Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
16 Aug

Does Eating Red Meat Increase Type 2 Diabetes Risk?

If you already eat Primal, your email inboxes are most likely filling up with links to the story. Concerned mothers clutching the local paper’s “Health” section are calling (or, if they’re hip, texting). Smug vegetarian Facebook friends are posting the story on your wall, sans commentary. Yes, it’s about that time again. It’s another week, it’s another observational study by data-mining researchers hoping to establish a solid link between red meat and some chronic, horrific illness. So, what’s killing us this time? Well, considering that they’ve already done studies linking red meat to colorectal cancer, heart disease, and outright death, type 2 diabetes is next.

Here’s a link to the full study (PDF). Researchers drew on data from three large-scale dietary habit questionnaires of medical professionals to explore how red and processed meat intakes associated with the incidence of type 2 diabetes. The first set was the Health Professionals Follow-Up Study, which comprised 37,083 male physicians followed for 20 years; the second was the Nurses’ Health Study I, which included 79,570 female nurses followed for 28 years; and the third was the Nurses’ Health Study II, which followed 87,504 women for 14 years. These data were pooled with additional data from 442,101 participants in existing studies, so it was a big pile of numbers with which to work.

Sure enough, they found a link between processed meat intake and type 2 diabetes, with a smaller link between unprocessed red meat and the illness. A daily 50 gram serving of processed red meat was associated with a 51% greater risk of developing type 2 diabetes, while a 100 gram serving of fresh red meat represented a 19% increased risk. Unprocessed meat included “beef, lamb, or pork as main dish” (roasts, steaks, chops), “hamburgers” (but I’m sure they got bunless burgers, right?), and “beef, pork, or lamb as sandwich or mixed dish” (served up on coconut flour bread, no doubt). Processed meat meant “hot dogs,” “bacon,” “sausage, salami, bologna, and other processed red meats.”

To give a complete picture of the data, I’ll briefly discuss what the “heavy meat eaters” did when they weren’t eating red meat. You tell me if you notice any alarming trends that might have something to do with type 2 diabetes. Folks in the highest quintiles of meat intake were the least active and the most sedentary. They exercised the least and smoked the most tobacco. They drank more alcohol than any other quintile. They guzzled more soda and other sweetened beverages. In the high meat quintiles, folks ate 800 more calories per day than folks in the low meat quintiles. They were much heavier, too (all muscle, I’m sure). Trans fat intake was higher in the high-meat quintiles, too, as was potato intake (since these data included the years before trans fats were taken out of fast food deep fryers, I’m thinking these guys enjoyed a burger and French fry value meal on occasion). They ate the least amount of fiber from grains, indicating they probably ate the most refined grains, drank the most coffee, and ate the fewest fruits and vegetables. In short, people who ate the most red and processed meat were also the unhealthiest by both Primal and mainstream standards. And if what they were doing was actually healthy or neutral (like drink coffee and avoid fiber from grains), it wasn’t by design. These people (all health professionals, ironically) most likely didn’t particularly care about their health.

There are also variables that weren’t even considered that could have impacted the results. Added sugar, which many people heap into their coffee, wasn’t covered. They did cover the polyunsaturated fat:saturated fat ratio, but those numbers only incorporated the fat content of whole foods like nuts, meat, eggs, and dairy, not whatever cooking oils were used to fry up all that meat. So there are a couple other significant confounders.

You know how we’re always making the point that people who eat the most meat, except for us weirdo Primal types, are also the most likely to be unhealthy in other areas, to eat fast food, to be sedentary, and to smoke? Well, here’s direct evidence that this actually is the case.

And then there’s the issue of relative versus absolute risk (for a good primer on relative risk, check out Dr. Eades’ post on the subject). 51% greater risk sounds pretty awful, right? I mean, that’s over half. And when most people hear a figure like that, they take notice. They don’t really think about what the number means in terms of absolute risk, but they immediately link whatever risk factor is being highlighted to the big scary percentage figure – and the damage is done. In reality, the effect size is tiny. The absolute risk of getting diabetes was rather small for a participant of the studies mined for their data – about 7% over the course of the 14-28 year range. A 51% increase in risk bumps that up to about 10.5%, not 58%, while a 20% increase bumps risk up to around 8.4%, not 27%. I don’t fault the researchers for using statistics, because they’re totally valid, but I worry that the average person will see those big percentages and think that represents absolute risk. And then they give up their meat.

So what’s the problem with observational studies?

It’s not that there’s anything inherently wrong with an observational study. In fact, they’re extremely useful and downright necessary for generating hypotheses, but they cannot establish causality. As both Mat Lalonde and Tom Naughton consistently emphasized during their presentations at the Ancestral Health Symposium, we do science and we do our cause a disservice when we overstate the evidence drawn from an observational study. The same goes for health researchers, who to their credit usually do a good job keeping their conclusions (if they make any at all) conservative. It’s the science reporters that love definitive headlines and concrete conclusions.

“Associated with”? Ha!

“Relative risk”? Never heard of it!

“Causes”? Now we’re talking!

Check out the headlines, which range from the conservative “Red Meat Linked to Increased Risk of Type 2 Diabetes” to the bordering-on-unequivocal “Bacon ‘increases risk of diabetes.” The former hails from the Harvard School of Public Health’s PR department, which actually conducted the study, while the latter comes from the Irish Independent. It’s a perfect example of what’s wrong with science reporting. Those headlines are designed to draw you in and precondition your expectations for the content. Heck, you might not even have time for the full text, in which case you’ll be left with the idea that bacon causes diabetes. Maybe it does, maybe (probably) it doesn’t, but we can’t know from observation.

As I read the study, I was pleasantly surprised by the restraint of the authors. Sure, the science reporters took the limited evidence and ran with it, but you expect that from them. It doesn’t surprise me anymore. The actual researchers, though, seemed to make it abundantly clear that no concrete conclusions about causality could be inferred from the data analysis. They even went on to propose a few potential mechanisms, as if to suggest that, I dunno, more studies were required to establish any sort of causality. In fact, they fully and continually admitted the limitations of the study as they composed the text. Until, that is, the very last sentence of the full text:

“Therefore, from a public health point of view, reduction of red meat consumption, particularly processed red meat, and replacement of it with other healthy dietary components, should be considered to decrease T2D risk.”

In other (my) words, “Despite our repeated insistence on the limitations of observational data analyses, and the fact that both causality and biological mechanism have yet to be established and indeed cannot ever be established through an observational study such as the one described in this paper, we recommend that the public reduce their consumption of red meat. The evidence in favor of such a recommendation is weak, poor, inconclusive, and highly confounded by listed variables like sedentary lifestyles, smoking, alcohol consumption, caloric intake, soda drinking, and bodyweight, plus the variables we didn’t even consider, including the oil the meat was cooked in, the baked goods the meat was served upon, and sugar intake, but do it anyway. We’re from Harvard, by the way.”

So, in the end, should this observational study cause red meat-eaters to worry? No. The confounding variables are vast and the absolute risk is low. Plus, remember: you are not the typical meat eater. You cook your meat in good fats, you eat plenty of vegetables, you lift heavy, you walk, you enjoy life, you savor relaxation and understand the pitfalls of stress, seed oils, sugar, and sunlight deprivation. Should any observational study in the future force you screaming from your butter/red meat/full-fat dairy/deep squats/barefoot running, remember that fact. No observational study should make you fear anything – not if you’re thinking clearly, can make the distinction between relative and absolute risk, and are able to identify potential confounding variables. But it should keep you questioning things, which is exactly what we need if we’re to keep learning, growing, and progressing.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. When this story hit last Thursday, my mother made sure to tell me about it, in an effort to get me back on a government-approved diet so I don’t die of a heart attack. Everything you said in this post is exactly the reasons I gave her for disregarding this sensationalist observational study. But nope, I’m not a scientist, so therefore I am not reliable on any kind of dietary/health advice. Good article, makes me feel like I really am learning something! (7 months primal)

    Primal Rob wrote on August 16th, 2011
    • Isn’t’ that nuts!! My stepdad was told that he is pre-diabetic and so in an effort to decrease his blood sugar levels they told him to take out sugary foods and drinks, starchy veggies and white processed grains, and in the same breath made sure to tell him to get his 6 servings of WHOLE GRAINS!!! GAAAHHH! Conventional Wisdom is madding!! Its so hard to break our loved ones of CW, but like you said I’m not a scientist so what do I know!! Geeze!

      Joanne - The Real Food Mama wrote on August 16th, 2011
      • The confusing part about that study is that they put red meat and processed meats in the same category, and that is a huge mistake, they dont account for the unsurmountable quantity of additives that deli meats have added to them.

        ruben wrote on August 16th, 2011
        • Hmm. I bet the inclusion of unprocessed meat actually brought the risk down a little. HAHAHAHA. I mean, funny-weird.

          Marnee wrote on August 16th, 2011
        • Also, you have to wonder what they would find if the red meat came from 100% grass fed animals.

          I bet they didn’t look at that, they never do.

          They can make any study have an outcome with any story they want to tell. Similar to the China Study.

          Primal Recipe wrote on August 16th, 2011
        • Many studies do, this one did not. They had 2 categories “processed meats” and “red meat”. That is what makes this observational study somewhat more interesting than most. I assume they have tried to corrected for confounding factors, but there is always the risk of missing ones. That is one of the dangers of observational studies.

          As Mark wrote: Unprocessed meat included “beef, lamb, or pork as main dish” (roasts, steaks, chops), “hamburgers” (but I’m sure they got bunless burgers, right?), and “beef, pork, or lamb as sandwich or mixed dish” (served up on coconut flour bread, no doubt).

          Processed meat meant “hot dogs,” “bacon,” “sausage, salami, bologna, and other processed red meats.”

          Victor Venema wrote on August 17th, 2011
        • True!!

          craig almaguer wrote on August 17th, 2011
  2. In other (my) words, “Despite our repeated insistence on the limitations of observational data analyses, and the fact that both causality and biological mechanism have yet to be established and indeed cannot ever be established through an observational study such as the one described in this paper, we recommend that the public reduce their consumption of red meat. The evidence in favor of such a recommendation is weak, poor, inconclusive, and highly confounded by listed variables like sedentary lifestyles, smoking, alcohol consumption, caloric intake, soda drinking, and bodyweight, plus the variables we didn’t even consider, including the oil the meat was cooked in, the baked goods the meat was served upon, and sugar intake, but do it anyway. We’re from Harvard, by the way.”

    My favorite part of this whole article

    I love my Daily reading of MDA

    Mike wrote on August 16th, 2011
    • Devastatingly well put.

      Timothy wrote on August 16th, 2011
      • Very good prose, Mark!

        DHT wrote on August 16th, 2011
    • yeah, i “pointed” on that, too…. :-) those people sure put drs. Emily and Shou-Ching in poor company!

      tess wrote on August 16th, 2011
  3. After I read this article I went to the freezer and took out a grassfed/finished fatty steak…boy am I hungry!

    Primal Palate wrote on August 16th, 2011
    • LOVE it. I am getting hungry too… lunch is something with chicken but dinner will be some BABY BACK RIBS!!

      Ay, can’t wait!!

      Primal Toad wrote on August 16th, 2011
    • And as long as you don’t couple that with smoking, refined carbohydrates, alcohol, soda, inactivity, and obesity, you might just steer clear of T2D…

      Peggy The Primal Parent wrote on August 16th, 2011
  4. These types of studies are so frustrating.

    Doug wrote on August 16th, 2011
  5. I hate 99% of all studies. I love people but studies like these kill people.

    When will it change?

    Primal Toad wrote on August 16th, 2011
    • It won’t. Stupidity is just another natural disaster, like hurricanes and earthquakes. Nature’s gotta take care of population explosion somehow.

      Peggy The Primal Parent wrote on August 16th, 2011
      • LOL !!!

        Primal Palate wrote on August 16th, 2011
      • yeah i just wish nature would take care of this problem without the long slow deaths that cost us so much of our health care dollars

        DThalman wrote on August 16th, 2011
      • Ha! Maybe it is mother nature taking over?!

        Most of us are safe from natural disasters in todays world. We get warned about hurricanes, tornados, tsunamis, severe t-storms, etc.

        I guess your right – it has to happen somehow!

        Primal Toad wrote on August 17th, 2011
      • “Stupidity is just another natural disaster”

        Wow! That is funny, sad and true. I’m going to steal that one.

        marc wrote on August 20th, 2011
    • @Primal Toad Not until they stop making money by employing such tactics.

      Google ‘Relative Risk — Absolute Deception
      Why “Studies” are Misleading — Studies Aren’t Science.’

      cancerclasses wrote on August 16th, 2011
  6. It confuses our friends that they know my family highly values things that are “healthy” AND that we eat a ton of red meat.

    I get a little weary of defending ourselves….thanks for this post. It’s very encouraging to those of us with non-primal friends and family!

    Anne wrote on August 16th, 2011
    • I defend myself by how I look with my shirt off. No words needed.

      Ed wrote on August 16th, 2011
      • Lol! :D Love this.

        Meg wrote on August 16th, 2011
    • I love your comment Anne, precisely because it draws attention to the mental short hand that people use. Thinking in depth is expensive (metabolically) and a lot of us prefer to make snap judgements so we can easily make decisions without having to dig into it. Advertisers and industry know this very well, which is why they choose what healthy is and market it to us as a set of choices: Healthy whole grains coupled with gallons of pasteurized skim milk, low fat chicken, vegetables out the wazoo and truckloads of soy. These are the prescribed healthy choices. When they think of these things they imagine a svelte physique jogging with a huge smile. Why? because that’s the person on TV who always eats like that. It’s ingrained.

      I’m finding that telling people about my diet is not worth it. Most will either: 1) think I’m lying about what I eat, that I don’t really eat that many eggs, steaks, sardines, and bacon strips or 2) think I’m lying about my exercise, that I must actually workout for six hours a day rather than the 30 minutes every other day that’s closer to the truth. This is especially the case when I tell them my cholesterol numbers (they are awesome, 1 yr Paleo this month).

      Under no circumstances do people think.. hmm.. maybe the CW is wrong. One caveat being those who already are skeptical of the mainstream medical community. For pretty much everyone else, the cognitive dissonance is just too much, and the pull of the crowd too strong.

      Tim wrote on August 16th, 2011
      • Tim, I completely agree. Generally anyone I tell about my eating habits has already guessed them from our spending lots of time together and my constant refusal of grains.

        I find its better to not give much of a reason other than I don’t like that food. (I also try to sneakily go to restaurants where I know there is a variety of dish choices so I can choose something primal.)

        Bles wrote on August 17th, 2011
      • I agree. If I try to explain Primal/Paleo to people, they respond with “Oh, so you’re just doing Atkins?” or “Oh, so its low-carb?” I’ll say kinda, and try to explain further & their eyes just glaze over. It’s very sad & frustrating to me that people don’t and won’t take the time to learn about what they are eating.

        Samantha wrote on August 24th, 2011
  7. Great post! Definitely clears up some misconceptions in the world of food.
    Thanks!

    Amy wrote on August 16th, 2011
  8. So this means I can go live off of fast food meals, as long as there’s no burger involved.

    Yay health!
    Awesome(or not)

    Lily Marie wrote on August 16th, 2011
  9. I just wonder what kind of people do these studies…

    I mean it baffles me that so many people listen to these “health experts” when in reality the experts themselves aren’t even healthy!

    My advice, eat foods that make you feel good about yourself. Nothing better than having a nice piece of steak with some vegetables and feeling great afterwards!

    Once people give Primal eating a try, they will realize how awesome it is.

    Dennis wrote on August 16th, 2011
    • Unfortunately, there are a lot of problems in the System of scientific research, and most of them revolve around funding. Medical studies funded by pharmacy companies often are pressured to find favorable results. Even independent, academic-only studies have to fight the endless fights for grants, and having a pedigree of showy conclusions that grabbed national attention ups your likelihood next time NIH grants roll around.

      I am by no means condoning what my fellow scientists do, but I do understand why they are often forced into this position.

      cTo wrote on August 16th, 2011
    • I agree, specially of those Dr Oz fans, he looks like a wax figure, wtf that is not healthy

      ruben wrote on August 16th, 2011
  10. I hate when crap studies are passed around to continue to make people think that CW is the way to go!! I am sure CW people reading this study are appalled and will go back to their whole sandwiches licky split!! To bad when they read the articles/studies they don’t even get that these people were eating all kinds of grains and sugars, so what does that really say!!

    Joanne - The Real Food Mama wrote on August 16th, 2011
  11. Excellent takedown. I wish there was a way to instill this skeptical mentality into every persons brain… sigh.

    Mark, we need to find a way to get articles such as this (your post, not the study) as overtly in the public eye as possible!

    Daniel wrote on August 16th, 2011
  12. It’s so funny that I don’t have colorectal cancer, heart disease, type 2 diabetes, and I’m not dead. I eat red meat every single day, oh and extra lard and bacon grease on EVERYTHING!

    Peggy The Primal Parent wrote on August 16th, 2011
  13. As a scientist, I 100% approve the deconstruction of the conclusions of the study as described in this post here.

    cTo wrote on August 16th, 2011
  14. Mark didn’t mention that they tried to correct for the differences in other health factors between the high meat and low meat populations.

    Adjusting for BMI reduced the correlation with diabetes a little, other adjustments such as sugar-sweetened drinks did not.

    Tim wrote on August 16th, 2011
  15. Aw Mark, give ‘em a break. These science writers are just playing. It’s a game to see how far they can bend science. They learned it from Big Pharma. lol

    rose wrote on August 16th, 2011
  16. I love red meat, I can’t help it. I’ve got fresh baby chicken legs that have been sitting in my freezer for a couple of weeks now, but I pass by Whole Foods on my way home every day. I pass by the fish section thinking that I should buy fresh salmon instead since as with most things, and especially food, variety is the spice of life. But not tonight, I have got leftover veggies (plenty of them of the T-boosting cruciferous variety) and steak that I plan on stir-frying with garlic butter and Braggs’ Aminos. More red meat tonight, I’m afraid. the chicken and fish can wait another day.

    Raphael wrote on August 16th, 2011
  17. Is beef heart considered red meat? I still have some left in the fridge and was unsure whether I would catch the diabetes as soon as I finished it. What is life without risk? mmmmm tasty risk.

    Chris Tamme wrote on August 16th, 2011
    • Nooo, if you eat the heart, then it will make your heart stronger!

      Good logic, just like this study.

      cTo wrote on August 16th, 2011
  18. It is possible red meat can trigger diabetes, but we have to practise caution the amount we eat. I used to eat two steaks a day, no exercise, and developed insulin resistance during the course of several months.

    Jen wrote on August 16th, 2011
    • How do you know that it was the steaks and not the lack of exercise? Or something else that you haven’t thought of? Unless you have a detailed log of everything you did during that period and controlled for the one difference (the steaks), which you didn’t, then you can’t make that inference.

      Stabby wrote on August 16th, 2011
      • Seriously… a fit and active person could easily get away with 2 steaks per day in the context of a healthy paleo diet rich in vegetables and natural foods. What an absurd conclusion.

        “We have to practise caution [in] the amount we eat” is true for anything, and depends on our own fitness and activity level amongst other things.

        David wrote on August 18th, 2011
    • It is possible but it’s also possible that bowling causes you to be fat–just look at all the fat bowlers then next time you go to a bowling alley.

      Jen, all the studies done on the subject of red meat so far have neglected to control for other factors. So while red meat might make you insulin resistant (with the knowledge we have of human physiology, there is nothing in red meat alone that should cause this) there is no way we could honestly know, because no one has run CONTROLLED experiments on red meat.

      You were inactive. Allow me to suggest that this may have had more to do with your unfortunate insulin resistance than the red meat consumption.

      I do hope you’re doing better now :)

      fritzy wrote on August 16th, 2011
    • I used to wear shoes, and I never had a suntan. When I started wearing vibrams instead, I got a tan.

      Vibrams cause suntan. Can I have a Harvard fellowship now?

      Timothy wrote on August 16th, 2011
      • zomg i have hella vibram suntan on my feet all the time.

        cTo wrote on August 16th, 2011
      • This is funny :-)

        Primal Recipe wrote on August 16th, 2011
      • I got moved over an aisle in the cubefarm at work, and lost 25 pounds! If everyone would move to my aisle they too could lose weight! My old aisle causes weight gain!

        Finnegans Wake wrote on August 17th, 2011
    • It is possible for high fat, low carb diets to cause non-pathological insulin resistance, which can be measured by a glucose intolerance test. In this scenario fasting insulin and fasting glucose would be low.

      T2D isn’t entirely about insulin resistance, a more accurate description could be: insufficient insulin production for the level of insulin resistance. Insulin production can be reduced from inflammation.

      Steven wrote on August 16th, 2011
    • If I recall correctly (and I may not), insulin resistance doesn’t necessarily imply T2D. Those on low carb diets become insulin resistant as their bodies adjust to low glucose levels, saving the available glucose for the brain. The difference between low carbers and T2 diabetics is that T2 diabetics display insulin resistance AND hyperglycemia. Perhaps your carb intake was sufficiently low during the blissful two-steaks-a-day period to induce insulin resistance?

      adamel wrote on August 16th, 2011
    • Read up on Arctic explorer Vilhajmer (sp) Stephenson, who lived with the Inuit and was healthy. He recreated an Inuit diet by eating only steaks (they were all grassfed in those days) and monitored by a NY hospital for one year. He was in great health at the end of it.

      Paysan wrote on August 12th, 2012
  19. And besides, how can you have your pudding if you don’t eat your meat?

    DillPickle wrote on August 16th, 2011
    • LMAO! I hope I’m not the only one who got that…

      Larry wrote on August 16th, 2011
      • LOL, not even close.

        Uncephalized wrote on August 16th, 2011
      • I didn’t get it, explain please :-)

        Primal Palate wrote on August 16th, 2011
        • PinkFloyd…album called “the wall”,song called”we dont need no education”

          Hopeless Dreamer wrote on August 16th, 2011
    • :)

      mindyk wrote on August 16th, 2011
      • Please forgive my pedanticism. The song is called “Another Brick in the Wall.” Great album. God I’m old.

        John wrote on August 17th, 2011
  20. Strangely, it tends to be after evenings and nights of piggish gluttony and binging on red meat (some nuts and cheese too) that I’m able to fast and grease the groove for a big chunk of the next day, only falling back on unsweetened coffee and or tea, perhaps with a dash of blood-sugar regulating cinnamon, to keep me sated and elated while I work on conditioning my muscles to be able to function during times of starvation. If I’m working on getting diabetes by doing this, I must be some sort of anomoly, because I keep getting more comfortable with these strenuous fasts as long as I’ve had a huge meal of animal parts the night before.

    Animanarchy wrote on August 16th, 2011
  21. For every piece of red meat that people don’t eat as a result of this study, I will eat two. It’s a sacrifice I’m ready to make.

    fritzy wrote on August 16th, 2011
  22. WARNING: reading of comically bad research papers while eating grass fed Roast Beef may constitute a choking hazard.

    Todd wrote on August 16th, 2011
  23. Thanks for posting this. I hadn’t heard of this study and as I’m going to be posting shortly on going Primal which will be a new concept I suspect for most of my readers, I feel better armed.

    I already get enough stick in RL for my choices (I had a friend looking up toxic levels of parsley and celery after I offered her a green smoothie last week) and coming out on my blog makes me feel I need to be prepared.

    Alison Golden wrote on August 16th, 2011
  24. Did some of you folks miss the following from Mark?

    “As I read the study, I was pleasantly surprised by the restraint of the authors…. The…researchers…seemed to make it abundantly clear that no concrete conclusions about causality could be inferred from the data analysis. They even went on to propose a few potential mechanisms, as if to suggest that, I dunno, more studies were required to establish any sort of causality. In fact, they fully and continually admitted the limitations of the study as they composed the text.”

    Harry wrote on August 16th, 2011
    • And yet came up with the conclusion that we should reduce our intake even though the study was weak and flawed in so many ways. This is sloppy, sloppy work. It is COMPLETELY USELESS if you don’t control for other factors.

      bbuddha wrote on August 16th, 2011
      • I am with Harry. And I am with Mark: “It’s not that there’s anything inherently wrong with an observational study. In fact, they’re extremely useful and downright necessary for generating hypotheses, but they cannot establish causality.”

        It is a scientific paper, which is written for scientists. The scientists will read the article and use it as inspiration for much more expensive double blind interventional studies, which can establish causality. For scientists this study is thus not “completely useless”, nor is it sloppy; the scientist reading the study will know the limitations of an observational study. And at least they make a distinction between “processed meats” and “red meat”. In that respect it may even be one of the better studies.

        The problem is that people are interested in nutrition and that scientists are nowadays forced to talk to the public. That explains the strange last sentence (one sentence!) and the press release.

        Probably their boss forced them to write this last sentence. A scientist reading the article, will effortlessly notice that there is no relation between the last sentence and the rest of the article, which is emphasized by being the last sentence. Thus scientifically it does no harm.

        Victor Venema wrote on August 17th, 2011
  25. How about real evidence from type 2 diabetics who are Primal and now have the lowest numbers ever… blood glucose readings, A1c lowered, and weight loss. Such research is always flawed, and I believe people just have to do what’s right for them. Do I miss grains and dairy? Heck no. Do I love bacon and sausage…you bet! Thanks for debunking these studies.

    Ron McCallum wrote on August 16th, 2011
  26. Heh. Mark, your quote “In other (my)words” is awesome.

    HutnerP wrote on August 16th, 2011
  27. Mark you have a wonderful way with words. The last two paragraphs were my favorite, I wanted to shout Halleluja across campus from my office window.

    Well here’s at least a mental Hurrah! for all of us Primal beings.

    And here’s to many more people doing their own critical thinking and questioning blanket statements in the media.

    Eryn wrote on August 16th, 2011
  28. As soon as I read the article in last Thursday’s newspaper, I just knew we’d be hearing about it on MDA this week!

    This weekend we went to a wedding. There was a nice mix of young people and old folks from about ages 10 years old to around 80 years old (my DH being one of the 80 year olds). Of everyone there except for several of the teenagers and early 20’s types, my DH and I (at 80 and 67 respectively) were the best looking people there as far as body weight, no bulging bellies and activity level! The bulging bellies started with a lot of the men in their 40’s and 50’s and got bigger as they got older in age.

    Of course no one wanted to hear about eating Primal, and we were the only 2 people there who didn’t eat any of the wedding cake – we must have been asked 8 or 9 times if we wanted any cake and why not!

    PrimalGrandma wrote on August 16th, 2011
    • People *really* don’t understand when you turn down cake. I got some odd looks when I declined dessert at a baby shower. I’m thinking of just saying I have a wheat allergy to avoid the hassle.

      sqt wrote on August 16th, 2011
      • Dieticians still push the idea that having “treat foods” in moderation (whatever the hell that means) is okay. The one I visited years ago pre-Primal was astounded that I didn’t like junk food.

        I told her I’d had enough of it as a kid and no longer wanted it. (I was one of those eat-all-burn-it-off-later types, which worked well for me before puberty struck.) Even as a kid, people loved having me at their birthday parties because I’d scrape the icing off my cake and give it to them. Never had much of a sweet tooth.

        But oh no. She couldn’t fathom that someone just… didn’t… like… cake. And that while I bake, none of my recipes are standard fare.

        So came the questions: “What do you bake with? How would you rate your caloric intake vs. your exercise? Do you restrict? Binge, purge? ” She thought I had an eating disorder!

        All because my treat foods were fruits and veg. LOL. Bit of a different situation, but these two comments reminded me of that, as well as the reason I’m glad my actual doctor isn’t a CW obsessed guy.

        Lisa wrote on August 22nd, 2011
      • I took ONE blood test that gave me a fasting glucose of 110 one time…since then I just say, “Oh I can’t eat that, I’m pre-diabetic.” According to CW, I am, so what the heck, I’ll use the CW in my favor for once! It’s easier than explaining all the other stuff that people just tune out anyhow. Now if someone ASKS how I’m losing all this weight, then by all means, I am more than happy to illuminate…

        Sarah wrote on September 13th, 2011
  29. You forgot to add…

    ‘This study was brought to you by The Dairy Association and your Leading Cereal Manufacturing Company”

    David wrote on August 16th, 2011
  30. Just imagine all those poor american indians that evolved on red meat. They had such a hard time to even survive with all those heart attacks, cardiocascular diseases, strokes and diabetes!
    They are so lucky white man came along and introduced them to grains and sugar, so they can finally be healthy.

    Primal Palate wrote on August 16th, 2011
    • Love it, awesome. You can’t beat good sarcasm, especially when pan fried in butter. I wish there was a like button here, cuz you’d get one.

      Tim wrote on August 16th, 2011
    • Not to mention the alcohol…

      Glamorama wrote on August 17th, 2011
  31. Did I miss the part where you explained how the researchers collected the data regarding individuals food intake?

    kem wrote on August 16th, 2011
  32. That’s SO interestig! I guess the 25 point reduction in my fasting blood sugar in 6 weeks was from all the…. oh, I don’t know, all I ate was red meat. But it couldn’t be that.

    Jennifer wrote on August 16th, 2011
  33. i think i’ll head downstairs now and chow some of the leftover grass fed NY steak that i cooked over madrone coals in my backyard fire pit last night, with a bunch of greens dressed with grapeseed oil and a little balsamic.

    DThalman wrote on August 16th, 2011
  34. Isn’t there another study out there claiming that eating eggs and delicious processed bacon for breakfast helps control the appetite and aids in weight control?

    Mike wrote on August 16th, 2011
  35. As a PRIMAL statistician with an epidemiology background who works in Public Health, I loved reading your story, especially your comments about confounders, limitations of observational studies, relative risk, etc. (words like that just excite me anyway!) I write scientific articles much like the one discussed here and felt you gave the field credit for what it does well and constructive criticism to be careful about overstating the results that we find. Thank you for your well-reasoned critique of this article!

    Tamara wrote on August 16th, 2011
  36. All this talk about bacon is making me hungry… maybe its that I’m IFing (another thing CW claims to be unhealthy).

    Milestone wrote on August 16th, 2011
  37. I don’t even tell my mom about the fat that I eat. I know where it would lead and I just don’t want the argument or the constant comments. The funny thing is, I eat EXACTLY like she ate growing up. She was raised on a farm and they provided most of their own food. Sadly, neither of my parents eat that way anymore because it’s too “expensive”. My dad even comments a lot that “…we used to have pastured eggs, grass fed beef, etc. growing up and now you have to pay a small fortune for it…” I just agree – because it’s pretty true depending on where you live, but I also tell myself that the “expense” is better spent on food I enjoy and a healthy lifestyle rather than on medication.

    Becky wrote on August 16th, 2011
    • Agreed! I’d rather spend my hard-earned money on good quality, fresh/organic foods that are not only a joy to eat but a joy to prepare, as well. Beats giving that money to the pharmacist and adding to your nice collection of little plastic containers with child-proof caps!

      PrimalGrandma wrote on August 16th, 2011
  38. Last week I researched the clinical trials that were used to get approval for Plavix, which my mother is prescribed $300 per 30 pills!) I was shocked what I found. The test groups were given Aspirin alone, or Plavix alone.

    The number of re-occurrences of strokes/heart attacks, etc were only 9.8% of the Plavix users. Fantastic! Less than a one in ten chance of a re-occurrence using this wonder drug (with a host of side effects).

    The aspirin only users: 10.6% reoccurrence. I was floored.

    The manufacturer even states that the difference between plavix and aspirin was “marginal.” But the marketing of course focuses on the improvement of Plavix versus taking NOTHING. So the TV commercials suggest “Take plavix to significantly reduce your risks or heart attack or stroke.” But what they DON’T say (you need to look up and read the actual trial results…who does that?) is that just an aspirin a day produces virtually the SAME results.

    Yet this type of research is what is used to get the FDA to approve these drugs and allow them to be advertised with the claims they use. They don’t lie…but they conveniently omit some pertinent factors.

    Another example of “relative” versus “absolute” risk. Compared to doing nothing, the drug produces results. But compared to just taking aspirin…not so much.

    Suffice it to say I have removed Mom from Plavix (saving all of us $300 a month in Medicare costs) and she is using aspirin. And I am COMPLETELY comfortable doing so.

    Peter wrote on August 16th, 2011
    • And I’ll add that mom (81 years old) is mostly primal but doesn’t know it. She is with me for the summer. Very little whole wheat bread, NOTHING refined. Mostly meat and veggies,and fruit. The blood pressure meds are next on my hit list.

      Peter wrote on August 16th, 2011
      • Peter, I’m impressed that you’re doing so much for your mom. I’m doing what I can for my husband. We’ve only been eating primal for about 3 months but we’re hoping it will help him get off the meds for his recently diagnosed Type 2 Diabetes. I started cooking low sodium about a year and a half ago because his blood pressure was creeping up so we went to a diet of 500-1,000mg sodium per day. Worked like a charm. His blood pressure is the best it’s ever been. Then he goes for his yearly and they tell him he has diabetes! His weight is excellent, he exercises every day, his blood pressure is great but now he has diabetes. Threw us both for a loop. So, in my research to find how to cook “lo-carb”, I came across Mark’s blog and everything clicked. My husband’s off one of the meds for his T2D, in just 3 months! and we’re hoping that by the time he has his next A1C test we might be able to get him off the other one. If not, we might just have to accept that it’s something he’ll have to live with, but we’re not there yet because it’s the only medication he has to take and he’s determined to do everything he can to try to get off of it. Keeping our fingers crossed :-)

        Becky wrote on August 16th, 2011
        • Fantastic! There is no question that nutrition and exercise are the keys to better health. But so is research and knowing the facts about these drugs. Many drugs to wonders, others…what a joke. Plavix was the #3 drug in the U.S. in 2010, with $4.6 billion in sales. And it’s virtually no more effective than a 3-cent aspirin!

          Good luck with hour husband…keep the faith and keep trying!

          Peter wrote on August 16th, 2011
      • Good for you getting her off the expensive and dangerous drug. change her bread to sprouted grains (if you can) just that little bit better :-)

        bbuddha wrote on August 16th, 2011
    • Do you have a link to that study?

      CathyN wrote on August 16th, 2011
      • Kathy, here it is. The bit I was referring to was section 14.2. Look at the chart comparing just aspirin, to just Plavix. The graph they include tells the story…virtually no difference! The other studies cited show similar unimpressive results.

        http://products.sanofi.us/PLAVIX/PLAVIX.html

        Peter wrote on August 16th, 2011
  39. I get blood tested every 6 weeks to document my progression starting in mid April. My father is a physition and became concerned of my liver enzymes and lipids when I aproached him with this diatary concept. I am one example of a pre diabetic, high cholesteral, morbid obese individual. Lost 50 lbs 80 to go, Glucos numbers are normal, Cholesteral is still a little high but trending better on all counts. Energy is way up, but not able to be measured other than the Honey Dos are almost caught up on, oh and I perform plyometric circut training twice a week and ride a bike 17 miles 3 days a week. But unfortunately this is not a measure of increased energy over my old ways of walking to get snacks or to the john. I sleep better and stopped snoring(Better for the wife) Doctor only seems to be concerned over the constant Keytones in my urine. A product of fat burning. I do not know much about this research however my experience and tests over the past 4.5 months would contradict the research specifically because I eat fish once a day and a rumanent animal(beef, Lamb, buffalo, or venison) every day. After yesturdays review, the doctor has advised me that, I am nolonger a diabetic risk. I am documenting everything including my activity for those of us too big to do too much. But I do like looking at all the graphs. I guess I have made a game out of it. Personally I can not believe my results are an acception.

    Davidr wrote on August 16th, 2011
  40. I eat a pound of red meat per meal.

    If this was true I would have lost a foot by now.

    Laws of the Cave wrote on August 16th, 2011

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