Dennis’s Pet Menace

As it happened, I’d already agreed to appear on Jeremy Sallis’ Lunchtime Live Show on BBC Radio Cambridgeshire – the plan being just to chat about cancery topics that might be of interest to listeners. Which would have been fine – if only The World Health Organization had left us in peace. But of course they chose last Tuesday to publish their lengthy cogitations on the subject of whether meat is bad for us – i.e. causes cancer.

Cue Press extremism: prime example The Times, quite predictably – they really aren’t great on biomedical science – who chucked kerosene on the barbie with the headline ‘Processed meats blamed for thousands of cancer deaths a year’.

But – to precise facts – and strictly it’s The International Agency for Research on Cancer, the cancer agency of the World Health Organization (WHO), that has ‘evaluated the carcinogenicity of the consumption of red meat and processed meat.’

But hang on … haven’t we been here before?

Indeed we have. As long ago as January 2012 in these pages we commented on the evidence that processed meat can cause pancreatic cancer and in May of the same year we reviewed the cogitations of the Harvard School of Public Health’s 28 year study of 120,000 people that concluded eating red meat contributes to cardiovascular disease, cancer and diabetes. To be fair, that history partially reflects why the WHO Working Group of 22 experts from 10 countries have taken so long to go public: they reviewed no fewer than 800 epidemiological studies! However, as the most frequent target for study was colorectal (bowel) cancer, that was the focus of their report released on 26th October 2015.

So what are we talking about?

Red meat, which means any unprocessed mammalian muscle meat, e.g., beef, veal, pork, lamb, mutton, horse or goat meat, that we usually cook before eating.

Processed meat: any meat not eaten fresh that has been salted, cured, smoked or whatever and commonly treated with chemicals to enhance flavour and colour and to prevent the growth of bacteria.

What did they say?

Processed meat is now classified as carcinogenic to humans – that is it goes into the top group (Group 1) of agents that cause cancer.

Red meat is probably carcinogenic to humans (Group 2A). Group 2B is for things that are possibly carcinogenic to humans.

Why?

Because 12 of the 18 studies they reviewed showed a link between consumption of processed meat and bowel cancer and because it’s known that agents commonly added to processed meat (nitrates and nitrites) can, when we eat them, turn into chemicals that can directly damage DNA, i.e. cause mutations and hence promote cancers.

For red meat 7 out of 15 studies showed positive associations of high versus low consumption with bowel cancer and there is strong mechanistic evidence for a carcinogenic effect i.e. when meat is cooked genotoxic (i.e. DNA-damaging) chemicals can be generated. They put red meat in the probably group because several of the studies that the Working Group couldn’t fault – and therefore couldn’t leave out – showed no association.

Stop woffling

My laptop likes to turn ‘woffling’ into ‘wolfing’. Maybe it’s trying to tell me something.

But is The WHO trying to tell us something specific about wolfing? To be fair, they have a go by estimating that every 50 gram portion of processed meat (say a couple of slices of bacon) eaten daily increases the risk of bowel cancer by about 18%. For red meat the data ‘suggest’ that the risk of bowel cancer could increase by 17% for every 100 gram portion eaten daily.

And what might that mean?

In the UK about 6 people in 100 get bowel cancer: if you take The WHO maximum estimate and have everyone eat 50 grams of processed meat every day of their lives such that 18% more of them would get bowel cancer, the upshot would be 7 people in 100 rather than 6. So it’s a small rise in a relatively small risk.

As the report points out, the Global Burden of Disease Project reckons diets high in processed meat cause about 34,000 cancer deaths per year worldwide and, if the reported associations hold up, the figure for red meat would be 50,000. Compare those figures with smoking that increases the risk of lung cancer by 20-fold and The WHO’s estimate of up to 6 million cancer deaths per year globally caused by tobacco use and 600,000 per year by alcohol consumption.

All of which suggests that it isn’t very helpful to lump meat eating, tobacco and asbestos in the same cancer-causing category and that The WHO could do worse than come up with a new classification system.

And the message?

Unchanged. Remember mankind evolved into the most successful species on the planet as a meat eater. As the advert used to say: It looks good, it tastes good and by golly it does you good – not least as a source of protein, vitamins and other nutrients. Do some exercise and eat a balanced diet – just in case you’ve forgotten, that means limit the amount of red meat (The WHO suggests no more than 30 grams a day for men, 25 g for women) so try fish, poultry, etc. Stick with the ‘good carbs’ (vegetables, fruits, whole grains, etc.), cut out the ‘bad’ (sugar – see Biting the Bitter Bullet), eat fishy fats not saturated fats and, to end on a technical note, don’t pig out.

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‘The Divine Swine’ Castelnuovo Rangone, Italy

Meanwhile back on the Beeb

When the meat story broke I was a bit concerned that we might end up spending the whole of Lunchtime Live on how many bangers are lethal – especially as we were taking calls from listeners. Just in case things became a bit myopic I had Rasher up my sleeve. Rasher, you may recall, was Dennis the Menace‘s pet pig (in the The Beano‘s comic strip) who had a brother (Hamlet), a sister (Virginia Ham) and various other porky rellos. To bring it up to date we’d have introduced Sam Salami and Frank Furter and, of course, Rasher’s grandfather who was the model for the bronze statue named ‘The Divine Swine’ to be found in the little town of Castelnuovo Rangone in Pig Valley, Italy, the home of Parma ham.

But I shouldn’t have worried. All was well in the hands of Jeremy Sallis who, being a brilliant host, ensured that we mainly chatted about meatier matters than what to have for breakfast.

References

Press release: IARC Monographs evaluate consumption of red meat and processed meat.

Q&A on the carcinogenicity of the consumption of red meat and processed meat.

Carcinogenicity of consumption of red and processed meat. www.thelancet.com/oncology Published online October 26, 2015

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Twists in a Tale: The trials, tribulations and unexpected treats that accompanied the writing of Betrayed by Nature

An old adage holds that everyone has a novel in them. It’s readily exploded, of course, by a glance at the widespread levels of illiteracy revealed by Twitter and other contemporary organs of unfettered soul-pouring. “No it isn’t” you retort, having glanced at one or two books that have done rather well of late. A fair point. Maybe it’s all these ‘writing seminars’ and ‘how to write a book’ books – everyone knows it’s dead easy to become a proper author: précis the plot, write out a detailed plan, discuss it with your publisher (all signed up and ready to go) and devise a rigid schedule: rise at five, 3,000 words by lunchtime, two hours kip, another 2,000 words, dinner, bed, reprise next day until finished. Finally, select the exotic location to which you will retire on the proceeds.

Once upon a time I sat down to write a novel. It was about cancer – not yet another of those estimable but rather egocentric and uninformative accounts of ‘battling against the odds’ but rather a sci-nov – a book that reads like a novel but where science (and the folk that do it) make the story. In ‘sci-nov’ I may have invented an acronym but certainly not a new genre. Writing science as a story is to walk in footsteps that have borne the brilliance of Steve Jones and Matt Ridley to mention only two luminaries – so you experience full well the trepidation that assailed Brahms in trying to write symphonies after Beethoven had a bit of a crack at it.

How not to write a book

But nowadays if you fancy trying it you know exactly what to do. Follow the above instructions and Bob’s your uncle. Except I didn’t. Do any of that. I just told myself someone should write this story – so get on with it. And I started with the first thing that occurred to me as dimly relevant. But after, I suppose, a couple of sentences I hit a problem. Proper authors reading this are doubtless smirking “Bit early to get writer’s block” but it wasn’t that.

For me the problem is called being a scientist. It simply is an utter pain having ingrained into you the notion that there are facts and that where facts are known you should jolly well get them right, as well as making them contribute to a clear and fascinating story. Oh to be scratching away at chick-lit or similar drivel! So by dinner-time on day one we had the grand total of 39 words. We’d spent hours trying to discover the birthday of William Norris (he was the first to spot that cancers might be heritable), judging the fairness of describing Jim Watson (the DNA double helix chap) as untidy and in deciding whether to note the annual number of cancer deaths in the world as 7½ million, 7.5 million, 7,564,802 or just round it up to eight million (thank you World Health Organization).

If someone had told me I’d got lucky that morning I would, of course, have given up – but it did indeed transpire, seven years and 100,000 words later, that on Day One I’d managed what was to become, almost exactly, my average daily rate.

But no one was there to utter such dire prophesies and so, one May day in New York in 2012, I found myself autographing my first fly-leaf dedication. Astonishing? I’ll say – sci-nov becomes sci-fi – but, remarkable to relate, this wasn’t my first amazing ‘author’ experience. Several months earlier I was beginning to grasp that popular science is a different world – a parallel universe to that of ‘normal’ science. Where I normally live, once something’s published it pretty well disappears into the facts mountain and you get on with the next experiment. In the ‘pop’ world you have to publicise – or to put it more painfully – self-publicise.

The first intimations of this came in a brief lecture from youngest son: “If you think it’s worth writing you must make an effort to tell everyone about it. You need a blog, Squire.” A quick visit to Wikipedia revealed that he was talking about a web log – a discussion or information site. But what to ‘discuss’ or ‘inform’ about? All I wanted to say was ‘read the book (subliminal message: it’s terrific).’ Re-consulting the Son Oracle elicited the instruction that “You need to pick up current cancer stories and explain them simply and clearly – that is, do it better than the science journalists. Should be a doddle for you. Let me have a look at your first effort and I’ll tell you if you’re on the right lines.” Gee one’s nearest and dearest can be so annoying!

Son Oracle has a word with Charles Darwin about the descent of man

That was how I met Susan. Our courtship was a paradigm of our times, conducted most chastely through the medium invented by Sir TimBL. She was looking for distraction, not in the usual sort of way, I hasten to add, but from embarking on post-surgical chemotherapy for bowel cancer. As a virgin blogger I was just desperate for someone experienced to tell me what to do. In the traditional male fashion my overtures were very much of the hope rather than anticipation variety – even with my manic enthusiasm for cells and molecules I had to admit that someone grappling with colorectal carcinoma might find less than irresistible the post of Reviewing Editor (unpaid) for articles on cancer. But no! She said yes!! Aren’t women amazing?!!! And this one stuck to her word by marking my first essay – with disconcerting perception – within 24 hours (university tutors please note!). And so our secret affair has blossomed and in the process we have become, as in the best of relationships, the best of friends.

I know, it’s a tear-jerker – but try this for a twist. Coincidentally with the book coming out – almost to the day – Susan had a meeting with her oncologist after which she vividly described the moment when he said what must to her have been almost unbelievable words:“Congratulations. You appear to be in full remission.”

All that before becoming a sci-nov author – clearly life after birth was going to be one long anti-climax. Well, that’s not exactly how it’s shaping up. I’d scarcely staggered from the literary delivery room when I was asked to talk at a meeting organised by Peterborough NHS – really to tell people about cancer. I found myself sharing the platform with a lovely lady called Jean who, after I’d warbled on about DNA and cells and coerced the audience into performing a bit of molecular theatre, told them what it had been like to find she had cancer. She used her experience to explain the tell-tale signs of the major cancers and then talked very simply and clearly about how she had dealt with all the ensuing stress arising from her particular version. Witnessing her courage in re-living difficult times for the benefit of others was quite an experience. I’m not sure how much attention they paid to me and molecules, but when Jean was speaking a falling pin would have been a serious distraction.

How did that happen then?

Meeting these wonderful people was not on the menu when I sat down to write Betrayed by Nature. There were three simple aims: write something enjoyable to read, get people interested in biology, and help folk deal with cancer. It never crossed my mind that becoming an author could confer the privilege of meeting Susan and Jean. I don’t know how successful the book will be but if it has a fraction of the effect that they have on those who hear their stories, no exotic retirement spot could offer equal contentment.