International red meat manual

They reported cases of colon cancer and cases of rectal cancer among 53, participants during They used Cox proportional hazards models to compute incidence rate ratios IRRs.

In this trial, substitution of fish for red meat was associated with a significantly lower risk for colon cancer, but not rectal cancer. They concluded that the risks for colon and rectal cancer differ according to the specific red meat subtype consumed.

Carr and colleagues published a meta-analysis about meat subtypes and their association with CRC, at the beginning of this year. Lamb consumption was also associated with increased risk of CRC. They announced that no association was observed for pork, and they recommended further analysis especially regarding the role of pork.

The exact mechanisms underlying the association between CRC risk and high intake of red and processed meat are uncertain. NOCs are mutagenic and potent carcinogenic agents in animals. Dietary NOCs are synthesized exogenously during meat processing from oxides of nitrogen nitrites or nitrates and amines or amides; so they are present in certain processed meats such as bacon, cured meats, sausages, ham, smoked fish and smoked cheeses.

Because they are considered irreplaceable in the prevention of Clostridium botulinum poisoning from consumption of cured meat by preventing spore germination. NOCs can be formed also endogenously after consumption of red and processed meat. HCAs and PAHs are potent carcinogens, which are produced during, high-temperature or on open flame cooking of meat, especially grilling, pan-frying and barbecuing for a long period. Martinez et al. Cross et al.

White meat poultry and fish is not associated with cancer risk. One of the main difference between red and white meat is heme molecule in muscles myoglobin, which is present in red meat in high concentrations.

Corpet et al demonstrated a dose-response relationship between heme iron and promotion of colon carcinogenesis. Heme iron can promote cancer some independent pathways. Second possible mechanism is fat peroxidation pathway. One product of this pathway is malondialdehyde, which is a carcinogen. On the other hand, heme iron promotes the production of reactive oxygen species ROS which induces genetic mutations.

Fatty diets favor obesity which in turn increases insulin resistance, thus promote tumor growth. Another important targets in promoting carcinogenesis are omega-6 PUFAs, especially arachidonic acid, 42 and cyclooxygenase 2 COX-2 expression. High level of COX-2 expression is found in cancer cells. PGE2 is major downstream effector of COX-2 and it inhibits apoptosis, favors invasion, motility and promotes angiogenesis.

The efficacy of nonsteroidal anti-inflammatory drugs, especially selective COX-2 inhibitors were shown in the reduction of colorectal polyps. Regarding red meat subtypes, most containing meat of arachidonic acid is pork muscle 2. Secondary bile acids that were under-recognized causes until now, gained great importance in recent years.

They are largely re-absorbed in the terminal ileum by an active transport mechanism. This small portion of BAs entering to colon, are metabolized by bacterial flora and they are converted into secondary BAs deoxycholic acid and lithocholic acid.

It has been shown that BAs, especially these hydrophobic secondary BAs can create chaos within colon epithelial cells. This excessive stress in colonic mucosa will lead to apoptosis from one hand, stimulates proliferation on the other hands.

Necrotic cells induced by hydrophobic BAs may elicit an inflammatory response. We know that tumor-promoting inflammation is one of the enabling characteristics of carcinogenesis. Sialic acids are monosaccharides on cell surface. The predominant sialic acids on most mammalian cells are N-glycolylneuraminic acid Neu5Gc and N-acetylneuraminic acid Neu5Ac. Exposure to Neu5Gc-containing foods like red meat, in the presence of certain commensal bacteria can cause to generation of auto-antibodies xeno-autoantibodies against Neu5Gc-containing glycans in human tissues.

Experimental evidence showed that inflammation due to xenosialitis could promote tumor progression. Some epidemiological observations exist to support an infectious etiology in human cancers.

For example, some neoplasms occur under immunosuppression, nutritional cancer risk factors may be linked to infections. Fusobacterium nucleatum and Streptococcus bovis was reported to be involved in colon polyps and colon cancer. Harald zur Hausen underlines a possible link between specific, thermo-resistant and potential carcinogenic bovine infectious agents and colorectal cancer incidence with high rate of beef consumption.

Epidemiological studies consist of correlation studies, case-control and cohort studies. We presented here, a summary of the data from 10 meta-analyses about the relationship between red and processed meat and CRC risk. Only 5 analyses included prospective cohort trials only, 2 , 14 , 19 , 20 , 24 the others included case-control studies besides cohorts. But, statistical heterogeneity was investigated in most of them.

Based accumulated data, international guidelines published up-to-date recommendations. Processed meat means red meat preserved by smoking, curing, salting or by adding preservatives. There are many types of processed meats such as ham, bacon, pastrami, salami, sausages, hot dogs, etc. American Society of Clinical Oncology ASCO mentions this convincing evidence between the increase of the chance of CRC and eating processed meat based on the same study, 17 under the chapter of the role of major nutrients in cancer prevention, in its website www.

Institut National du Cancer INC from France repeats this consumption of g of red meat per week besides completing the rest need of protein by white meat, fish, eggs and vegetables. Dietary modification is an important approach to cancer control. Regarding specific red meat subtypes, the association with increased risk was found for beef consumption in two trials one of them is weakly associated , for pork consumption in three trials and for lamb intake in one trial.

An interesting observation is the existence of this risk only for pork intake and rectum cancer and lamb intake and colon cancer, respectively in one trial. Beef and pork consumption was found also to be associated with colon cancer only in women, in one trial.

Whether CRC is one disease or the existence of 2 categories of CRC colon and rectum or proximal and distal or right and left colon and the link between etiologic factors and molecular subtypes are another hot topics of discussion, which need further investigations. They recommend also limiting intake of processed meat. White meat fish and poultry is not associated with CRC risk and is recommended safely. To diminish carcinogenic effects of HCAs, diet should be high in dietary fibre sources such as wheat bran and vegetables.

Formation of HCAs can be reduced by avoidance of exposure of meat surfaces to flames, usage of aluminum foil to wrap meat before oven roasting and microwave cooking. To eat meat safer, different trimming processes can be applied on the market, to decrease fat content. Meat is an important source of nutrients and should be consumed moderately and balanced with other foods. National Center for Biotechnology Information , U. Journal List Oncol Rev v.

Oncol Rev. Published online Dec Nuri Faruk Aykan. Author information Article notes Copyright and License information Disclaimer. Corresponding author. This article has been cited by other articles in PMC. Abstract Colorectal cancer CRC is the third most common cancer in men and the second in women worldwide. Key words: Red meat, processed meat, colorectal cancer, colon cancer, rectal cancer. Methods of research A systematic literature search for publications on red and processed meat and colorectal cancer was conducted in PubMed without language restrictions until 1 November to prepare this review.

Results After exclusion of reviews, updates of previous publications, and one study about diabetes and CRC, we identified 10 meta-analyses 2 , about red meat and CRC risk Table 1 and one meta-analysis about red meat subtypes and CRC risk. Open in a separate window. Meta-analyses for red meat and processed meat Sandhu et al. Red meat subtypes and colorectal cancer As we see above, many trials addressed to the potential risk between CRC and the intake of red and processed meat.

Table 2. Red meat sub-types and colorectal cancer risk. Potential mechanisms The exact mechanisms underlying the association between CRC risk and high intake of red and processed meat are uncertain. N -nitroso compounds NOCs are mutagenic and potent carcinogenic agents in animals. Heterocyclic amines and polycyclic aromatic hydrocarbons HCAs and PAHs are potent carcinogens, which are produced during, high-temperature or on open flame cooking of meat, especially grilling, pan-frying and barbecuing for a long period.

Heme iron White meat poultry and fish is not associated with cancer risk. Non-human sialic acid and xenosialitis hypothesis Sialic acids are monosaccharides on cell surface. Infectious agents Some epidemiological observations exist to support an infectious etiology in human cancers.

Discussion Epidemiological studies consist of correlation studies, case-control and cohort studies. References 1. Int J Cancer ; :E The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence. Packing and labeling Labeling Packing and tray handling Weigh price labeling All Packing and labeling.

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