but sausages.
All this boils down to is that men have some new information to build into a healthy lifestyle. The fundamentals of eating a balanced diet haven’t changed. We just now have a clearer line of what should and shouldn’t be a regular addition to our plate. You can finish your sausage roll now; just try not to make it your go-to snack.