“Red Meat: Bane or Boon?” Host Script for Health Action Program, 4/9/12
Audio soundfile at http://archive.wbai.org/files/mp3/wbai_120409_230050haction.mp3
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.