Bacon on hospitals’ menu — an oxymoron of our health system?

Would hospital patients be better off if they could bring their own meals from home? Data obtained via a Freedom of Information Request revealed earlier this year that 113 NHS hospitals serve nitrite-containing ham and bacon to their patients.

Some may rejoice to eat their favourite food while donning a hospital gown, but the medical community should know better. A link between processed meats and cancers was established in 2015 after the World Health Organization’s International Agency for Research on Cancer released a report classifying processed meats as Group 1 carcinogen (in the same category as smoking, asbestos and mustard gas). The link is strongest for colorectal cancers.

To be sure, colorectal cancers are the third most common cancer among adults in the UK with more than 110 new cases and 44 deaths every day.

While a number of different factors can lead to bowel cancers, it is believed that 13% of cases are being caused by eating processed meat.

Sadly, there is a growing incidence of colorectal cancer among those under 50, which is believed to be 1.8% annually. The cause for this rise has not been established, but analysis of sales of processed meats reveals a gradual increase in the last few years, a correlation which suggests an increase in consumption. NHS hospitals should not be among those supporting the higher sales.

The Cancer Council recognises the link between processed meat and the risk of cancer and recommends eliminating them from the diet or keeping them at an absolute minimum.

A recent prospective study in the UK published in the International Journal of Epidemiology suggests that consumption of every 25g of processed meat a day increases the cancer risk by 20%. Twenty-five grams is the equivalent of half a slice of a typical ham or half a sausage. Most hospital menus serve double that amount in one meal.

Processed meats not only contain nitrates — the compounds responsible for cancer — but they also have high levels of sodium and saturated fats. These factors in processed meats are believed to increase the risk for chronic diseases such as heart disease and diabetes.

A systematic review and meta-analysis published in 2010 by researchers at the Harvard School of Public Health found that the daily consumption of 50g of processed meat (i.e., 1 slice of ham) increases the risk of heart disease by 42% and the risk of diabetes by 19%.

Some critics might claim that removing processed meat from the patients’ menu won’t make much of a difference given the short duration of most hospital admissions. However, such fault-finding misses the point. When examining statistics following the 2007 smoking ban in enclosed public places, public health policies can be quite influential.

More people succeeded in quitting smoking after the ban, bringing the number of adult smokers from 22% in 2006 to 14.9% in 2017. During the same period, a study at the Centre for Population Health Studies at the University of Glasgow showed a drop of 17% in hospital admissions for heart attack and a 18% drop in hospital admissions of asthmatic children.

Given that doctors are duty-bound to put their patients’ well-being first and not inflict any harm, we need to question why a known Group 1 carcinogen is served to patients while under our care. Moreover, hospitals should be leading by example and providing foods rich in nutrients – the health benefits of which are long-established.

What is more, hospitals should take advantage of the opportunity to educate in-patients and their families about healthy eating guidelines.

A 2018 survey conducted by the British Nutrition Foundation revealed that nearly half of adults are confused about the inconsistent nutritional advice they come across in the media. The same survey reported on the public’s interest in learning about healthy living. This is an opportunity not to be missed.

This together with the overwhelming evidence of the link between processed meats and lifestyle diseases highlight the need to review NHS hospital food policies. Two years ago, the American Medical Association’s House of Delegates passed a resolution and urged hospitals to remove processed meats from their menus in order to improve the health of their patients.

We know that nutrition has a huge impact on health, and if we want to tackle the epidemic of chronic diseases we are facing, then we need to endorse and prioritise good nutrition wherever possible. That is why every medical doctor across the UK should advocate for a ban of carcinogenic processed meats at all NHS hospitals.

Published in as a guest post by Dr Leila Dehghan and Dr Shireen Kassam. Dr Dehghan is a doctor turned plant-based nutritionist, while Dr Kassam is a Consultant Haematologist and Honorary Senior Lecturer at King’s College Hospital, London.