Kjøttindustriens reklamebyrå Matprat har ved flere anledninger sagt at de nye nordiske kostrådene bruker gammel forskning og forveksler tallene 350 og 500 gram rødt kjøtt per uke. Stemmer dette?
Hva slags forskning og data baseres kostrådet om maksimalt 350 gram rødt kjøtt per uke? Les også: Kjøtt – hva sier de nye kostrådene? og Rødt kjøtt og bearbeidet kjøtt
Noen av de relevante studiene kostrådet om maksimalt 350 gram rødt kjøtt per uke baseres på, er CUP 2017 ved WCRF, denne (Bechthold med flere, 2019) og data (men ikke konklusjonen) fra denne studien (Burden of Proof).
Les også: Rødt kjøtt i NNR2023: hvorfor 350 gram per uke? Svar på kritikk fra Opplysningskontoret for egg og kjøtt i Norsk tidsskrift for ernæring
Les også: Norske kostråd 2024
WCRF: 350 gram rødt kjøtt per uke
Sitert WCRF https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317613/
“If you eat red meat, limit consumption to no more than ∼3 portions per wk. Three portions is equivalent to ∼350–500 g (12–18 oz) cooked weight of red meat. The term “red meat” refers to beef, veal, pork, lamb, mutton, horse, and goat.”
I denne saken i Aftenposten 2. november (du kan lytte saken om du ikke har abonnement for å lese) forklarer leder for NNR 2023 Rune Blomhoff at hovedgrunnlaget for vurdering av helserisiko ved rødt kjøtt var analyse av data om tarmkreft i WCRF sin kunnskaps-oppsummering CUP fra 2017 (lenke). Han påpeker at CUP tilfredsstiller alle kvalitetskrav og at de i tillegg vurderer helseeffekten av rent og prosessert kjøtt hver for seg, og rødt kjøtt samlet.
Hvordan har NNR kommet fram til akkurat 350 gram? Samleanalysen i NNR-rapporten finner at 350 gram uprosessert rødt kjøtt i uken øker risikoen for tykktarmskreft.
“Spiser man mye mindre enn dette øker risikoen i befolkningen for at man får i seg for lite av enkelte næringsstoffer som er i rødt kjøtt som vitaminer og noen mineraler. Det er disse to hensynene vi har balansert“, sier Blomhoff til Aftenposten.
Dette betyr at hvis NNR 2023-forfatterne var sikre på at hele den nordiske og baltiske befolkningen var flinke til å spise riktig, så hadde anbefalingen vært betydelig lavere enn 350 gram per uke.
Les også: Hva slags mat er ultraprosessert? og To typer ultraprosessert mat som skader helsen
Nyere studier
19. oktober 2023 kom denne studien. Den konkluderer med følgende:
“Comparing the highest to the lowest quintiles, hazard ratios (HR) were 1.62 (95% confidence interval [CI]: 1.53, 1.71) for total red meat, 1.51 (95% CI: 1.44, 1.58) for processed red meat, and 1.40 (95% CI: 1.33, 1.47) for unprocessed red meat.”
“Our study supports current dietary recommendations for limiting consumption of red meat intake and emphasizes the importance of different alternative sources of protein for T2D prevention.”
Kilde: Xiao Gu, Jean-Philippe Drouin-Chartier, Frank M. Sacks, Frank B. Hu, Bernard Rosner, Walter C. Willett, Red meat intake and risk of type 2 diabetes in a prospective cohort study of United States females and males, The American Journal of Clinical Nutrition, 2023,
ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2023.08.021.
https://www.sciencedirect.com/science/article/pii/S0002916523661192
Les også: Lansering av Helsedikrektoratets rapport Utviklingen i norsk kosthold 2023 – det er meldt at et stort EU-prosjekt, med 20% av helsebudsjettet til forebygging, er på vei! Norge vil koordinere og lede dette prosjektet. 25 land er med, planlagt/bevilget 21 milliarder på 4 år!
Kjøtt og ikke-kreft, annet enn hjerte- og kar
Videre er også disse relevante:
Papier K, Fensom GK, Knuppel A, et al. Meat consumption and risk of 25 common conditions: outcome-wide analyses in 475,000 men and women in the UK Biobank study. BMC Med. 2021;19(1):53. Published 2021 Mar 2. doi:10.1186/s12916-021-01922-9 lenke: https://pubmed.ncbi.nlm.nih.gov/33648505/ Meat consumption and risk of 25 common conditions: outcome-wide analyses in 475,000 men and women in the UK Biobank study – PubMed (nih.gov)
Her er det brukt data fra UK Biobank, 474 985 deltagere. Sitert abstracts, formattert av oss:
“In multi-variable adjusted (including BMI) Cox regression models corrected for multiple testing, higher consumption of unprocessed red and processed meat combined was associated with
- higher risks of ischaemic heart disease (hazard ratio (HRs) per 70 g/day higher intake 1.15, 95% confidence intervals (CIs) 1.07-1.23),
- pneumonia (1.31, 1.18-1.44),
- diverticular disease (1.19, 1.11-1.28),
- colon polyps (1.10, 1.06-1.15),
- and diabetes (1.30, 1.20-1.42);
results were similar for unprocessed red meat and processed meat intakes separately.
Higher consumption of unprocessed red meat alone was associated with a lower risk of iron deficiency anaemia (IDA: HR per 50 g/day higher intake 0.80, 95% CIs 0.72-0.90).
Higher poultry meat intake was associated with higher risks of
- gastro-oesophageal reflux disease (HR per 30 g/day higher intake 1.17, 95% CIs 1.09-1.26),
- gastritis and duodenitis (1.12, 1.05-1.18),
- diverticular disease (1.10, 1.04-1.17),
- gallbladder disease (1.11, 1.04-1.19), and
- diabetes (1.14, 1.07-1.21),
- and a lower IDA risk (0.83, 0.76-0.90).”
I NNR 2023 sitt oppsummeringskapittel om rødt kjøtt fra NNR 2023 står følgende:
Side 224:
“For more information about the health effects, please refer to the background paper by Jelena Meinilä and Jyrki K. Virtanen (Meinilä & Virtanen, 2023). For more information about the environmental impacts, please refer to the following background papers (Benton et al., 2022; Harwatt et al., 2023; Meltzer et al., 2023; Trolle et al., 2023)”
Side 226:
“As discussed by Meinilä and Virtanen (2023), red meat can be a good source of nutrients, in particular protein, iron, zinc and vitamin B12. However, regular high intake of red meat and processed red meat, may increase the risk of colorectal cancer, cardiovascular diseases and type 2 diabetes due to several mechanisms (IARC, 2018; Meinilä & Virtanen, 2023; WCRF/AICR, 2018e).
The risk increase appears to be linear with most outcomes (Meinilä & Virtanen, 2023; WCRF/AICR, 2018e).
Based on all available evidence, considering both beneficial effect of nutrients and the dose-response curves demonstrating adverse effects for several chronic diseases, NNR2023 recommends that the intake of red meat should be limited to maximum 350 grams/week (cooked or ready-to-eat weight). The Committee notes that a clear-cut level of intake that minimizes risk is difficult to set, as the associations are often linear.”
Publikasjoner om kjøtt og kreft:
Knuppel A, Papier K, Fensom GK, et al. Meat intake and cancer risk: prospective analyses in UK Biobank. Int J Epidemiol. 2020;49(5):1540-1552. doi:10.1093/ije/dyaa142 (PubMed (nih.gov) ).
Sitert abstracts, formattert av oss:
“Results: During a mean follow-up of 6.9 years, 28 955 participants were diagnosed with malignant cancer.
After correction for multiple testing, red and processed meat combined, and processed meat, were
- each positively associated with colorectal cancer risk [hazard ratio (HR) per 70 g/day higher intake of red and processed meat 1.32, 95% confidence interval 1.14-1.53; HR per 20 g/day higher intake of processed meat 1.18, 1.03-1.31]
- and red meat was associated with colon cancer risk (HR per 50 g/day higher intake of red meat 1.36, 1.13-1.64).”
“Conclusions: Higher intake of red and processed meat was specifically associated with a higher risk of colorectal cancer; there was little evidence that meat intake was associated with risk of other cancers.”
Publikasjoner om kjøtt og hjerteinfarkt
Denne publikajsonen baseres på 13 studier med til sammen 1 427 989 deltagere. Papier K, Knuppel A, Syam N, Jebb SA, Key TJ. Meat consumption and risk of ischemic heart disease: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2023;63(3):426-437. doi:10.1080/10408398.2021.1949575 (lenke https://pubmed.ncbi.nlm.nih.gov/34284672/)
Sitert abstracts, formattert av oss:
“The meta-analysis was conducted using fixed-effects models. Thirteen published articles were included (ntotal = 1,427,989; ncases = 32,630).
Higher consumption of
unprocessed red meat was associated with a 9% (relative risk (RR) per 50 g/day higher intake, 1.09; 95% confidence intervals (CI), 1.06 to 1.12; nstudies = 12)
and processed meat intake with an 18% higher risk of IHD (1.18; 95% CI, 1.12 to 1.25; nstudies = 10).
There was no association with poultry intake (nstudies = 10).
This study provides substantial evidence that unprocessed red and processed meat, though not poultry, might be risk factors for IHD.”
Flere relevante studier:
Struijk EA, Fung TT, Sotos-Prieto M, et al. Red meat consumption and risk of frailty in older women. J Cachexia Sarcopenia Muscle. 2022;13(1):210-219. doi:10.1002/jcsm.12852 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818608/
https://www.bmj.com/content/357/bmj.j1957
Noen flere studier – som analyserte EAT-Lancet-kostholdet
EAT-Lancet score and major health outcomes: the EPIC-Oxford study – PubMed (nih.gov)
The Association between the EAT-Lancet Diet and Diabetes: A Systematic Review – PubMed (nih.gov)
Eldre artikler ved Oxford universitet
Low meat diets reduce environmental harm from food production | Future of Food (ox.ac.uk)
WHO, WCRF og andre fagpanel om kjøtt
WCRF, WHO, Harvard Universitet og flere andre fagpanel fraråder å spise bearbeidet kjøtt og anbefaler å begrense rødt kjøtt til 350 – 500 gram per uke. Det er godt dokumentert at for mye kjøtt kan øke risiko for diabetes type 2, overvekt, hjerteinfarkt og kreft i tykktarm og endetarm, den vanligste formen for kreft i Norge og Vesten.
The Lancet: helse- og miljøskadelig
Vi bør alle redusere kjøttinntaket til ganske lave mengder for både helse og miljø, ifølge en lederartikkel med tittel We need to talk about meat i verdens anerkjente medisinske tidsskrift The Lancet. Forfatterne går gjennom forskernes forslag til å begrense kjøttforbruket, inkludert kjøttskatt, gjennomgang subsidier for kjøttproduksjon og forandring av forbruksvaner.
De understreker at disse tiltakene må settes på plass så snart som mulig for vår planet og vår helse. The Lancet skriver følgende:
«Meat production doesn’t just affect the ecosystem by production of gases, and studies now question the system of production’s direct effect on global freshwater use, change in land use, and ocean acidification. A recent paper in Science claims that even the lowest-impact meat causes “much more” environmental impact than the least sustainable forms of plant and vegetable production. Population pressures, with global population predicted to increase by a third between 2010 and 2050, will push us past these breaking points.»
«So what is a healthy amount of red or processed meat? It’s looking increasingly like the answer, for both the planet and the individual, is very little. Saying this is one thing. Getting the world to a place where we have the ability to balance the desire to eat whatever we want with our need to preserve the ecosystem we rely on to sustain ourselves is quite another. The conversation has to start soon.»
Link til ledersiden er her. Editorial. We need to talk about meat. Lancet. 2018;11:2237.
Nordisk ministerråd: risiko for tykktarmskreft, diabetes 2, overvekt og hjertesykdom
“There is strong epidemiological evidence that high consumption of processed meat increases the risk of colorectal cancer, type-2 diabetes, obesity, and coronary heart disease. Similar, but weaker, associations have been observed for red meat. Replacing processed and red meat with vegetarian alternatives (such as pulses), fish, or poultry reduces the risk.”
Kilde: Nordisk ministerråd, 2012. Nordiske ernæringsanbefalinger 2012. Part 1, Summary, principles and use, 5th edition.
fraråder på daglig basis
Bearbeidet kjøtt er i praksis alle ferdigprodukter, både av hvitt og rødt. Ferdigprodukter av kjøtt inneholder i tillegg ofte for mye salt, og hele 30 % saltinntaket i norsk kosthold kommer med kjøttprodukter.
Les også: Bør vi spise mindre rødt kjøtt? Tidsskriftet for Den norske legeforening, oppsummert 2020
Kreftforeningen USA, 2020
«The best available evidence continues to support recommendations to limit intake of red and processed meats for cancer prevention.Potential biologic mechanisms underlying these associations include consumption of nitrates and nitrites in processed meats, with oxidative DNA damage from the formation of nitrosamines in the gut catalyzed by heme iron and the formation of heterocyclic aromatic amines and polycyclic aromatic hydrocarbons during high‐heat cooking of meat,such as cooking meat over flames or grilling.
It is not known whether there is a safe level of consumption for either class of meat products, since the risk of colon cancer increases 23% with each additional serving (almost 2 ounces) of processed meat and 22% per 3 ounces serving of red meat”
Kilde: Rock CL, Thomson C, Gansler T, et al. American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. Published online June 9, 2020. Hele retningslinjen kan leses her https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21591
WHO fraråder å spise bearbeidet kjøtt
“Avoid processed meat; limit red meat and foods high in salt.”
Kilde: EU´s 12 råd for kreftforebygging, råd 5
American Institute for Cancer Research (AICR) om tykktarmskreft og hjertesykdom
“Bacon, ham, cold cuts—we get a lot of questions about processed meats, almost more than any other type of food. AICR sets the record straight on processed meats and their link to cancer.
Processed meat is meat preserved by smoking, curing or salting, or the addition of chemical preservatives. Processed meats include ham, salami, bacon and sausages such as frankfurters and chorizo.
AICR’s Diet, Nutrition, Physical Activity and Cancer: a Global Perspective, our Third Expert Report, found that eating even small amounts of cold cuts or other processed meats on a regular basis increases the risk of colorectal cancer. For processed meat, every 50 grams (about one hot dog or two slices of ham) eaten daily raises the risk of colorectal cancer by 16 percent. Therefore, AICR recommends that you eat little, if any, processed meat.
Kilde: American Institute for Cancer Research, FAQ: Processed Meat and Cancer. https://www.aicr.org/resources/blog/processed-meat-and-cancer/
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