Legal Feasibility of US Government Policies to Reduce Cancer Risk by Reducing Intake of Processed Meat.

ABSTRACT

Policy Points High-profile international evidence reviews by the World Health Organization, the World Cancer Research Fund, the American Institute for Cancer Research, and the American Cancer Society concluded that processed meat consumption increases the risk of cancer. The red meat and processed meat industries are influential in the United States and in several other nations. The US federal government supports public-private partnerships for commodity meat promotion and advertising. Four potential policy options to affect consumption of processed meat are taxation, reduced processed meat quantities in school meal standards, public service announcements, and warning labels. Feasibility of these options would be enhanced by an explicit and science-based statement on processed meat in the 2020-2025 Dietary Guidelines for Americans. CONTEXT The World Health Organization, the World Cancer Research Fund, and the American Cancer Society have each in recent years concluded that processed meats are probable carcinogens. The 2015-2020 Dietary Guidelines for Americans did not separately evaluate health effects of processed meat, although it mentioned lower processed meat intakes among characteristics of healthy diets. METHODS: We summarized the international scientific literature on meat intake and cancer risk; described the scientific and political processes behind the periodic Dietary Guidelines for Americans; described the US red meat and processed meat industries and the economic structure of government-supported industry initiatives for advertising and promotion; and reviewed and analyzed specific factors and precedents that influence the feasibility of four potential policy approaches to reduce processed meat intake. FINDINGS: Based on a review of 800 epidemiological studies, the World Health Organization found sufficient evidence in humans that processed meat is carcinogenic, estimating that each 50-gram increase in daily intake increases the risk of colorectal cancer by 18%. Among the four policy responses we studied, legal feasibility is highest in the US for three policy options reducing processed meat in school meals and other specific government-sponsored nutrition programs; a local, state, or federal tax on processed meat; and public service announcements on health harms of processed meats by either the government or private sector entities. Legal feasibility is moderate for a fourth policy option, mandatory warning labels, due to outstanding legal questions about the minimum evidence required to support this policy. Political feasibility is influenced by the economic and political power of the meat industries and also depends on decisions in the next round of the Dietary Guidelines for Americans about how to assess and describe the link between processed meat consumption and cancer risk. CONCLUSIONS: Public policy initiatives to reduce processed meat intake have a strong scientific and public health justification and are legally feasible, but political feasibility is influenced by the economic and political power of meat industries and also by uncertainty about the likely treatment of processed meat in the 2020-2025 Dietary Guidelines for Americans.