Saturday, May 23, 2009

Is red meat bad for you?

I originally wrote the post below for my FOOD & HEALTH SKEPTIC blog but I think it is of general interest so I am posting it here too

Below is a research summary circulated on a mailing list for medical practitioners. It arrived under the heading: "Red meat is bad for you —and bad for everyone else". Further below is the journal abstract (summary) concerned -- from a very respectable medical journal. The whole thing is, however, one big confidence trick and will achieve nothing other than frightening people off perfectly harmless food that they would otherwise enjoy. The entire report is a scientific, statistical and ethical nothing. Let me tell you very quickly why.

For a start, the "hazard ratios" (relative risks) reported are negligible -- at 1.2, 1.3 etc. The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0."

OK. So who cares about a silly old Federal Reference Manual on Scientific Evidence? But it gets worse. The findings are reported in terms of upper and lower quintiles. In other words they threw away three fifths of the information that they had in order to arrive at their reported conclusions. That is quite simply dishonest and unethical. NO categorization of such data for analytical purposes is now ethically defensible. In pre-computer days, when all calculations had to be performed by hand, doing so could in some cases be justified but with the advent of computers there is NO reason why regression techniques that include ALL the data cannot be used. I note that before I had access to computers, I analysed the data from my first ever piece of research (in 1966) using a regressional technique. Even at that early stage I did not contemplate throwing away any of my data in the course of analysing it.

Had the whole of the data been analysed using a regressional technique, there is no doubt the the resultant correlation between meat consumption and disease would have been derisorily small and maybe even of negative sign, indicating that red meat eating is NOT a cause of cancer, heart disease etc. It is certainly not "bad for you —and bad for everyone else". The authors would of course be aware of that but have nonetheless chosen to present their data in a way that makes mountains out of pimples, which seems to me quite simply unethical.

So how did such a piece of utter crap get published in a medical journal? More particularly, why is such crap ROUTINELY published in medical journals? I am afraid that it is a sad outcome of the "publish or perish" regime that prevails in academe. Researchers need to get papers published in order to be promoted. So a well-meaning consensus has emerged among journal editors that they will accept extreme quintile reports out of solidarity with their colleagues. Otherwise they would have to reject more than half of what they currently publish. That the practice routinely results in the public being deceived is of no account. It is an utter disgrace but I doubt if I will live to see it stopped. An ethical vacuum prevails where the public would normally expect the highest ethical standards.

The emailed circular from DocAlert Messages below:
Further evidence of a link between red meat and poor health has emerged from a large cohort of older US adults. Men and women in the top fifth of red meat intake had a significantly higher risk of death over 10 years than men and women in the bottom fifth (hazard ratio for men 1.31, 95% CI 1.27 to 1.35; for women 1.36, 1.30 to 1.43). The authors also found a link between death and a high intake of processed meat such as bacon, ham, and sausage.

The 545 653 adults were between 50 and 71 when they filled in a detailed food frequency questionnaire in 1995. By 2005, more than 71 000 had died. These large numbers mean the authors were able to estimate with some precision the risks associated with eating red and processed meats for both men and women. The analyses were fully adjusted for other lifestyle factors likely to influence lifespan, especially smoking.

These data add to other observational studies that suggest we should all eat less red and processed meats. Not least because the increasing consumption of meat in many countries is putting a strain on global supplies of water, energy, and food in general, says a linked comment (p 543). It is costlier in all these precious resources to grow meat to eat than to grow vegetables and grains instead.

Journal abstract below:
Meat Intake and Mortality: A Prospective Study of Over Half a Million People

By Rashmi Sinha et al.

Background: High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.

Methods: The study population included the National Institutes of Health–AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire administered at baseline. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of meat intake. The covariates included in the models were age, education, marital status, family history of cancer (yes/no) (cancer mortality only), race, body mass index, 31-level smoking history, physical activity, energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption, and menopausal hormone therapy among women. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.

Results: There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up. Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality. Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes. Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes. When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.

Conclusion: Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

Arch Intern Med (2009) Vol. 169 No. 6. 562-571

In addition to the statistical and ethical failures that I have detailed above, there are of course other large problems with the interpretation of the study. The first or second thing you learn in Statistics 101 is that "correlation is not causation". The authors above were cautious NOT to make causative inferences from their data but that message got lost downstream. Even well-informed people reading the report DID assume a causative relationship. They assumed that red meat eating CAUSED heart disease etc. But NO epidemiological study enables causative inferences. There could easily be third or fourth factors producing the observed association.

Just to give a top-of-the head example of how that could have played out: Given the weak associations reported, maybe a substantial proportion of those who ate little or no meat were Seventh Day Adventists. Adventists are an exceptionally healthy group who encourage vegetarianism. So WHY are they exceptionally healthy? Nobody really knows but it seems likely that the strong social and psychological support that they get from their heavy church involvement reduces stress and thus also reduces stress-related disease. And heart disease is partly a stress-related disease. So even if we accept as proper the statistical jiggery pokery reported above we may be basing our conclusions entirely on the doings of Seventh Day Adventists -- which is not of much relevance to the rest of society.

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Don't let Leftists get away with their sneering ignorance

So I'm sitting around with family, and one conservative member mentions something he saw on Fox News.

A progressive member starts in with the passive-aggressive giggle of dismissal, and then the condescending "you mean you watch Fox News?"

And the conservative member says "Yup. Fair and balanced."

More giggles. "Oh, gosh! Do you know how many lies they tell?"

Now normally when this progressive member disparages Fox News (this is certainly not the first time) I keep my mouth shut in the name of family harmony. Which I think, unfortunately, only re-enforces the idea in such people's minds that their assertion is correct. But I decided I needed to chime in this time. The giggles are one thing. The condescension I usually gloss over. But the "lies" thing. I wasn't going to let that drop.

"No. I don't know. Tell me a lie Fox News has told."

Giggles. "Well I don't watch it."

"So you don't watch it, but you know they tell lies? How do you know they tell lies?"

"Well I read somewhere..."

"You read somewhere? How do you know that wasn't a lie?"

"Well I don't. They all do it, that's what I'm saying."

"Then why single out Fox?"

"Well I read somewhere that they were the worst."

"And you believe what you read?"

"Well let's not get into anything political. Why can't people just talk about things anymore?"

Why not indeed. Who brought it up? Who got nasty about it?

Fortunately, I suppose, the phone rang. It was for the progressive.

So I'm sitting here thinking ... "Fox News lies, but you don't have any examples and you don't watch it. They all lie, but you know Fox is 'the worst' because you read something one of the other liars wrote?"

The problem is, they're used to people either politely keeping quiet, backing down, or patting them on the head for echoing what they've been instructed to believe and many others have accepted ... typically the people they hang out with.

Don't let it happen anymore. When anyone tries to espouse how "hateful" conservative-friendly networks and show hosts are, make them back it up. Watch them back down. Stop an echo.

SOURCE

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ELSEWHERE

British aid money wasted : "Millions of pounds in taxpayers’ money have been wasted on failed reconstruction projects in Afghanistan, according to an internal assessment by the Department for International Development. An evaluation by independent consultants criticised the department’s approach to planning, risk management and staffing, and said poor co-ordination with the rest of Whitehall meant that the department was slow to shift strategy as the military effort moved to counter-insurgency. The report reveals that in 2006-07, more than half of the department’s large projects, in which millions of pounds were invested, were deemed likely to fail, excluding money put into a fund run by the World Bank. Only a quarter of state building projects were rated successful in 2006, with 4.5 per cent of them rated value for money. Among the failed projects singled out in the Country Programme Evaluation is the Afghanistan Stabilisation Fund, designed to “establish basic security and good governance in the district and provinces of Afghanistan”. This was begun in 2004 with a £20 million payment to the Afghan Government but ended three years later with “little evidence of tangible benefit”.

AK: Palin vetoes $28.6 million in federal “stimulus” funds : “Gov. Sarah Palin announced today she is vetoing the state Legislature’s decision to accept $28.6 million in federal economic stimulus money for energy relief. Palin also vetoed nearly $12 million from the state budget for construction projects. The biggest project she targeted was the improvement of the Anchorage courthouse. She also cut Southeast Alaska projects funded with cruise ship tax money. … Palin argued that taking the stimulus money would require the state to entice local communities to adopt building codes. ‘There isn’t a lot of support for the federal government to coerce Alaska communities to adopt building codes, but lawmakers can always exercise checks and balances by overriding my veto,’ Palin said in a written statement.”

NY: Terror suspects appear in court: “The four men arrested Wednesday night and accused of plotting to place bombs at New York City synagogues and shoot down National Guard jets appeared in court today, and an attorney for one of the defendants claimed his client suffers from mental illness. At a hearing for three of the defendants, Assistant U.S. Attorney Eric Snyder called the men ‘extremely violent’ and said, ‘It’s hard to envision a more chilling plot.’”

Stupid copyright restrictions: "Thanks to horribly egregious copyright legislation, books published from the late sixties onward are typically under copyright for 100 years, meaning that someone besides the author is charged with administering rights. That person is usually completely ignorant of book publishing and the content of the book or why it matters. All he wants is money that is not there. More often than not, this person will refuse to make a deal. And the book stays out of print, for the rest of our lifetimes at least. This is what copyright extensions have amounted to: great impediments to printing books and preserving literary legacies. Already, provisions of the law have burned more books than most despots in human history. And this has only just begun. We are going to be seeing this nonsense for another 100 years at least. Sad to say, many of the books that will fail to be printed are great books. But they might as well have never been written. The author is in no position to protest because he or she is six feet in the ground. His or her legacy, about which the heir cares less than nothing, is buried too. The problem is that within the structure of IP there is no rational way to price anything. The property is made scarce only by the state. Its scarcity is otherwise wholly artificial.”

Going Dutch : “Despite budget shortfalls, the Netherlands doesn’t seem interested in returning to its 1970s model of confiscatory rates of taxation. When their economy stagnated, the government quickly moved to slash the corporate tax rate from 35 percent to 25.5 percent. (In the United States, it’s roughly 40 percent) A recent proposal by the right-leaning government of Jan Peter Balkenende would lower inheritance tax rates from 27 percent to 20 percent for family members, and from 68 percent to 40 percent for non-family members. And with government coffers thinning and an aging population, a recent piece of legislation would push the retirement age from 65 to 67.”

Don’t judge the chemo kid : “The story of Daniel Hauser, a 13-year-old boy from Minnesota with Hodgkin’s lymphoma, became tabloid fodder overnight. The boy and his mother are on the lam because the mother refuses, because of her beliefs, to authorize chemotherapy treatments for her son. Hodgkin’s lymphoma has a 90 percent cure rate with chemotherapy, and a 95 percent chance of killing a person without it. Chemotherapy will likely save Daniel’s life, and as a pediatrician I wouldn’t hesitate for a moment to recommend it. But I would also like to turn down the volume on the talk-radio chatter and outraged editorials. That’s because nobody seems to be talking about what it takes to beat Hodgkin’s (or any other cancer). What it takes is a grueling regimen that can indeed give even a dying person pause.”

Will the government be the new king of all media? : “Howard Stern swore off free broadcast radio in 2004 in part because of federally mandated decency rules. The self-annointed ‘king of all media’ may have stepped off the throne in doing so. Them’s the breaks in the competitive media marketplace, contorted as it is by government speech controls. Some would argue that a new king of all media is seeking the mantle of power now that the Obama administration is ensconced and friendly majorities hold the House and Senate. The new pretender is the federal government.”

All cost, no benefit : “The Obama administration’s plan to require new passenger vehicles sold in 2016 to get an average of 39 miles per gallon or better (30 mpg or more for SUVs, pickups and minivans) is likely to be all cost and no benefit. If the proposed fuel efficiency standards were in place today, Edmunds.com reports that only two cars — the 2010 Toyota Prius (50 mpg) and the 2009 Honda Civic Hybrid (42 mpg) — would meet the standard. Angry environmentalists might thus find themselves key-scratching ‘gas guzzlers’ such as the 2009 Honda Fit (31 mpg), the 2009 Mini Cooper (32 mpg) and the 2009 Smart ForTwo (36 mpg). There is little dispute that, as a consequence, cars would become more expensive and industry profits more scarce.”

For more postings from me, see TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, GUN WATCH, SOCIALIZED MEDICINE, FOOD & HEALTH SKEPTIC, AUSTRALIAN POLITICS, IMMIGRATION WATCH INTERNATIONAL, EYE ON BRITAIN and Paralipomena

List of backup or "mirror" sites here or here -- for readers in China or for everyone when blogspot is "down" or failing to update. Email me here (Hotmail address). My Home Pages are here or here or here

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The Big Lie of the late 20th century was that Nazism was Rightist. It was in fact typical of the Leftism of its day. It was only to the Right of Stalin's Communism. The very word "Nazi" is a German abbreviation for "National Socialist" (Nationalsozialist) and the full name of Hitler's political party (translated) was "The National Socialist German Workers' Party" (In German: Nationalsozialistische Deutsche Arbeiterpartei)

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