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Letter to School Lunch Professionals

March 1, 2014

Dear School Food Service Professional,

Today marks the beginning of a month dedicated to creating awareness about the risk of colorectal cancer. According to the American Cancer Society, colorectal cancer is the third most common cancer found in men and women, with 1 in 20 people developing it in his or her lifetime. It is estimated that more than 50,000 Americans will die from colorectal cancer in 2014.

Processed meat products are strongly linked to colorectal cancer, and they are widely consumed in school breakfasts and lunches. Processed meat products are those prepared and/or preserved by curing, smoking, salting, or adding chemical preservatives.  These products include hot dogs, ham, bacon, pastrami, salami, pepperoni, bologna, liverwurst, bratwurst, sausage, luncheon meat, and, depending on the processing, hamburgers and minced meats.

The Institute of Medicine's report School Meals: Building Blocks for Healthy Children raised concerns about the use of processed meats, such as hot dogs, bacon, and sausage, in school meals because of cancer risk. Processed meats also increase the risk of premature death, cardiovascular disease, and diabetes. Here below is a summary of the evidence to date:

Premature Death

A study from the Harvard School of Public Health showed that a daily serving of processed meats, like one hot dog, sausage, or a few bacon strips, consumed on a daily basis increases the risk of premature death from heart disease or cancer by 20 percent.

Cardiovascular Disease

The federal government’s 2010 Dietary Guidelines for Americans say that processed meats are a major contributor of solid fats and increase the risk of cardiovascular disease.


A review in the journal Diabetologia found that those who regularly eat processed meats increase their risk for diabetes by 41 percent.


Consuming processed meats increases the risk of colorectal cancer, according to a large number of studies, including the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

  • An NIH-AARP Diet and Health Study found that for every 10 grams of processed red meat consumed on a daily basis, prostate cancer risk increases 10 percent.
  • A study in Taiwan showed that consumption of cured and smoked meat can increase children’s risk for leukemia.
  • A study in Australia found that women’s risk for ovarian cancer increased as a result of eating processed meats.

Because numerous studies have repeatedly shown that frequent processed meat consumption is associated with increased risk of colorectal cancer and other forms of cancer, the World Cancer Research Fund/American Institute for Cancer Research recommends avoiding any consumption of processed meat products.

And, according to that same report, consuming just one 50-gram serving of processed meat (about the amount in one hot dog) per day increases the risk of colorectal cancer, on average, by 21 percent. Few people, other than cancer researchers and food-industry scientists are aware of the well-established link between consumption of processed meat and the development of colorectal cancer. We have a duty to protect consumers, especially children, from the risks associated with consumption of processed meats.

Therefore, during Colorectal Cancer Awareness Month, we are asking school food service directors to proactively plan for the removal of processed meats beginning in the next school year (2014-15). There are many alternative menu items for schools to consider in lieu of processed meat.

Thank you for all you do for our nation’s children. Please stand with us to prevent and protect our young people from the risk of colorectal cancer.

We welcome you to be in touch with us about any questions you might have, and also would like to know if your school will commit to removing processed meat for the next school year. You can contact us at jeckart@pcrm.org or 202-527-7337. 


Neal Barnard, M.D.