Red meat consumption and long-term cancer risk Alicja Wolk

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1 Red meat consumption and long-term cancer risk Alicja Wolk Professor of Nutritional Epidemiology Institute of Environmental Medicine Karolinska Institutet

2 WCRF/AICR report 2007 Food, Nutrition, Physical Activity and the Prevention of Cancer Recommendations Animal foods Limited intake of red meat and avoid processed meat Personal recommendation People who eat red meat to consume less than 500g a week, very little if any to be processed Public health goal Population average consumption of red meat to be no more than 300g a week, very little if any of which to be processed World Cancer Research Fund May,

3 Convincing increased risk Limited suggestive Increased risk Red meat and cancer scientific evidence Red meat Colorectum Esophagus Lung Pancreas Endometrium Processed meat Colorectum Esophagus Lung Stomach Prostate World Cancer Research Fund 8 May

4 Criteria for grading evidence 1 Convincing Evidence strong enough to support a judgement of a convincing causal relationship, which justifies goals and recommendations designed to reduce the incidence of cancer 2 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 conclusion 5 Substantialeffect unlikely 8 May

5 Convincing increased risk Limited suggestive Increased risk Red meat and cancer -scientific evidence Red meat Colorectum Esophagus Lung Pancreas Endometrium Processed meat Colorectum Esophagus Lung Stomach Prostate World Cancer Research Fund 8 May

6 8 May

7 Increased risk of colorectal cancer in relation to red meat consumption Highest vs. Lowest category Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, (2006) 8 May

8 Increased risk of colorectal cancer in relation to processed meat consumption Highest vs. Lowest category Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, (2006) 8 May

9 Dose response relationships between red meat or processed meat consumption and colorectal cancer risk Larsson SC., Wolk A. Meat consumption and risk of colorectal cancer. Int. J. Cancer: 119, (2006) 8 May

10 8 May

11 Red meat consumption and risk of cancers of the distal colon Swedish population Int. J. Cancer 2005; 113,

12 8 May

13 Red meat consumption and risks of pancreatic cancer per 120 g per day increment 8 May

14 Processed meat consumption and risk of pancreatic cancer per 50 g per day increment 8 May

15 8 May

16 Red meat and risk of stomach cancer Swedish population 8 May

17 Processed meat and risk of stomach cancer Swedish population 8 May

18 N-Nitrosodimethylamine intake and risk of stomach cancer Swedish population 8 May

19 8 May

20 Prostate cancer processed meat Highest vs. Lowest Category 8 May

21 Potentially preventable proportion of Gastrointestinal Cancers in Swedish men Red meat, 4 serving/week Cancer Prevalence PAR* Colorectal 32% 9% Pancreatic 32% 9% Processed meat, 3 servings/week Gastric 59% 19% *PAR, population attributable risk 8 May

22 Potentially preventable proportion of Gastrointestinal Cancers in Swedish women Red meat, 4 serving/week Cancer Prevalence PAR* Colorectal 25% 7% Pancreatic 25% 7% Processed meat, 3 servings/week Gastric 44% 15% *PAR, population attributable risk 8 May

23 Stroke Red meat and stroke, Swedish women Total red meat, 86g vs. 36g/d Total stroke 1680 cases 1.12 (95% CI) Cerebral infarction 1310 cases 1.22 (95% CI) Processed meat, 49g vs. 16g/d Total stroke 1.18 (95% CI) Cerebral infarction 1.24 (95% CI) Larsson, Virtamo, Wolk. Stroke 2011;42: May

24 Stroke Red meat and stroke, Swedish men Total red meat, 136g vs. 63g/d Total stroke 1.15 (95% CI) Cerebral infarction 1.06 (95% CI) Processed meat, 49g vs. 16g/d Total stroke 1.23 (95% CI) Cerebral infarction 1.18 (95% CI) Larsson, Virtamo, Wolk. Am J Clin Nutr 2011;94: May

25 8 May

26 Red meat intake and risk of all-cause mortality American population Men Wome n 8 May

27 Red meat intake and mortality cancer, cardiovascular and all-cause mortality American population Cancer mortality Cardiovascular mortality All-cause mortality 8 May

28 Summary There is convincing evidence, that red meat (unprocessed and processed) 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. 8 May

29 Thank you! Alicja Wolk Professor Institute of Environmental Medicine Karolinska Institutet

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