Abstract

Based on a large volume of observational scientific studies and many summary papers, a high consumption of meat and processed meat products has been suggested to have a harmful effect on human health. These results have led guideline panels worldwide to recommend to the general population a reduced consumption of processed meat and meat products, with the overarching aim of lowering disease risk, especially of cancer. We revisited and updated the evidence base, evaluating the methodological quality and the certainty of estimates in the published systematic reviews and meta-analyses that examined the association between processed meat consumption and the risk of cancer at different sites across the body, as well as the overall risk of cancer mortality. We further explored if discrepancies in study designs and risks of bias could explain the heterogeneity observed in meta-analyses. In summary, there are severe methodological limitations to the majority of the previously published systematic reviews and meta-analyses that examined the consumption of processed meat and the risk of cancer. Many lacked the proper assessment of the methodological quality of the primary studies they included, or the literature searches did not fulfill the methodological standards needed in order to be systematic and transparent. The primary studies included in the reviews had a potential risk for the misclassification of exposure, a serious risk of bias due to confounding, a moderate to serious risk of bias due to missing data, and/or a moderate to serious risk of selection of the reported results. All these factors may have potentially led to the overestimation of the risk related to processed meat intake across all cancer outcomes. Thus, with the aim of lowering the risk of cancer, the recommendation to reduce the consumption of processed meat and meat products in the general population seems to be based on evidence that is not methodologically strong.

you are viewing a single comment's thread
view the rest of the comments
[–] [S] 2 points 2 weeks ago* (last edited 2 weeks ago)

Haha, epidemiology is "evidence that is not methodologically strong." Sounds a little like saying water is wet, but the authors must've thought that it needed saying.

The main identified methodological shortcomings were:

(1) a lack of a reference to a predetermined/a priori published research objective, that is, a protocol or an ethics approval, which, according to AMSTAR, indicates a high risk of selectively reported results;

(2) incomprehensive literature searches, which indicates a high risk of overlooking relevant literature;

(3) not considering the scientific quality of the evidence in formulating the conclusions, which indicates a high risk of emphasizing results from weak study designs;

(4) not reporting the conflicts of interest of the authors of the reviews as well as those of the original included primary studies.

Case control studies showed large "risks" but prospective cohort studies showed small or no effects. The authors say this is caused by recall bias. They point out that IARC downgraded red meat because bias and confounding could not be ruled out, while the same studies, with identical methods, also measured processed meat.

Not mentioned in this paper, but meat is all bucketed into the same label. IARC only differentiates "processed meat" and "red meat." Which is to say that eating pork ribs slathered in high carbohydrate sauces would've been considered to be the same as eating an unflavoured steak. Bacon, hot dogs with lots of carbohydrate filler, blood sausage, all the same.

"Not methodologically strong," indeed.

  • source