Trieu K.,University of Sydney |
Neal B.,University of Sydney |
Hawkes C.,World Cancer Research Fund |
Dunford E.,University of Sydney |
And 6 more authors.
PLoS ONE | Year: 2015
Objective To quantify progress with the initiation of salt reduction strategies around the world in the context of the global target to reduce population salt intake by 30% by 2025. Methods A systematic review of the published and grey literature was supplemented by questionnaires sent to country program leaders. Core characteristics of strategies were extracted and categorised according to a pre-defined framework. Results A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products (n = 61), establishment of sodium content targets for foods (39), consumer education (71), front-of-pack labelling schemes (31), taxation on high-salt foods (3) and interventions in public institutions (54). Legislative action related to salt reduction such as mandatory targets, front of pack labelling, food procurement policies and taxation have been implemented in 33 countries. 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviours relating to salt. Conclusion The large and increasing number of countries with salt reduction strategies in place is encouraging although activity remains limited in low- and middle-income regions. The absence of a consistent approach to implementation highlights uncertainty about the elements most important to success. Rigorous evaluation of ongoing programs and initiation of salt reduction programs, particularly in low- and middle- income countries, will be vital to achieving the targeted 30% reduction in salt intake. © 2015 Trieu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source
Reedy J.,U.S. National Cancer Institute |
Wirfalt E.,Lund University |
Flood A.,University of Minnesota |
Mitrou P.N.,World Cancer Research Fund |
And 7 more authors.
American Journal of Epidemiology | Year: 2010
The authors compared dietary pattern methods-cluster analysis, factor analysis, and index analysis-with colorectal cancer risk in the National Institutes of Health (NIH)-AARP Diet and Health Study (n = 492,306). Data from a 124-item food frequency questionnaire (1995-1996) were used to identify 4 clusters for men (3 clusters for women), 3 factors, and 4 indexes. Comparisons were made with adjusted relative risks and 95% confidence intervals, distributions of individuals in clusters by quintile of factor and index scores, and health behavior characteristics. During 5 years of follow-up through 2000, 3,110 colorectal cancer cases were ascertained. In men, the vegetables and fruits cluster, the fruits and vegetables factor, the fat-reduced/diet foods factor, and all indexes were associated with reduced risk; the meat and potatoes factor was associated with increased risk. In women, reduced risk was found with the Healthy Eating Index-2005 and increased risk with the meat and potatoes factor. For men, beneficial health characteristics were seen with all fruit/vegetable patterns, diet foods patterns, and indexes, while poorer health characteristics were found with meat patterns. For women, findings were similar except that poorer health characteristics were seen with diet foods patterns. Similarities were found across methods, suggesting basic qualities of healthy diets. Nonetheless, findings vary because each method answers a different question. Source
Monday was a rough day for bacon lovers, as well as for fans of hot dogs, sausage and salami. That's when a report by a cancer research group from the World Health Organization announced that there was sufficient evidence from epidemiological studies to show that eating processed meat can cause colorectal cancer in people. The researchers also classified processed meat as a human carcinogen, or cancer-causing agent. The news for people who eat steaks and other unprocessed red meat was only slightly better. After reviewing data from more than 800 studies that looked at the link between the consumption of red meat or processed meat and the risk of certain cancers, the panel of 22 scientists categorized red meat as probably causing cancer. The group also concluded there was strong, but still limited, evidence of an association between eating red meat and colorectal cancer. In addition, the data showed a connection between eating processed meat and an increased risk of developing stomach cancer, as well as a positive link between red meat and cancers of the pancreas and prostate, according to the findings, published online (Oct. 26) in the journal Lancet Oncology. But the evidence for these associations was not as strong as the evidence found for colorectal cancer. [Cancer-Fighting Diet: 6 Tips to Reduce Your Risk] The WHO said its findings were a scientific evaluation of the evidence, rather than a set of recommendations about what people should or should not be eating. Because the WHO findings received widespread media attention and represented a definitive health warning about the dangers of processed meat, it left many consumers wondering what to do, how to pack their lunches and whether everyone needed to become a vegetarian. In addition, many consumers were confused about which foods fell into the categories of processed and red meats, which compounds in these foods seemed to promote cancer, or how much of these meats, if any, were safe to include in a person's diet. For answers to these and other pressing questions, Live Science turned to two experts on nutrition and cancer prevention. The WHO data showed that a person who eats a little bit less than 2 ounces of processed meat a day, which is equal to one small hot dog or about two slices of salami, is 18 percent more likely to develop colorectal cancer than someone who eats none, said Alice Bender, a registered dietitian and the associate director of nutrition programs at the American Institute for Cancer Research. AICR is a nonprofit group based in Washington, D.C., that supports research on diet, nutrition and cancer prevention, and was not involved in the WHO report. Bender said that processed meat is any meat that has been preserved by smoking, curing, salting or adding chemical preservatives. This puts most of the cold cuts at the supermarket deli counter — such as ham, pastrami, turkey and bologna — into this category, along with bacon, sausage, hot dogs, corned beef, pepperoni, beef jerky as well as canned meat, like Spam. Turkey bacon and turkey sausage are also processed meat, as are smoked turkey and smoked chicken, Bender said. Red meat includes beef, pork, veal and lamb, and also horse, goat and mutton (meat from sheep), although these are rarely consumed in the United States. Although research has not yet revealed exactly why diets high in processed meat and red meat increase the risk of colon cancer, the WHO report has identified a few possible culprits that may be responsible. Some of the substances used in the smoking process to preserve meats may lead to the formation of the cancer-causing compounds called polycyclic aromatic hydrocarbons (PAHs), Bender told Live Science. Also, processing meat often involves using nitrites as preservatives to prevent bacterial growth and as coloring agents, but nitrites may form compounds called N-nitroso compounds. Red meat has a lot of iron in a form called heme iron, which may also stimulate the production of N-nitroso compounds in the gut. The compounds have been found to cause cancer in animal studies, Bender said. Cooking methods may also play a role. High-temperature methods, such as grilling, frying or broiling, which might be used with beef or pork, can form more cancer-promoting chemicals, such as heterocyclic amines (HCAs), and the char on the outside of meats can contain PAHs. [10 Do's and Don'ts to Reduce Your Risk of Cancer] Although the WHO report didn't make any dietary recommendations, and the American Cancer Society Guidelines on Nutrition and Physical Activity and Cancer Prevention currently advise people in a very general way "to limit how much processed meat and red meat they eat," the guidance from the American Institute for Cancer Research includes specific amounts of meat in its dietary recommendations. They recommend that people avoid eating processed meat, or reserve eating it to only a few special occasions during the year, such as a hot dog at the ballpark, a sausage when tailgating and bacon on Christmas morning, Bender said. For red meat, the AICR recommendations call for eating no more than 18 ounces of cooked red meat weekly, which is an amount that doesn't increase colon cancer risk appreciable, based on an evaluation of the evidence done for AICR by a worldwide panel of experts, Bender said. Red meat can be a source of protein, iron, zinc and vitamin B-12 in some people's diet, she said. Six card-deck size portions, or roughly 3-ounce servings, of red meat would fall under the recommended limit, Bender said. The conclusions reached by the WHO scientific panel come as no surprise, said Dr. Tim Byers, a professor of preventive medicine at the Colorado School of Public Health in Aurora. Byers previously served on two expert review committees — one for the World Cancer Research Fund, and one for the American Cancer Society. He said that both those groups reviewed basically the same set of evidence and came to similar conclusions. "The data was quite clear from these analyses that eating processed meat can increase colon cancer risk, and that red meat can also increase the risk, but to a lesser extent," Byers told Live Science. However, the size of the risk that comes with eating processed meat is relatively small in relation to colon cancer, and it would have about the same size impact on the risk for the disease as three other known colon cancer risk factors — being overweight, being physically sedentary or not eating enough fruits and vegetables, he said. If people decide on the basis of the WHO report to stop eating red meat, this would reduce their risk for colon cancer to some extent, Byers said. In contrast, undergoing colonoscopy screenings has a huge effect on reducing the risk of colon cancer, he said. Editor's note: A correction was made to this article on Oct. 31. The article originally stated that the AICR was involved in writing the new report, but it was not. 7 Cancers You Can Ward Off with Exercise 7 Foods You Can Overdose On Science You Can Eat: 10 Things You Didn't Know About Food Copyright 2015 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Jebb S.A.,MRC Human Nutrition Research |
Aveyard P.N.,University of Oxford |
Hawkes C.,World Cancer Research Fund
Obesity Reviews | Year: 2013
Summary: Tackling obesity has been a policy priority in England for more than 20 years. Two formal government strategies on obesity in 2008 and 2011 drew together a range of actions and developed new initiatives to fill perceived gaps. Today, a wide range of policies are in place, including support for breastfeeding and healthy weaning practices, nutritional standards in schools, restrictions on marketing foods high in fat, sugar and salt to children, schemes to boost participation in sport, active travel plans, and weight management services. Data from annual surveys show that the rate of increase in obesity has attenuated in recent years, but has not yet been reversed. This paper considers the actions taken and what is known about the impact of individual policies and the overarching strategy to tackle obesity in England. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity. Source
It’s official: Processed meat — such as hot dogs, bacon, corned beef and salami — causes cancer. Years of evidence and numerous studies have linked processed meat to colorectal, or bowel, cancer. Now, after reviewing more than 800 epidemiological studies, the World Health Organization has designated such meats as carcinogenic. WHO made the announcement online October 26 in The Lancet Oncology. WHO’s International Agency for Research on Cancer classifies processed meat — meat altered through salting, curing, fermenting or smoking — as a Group 1 carcinogen. This group of cancer-causing agents also includes smoking and asbestos. The ranking means there’s convincing evidence linking the modified meats to colorectal cancer, evidence as strong as that linking smoking to cancer. This does not mean that eating processed meat is as risky as smoking. An analysis by the research charity group Cancer Research UK in London offers some perspective: Research suggests that 61 people per 1,000 in the United Kingdom will develop bowel cancer during their lives. Among those 1,000 who eat the most processed meat, you’d expect 66 to develop bowel cancer, while among those who eat the least processed meat, about 56 would develop bowel cancer. The IARC also classified red meat, (beef, veal, mutton, lamb, pork, horse and goat) as “probably carcinogenic.” This Group 2A classification means eating red meat was correlated with an increased risk for some cancers including bowel, pancreatic and prostate, but other explanations for the increase couldn’t be ruled out. In the IARC evaluation, prospective cohort studies, which follow large groups of healthy people and track information on exposures as they go along, were given the most weight. Additional evidence came from case-controlled studies, which look at people who are already sick and ask them about things like their food habits before they got cancer. While evidence linking processed meats and bowel cancer was the strongest, some studies also suggested a link between processed meat and stomach cancer and red meat and pancreatic and prostate cancer. The IARC doesn’t make diet recommendations, but other organizations have been suggesting for years that people limit their intake of red and processed meat. “This is an important step in helping individuals make healthier dietary choices to reduce their risk of colorectal cancer in particular,” Susan Gapstur, vice president of epidemiology at the American Cancer Society, said in a statement. The London-based World Cancer Research Fund recommends eating no more than 500 grams of red meat per week, and eating as little as possible of processed meats. One hot dog is about 45 grams; 100 grams is roughly a portion the size of a deck of cards — slightly less than a quarter-pound hamburger, for instance. Several cancer-causing mechanisms are probably at play, the IARC notes. Curing and smoking meat can generate nitroso compounds, which damage DNA. High amounts of iron — found naturally in red meats — also increase production of these compounds. The way meat is prepared may raise cancer risks, too. The high temperatures of pan frying, grilling and broiling can produce aromatic amines (also found in tobacco smoke), which do cellular damage. It may seem counterintuitive that something like meat, part of the human diet for ages, could be bad for you, says Mariana Stern, a cancer epidemiologist from the University of Southern California in Los Angeles. She was one of the 22 scientists on the IARC panel. In fact, meat does provide important proteins and other micronutrients such as B vitamins, iron and zinc, the IARC notes. But quantity and life expectancy are different today than in the past, Stern says. “Age is the biggest carcinogen that we have,” she says. “We’ve been eating meat for a long time, but currently, we may be eating it in much higher amounts and our life expectancy is higher so we have more time to develop cancers.”