Wednesday 25th January 2012

The Lime Tree Children’s Centre,

Heathfield Road, Heathfield B19 1JH
WHMAG Meeting Agenda – 250112

7th Deccember 2011

6.00pm – 7.30pm

BVSC, 138 Digbeth, Birmingham B5 6DR

The report was commissioned in October 2010 and was submitted in January 2011.

 breastfeeding – LINks response -20 4 11 THREE SIGNATURES (2)

Venue: St Paul’s Centre, 405B Belchers Lane, Birmingham B9 5SY

Venue: Quinborne Community Centre, Ridgacre Road, Quinton, Birmingham

Venue: Chinnbrook Play Centre, 213 Trittiford Road, Billesley, Birmingham, B13 OET

Red meat and bowel cancer risk

Red meat – such as beef, lamb and pork – can form part of a healthy diet. But eating a lot of red and processed meat probably increases your risk of bowel (colorectal) cancer. That’s why the Department of Health is advising people who eat more than 90 grams (cooked weight) of red and processed meat a day to cut down to 70 grams.

Red meat is a good source of protein, vitamins and minerals, such as iron and zinc.

But evidence shows that there is probably a link between eating red and processed meat, and risk of bowel cancer. People who eat a lot of these meats are at higher risk of bowel cancer than those who eat small amounts.

If you eat more than 90 grams of red or processed meat a day – the equivalent of about three thin-cut slices of roast beef, lamb or pork, where each slice is the about the size of half a piece of sliced bread – it is recommended that you cut down to 70 grams, which is the average adult daily consumption of red and processed meat in the UK.

If you eat more than 90 grams of red and processed meat a day, cutting down to 70 grams could help reduce your risk of bowel cancer. Other healthier lifestyle choices, such as maintaining a healthy weight, keeping active and not smoking can also help reduce your risk.

According to UK dietary surveys, 4 in 10 men and 1 in 10 women eat more than 90g of red and processed meat a day.

• How much red and processed meat should we eat?
• Portion sizes and cutting down
• Frequently asked questions

What counts as red and processed meat?

The new advice refers to red meat and processed red meat.

Red meat includes beef, lamb and pork. It does not include chicken or turkey meat.

Processed meat refers to meat that has been preserved by smoking, curing, salting or adding preservatives. This includes sausages, bacon, ham, salami and pates.

How much red and processsed meat should we eat?

The new advice is for adults. To read advice for children, see below.

Adults

If you eat more than 90 grams of red or processed meat a day, it is recommended that you reduce your intake to 70 grams per day, which is the average UK consumption.

You can do this by eating smaller portions of red and processed meat and swapping them for alternatives, and by eating these meats less often.

If you eat more than 90g of red and processed meat on a certain day, you can eat less on the following days or have meat-free days, so that over time your consumption is not more than 70 grams per day on average.

Children

Children over five should eat a healthy, balanced diet in which meat and other sources of protein – such as fish, eggs and beans – is present in the same proportion as it is in a balanced diet for an adult.

Children do not need as much food as adults, and the amount they need depends on their age and size. For help with portion sizes for children, see Change4Life: Me-size meals.

Portion sizes and cutting down

These examples of the weight of various cooked meat products can help you to find out how much red and processed meat you eat. The amount in grams represents the cooked weight:

• A Big Mac: 70 grams
• A quarter pounder beefburger: 78 grams
• A 5oz rump steak: 102 grams
• A grilled 8oz beef steak: 163 grams
• A cooked breakfast (two standard British sausages – often sold in packs of eight that weigh 1lb or 454 grams and measuring around 9cm long – and two thin-cut rashers of bacon): 130 grams
• A Peperami: 25 grams
• A large doner kebab: 130 grams
• A portion of Sunday roast (three thin-cut slices of roast lamb, beef or pork, about the size of half a slice of sliced bread): 90 grams

Cutting down

You can cut down on red and processed meat by eating smaller portions, and by eating them less often.

These swaps can help you to cut down without making radical changes to your diet.

• Breakfast: if it’s a full English, swap either the bacon or sausages for extra mushrooms, tomatoes or toast.
• Sandwiches: swap one of your ham or beef sandwiches for a non-red meat filling, such as chicken or fish.
• Pie and chips: swap your steak pie for chicken pie.
• Burger: swap your quarter pounder burger for a standard hamburger. Or choose a chicken, fish or a vegetable burger for a change.
• Sausages: swap to having two pork sausages rather than three, and add a portion of vegetables.
• Sunday roast: swap your roast beef, pork or lamb for roast chicken 
• Steak: swap an 8oz steak for a 5oz  If you’re out at a restaurant why not try the catch of the day?
• Casseroles, stews and curries: include more vegetables, and use less red meat.
• Swap lamb or beef mince for turkey or vegetarian mince in your spaghetti bolognaise, lasagne and chilli con carne.
• Have a meat-free day in the week. Swap red or processed meat for fish or shellfish, or have a vegetarian meal.

Frequently asked questions

What is the new advice on eating red and processed meat?

The new advice says adults who eat more than 90 grams of red and processed meat a day should reduce their intake to 70 grams a day, which is the average daily consumption in the UK. This is because there is probably a link between eating a lot of red and processed meat, and bowel (colorectal) cancer.

You can do this by eating these meats less often or eating smaller amounts, or by exchanging them for alternatives.

Where does this advice on red and processed meat come from?

The advice is being issued by the Department of Health.

Why is this advice being given now (February 2011)?

The new advice is based on a report called Iron and Health, by the Scientific Advisory Committee on Nutrition (SACN), published in February 2011. SACN is a committee of independent nutrition experts who advise the government on diet and nutrition.

Why has SACN issued advice on meat, when its report is about iron?

In its report SACN looked at studies that assessed the link between iron and bowel cancer. Since red meat is a source of iron in the UK, the report also examined the evidence on red and processed meat and bowel cancer. SACN concluded that eating a lot of red and processed meat probably increases risk of bowel cancer, and advised accordingly.

How much red and processed meat do we eat in the UK?

SACN used data from the National Diet and Nutrition Survey (NDNS) to estimate adult consumption of red and processed meat in the UK. 

The NDNS gives estimates of total meat and meat dishes consumed in the UK.

Based on data from the NDNS (2000 to 2001), the average total red meat consumption for men is around 88 grams per day. For women, it is around 52 grams per day. This gives an average of 70 grams per day for all adults.
  
Why is this advice aimed at those who eat more than 90 grams of red or processed meat a day?

SACN examined evidence from scientific studies and concluded that eating red and processed meat probably increases the risk of bowel cancer.

However, SACN could not identify the amount of red and processed meat that may increase the risk of bowel cancer because of inconsistencies in the data. Since average daily adult consumption of red and processed meat in the UK is 70g, those who eat more than 90 grams are considered to have a relatively high intake of these meats. It is recommended that these people cut down on red and processed meat, so that their consumption is in line with average consumption.

If I cut down on red and processed meat, will I still get enough iron?

Yes, providing that you are eating a balanced diet that includes other good sources of iron. These include lentils, beans, eggs, fish, chicken, turkey, nuts and breakfast cereals.

SACN looked at the impact of eating less red and processed meat on iron intake, using data from the 2000/2001 National Diet and Nutrition Survey.

SACN estimates that if people who eat more than 90 grams a day of red and processed meat reduce their consumption to 70 grams per day, this will not increase the number of people who do not get enough iron in their diet.

Low iron intake is not the only cause of iron deficiency anaemia. It can also be caused by increased blood losses due to menstruation, or by gastrointestinal (stomach and intestine) disease, which increases gastrointestinal blood loss. A common cause of iron deficiency anaemia in older adults is gastrointestinal blood loss due to the use of some medicines, such as aspirin.

Certain groups are more at risk from iron deficiency anaemia: these include toddlers, girls and women of childbearing age and some adults aged over 65 years. The most common symptoms of iron deficiency anaemia are tiredness, lack of energy, shortness of breath and irregular heartbeat. You can learn more about symptoms, diagnosis and treatment on our iron deficiency anaemia pages. If you are concerned you may be iron deficient, see your GP.

Is this the first time the Department of Health has issued advice on red and processed meat?

No, but this is the first time the Department of Health has given advice on what are considered high intakes of red and processed meat.

The existing Department of Health advice on meat – which still stands – is to eat some meat or meat products, or other sources of protein, as part of a healthy, balanced diet.

Does anyone else give advice on eating red and processed meat?

The World Cancer Research Fund report Food, Nutrition, Physical Activity and the Prevention of Cancer provided advice on red and processed meat in 2007. They said that the evidence that red and processed meats are causes of bowel cancer is convincing. They advise that people eat no more than 500g of red meat per week (around 70g per day), and avoid processed meats.

Why are red and processed meat considered together?

SACN found that there was no clear basis in the scientific evidence for separating unprocessed red meat and processed meat when it comes to their link to bowel cancer. Additionally, many of the scientific studies reviewed by SACN did not separate red and processed meat. SACN therefore considered the impact of a reduction in total red meat intake, and advised accordingly.

Can red and processed meat form part of a healthy diet?

Yes. Department of Health advice is to consume some meat and/or meat products, or other sources of protein, as part of a healthy balanced diet.

Meat is a good source of protein, and vitamins and minerals such as iron, selenium, zinc and B vitamins. It is also one of the main sources of vitamin B12, which is only found in foods from animals, such as meat and milk.

Choose healthier meat and meat products, such as lean cuts of meat and leaner mince, where possible. You can learn more about healthy eating basics in Eight tips for healthy eating.

How common is bowel cancer?

In England, bowel cancer is the third most common type of cancer. An estimated 38,000 new cases of bowel cancer are diagnosed each year and an estimated 16,000 people die from bowel cancer each year. Approximately 80% of bowel cancer cases develop in people who are over 60.

In 2007, about 17,600 cases of bowel cancer were diagnosed in women, making it the second most common cancer in women after breast cancer. There were about 21,000 cases in men, making it the third most common cancer in men after prostate and lung cancer.

You can learn more about bowel cancer, its symptoms, diagnosis and treatment in Bowel cancer.

I’ve been eating red meat regularly for many years and am now worried about bowel cancer. What should I do?

Find out more about the symptoms of bowel cancer. If bowel cancer is detected early, it is more treatable.

Early symptoms include changes in your bowel habits. If you’ve noticed blood in your stools or they have been looser for three weeks, see your doctor.

The NHS Bowel Cancer Screening Programme started in 2006. Adults in England between the ages of 60 and 75 who are registered with a GP will automatically be sent an invitation for screening in the post. To learn more, read Bowel cancer: screening.

To reduce you risk of bowel cancer, there are several changes you can make to your lifestyle (see the next question).

If you’re still concerned about bowel cancer, talk to your GP.

What else can I do to reduce my risk of bowel cancer?

People who smoke cigarettes are at greater risk of developing bowel cancer. Stopping smoking will reduce your risk.

Obesity and being inactive are also linked to an increased risk of bowel cancer. There is advice on how to achieve a healthy weight in Lose weight and on getting more active in Health and fitness.

In general, people who have a healthy balanced diet are less likely to get certain types of cancer. Learn more about a balanced diet in Food and diet.

You can learn more about reducing your risk of bowel cancer in Bowel cancer: causes and Bowel cancer: prevention.

The energy diet

The best way to eat if you want to banish tiredness is to have a healthy, balanced diet that contains foods from four main food groups in the right proportions. The four food groups are:

• potatoes, bread, rice, pasta and other starchy foods
• fruit and vegetables
• milk and dairy foods
• meat, fish, eggs, beans and other non-dairy sources of protein

1. Eat at regular intervals: if you eat at regular times, your body knows when your next meal is coming and learns to manage feelings of hunger and sustain your energy levels. Try to eat three meals a day and limit snacks – especially high-fat ones – between meals.

2. Start the day well: breakfast gives you the energy you need to face the day. Despite this, up to one third of us regularly skip breakfast, according to the British Dietetic Association.

Go for healthier options, such as porridge with fruit; vegetable omelette or wholemeal toast with a scraping of low-fat spread or jam.  

If you can’t face eating as soon as you get up, take a high-fibre snack to eat on the run, rather than snacking on high-sugar or high-fat foods.

3. Aim for 5-a-day: most people in the UK eat too much fat, sugar and salt, and not enough fruit and vegetables.

Fruit and vegetables are good sources of vitamins, minerals and fibre, essential nutrients that your body needs in order to work properly. Try to incorporate at least five portions of a variety of fruit and veg into your daily diet. They can be fresh, frozen, tinned, dried or juiced to count.

Read more about how to get your 5-a-day.

4. Slow it down: starchy foods (also called carbohydrates) such as potatoes, bread, cereals and pasta are an important part of a healthy diet. They’re a good source of energy and the main source of a range of nutrients in our diet.

Starchy foods should make up about a third of everything you eat. But there are different types of starch. Where possible, go for slow-burning whole grain or wholemeal varieties, as they provide energy gradually.

5. Say no to sugar: adults and children in the UK eat too much sugar. Sugar is not only bad for your teeth, it can also be bad for your waistline. And it gives you a rush of energy, but one that wears off quickly.

Cutting out all sugar is virtually impossible. There are natural sugars in lots of foods, including fruit and veg, and you don’t need to avoid these. But it’s a good idea to cut down on foods with lots of added sugar, such as sweets, cakes, biscuits, non-diet fizzy drinks and chocolates.

6. Get enough iron:  Two out of five (42%) teenagers and one in three (33%) of 19-24 year olds have low iron stores, according to the National Diet and Nutrition Survey. Being low on iron can make you feel tired, faint and look pale.

While red meats, green vegetables and fortified foods such as breakfast cereals are good sources of iron, the important thing is to eat a range of foods to get enough iron.

7. Drink wise: watch your intake of alcohol. It can dehydrate you, which will make you feel tired. Make sure you stay hydrated in general by drinking six to eight glasses of fluid a day, preferably water, milk or fruit juice.

8. Eat enough: make sure you eat the right amount for your activity level. The average man needs around 2,500 calories a day, and the average woman needs 2,000 calories. But remember, we all overestimate how active we are.

Self-help tips to fight fatigue

Many cases of unexplained tiredness are due to stress, not enough sleep, poor diet and other lifestyle factors. Use these self-help tips to restore your energy levels.

Energy-sustaining snacks

• wholegrain cereal with reduced-fat milk
• a piece of fruit
• salad with grilled chicken
• hard-boiled egg or lean ham and mustard sandwich on wholemeal bread
• a low-fat yoghurt
• wholemeal toast, a fruit bun or slice of malt loaf – each with low-fat spread 

Eat often: a good way to keep up your energy through the day is to eat regular meals and healthy snacks every three to four hours, rather than a large meal less often.

Read more about healthy eating.

Get exercise: you might feel too tired to exercise, but regular exercise will make you feel less tired in the long run and you’ll have more energy. Even a single 15-minute walk can give you an energy boost, and the benefits increase with more frequent physical activity.

Start with a small amount of exercise. Build up your physical activity gradually over weeks and months until you reach the recommended goal of half an hour a day.

Read more about starting exercise.

Lose weight: if your body is carrying excess weight, it can be exhausting. It also puts extra strain on your heart, which can make you tired. Lose weight and you’ll feel much more energetic. Apart from eating healthily, the best way to lose weight is to be more active and do more exercise.

Read more about how to lose weight.

Get enough sleep: it sounds obvious, but two-thirds of us suffer from sleep problems, and many people don’t get the sleep they need to stay alert through the day. The Royal College of Psychiatrists’ advice on getting a good night’s sleep is to go to bed and get up in the morning at the same time everyday; avoid naps through the day, and have a hot bath before bed (as hot as you can bear without scalding you) for at least 20 minutes.

Read more about how to get a good night’s sleep.

Reduce stress: stress uses up a lot of energy. Try to introduce relaxing activities into your day. This could be working out at the gym, or a gentler option such as listening to music, reading or spending time with friends. Whatever relaxes you will improve your energy.

Read more about how to relieve stress.

Talk about it: there’s some evidence that talking therapies such as counselling or cognitive behavioural therapy (CBT) might help to fight fatigue. See your GP for a referral for talking treatment on the NHS or for advice on seeing a private therapist.

Read more about counselling.

Cut out caffeine: The Royal College of Psychiatrists recommends that anyone feeling tired should cut out caffeine. It says the best way to do this is to gradually stop having all caffeine drinks (and that includes coffee and tea and cola drinks) over a three-week period. Try to stay off caffeine completely for a month to see if you feel less tired without it.

You may find that stopping caffeine gives you headaches. If this happens, cut down more slowly on the amount of caffeine that you drink.

Drink less alcohol: although a few glasses of wine in the evening helps you fall asleep, you sleep less deeply after drinking alcohol. The next day you’ll be tired even if you sleep a full eight hours.

Cut down on alcohol before bedtime. You’ll get a better night’s rest and have more energy. The NHS recommends that men should not regularly drink more than 3-4 units a day. Women should not regularly drink more than 2-3 units a day. ‘Regularly’ means drinking every day or most days of the week.

Read more about how to cut down on alcohol.

Drink more water: sometimes you feel tired simply because you’re mildly dehydrated. A glass of water will do the trick, especially after exercise.