Red meat consumption and long-term cancer riskg

Alicja Wolk

Professor of Nutritional EpidemiologygyInstitute of Environmental MedicineKarolinska Institutet

WCRF/AICR report 2007WCRF/AICR report 2007Food, Nutrition, Physical Activity and the

Prevention of CancerPrevention of Cancer

RecommendationsAnimal foods

Limited intake of red meat and avoid processed meatPersonal recommendation

People who eat red meat to consume less than 500g a week, er little if an to be processedvery little if any to be processed

Public health goal

Population average consumption of red meat to be no more thanPopulation average consumption of red meat to be no more than300g a week, very little if any of which to be processed

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World Cancer Research Fund 2007

Red meat and cancer i tifi idscientific evidenceRed meat Processed meat

Convincingincreased risk

Colorectum Colorectum

Esophagus EsophagusLimited –suggestiveIncreased risk

p gLung

Pancreas

p gLungStomach

EndometriumProstate

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World Cancer Research Fund

Criteria for grading evidence

1 Convincing Evidence strong enough to support a judgement of a convincing causal relationship whichof a convincing causal relationship, which justifies goals and recommendations designed to reduce the incidence of cancer

2 P b bl Sli h l k f b b ll j if2 Probable Slightly weaker from above, but can generally justify recommendations

3 Limited- Evidence too limited to permit a probable or suggestive convincing causal judgement

4 Limited –no conclusionno conclusion

5 Substantial-effect unlikely

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Red meat and cancer i tifi id-scientific evidenceRed meat Processed meat

Convincingincreased risk

Colorectum Colorectum

Esophagus EsophagusLimited –suggestiveIncreased risk

p gLung

Pancreas

p gLungStomach

EndometriumProstate

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World Cancer Research Fund

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Increased risk of colorectal cancer in relation tored meat consumption

Highest vs. Lowest category

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Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, 2657-2664 (2006)

Increased risk of colorectal cancer in relation toprocessed meat consumption

Highest vs. Lowest category

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Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, 2657-2664 (2006)

Dose response relationships between red meat or processed meat consumption and colorectal cancer risk

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Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, 2657-2664 (2006)

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Red meat consumption and risk of cancers of the distal colon

Swedish population

Int. J. Cancer 2005; 113, 829-34

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Red meat consumption and risks of pancreatic cancerper 120 g per day increment

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Processed meat consumption and risk of pancreatic cancer per 50 g per day increment

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Red meat and risk of stomach cancerSwedish populationSwedish population

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Processed meat and risk of stomach cancerSwedish populationSwedish population

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N-Nitrosodimethylamine intake and risk of stomachcancercancerSwedish population

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Prostate cancer –processed meat

Highest vs. LowestCategoryg y

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Potentially preventable proportion ofGastrointestinal Cancers in Swedish menGastrointestinal Cancers in Swedish menRed meat, ≥ 4 serving/weekCancer Prevalence PAR*Colorectal 32% 9%Pancreatic 32% 9%Pancreatic 32% 9%

Processed meat, ≥3 servings/weekgGastric 59% 19%

*PAR, population attributable risk

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Potentially preventable proportion ofGastrointestinal Cancers in Swedish womenRed meat, ≥ 4 serving/week

Gastrointestinal Cancers in Swedish women

Cancer Prevalence PAR*Colorectal 25% 7%Pancreatic 25% 7%Pancreatic 25% 7%

Processed meat, ≥3 servings/weekgGastric 44% 15%

*PAR, population attributable risk

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Stroke

Red meat and stroke, Swedish womenTotal red meat, ≥86g vs. ≤36g/d

Total stroke 1680 cases 1.12 (95% CI) 0.95-1.32Cerebral infarction 1310 cases 1 22 (95% CI) 1 01 1 46Cerebral infarction 1310 cases 1.22 (95% CI) 1.01-1.46

Processed meat, ≥49g vs. ≤16g/dTotal stroke 1.18 (95% CI) 1.00-1.38( )Cerebral infarction 1.24 (95% CI) 1.04-1.49

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Larsson, Virtamo, Wolk. Stroke 2011;42:324-29

Stroke

Red meat and stroke, Swedish menTotal red meat, ≥136g vs. ≤63g/d

Total stroke 1.15 (95% CI) 1.00-1.33Cerebral infarction 1 06 (95% CI) 0 90 1 25Cerebral infarction 1.06 (95% CI) 0.90-1.25

Processed meat, ≥49g vs. ≤16g/dTotal stroke 1.23 (95% CI) 1.07-1.40( )Cerebral infarction 1.18 (95% CI) 1.01-1.38

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Larsson, Virtamo, Wolk. Am J Clin Nutr 2011;94:417-21

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Red meat intake and risk of all-cause mortalityRed meat intake and risk of all cause mortalityAmerican population

Men Women

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Red meat intake and mortalitycancer, cardiovascular and all-cause mortality, y

American population

Cancer mortality

Cardiovascular mortality

All-cause mortality

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Summary

There is convincing evidenceconvincing evidence, that red meat (unprocessed and d) i i t d ith i d i k f l t lprocessed) is associated with increased risk of colorectal

cancer.

There is an accumulating evidence regarding increased risk for other cancer sites.

Red meat consumption has been shown to be associated with increased risk for cardiovscular diseases and diabetes as well as increased mortality.

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Thank you!

Alicja Wolk

ProfessorInstitute of Environmental MedicineKarolinska Institutet