Toast

A new campaign is warning people that burning some food, such as toast, is a potential cancer risk.听Here, the evidence for this claim is explored by David Spiegelhalter,听Professor of the Public Understanding of Risk at the new Winton Centre for Risk and Evidence Communication.听

People may just consider this yet another scare story from scientists, and lead them to dismiss truly important warnings about, say, the harms from obesity

David Spiegelhalter

探花直播Food Standards Agency (FSA) today launched its听Go for Gold听campaign, encouraging us not to burn our roast or fried vegetables and keep our oven chips at a nice golden colour. 探花直播idea is to reduce people鈥檚 intake of acrylamide, a chemical that is听鈥渃reated when many foods, particularly starchy foods like potatoes and bread, are cooked for long periods at high temperatures, such as when baking, frying, grilling, toasting and roasting.鈥澨(FSA)

Acrylamide can be, in large doses, a very nasty substance. It is used as an industrial sealant, and workers with very high exposures suffered serious neurotoxicity. Very high doses have been shown to increase the risk of mice getting cancer. 探花直播IARC (International Agency for Research on Cancer) considers it a 鈥樷, putting it in the same category as many chemicals, red meat, being a hairdresser and shift-work.

However, there is no good evidence of harm from humans consuming acrylamide in their diet:听听that 鈥淎t the moment, there is no strong evidence linking acrylamide and cancer.鈥澨

This is not for want of trying. A听听(EFSA) lists 16 studies and 36 publications, but concludes

In the epidemiological studies available to date, AA intake was not associated with an increased risk of most common cancers, including those of the GI or respiratory tract, breast, prostate and bladder. A few studies suggested an increased risk for renal cell, and endometrial (in particular in never-smokers) and ovarian cancer, but the evidence is limited and inconsistent. Moreover, one study suggested a lower survival in non-smoking women with breast cancer with a high pre-diagnostic exposure to AA but more studies are necessary to confirm this result.听(p185)

Remember that each study is testing an association with a long list of cancers, so using the standard criteria for statistical significance, we would expect 1in 20 of these associations to be positive by chance alone.

A standard response might be the over-used clich茅: 鈥榓bsence of evidence is not evidence of absence鈥. If there has been a huge effort to find an association, and none has been found, it鈥檚 true that this may not be direct evidence of the absence of an effect (though this can never be proved anyway). But it听can听be considered evidence of something that is not very important.

Given the numbers provided by EFSA and FSA, it is perhaps unsurprising that no association has been shown in large studies. EFSA calculated a BMDL10听of 170 碌g/kg body weight/day 鈥 this means it is unlikely that exposures at this level would cause tumours in mice (technically it is the lower end of a confidence interval for the dose that would cause 10% increased tumours). They then compare this with human acrylamide exposure obtained from multiple detailed dietary surveys, which for adults has an average of 0.56 and a 鈥榟igh鈥 of 1.1 碌g/kg/day, in the sense that 97.5% of people consume less than this. 探花直播BMDL10听is then divided by these exposures to give the 鈥榤argin of exposure鈥, which rather confusingly end up being high for low risks and low for high risks.

So, for example, adults with the highest consumption of acrylamide could consume 160 times as much and still only be at a level that toxicologists think unlikely to cause increased tumours in mice (that's essentially what the 鈥榤argin of exposure鈥 means).听

This all seems rather reassuring, and may explain why it鈥檚 been so difficult to observe any effect of acrylamide in diet. But, for cancer, toxicology committees demand a rather arbitrary margin of exposure of 10,000 before considering the chemical essentially acceptable.

Reactions to the FSA鈥檚 Go for Gold campaign may range from the extremes of encouraging obsessive concern in the worried-well, to irate editorials on yet another intrusion from the 鈥榥anny state鈥. More worrying, people may just consider this yet another scare story from scientists, and lead them to dismiss truly important warnings about, say, the harms from obesity.

say that 鈥渞esearchers estimate that overweight and obesity are behind around 18,000 cases of cancer each year in the UK鈥. In stark contrast, the FSA provide no estimate of the current harm caused by acrylamide, nor the benefit from any reduction due to people following their advice. To be honest, I am not convinced it is appropriate to launch a public campaign on this basis.

探花直播 is a new centre hosted within the听Department of Pure Mathematics and Mathematical Statistics.



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