 In 2018, arguably the most prestigious cancer research institution in the world, the International Agency for Research on Cancer of the World Health Organization, published a report on processed meat, concluding that foods like bacon, ham, hot dogs, lunch, meat, and sausages are cancer-causing. Classifying processed meat as a Group 1 carcinogen. These findings conclude the director of the agency further support current public health recommendations to limit the intake of meat. Next question, putting processed meat in the same carcinogenic classification as asbestos or tobacco, or as a pesticide company roughly put it, how can eating processed meat fall into the same category as mustard gas? The classification only relate to the strength of evidence that the agent causes cancer or not. Not how much cancer. This does not mean they're all equally dangerous. It's safer to eat a sandwich filled with pastrami than plutonium, even though they're both Group 1 carcinogens. Both substances known to cause cancer in people. OK, so just how dangerous is meat? The relative risk of colorectal cancer was 18% for every 50 grams a day. OK, so what exactly does that mean? Well, the 50 grams is about one hot dog or two breakfast links or two slices of Canadian bacon or ham, so a daily sandwich with one or two slices of bologna would increase your colorectal cancer risk by 18%. But a half-pound pastrami on rye would bump it up more like 80%. OK, but what does the 18% increase risk really mean? One way to look at it is absolute risk versus relative risk. Assuming that the lifetime risk of colorectal cancer is about 5%, like 1 in 20, increasing risk about 20% would only bump up your absolute risk of getting colorectal cancer from 5% to 6%. Now, on a population scale, an 18% drop in risk could mean about 25,000 fewer cases of colorectal cancer every year in the United States, 25,000 fewer families a year dealing with that diagnosis if we swapped out the daily bologna sandwich for hummus or chose veggie dogs instead. So all depends how you look at it. Colorectal cancer is our second-leading cause of cancer death for men and women combined after lung cancer. So if you don't smoke, colon and rectal cancer may be your greatest cancer nemesis, but we can drop the risk of getting it by about a fifth with a single dietary tweak, cutting and serving a processed meat out of our daily diet. How does 18% increase cancer risk compare to other risky behavior? In my testimony before the Dietary Guideline Scientific Committee, I made what may sound like a hyperbolic metaphor. I mean, we try not to smoke around our kids why would we send them to school with a bologna sandwich? But that's not hyperbole. According to the surgeon general, living with a smoker increases your risk of lung cancer by 15%. So breathing second-hand smoke day in and day out increases risk of lung cancer almost as much as eating and serving of processed meat day in and day out increases risk of colorectal cancer. The meat industry responded by saying that the risks and benefits must be considered together before telling people what to eat or breathe. I mean, think about all the bologna benefits. Lunch meat isn't just about cancer, but convenience. Indeed, processed meat isn't just about cancer. An article railing against the World Health Organization's Meat Terrorism cited the global burden of disease studies comparing how many cancer deaths are caused by processed meat consumption compared to tobacco or alcohol use. But if you look at this study, they're referencing the 30-something thousand deaths attributable to higher processed meat intake are just the colorectal cancer deaths and don't also include the 100,000 deaths from diabetes or the 400,000 deaths from heart disease. So in actuality, we may be talking a half million deaths attributable to processed meat. And it's not just colon and rectal cancer. If you look at the science since the IARC decision was published, processed meat may also increase the risk of prostate cancer, breast cancer, and pancreatic cancer. Unfortunately, despite growing public health concerns about processed meat consumption, there have been no changes in the amount of processed meat consumed by USLs over the last 18 years. Of course, it would have helped if the last dietary guidelines for Americans had happened to mention that processed meat was a carcinogen. An explicit and science-based statement on processed meat in the next dietary guidance would certainly help, but the scientific committee made no such recommendation. Sadly, even those diagnosed with colorectal cancer hardly improved their overall lifestyle after diagnosis, though that may be because 70% of cancer patients had never received nutrition advice from their medical providers during or after treatment. That just blows me away. Despite the continued obfuscation of the issue by the meat industry, they learned well from the tobacco merchants, meat should continue to be a focus of public health action. New York City is leading the way, passing legislation to ban processed meats from school meals. What a concept, not giving our kids carcinogens. Meanwhile, the processed meat industry is trying to reformulate its products, kind of like in the pharmaceutical area, where you try to mitigate the potential adverse effects of one drug by prescribing an additional drug, like you could add fiber to hot dogs or something to try to counterbalance the risk, potentially reducing the cancer load by changing how it's processed, rather than by banning processed meat altogether.