Processed Meat is Not All the Same: How to Choose Wisely

How unhealthy is processed meat? A big new paper stated, "“The existing evidence [is] weak.” But don't run to the bacon aisle just yet... There are risks, and you can make smarter choices. Here's how.

Just how unhealthy is processed meat? Well, if you digest the intellectual processed food that is conventional media headlines, you might confidently conclude a hotdog is really a metabolic health grenade in a phallic disguise.

Quoting from CNN, “Habitual consumption of even small amounts of processed meat… is linked to increased risk of developing type 2 diabetes, ischemic heart disease, and colorectal cancer.”

Technically, that’s not wrong. But most articles like this leave out critical nuances — the kind that actually matter to your health decisions. Let’s break it down and digest the data…

The CNN report is based on a new paper about processed meat and health published in Nature Medicine. Here’s a fun exercise: search the words “weak” and “inconsistent” in the paper — they show up about 18 times in the main text and captions. For example:

“These associations each received two-star ratings reflecting weak relationships or inconsistent input evidence.”

“These associations are rated as relatively weak two-star relationships, reflecting small effect sizes and/or lack of consistent evidence. We found a weaker one-star association between processed meat and ischemic heart disease.”

“The existing evidence [is] weak.”

Over Confident Conclusions

How, then, do media headlines, internet influencers, and public health authorities come to such confident conclusions about the negative impact of processed meats on health?

Let me play devil’s advocate for a moment.

Yes, the data are weak. But the pattern is consistent across observational studies. And for the big health questions — cancer, diabetes, heart disease — randomized controlled trials are impractical, if not impossible. So, we rely on observational data and plausible biological mechanisms, however imperfect.

In general, that data points in the direction that processed meat is a net negative on health. I’m not here to challenge the side to which the preponderance of evidence leans. Based on a lack of high-quality data and the “precautionary principle,” I would not advocate for processed meat consumption per se. However…

It’s also important to acknowledge that:

1. The evidence is weak.

2. The current evidence base is riddled with confounders. Quoting from the new paper in Nature Medicine, “a considerable number of studies included in this meta-analysis did not account for dietary confounding factors beyond energy intake.”

3. Not all processed meat is the same.

After the following funding disclosure, the rest of this letter will focus on point 3 because I think it’s the most practical and most overlooked.

Amendment: A Brief Aside on Funding Source

While I realize financial interests do frame and inform research, I do not generally comment on funding sources unless I think it is especially relevant. I had not initially included statement about the funding source for the study at hand; however, in the five hours since release of this letter I’ve received several request to report that the “Research reported in this publication [the Nature Medicine paper] was supported by the Bill & Melinda Gates Foundation (OPP1152504).” Take that for whatever it’s worth to you. Now, let’s continue.

Not All Processed Meat is the Same

To differentiate among processed meats, we must first ask, “why, mechanistically, are processed meats thought to be unhealthy?”

In brief, processed meats can contain harmful compounds. But using careful selection methods and cooking dips, you can reduce your ingestion of these compounds and “have your jerky and eat it too.”

In the rest of this letter, we discuss:

• How to minimize exposure to potentially harmful compounds in processed meats

• Labels to Look For at the Grocery Store

• Cooking and marinading tips to reduce formation of these harmful compounds when cooking at home

• Direct you to more resources on nitrates and nitrites