Medicine And The Media

Legal, decent, honest, and truthful

BMJ 1995; 311 doi: (Published 25 November 1995) Cite this as: BMJ 1995;311:1442
  1. Gill Langley, scientific consultant and freelance writer
  1. Hitchin

    Popeye, “strong to the finish, ‘cos he eats his spinach,” and Jack Sprat, who would eat no fat (and his wife would eat no lean), seem to have inspired the Meat and Livestock Commission's campaign Meat Matters, which is aimed at consumers, health professionals, and journalists.

    One of the eye catching national advertisements compares the dietary iron contained in a huge tower of raw spinach on one plate and a grilled steak on the other. A great photo opportunity, but not quite the “rational” approach boasted by the commission. Although steak ranks highly among meats in iron content, spinach is not the front runner among plant sources. Indeed, Popeye might have done better to take a spoonful of black molasses since, gram for gram, molasses, cashew nuts, soya beans, wholemeal bread, and even popadums provide considerably more, and better absorbed, iron than does spinach.

    A more equitable approach, although less visually striking, would have compared similar portions of cooked soya beans and steak. The beans would provide about half of the absorbable iron bound in the steak. A helping of cauliflower and a baked potato would boost the available iron in the vegetarian meal as high as that of the steak plus, say, some coleslaw (and incidentally, with less fat, less sodium, more fibre, and more vitamin C than the meat option). But then, Meat Matters is not about promoting vegetarianism, or about drawing attention to the nutritional downside of meat.

    Fat is the topic of a similar advertisement that contrasts cottage cheese and pork. Surprisingly, we are told that a lean, trimmed, grilled pork steak contains less fat than an equal helping of cottage cheese. More details about the new, lower fat meats are supplied in the attractive booklets, available on request. But not everyone is a Jack Sprat. How many consumers buy only the leanest cuts, cut off every visible scrap of adipose tissue, cook without added fat, and finally dab the cooked meat with kitchen paper before serving?

    When it comes to the information contained in the booklets, the argument that we should eat meat today because if humans had not eaten meat in the past “we may not have developed as we are” seems irrelevant. Doctors and other health professionals without specialist knowledge of nutrition may be reassured by the plethora of figures provided and the references cited. The expert who looks more closely could feel a little uneasy.

    Most nutritional guidelines, including those of the Committee on Medical Aspects of Food Policy, express fat intake as a percentage of dietary energy. Many people are familiar with recommendations to reduce fat intake to 33-35% of dietary energy consumed. In Meat Matters the percentage terminology refers to weights: grams of fat per 100 grams of meat. Extra lean mince is thus described as containing less than 10% fat, but this translates into 46% fat by energy content--a figure not supplied. The fact that percentages by weight are being used is nowhere made explicit; so it would be easy to underestimate the fat provided by even the leanest meat.

    Perusing the campaign materials, readers may not notice that the sideswipes against vegetarians and demi-veggies, carefully extracted from expert reports, are couched in conditional terms--a low consumption of red meat “may” compromise iron status, for example. The statement that “it is now acknowledged that specific measures must be taken” by people who eat little meat, to improve their iron absorption, sounds serious. But who acknowledges this, on what grounds, and what specific measures are referred to? The fallacious underlying theme, that vegetarians are especially prone to iron deficiency, may well be the take home message.

    Reading that vitamin B12 is “not found naturally in foods of plant origin” you might assume that vegan diets are bound to be deficient in this vitamin. But this is not so, because yeast extracts and nutritional yeast, many breakfast cereals, and some vegetable margarines, soya milks, and meat substitute soya dishes are fortified with B12 (from non-animal sources).

    Despite endorsements from the British Dietetic Association and the Family Heart Association, this is still an advertising campaign, not an impartial educational exercise. In terms of their fat and iron contents, no doubt the new extra lean meats, carefully trimmed and conscientiously cooked, can play their part in a balanced diet. But supermarket shelves are predominantly stacked with traditional cuts, some with a sizeable band of fat. Other popular meat items include bacon rashers (up to 72% of calories as fat) and pates (some with a whopping 85% of calories as fat).

    It would be unfortunate for the health of the nation if the facts were obscured by the “creative treatment” used in this campaign, and if its message were read as a nutritional carte blanche for meat and meat products.