We’ve had three weeks to digest the World Health Organization (WHO) statement about processed meat and cancer, and the most common question I’m getting is “What should I eat instead?” As the Internet debates whether bacon will give you cancer or not, let’s get practical here. What’s for lunch?
But first, briefly, in case you missed it, here’s a quick recap. On October 26, WHO’s International Agency for Research on Cancer (IARC) announced that there is “sufficient evidence in humans that the consumption of processed meat causes colorectal cancer.” Hysteria ensued. We do love our bacon.
A clarifying statement followed, as well as a helpful Q&A, and we quickly learned that the estimated increase in risk is actually relatively small, at least compared to other carcinogens like cigarettes. If you eat 50g of processed meat (about 2 slices of bacon) every day, your risk is estimated to increase by about 18%. Given that your risk of developing colorectal cancer starts at about 5%, an 18% increase means your risk goes up to about just 6%.
Still, if you’re interested in doing all you can to avoid being one of the 9300 Canadians to die each year of colorectal cancer, you’d be wise to look for alternatives to processed meat, of which there are many.
Additionally, three other considerations are missing from the back and forth headlines:
- Being a heavy processed meat eater also increases your heart disease and diabetes risk. This, like the cancer association, is not new. The Institute for Health Metrics and Evaluation’s Global Burden of Disease study estimates that in 2013, the number of deaths worldwide attributable to a diet high in processed meat was 526,000 for cardiovascular disease and 84,000 for diabetes, compared to 34,000 for bowel (aka colorectal) cancer.
- Processed meat is more than bacon and sausage. While bacon is trendy and makes headlines, my experience with ordinary Canadians, at least in Alberta and Saskatchewan, is that we eat more ham and sausage, and an awful lot of processed chicken and turkey. Yes, poultry is on the list! From the IARC’s original statement:
“Processed meat refers to meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation. Most processed meats contain pork or beef, but processed meats may also contain other red meats, poultry, offal, or meat by-products such as blood.”
- Processed meat is generally sky-high in sodium. A 100g serving of ham delivers about 1249mg, a sizeable chunk of the recommended 2000mg daily max. You might expect chicken to be better, but it’s not, clocking in at 1302mg. And then there are the nitrites.
So, while many are saying, “This doesn’t apply to me – I don’t eat bacon every day,” the question to ask is, how often do you eat any kind of processed meat. If it’s most days, perhaps it’s time to consider some alternatives.
The good news is, we have many healthier choices. Most of the questions I’ve had and food records I see involve sandwiches, so here are seven better sandwich fillings that are just about as easy as packaged ham, and a whole lot better for you.
- Canned tuna. Easy, inexpensive, lean protein. Worried about mercury? Don’t be. “Chunk light” tuna is very low. “Solid white” or “albacore” is a bit higher, but limits on it are only recommended for children, pregnant and breastfeeding women and women who may become pregnant. Feel guilty for mixing it with mayonnaise? No need. Mayonnaise is mostly healthy fat. It is, however, 100 calories per tablespoon, so don’t go overboard. Two to three tablespoons for a 6-oz (180g) can of tuna is quite reasonable. Or choose light mayonnaise if you want fewer calories.
- Canned salmon. Even better. Very low in mercury, plus you get healthy omega-3 fat. Doesn’t appeal to you? This curried canned salmon sandwich recipe from Dietitians of Canada might just change your mind.
- Peanut butter. Healthy fat, protein, comfort food. Mmmmm. Peanut butter is not quite as high in protein as meat, fish, or chicken, so you might want to enjoy with a glass of milk or other protein source. Throw in a sliced banana (yum!) and you have a fruit serving down, with a good shot of potassium to boot.
- Roasted chicken. Most grocery store delis offer rotisserie chicken hot and ready to eat. Unfortunately, they’re usually not labelled with nutrition facts, but the Canadian Nutrient File lists their sodium content as 337-661mg of sodium per 100g serving. Or you can pick up cooked chicken breast strips like these, which contain no nitrites and less than half the sodium in deli/processed chicken slices (400mg per serving). Still higher than roasting your own, but handy in a pinch.
- “In-store” roasted meat. Ask at the deli counter – some grocery stores will actually roast pork tenderloin, beef, bison or turkey in the store, so fresh meat becomes as convenient as processed meat. Or, better yet, roast it yourself and slice up the leftovers for sandwiches. That way you know for sure what’s in it.
- Hummus. Whole grain tortilla + hummus + your favourite raw or roasted veggies = surprisingly good. My kids go for sliced cucumber and tomatoes, but I’ll take roasted red peppers with pre-washed spinach please. Again, hummus is not that high in protein, so think about sprinkling in some sunflower seeds or feta cheese. A Greek yogurt for dessert will top up your protein quota for lunch.
- Egg salad. Eggs are another inexpensive source of protein, as well as other nutrients, including vitamin A and lutein. Eating up to seven eggs a week appears to be fine, unless you have diabetes or heart disease or are at elevated risk for them. If so, I’d recommend sticking to just 2-3 egg yolks a week (the whites are fine), until researchers untangle the complex web of cause and effect here.
What about so-called “natural” deli meats? I wouldn’t recommend those every day either. They contain potentially cancer-causing nitrites just like regular deli meats, except they get it from a natural source, cultured celery extract. Of course, it’s cultured in a lab, so while it’s technically from a natural source, it’s not like eating a stalk of celery. Whether they’re any healthier isn’t known.
What about local or organic processed meat from trustworthy suppliers? While they may be better for the environment, and you can feel good about supporting local farmers, there is no reason that they would be any different from mass marketed ones in terms of their effect on cancer, heart disease, and diabetes risk.
Having the occasional a ham sandwich or BLT probably won’t hurt, but if deli turkey and chicken, sausages, bacon, smoked salmon, Montreal smoked meat, hot dogs, and other processed meats make a regular appearance on your menu, consider substituting some of these alternatives every other day or more.
What other sandwich fillings do you enjoy? Join the conversation on Facebook.