A perfect summer and fall include being outside and grilling with family and friends. The menu often includes burgers, steak, brats and hot dogs. However, the meat choices we make and how we prepare them can put us at risk for colorectal cancer. This doesn’t mean we still can’t enjoy many of these foods. We just need to make informed choices.

According to the American Cancer Society (ACS), excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in men and women in the United States. There has been a rising incidence in colorectal cancer among young adults since at least the mid 1990’s. According to the ACS, from 2012 through 2016, diagnosis has increased every year by 2% in people younger than 50 and 1% in people 50-64.

There is evidence that consuming red meat and processed meats increases the risk of colorectal cancer.

The American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) did a systemic review of the global scientific literature and analyzed how foods and their nutrients affect the risk of developing cancer. The multidisciplinary panel of independent experts reviewed hundreds of scientific studies and evaluated the evidence. The AICR Diet, Nutrition, Physical Activity and Cancer: A Global Perspective - The Third Expert Report, was published in 2018. The reports that comprise the Third Expert Report summarize reviews of certain cancer sites and risk factors. There were two previous reports done in 1997 and 2007.

They found “probable” evidence that red meat increases the risk of colorectal cancer. Currently it is recommended to avoid greater than 12-18 ounces per week of red meat. Three ounces of meat is equivalent to a deck of cards. Red meat includes beef, pork, lamb and goat. Many are surprised when we discuss that pork is actually a red meat. Pork has been advertised over the years as “the other white meat”, which was used to create awareness of pork being another healthy option to chicken. One way to reduce your red meat intake is to include more chicken, turkey and fish. There is not enough evidence yet about duck and venison, which are considered red-colored meat.

So why is red meat linked to colorectal cancer?
Red meat contains heme iron, which can lead to the production of free radicals. Free radicals can cause oxidative damage to DNA, protein and cell membranes. It also promotes the formation of carcinogenic N-nitroso compounds within the gut.

Grilling meats can increase risk of cancer as well. The AICR notes that cooking meat at high temperatures or over an open flame produces two types of cancer causing substances called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). PAHs are present in the flames that can stick to the surface of the meat. HCAs form in the meat when its proteins react to the intense heat of the grill.

How can we grill more safely?

1. Grill vegetables or fruit instead. They don’t form HCAs when cooked. Fruits and vegetables also increase your consumption of cancer protective antioxidants.
2. Marinating your meats before you grill them may decrease the formation of the HCAs.
3. Trimming the fat off your meat can help reduce flame flare-ups.
4. Cut your meat into smaller portions can help to reduce cooking time.

There is also “Convincing” evidence that consuming processed meats increases the risk of colorectal cancer. It is recommended to consume very little, if any, processed meats. Processed meats include those that are preserved by smoking, curing, salting or the addition of chemical preservatives. Examples include brats, hot dogs, ham, bacon, salami, sliced meat from the deli and prepackaged deli meats. The World Health Organization's International Agency for Research on Cancer named processed meat as a carcinogen back in 2015. It was found that for every 50 grams of processed meats eaten daily, that it increased colorectal cancer risk by 16%. 50 grams is equivalent to one hot dog. N-nitroso compounds also form when nitrites that are used to preserve meat combine with amines from amino acids. This can be created during the meat curing process as well as in the digestive tract. Unfortunately there is no clear evidence yet that consuming nitrate free or unprocessed meats are any safer.

It is recommended to limit your processed meats to a special occasion, such as an occasional baseball game or a holiday.

Ways to reduce processed meats:

• Replace deli meats with fresh meat. You can make sandwiches with cooked and sliced meat, such as a chicken breast, turkey or roast beef.
• Try the seasoned turkey recipes below instead of using regular Italian sausage or breakfast sausage.
• Omit sausage or hamburger in chili, soups or burritos. Use more beans instead.
• Include other sources of protein such as eggs, cottage cheese, yogurt, tofu, hummus, fish, nuts, edamame, chicken, turkey, peanut butter.

Seasoned turkey to replace breakfast sausage

• 2 pounds ground turkey
• 2 teaspoons dried sage
• 2 teaspoons salt
• 1 teaspoon black pepper
• ½ teaspoon red pepper flakes
• ¼ teaspoon dried marjoram

You can shape the seasoned meat into patties or use as a ground turkey breakfast sausage. Cook patties over medium heat until done and it achieves 165 degrees. Meat should not be pink and juices clear.

Ground turkey seasoned like Italian sausage

• 1 pound ground turkey
• 1 teaspoon pepper
• 1 ½ teaspoon Italian seasoning
• 1 teaspoon garlic powder
• 1/8 teaspoon red pepper flakes
• ¾ teaspoon dried fennel seeds
• Garlic salt per your taste

Mix seasonings together in a small bowl. Add the spice mixture to the turkey, while mixing well with your hands or a spoon. Cook the ground turkey over medium heat, breaking the burger into smaller pieces as it cooks. Cook until done and meat is no longer pink.

The AICR Diet, Nutrition, Physical Activity and Cancer: A Global Perspective - The Third Expert Report can be found at https://www.aicr.org/research/third-expert-report/

Tracie Swearingen, RD, CSO, LD

Tracie has been a Registered Dietitian since 1999 and has worked specifically with outpatient cancer patients since 2005.

As an oncology dietitian her goal is to provide compassionate care and empathy to those dealing with a cancer diagnosis.

“I want to prevent or decrease a patient’s symptoms caused by treatment or diagnosis. Helping to maintain our patients’ quality of life is very important to me. My role as an oncology dietitian focuses not only on good nutrition during cancer treatment, but also cancer prevention and survivorship.”

Tracie serves patients primarily in the Coon Rapids and Fridley clinics.