Processed Meats Increase Heart Disease, Diabetes and Cancer Risk

(First appeared as Processed Meats Increase Heart Disease and Cancer Risk on Technorati.)
Processed meat consumption is surging as Americans gobble up hot dogs, sausage and cold cuts in record numbers. We’re paying the ultimate price for this inexpensive, easy preparation food source as the risk of heart disease, cancer and diabetes have been conclusively linked to processed meat products.

The results of a large study published in Circulation clearly demonstrate that even small quantities of processed meats, as small as 2 ounces eaten daily, increases the risk of heart disease by 42% and diabetes by 19%. The two diseases account for 700,000 deaths annually in the US, a number which could be significantly decreased by making sensible dietary modifications.

Heart Disease Risk Can Be Slashed

The study was one of the first to separate processed meat products from unprocessed beef, pork or lamb. Based on this information, it’s possible to determine that the higher fat levels in meat are not the direct cause of increased disease risk. The high sodium and chemical preservative content of the processed meats are linked to the dramatic increased incidence previously associated with meat consumption in general.

Sodium is a known factor in heart disease as it increases blood pressure and causes changes to the blood’s ability to properly clot. People eating the highest amount of processed meats take in nearly three times the daily recommended amount of salt. Although this study did not find a direct link to heart disease from unprocessed meat consumption, it’s still advisable to moderate the amount of beef and pork as typical cooking methods lead to the accumulation of aging byproducts known as AGE’s (anti-glycation end products). Based on the results of this study, 300,000 lives could be spared each year by scaling back or eliminating processed meats.

Cancer Incidence Linked To Chemical Preservatives

Sodium Nitrite is the main preservative used in meat processing, and adds a healthy looking  fleshy red color to the meat. Those consuming the highest amounts of nitrite through processed meats have shown a 67% increase in pancreatic cancer and a 74% increase in leukemia. Digestive cancers such as those of the stomach and colon are twice as common among those who eat the largest amount of processed meats.

We have not evolved to eat food which has been pumped full of preservative chemicals and sodium. Processed meats have been artificially manipulated to appeal to our taste with no regard to the mountain of evidence demonstrating it is slowly leading to our demise. Total meat consumption should be limited due to the excess calories and potential for weight gain, while processed meat products need to be eliminated from our diet, or minimized to an occasional treat. This study proves with sobering scientific fact that one small dietary change could have a large impact on the rest of our life.

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Q & A: Diagnosing Cushing"s Disease in Dogs with Diabetes Mellitus

Rex is an 8-year-old male Schnoodle who presented to us a month ago with owner complaints of polyuria and polydipsia (PU/PD) and polyphagia. On physical examination, his abdomen was a bit pendulous, with a body condition score of 7/9 (body weight, 8.5 kg). Marked hepatomegaly was found, which was verified by abdominal radiography. The physical examination was otherwise unremarkable, with no other signs of Cushing’s syndrome (e.g., no hair loss, muscle atrophy, comedomes, calcinosis cutis).

We submitted a complete blood count, serum chemistry panel, complete urinalysis, and urine culture to the lab that day, which showed the following abnormalities:

Serum Chemistry Panel:

• Alkaline phosphatase: 1061 IU/L (reference range, 5-131)


• GGT: 18 IU/L (reference range, 1-12)


• Glucose: 649 mg/dl (reference range, 70-138)


• Triglyceride 414 mg/dL (reference range, 29-291)

Urinalysis and Culture

• Specific gravity: 1.029


• Glucosuria: 3+


• Ketones: Negative  


• Urine culture: negative

Based on the hyperglycemia and glycosuria we diagnosed diabetes mellitus and started Rex on NPH insulin (Humulin-N) at the dosage of 4 U BID (0.5 U/kg/injection). He responded to insulin with a moderate decrease in PU/PD, but the thirst remained excessive.

We did an serial blood glucose cure 2 weeks later. Results showed marked and persistant hyperglycemia (> 400 mg/dl) throughout the day. Based upon the glucose curve, we diagnosed insulin resistance and did a low-dose dexamethasone response test. Results of that test were positive, and indicate pituitary-dependent Cushing’s disease (see below):

• Basal cortisol: 5.8 μg/dl (reference range, 1.0-5.0 μg/dl)


• 4-hr post-cortisol: 0.9 μg/dl (reference range, <1.4 μg/dl)


• 8-hr post-cortisol:  5.7 μg/dl (reference range, <1.4 μg/dl)

I’d like to start Rex on trilostane (Vetoryl, Dechra Animal Health) for the Cushing’s disease and insulin resistance. Am I on the right course with this dog?

My Response:

The problem with diabetic dogs is that it’s very difficult to make a diagnosis of Cushing’s with certainty unless we see cutaneous changes. PU/PD, polyphagia, and high liver values all could be secondary to the diabetes. False-positive test results on a LDDST are very common in dogs with nonadrenal illness, such as diabetes (1-3).

Does he have any cutaneous signs (hair loss, etc)? His insulin dose isn’t high enough to say that he has insulin resistance. I’d recommend that you continue to monitor Rex closely an slowly raise his NPH dose to see if that helps control his signs. Because it can be very difficult to be sure in these diabetic dogs, sometimes observation and monitoring is the best course.

Follow-up:

Rex’s coat looks pretty normal right now. We’ll try raising his insulin dose before assuming that Cushing’s disease is his underlying problem. Two more questions:

1. At what insulin dose do we get concerned about resistance?


2. Could diabetes explain the pot belly and marked hepatomegaly?

My Response:

We define insulin resistance as doses greater than 2.2 U/kg/injection to control hyperglycemia (4), so we aren’t even close to the doses required to diagnose resistance.

And yes, diabetic dogs can get marked hepatomegaly secondary to fat accumulation in the liver. That can lead to a mild-moderate “pot bellied” appearance.

Because it can be very difficult to make a diagnosis of Cushing’s syndrome in dogs with diabetes, observation and monitoring is the best course in many of these patients. If Cushing’s disease is present, it will be progressive and other signs will develop to make the diagnosis easier to confirm.

References:

1. Kaplan AJ, Peterson ME, Kemppainen RJ. Effects of disease on the results of diagnostic tests for use in detecting hyperadrenocorticism in dogs. Journal of the American Veterinary Medical Association 1995;207:445-451.


2. Kaplan A, Peterson ME. Effects of nonadrenal disease on adrenal function tests In: Bonagura JD (ed): Current Veterinary Therapy XIII. Philadelphia, WB Saunders Co., 2000; pp 362-363.


3. Melián C, M. Pérez-Alenza, D, Peterson ME. Hyperadrenocorticism in dogs, In: Ettinger SJ (ed): Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat (Seventh Edition). Philadelphia, Saunders Elsevier, 2010; pp. 1816-1840.


4. Peterson ME. The difficult diabetic: Acromegaly, Cushing’s, and other causes of insulin resistance. North American Veterinary Conference (NAVC) Conference 2012: Small Animal & Exotics Proceedings. pp. 873-879.