Troubling assumptions behind GBD 2019 on the health risks of red meat

We echo the compliments of Alice Stanton and colleagues1

  • Stanton AV
  • Leroy F
  • Elliott C
  • Mann N
  • Wall P
  • De Smet S

36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable?. to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. We also support Stanton and colleagues’ call for further clarification, justification, or reconsideration of the theoretical minimum risk exposure level of zero for unprocessed red meat selected by GBD in their latest estimates. Not only does the increase in the estimated burden appear implausible, but the lack of transparency in the assumptions underlying the calculations undermines the authority of the GBD estimates.When the assumptions used within a study are not clearly stated and explained, the results become questionable, and replication difficult. Estimates of preventability are exquisitely dependent on their underlying assumptions—as outlined by discussions surrounding population attributable fraction methodologies.2What does the population attributable fraction mean?.,  3

  • Azadnajafabad S
  • Karimian M
  • Roshani S
  • et al.

Population attributable fraction estimates of cardiovascular diseases in different levels of plasma total cholesterol in a large-scale cross-sectional study: a focus on prevention strategies and treatment coverage. Further, insufficient clarity of such assumptions potentially reduces their use within policy development.World Cancer Research Fund (WCRF) International has been at the forefront of exploring the relationships between diet, nutrition, physical activity, and cancer for over 20 years. Following our review of the evidence related to unprocessed red meat, we concluded that red and processed meat are causal contributors to the development of colorectal cancer. Nevertheless, neither WCRF nor other international organisations recommend complete avoidance of meat. In many diets worldwide, red meat is an important source of several nutrients.4What is the role of meat in a healthy diet?. Removing meat from such diets is impractical and unrealistic, and carries a risk of nutritional deficiency judged to outweigh future cancer risk.5

  • Knuppel A
  • Papier K
  • Fensom GK
  • et al.

Meat intake and cancer risk: prospective analyses in UK Biobank.,  6World Cancer Research FundAmerican Institute for Cancer Research
Diet, nutrition, physical activity and cancer: a global perspective: a summary of the third expert report. The absence of an explicit rationale for the assumptions underlying the GBD estimates is troublesome, unsupported by the evidence, and unrealistic.

We declare no competing interests.

References

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    • Leroy F
    • Elliott C
    • Mann N
    • Wall P
    • De Smet S

    36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable?.

    Lancet. 2022; 399: e23-e26

  2. 2.

    What does the population attributable fraction mean?.

    Prev Chronic Dis. 2007; 4: A14

  3. 3.
    • Azadnajafabad S
    • Karimian M
    • Roshani S
    • et al.

    Population attributable fraction estimates of cardiovascular diseases in different levels of plasma total cholesterol in a large-scale cross-sectional study: a focus on prevention strategies and treatment coverage.

    J Diabetes Metab Disord. 2020; 19: 1453-1463

  4. 4.

    What is the role of meat in a healthy diet?.

    Anim Front. 2018; 8: 5-10

  5. 5.
    • Knuppel A
    • Papier K
    • Fensom GK
    • et al.

    Meat intake and cancer risk: prospective analyses in UK Biobank.

    Int J Epidemiol. 2020; 49: 1540-1552

  6. 6.
    • World Cancer Research Fund
    • American Institute for Cancer Research

    Diet, nutrition, physical activity and cancer: a global perspective: a summary of the third expert report.

Article Info

Publication History

Published: 06 August 2022

Identification

DOI: https://doi.org/10.1016/S0140-6736(22)01283-1

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© 2022 Elsevier Ltd. All rights reserved.

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