Editor
Headlines such as `Big meat eaters cancer warning' (Daily Mail, 13 September) have appeared in advance of the publication of the Department of Health's report on diet and cancer.(1, 2) A prospective study, however, analysed data from a nationwide random stratified sample of British adults to determine the relation between diet and cancer and found a protective role for fruit and salads but no evidence that frequent consumption of meat is a risk factor for cancer.
Details of dietary habits (including the usual frequency of consumption of 31 food items), smoking behaviour, and health status were obtained from respondents to the health and lifestyle survey in 1984-5, and details on health status were obtained from the follow up survey in 1991-2.(3) All participants were flagged on the NHS Central Register so that death certificates were received with appropriate coding (International Classification of Diseases, ninth revision). Altogether 1630 men and 2030 women, aged 35-75, did not have cancer in 1984-5 and either were interviewed again in 1991-2 or had died from cancer by then (89 men and 73 women, including 28 who had died of colorectal cancer). Forty four men and 76 women who were interviewed again in 1992 had developed cancer.
Logistic regression analysis was used to examine the relation of the frequency of consumption of red carcase meat and of fruit and salad in winter(4) (reflecting year round consumption) with the development of cancer over seven years. Confounding variables included age (in five year categories) and smoking (in four categories), with the sexes analysed separately. The importance of smoking as a significant risk factor for the development of cancer was confirmed.
There were no indications that, when compared with the reference category of eating red meat less than once a week, more frequent consumption of meat was associated with the development of cancer in men or women (figure). In contrast, there were significant trends for the relation between increasing frequency of consumption of fruit or salads in winter with a decreasing risk of developing cancer, the association being strongest with salads in men and with fruit in women.
Most of the supportive evidence in prospective studies for an association between consumption of meat and colorectal cancer comes from the United States rather than Europe.(5) The way in which the meat is cooked and the relation of meat to fruit and salad vegetables in a balanced diet might explain the inconsistent findings.
Brian D Cox University lecturer
Margaret J Whichelow Senior research associate Health and Lifestyle Survey, Department of Community Medicine, Institute of Public Health, University of Cambridge, Cambridge CB2 2SR
References
- Department of Health Committee on Medical Aspects of Food Policy Working Group. Nutritional aspects of the development of cancer. London: Stationery Office, 1997.
- White C. New study reports that diet is critical to cancer prevention. BMJ 1997;315:831. (4 October.)
- Cox BD, Huppert FA, Whichelow MJ, eds. The health and lifestyle survey: seven years on. Aldershot: Dartmouth Publishing, 1993.
- Cox BD, Whichelow MJ. Seasonal fruit consumption in relation to the development of, or death from, cardiovascular disease. Proc Nutr Soc (in press).
- Bingham SA. Epidemiology and mechanisms relating diet to risk of colorectal cancer. Nutr Res Rev 1997;9:197-239.
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