“Red Meat: Bane or Boon?” Host Script for Health Action
Program, 4/9/12
MR. LEDERER: Welcome
to Health Action. I'm Bob Lederer. And
tonight we're taking on a very controversial issue in the field of nutrition
and health, so brace yourself to hear someone who's firmly going against the
grain (pun intended). We're going to give
some close scrutiny to a recent, large-scale and highly‑publicized Harvard
study that purported to show that ANY level of red meat consumption increased
the rate of mortality. The osteopathic
physician and author we will speak with is one of a growing chorus of nutrition
experts with a very different view and a very different clinical
experience. Let me state up front that I
am not necessarily endorsing all of this doctor's views and recommendations,
but particularly because I know that many in our audience are highly
health‑conscious and critical thinkers, I think it's important to hear this
rarely aired viewpoint.
To begin, here is a typical example of the many media
accounts of the study - this one from the Los Angeles Times of March 12,
2012. Under the headline, "All red
meat is bad for you, new study says,"
[http://www.chicagotribune.com/health/la-he-red-meat-20120313,0,2364743.story],
the article reads:
QUOTE: Eating red
meat - any amount and any type - appears to significantly increase the risk of
premature death, according to a long-range study that examined the eating
habits and health of more than 110,000 adults for more than 20 years.
For instance, adding just one 3-ounce serving of unprocessed
red meat - picture a piece of steak no bigger than a deck of cards - to one's
daily diet was associated with a 13% greater chance of dying during the course
of the study. Even worse, adding an
extra daily serving of processed red meat, such as a hot dog or two slices of
bacon, was linked to a 20% higher risk of death during the study.
"Any red meat you eat contributes to the risk,"
said An Pan, a postdoctoral fellow at the Harvard School of Public Health in
Boston and lead author of the study, published online Monday in the Archives of
Internal Medicine.
Crunching data from thousands of questionnaires that asked
people how frequently they ate a variety of foods, the researchers also
discovered that replacing red meat with other foods seemed to reduce mortality
risk for study participants.
Eating a serving of nuts instead of beef or pork was
associated with a 19% lower risk of dying during the study. The team said choosing poultry or whole
grains as a substitute was linked with a 14% reduction in mortality risk;
low‑fat dairy or legumes, 10%; and fish, 7%. UNQUOTE
And now joining us by phone to look behind these scary
statistics is James Carlson (http://drjamescarlson.com/), an osteopathic doctor
in Port Jefferson Station, New York. Dr.
Carlson is a board‑certified family physician and clinical biochemist with 20
years of experience treating people with obesity, heart disease, diabetes, and
cancer. He is the author of the book
Genocide: How Your Doctor's Dietary Ignorance Will Kill You. Thanks for joining us on Health Action, Dr.
Carlson.
DR. CARLSON: Thanks
so much for having me.
MR. LEDERER:
Okay. Well, this study really has
impressively large numbers of patients and seemingly large risk, large
increased death rates for red meat eaters.
So can you start by giving us your overall view of the study and how its
findings contrast with your clinical experience. And as part of your answer, help us
understand the difference between an observational study and an intervention
study.
DR. CARLSON: Of
course, of course. When I first heard
about this study about a month ago, I think it came out in March, I immediately
was suspect, with the results because of
what I see in my own practice. And
basically in my practice, I focus on the treatment of Type 2 diabetes or
diabetes in general, Type 1 and 2, obesity, heart disease, blood pressure
issues, et cetera. And the way I
approach these particular disease processes is by doing exactly what the
studies suggest that we shouldn't be doing, and that's by having patients
consume more red meat, animal products, and back off on their whole grains and
fruits and all.
So when I heard the results of the study, I immediately
raised an eyebrow and I said, okay, here we go, another, anti-red meat study.
When you look at the study further, you really do need to
understand the difference between an observational study and an interventional
study. And it's interesting because in
an observational study, it's basically a study where they don't have, your
classic control groups. You know, you're
just kind of drawing inferences about possible effects of a treatment or a
change on your subjects, and no treated group or control group is
entertained. And this is outside the
control of the investigator.
When you look at the interventional type of study, this is
the study we're more familiar with. This
is where you have, you know, two groups.
You'll have one group where you, create a change. We'll use the example of maybe having these
particular people eat, red meat and then your control group where they don't
eat red meat and, you'll keep everything the same. And this is usually what we call a
prospective study where you follow the participants forward. It could be retrospective where you follow them
backward. But observational studies are
fraught with hazards, and this indeed was how the Harvard study itself, was
created.
But it flies in the face of what I've seen clinically over
the last 20 years as to how I treat my patients. And by giving my patients or suggesting to
them to consume more red meat, I'm seeing, wonderful health benefits, not the
scary stuff that they're suggesting in the study.
MR. LEDERER: Now, Dr.
Carlson, the Harvard study is the latest of a long line of observational
studies claiming to show that red meat poses a risk of coronary heart disease
and even cancer. But a 2009 book titled
The Vegetarian Myth: Food, Justice & Accountability
[http://lierrekeith.com/vegmyth.htm], by small farmer, feminist, and
environmentalist Lierre Keith, has a chapter summarizing the evidence debunking
the alleged causative link between red meat and various illnesses and
death.
She writes that "a meta‑ [or combined] analysis of 167
cholesterol‑feeding experiments found that raising dietary cholesterol had a
negligible effect on blood cholesterol, and no link to coronary heart disease
risk." And Lierre Keith also notes
that "there are human cultures consuming 80% of their calories in the form
of saturated fat with no coronary heart disease."
So let me ask you:
What's your view of the evidence behind this supposed link between meat,
cholesterol, fat on the one hand and then disease on the other hand that is
really widely believed both within the medical profession and the nutrition
profession?
DR. CARLSON: Great ‑‑
it's a great question. And it's
interesting too because Lierre Keith
actually mentioned there are human cultures consuming 80% of their
calories in the form of saturated fat.
When the medical profession can't understand something like this, they
call it a paradox. So she's probably
referring to the Stein paradox or the French paradox, or the Eskimo or Inuit
paradox where they consume high saturated fat and cholesterol but yet they have
very little to zero coronary heart disease and Type 2 diabetes.
The evidence behind the supposed meat- cholesterol-fat disease
connection, I, again, from my clinical experience over the last 20 years, I've seen the studies, I've seen a lot of
them and, for me, the evidence is flimsy at best.
But I like the word, I like the word that you used,
"believed," it's so widely believed within both the medical and
nutritional professions, because beliefs can be right or wrong. You know, truths and facts just are. And at the outset when I'm counseling my patients
on the correct way to eat, I'll tell them that this is not my theory, opinion,
supposition or belief. These are the nutritional facts.
And this is a controversial topic, so I don't mean to
appear, arrogant or what not or obnoxious when I say that, it's just that, I've
seen what I've seen clinically over the last 20 years. And I, being a clinical biochemist, I also
understand biochemically, what's happening to create these positive health
benefits.
So my view of the evidence behind these supposed meat
cholesterol-fat-disease connections, very flimsy and a lot of these, are the
observational studies.
MR. LEDERER: Well,
why don't you just tell us briefly what's known now about the role of
cholesterol in the circulatory system and the nervous system.
DR. CARLSON: Well,
cholesterol is extremely, when we're looking at the health benefits, of course,
of cholesterol in the foods that we're eating, say, in the red meat, very
beneficial for, proper nervous system growth.
Very, very beneficial, for I'm sorry, you mentioned nervous system. And what was the other one?
MR. LEDERER: And
circulatory.
DR. CARLSON: Oh,
circulatory. You know, actually, it's
very important because cholesterol is an extremely important biomolecule in our
cell membranes. And without cholesterol,
you can't have proper nerve function.
You can't really have proper circulatory function without, cholesterol
being found in the diet.
Now, I'm talking about cholesterol in the foods we eat, I'm
talking about the cholesterol, say, in red meat, in butter, and the things that
we're told to avoid. And I'm also going
to say, too, that saturated fat is very important to consume as well.
We get into trouble when the body is allowed to create
cholesterol, to create fat. And I need
to stress that the creation of cholesterol and fat in our bodies comes from the
modification of sugar molecules known as glucose and fructose. So glucose and fructose, wherever it may come
from, whatever its source, the body will create cholesterol and fat from. And this is where it gets dangerous, when
we're creating cholesterol and fat from sugar, not from the consumption of
cholesterol and fat in food items.
MR. LEDERER: And what
are the most common sources of glucose and fructose in the in the modern U.S.
diet?
DR. CARLSON: Oh,
boy. Well, no one would argue cakes and
candies and processed foods. But I take
it a step further. And this is where I
get a little controversial because I do indeed pick on whole grains and
multigrains and seven grains and whole wheat pasta and brown rice and yogurt
and oatmeal and, of course, fruit. And I
always get these weird looks from nutritionists, doctors, fellow colleagues
when I say that.
But let's look at it.
Let's just analyze, what I'm really saying. What I'm really saying is, those food items I
just mentioned, they contain an overabundance of carbohydrates. Carbohydrates are broken down into simple
sugars, and the body uses these simple sugars to create cholesterol and
fat. And that's a biochemical fact, so
that's undisputable. And it's disputed
widely. And I even have colleagues who
dispute it. But any basic biochemical
textbook will show you that, of course, carbohydrates are broken down into
simple sugars, and it's the simple sugars the body uses to create plaque forming
deadly cholesterol and fat.
MR. LEDERER: And so,
what has been both the research and your experience with the role of reducing
carbohydrates, whether they're complex, whether they're whole grain, or whether
they're refined, in alleviating diabetes and heart disease?
DR. CARLSON: It's
been my experience that when I back off on, or tell my patients to back off on the whole
grains now, remember, as a physician, I'm privileged, you know, where I can
analyze blood work, where I can look at blood data such as triglycerides, fats
in the blood, HDL, good cholesterols, total cholesterols and whatnot, checking
blood pressure and all, analyzing blood sugars.
When I have my patients who are, say, a Type 2 diabetic,
when they back off on their whole grains and fruits, their sugar numbers do
indeed get better, they have better control of their numbers and, interestingly
enough, blood pressures also start to drop.
Basically, when I back off or have my patients back off on
carbohydrates in all of their, shapes and sizes, very wonderful things happen
metabolically. When my patients consume
more red meat or, say, even poultry and, of course, lamb and pork, their
numbers do indeed get better.
And it's also an interesting thing, Bob, that over the last
20 years, the single biggest thing that I've seen to help raise HDL, or good
cholesterol, has not been exercise or anything like that, has not been, say,
you know, fish oils or anything. It's
actually been the consumption of saturated fat or increased consumption of
saturated fat and cholesterol in one's diet.
MR. LEDERER: And by
the way, just one slight clarification.
In your litany of foods that contain carbohydrates that can be harmful,
you included yogurt, but weren't you really just referring to flavored
yogurt? Because plain…
DR. CARLSON: I am.
MR. LEDERER: Plain
yogurt…
DR. CARLSON: And you
know why?
MR. LEDERER: Is not,
does not have carbohydrates; right?
DR. CARLSON: Good
distinction. Plain yogurt. And, of course, there's, the Greek yogurt out
there is actually pretty low in carbs.
So, no, we're going to move that out, you know, from that whole litany
there.
MR. LEDERER:
Okay. All right. Well, nutrition writer Denise Minger prepared
a recent analysis of the new Harvard red meat study (http://www.marksdailyapple.com/will-eating-red-meat-kill-you/#axzz1rwuNb5ph)
and she noted "the folks eating the most red meat were also the least
physically active, the most likely to smoke, …the least likely to take a
multivitamin….[and had] higher BMIs, which is a measure of obesity, higher
alcohol intake, and a trend towards less healthy non-red-meat food
choices. Although -- continuing from her
quote, although the researchers tried their darnedest to adjust for these
confounders, or confusing factors, not even fancy-pants math tricks can
compensate for the immeasurable details involved in unhealthy living, the
tendency -- as well as the tendency for folks to misreport their diet and
exercise habits, and whatever mild insanity emerges from trying to remember
every food that hit your tongue during the past year." And that's a reference to the method of the
study was based on food surveys that were updated about every four years. What do you think of her analysis of this
study?
DR. CARLSON: I think
it's a very good analysis. I mean,
basically in nutshell, she's defining an observational study. And that goes back to trying to remember, you
know, every food that hits your tongue during the past year, quote-unquote. But, you know, the thing is it's exactly what
they're doing in this study. They're
not, you know-- when I analyze my patients' food intake, I have them do a food
diary where they're actually -- I tell them whatever you put in your mouth, I
don't care if it's a Tic Tac or whatever, I want to know what's going on, write
it down at the time.
You know, now you're going retrospectively, trying to have
people remember what they ate. And it's
an interesting psychological thing. You
know, if we're being watched, we tend to want to, you know, look better, you
know, so we'll say we eat more of this, that or the other thing and we'll tend
to put, you know, even less of things we know we shouldn't be eating even
though we are.
So I definitely agree with her analysis there. And it's interesting too because it was --
or, you know, we picked on red meat. The
glaring thing was red meat, the evil was red meat, and they didn't even look at
the higher BMIs, the higher alcohol intake, the most likely to smoke and all
that. It was just "red meat is
bad" is basically the glaring headline.
MR. LEDERER: All
right. Well, Ned Kock, who's a professor
of advanced statistics at Texas A&M International University, who has
dissected several medical studies, concluded
[http://healthcorrelator.blogspot.com/2012/04/2012-arch-intern-med-red-meat-mortality.html]
that the Harvard researchers in this study made a critical error in failing to
control for two factors that skewed the results: One is gender. In this sample, the women consumed a lot MORE
red meat than the men, yet they died at LOWER rates than men. But the authors averaged the results of the
women with those of the men, so this key distinction was submerged.
The second factor that he says that researchers should have
controlled for was diabetes incidence due to excess calorie intake. Professor Kock's analysis found that the more
red meat was consumed, the FEWER people died from diabetes.
And he concludes, quote, the data reported by the authors
suggests that, when we control for biological sex and incidence of diabetes, an
extra 234 grams of red meat per day, okay, so this extra red meat is associated
with a REDUCTION in mortality of approximately 23 percent. That is the exact opposite...of what was
reported by the authors, unquote.
And then he notes, not incidentally, that this -- what
sounds like a big effect, 23% reduction in mortality, is also a minute effect,
just like the effect [of the red meat on mortality] that was reported by the
authors." In other words, the
actual numbers of deaths are not even that big in the first place. But --
DR. CARLSON: Right.
MR. LEDERER: -- in
any case, that when-- when controlled by these other factors, that it's
actually not an increase, it's a reduction.
What do you think of Professor Kock's analysis?
DR. CARLSON: It's --
it's interesting because, being in clinical medicine, that's exactly what I
see. And the more red meat that my
patients consume, I'm not going to say that fewer people die from diabetes, but
I will say this: The better controlled
my patients are with their blood sugars to the point where the vast majority of
them do not need medications.
Now, if we extrapolate or just look at it scientifically,
the side effects of diabetes, say, the blindness or the heart disease or the
need for dialysis, is all due secondary to the elevated blood sugars. So when I control blood sugars, by having
them back off on carbs and eating more red meat, I'm lowering their risk of
adverse events from the diabetes. So
that's exactly what I'm seeing.
And I'm going to have to agree that an extra amount of red
meat per day associated with a reduction in mortality, again, I'm going to have
to say that that's also true because not even so much of my Type 2 diabetics
and Type 1s who do phenomenally well with carbohydrate restriction and eating
more red meat, but also, I see HDLs increase, I see weight loss come off, I see
blood pressures normalize. So I'm seeing
-- not to look too much into what he did, but that's exactly what I see in
clinical medicine.
MR. LEDERER:
Okay. So now, let's turn to the
finding in the Harvard study that consumption of PROCESSED red meats -- such as
bacon, hot dogs, salami, bologna, and so forth --correlated with even higher
death rates than those who ate unprocessed red meats.
Now, since nitrites and nitrates are contained in all these
products and have been found to be cancer-causing, would you say that these
forms of meat are bad dietary choices that could well worsen one's health over
the long term?
DR. CARLSON: Due to the
presence of the nitrates and nitrites, you would want to be careful consuming
these. And, I generally have my patients, try to avoid these things.
You know, it's interesting though, if you do a literature
search on nitrates and nitrites, and I came across some data in 2011, December
2011, saying that they weren't even being recognized as being carcinogens,
which I found quite interesting. But
it's well known that nitrosamines are indeed cancer-causing, so you definitely
would want to be careful with that. I
think the statistic was 20% versus 13%
processed versus unprocessed--
MR. LEDERER: Right.
DR. CARLSON: --
respectively. So, you would want to be
careful. I'm not going to sit there and tell people to eat a slab of bacon or
salami or bologna. But when you get into
a whole gradation, it's like, what's
worse? I get proposed this question all
the time, is that, for a Type 2 diabetic, what's worse, consuming, whole grains
versus processed meats versus unprocessed meats. I'm going to go with the, of course, the
whole grains. And I'm going to say,
well, if you're going to eat processed foods, do it, in moderation, and
certainly -- mild to moderate consumption, and certainly make sure you're
taking, vitamin supplements, especially vitamin C, which is known to neutralize
nitrosamines.
MR. LEDERER: Well,
speaking of extra vitamins, one of the things not addressed in this study and
was actually criticized by a letter writer to the Annals of Internal Medicine a
couple weeks after that Harvard study was published was the fact that in this
country, most red meat comes from corn-fed cattle that are confined in close
quarters and filled with antibiotics and growth hormones which, of course,
undermine human health. And I would add
that this method of mass livestock production with its massive use of huge
acreage of land, very destructive of the land.
The use of chemical fertilizers and pesticides has been well documented
to be tremendously destructive of the environment and a contributor to global
warming, not to mention the cruelty to the animals involved. But that's for another program.
What I wanted to focus on is the fact that this study didn't
look at any possible differences between those who ate corn-fed beef versus
pasture or grass-fed beef.
DR. CARLSON: Right.
MR. LEDERER: Of
course, that's a tiny number in this country.
But as nutrition writer and supplement producer Michael Mooney wrote
actually today, that when you compare corn-fed beef to grass-fed -- grass-fed
beef is four times higher in vitamin E, five times higher in total Omega 3
fatty acids, four times higher in selenium, and higher in vitamin B1, B2,
calcium, magnesium and K, each of which have been found in different degrees to
prevent either cardiovascular disease, cancer, or to help prevent
cardiovascular disease, cancer, or depression.
So I realize that grass-fed beef is much more expensive and
it's hard to find outside of middle-class neighborhoods, but do you recommend
that your patients try to include grass-fed beef in their diets? And you alluded to the use of supplements,
but would you say for people who have to eat the conventional commercial red
meat, that they should take high-dose nutritional supplements to try to, make
sure they get some of those vital nutrients?
DR. CARLSON:
Definitely. And you know what,
that's representative of the vast majority of what we here in America
consume. It's not the grass-fed, it's
the grain-fed. And the problem with the
grain-fed is, as you alluded to -- and what supplements would those be would
be, of course, vitamin C, you know, B complex, vitamin D as in David.
The more the cattle or the beef that's grain-fed, you have
more Omega 6 fatty acids, which are pro-inflammatory and less, Omega 3. The grass-fed beef is much better for you. And I know, of course, it's more
expensive. So if you can't afford the
grass-fed beef --this is one of those, you know, what's the lesser of two
evils. If you can't afford the grass-fed,
you're going to have to go after the grain-fed.
The
other thing that I want to say before I forget is that, interestingly enough,
the grain-fed -- let me get this right -- the grain-fed beef actually has more
E. coli, more problems with E. coli. You
know, so that whole E. coli, O157:H7
that
basically is seen a lot more so with grain-fed beef. So there's a multitude of benefits, of
course, for the grass‑fed
versus the grain‑fed.
MR. LEDERER:
Okay. Now, I'm sorry to interrupt
you.
DR. CARLSON: That's
okay.
MR. LEDERER: We're
very short on time. So let me just
quickly touch on one final issue not addressed in the study, which was the fact
that compounds called AGEs that are present in many foods but in higher levels
in meats have been linked to a variety of illnesses and tend to be dramatically
increased with high-temperature cooking.
And, this is also true of a cancer-causing chemical called heterocyclic
amines.
So would you agree with the advice of the American Dietetic
Association to avoid oven frying, deep frying, broiling, and roasting meat, and
instead use steaming, poaching, stewing, and boiling to reduce these toxic
compounds?
DR. CARLSON: I
would. I mean, we do know that these
advanced glycation end-products and we do know that some heterocyclic amines --
just quickly, though, for the audience, heterocyclic amines are interesting
critters because they range from vitamins, such as niacin, to cancer-causing,
amines. We do see these created more so
in the types of cooking -- oven frying, deep frying -- that you mentioned, so I
would definitely say, go with the steaming, the poaching, the stewing, the
boiling.
And I also tell my patients too on top of, supplements to get
your beef, to the temperature of 140.
Don't overcook it. You know, and
we've known for quite some time, although we may not have known of AGEs and
heterocyclic amines, that, the more you,
quote-unquote, cook your food or, quote-unquote, burn your food, that it tends
to be more carcinogenic. And that was
just becoming more educated and we know about these advanced glycation end-products
and, of course, the heterocyclic amines.
So I would say, yes, be very careful how you indeed cook the meat.
MR. LEDERER:
Okay. You have 30 seconds to just
give us a take-home message about this Harvard study and what people should
think about in terms of the role of red meat in their diet.
DR. CARLSON: I would
say be very cautious with this study.
It's one of many studies that are just I think, setting out a bias
toward the consumption of red meat. Red
meat is not evil. Red meat is definitely
very, very good to eat. Especially if
you're obese or Type 2 diabetic or have heart issues, red meat is definitely
the way to go. Of course, go with grass-fed
versus the grain-fed and all. Don't
forget your vitamins. And, definitely
back off on your whole grains and your fruits, the things that I feel
clinically are what's causing the major issues with, Type 2 diabetes, heart
disease, and the list goes on.
MR. LEDERER:
Okay. And I want to thank my
guest, Dr. James Carlson, osteopathic physician and author of Genocide: How
Your Doctor's Dietary Ignorance Will Kill You.
His website is http://drjamescarlson.com.
And, to obtain all the references listed in tonight's show
and much more information, you can visit the Facebook page "Red Meat Won't
Kill You," sponsored by the Weston A Price Foundation. Just go to
Facebook.com and search for "Red Meat Won't Kill You." The Foundation supports movements aimed at
restoring nutrient-dense foods to the diet through accurate nutrition
instruction, organic and biodynamic farming, pasture-feeding of livestock,
community-supported farms, and other strategies.
On their website, westonaprice.org, they state,
"Although many of our members are farmers, the Foundation has no ties with
the meat or dairy industry, nor with any organization promoting these
industries."
And also on the Facebook page and the Foundation site, you
can find a link to the Brooklyn chapter which lists sources of grass-fed animal
products in the NY-NJ area, including a consumer co-op, the Park Slope Food Co-op.
Click here to find a local Westonaprice.org
chapter.
Dr. James Carlson
attained degrees in biochemistry and cellular physiology from Cornell
University before receiving his medical degree from the New York College of
Osteopathic Medicine in Old Westbury, New York. He served as the chief resident
at Delaware Valley Medical Center in Langhorne, Pennsylvania, and later
obtained a master's of business with an emphasis on healthcare economics and
physician practice management from Regis University in Denver, Colorado.
Carlson holds a juris doctorate, with an emphasis in healthcare law from
Concord University School of Law, located in Los Angeles, California. His is
the author of GENOCIDE: How Your Doctor's Dietary Ignorance Will Kill You.
Currently, he is currently in a private medical practice in Port Jefferson ,New
York.
Bob Lederer has been a
journalist and advocate for health empowerment for 25 years, and is a new
member of the Weston A. Price Foundation. In 1990 he cofounded a program
offering grassroots perspectives on HIV/AIDS on WBAI/Pacifica Radio, and has since
1994 been co-producer/co-host of Health Action, a weekly WBAI show covering
alternative approaches and challenges to corporate undermining of health and
blockages to health care access. For many years he was an activist with ACT UP,
the AIDS Coalition to Unleash Power, demanding research on and access to both
conventional and alternative HIV/AIDS treatments and preventive measures such
as needle exchange. Since 2006 he has been Researcher and Policy Analyst with
the Bronx Health Link, a nonprofit agency doing research, education and
advocacy for low-income residents of the Bronx. He is currently working toward
a Masters in Public Health at Hunter College.
Health Action airs
Mondays from 11:00-11:30 PM on WBAI/Pacifica Radio in New York (99.5 FM, livestreaming
at wbai.org) and can be accessed in the audio archives for 90 days after each
program.
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