Wednesday, March 7, 2018

Quick Nutrition Tips for Lowering the Risk of Colon Cancer

It's March, which means it's both National Colorectal Cancer Awareness Month and National Nutrition Month. And that's an apt combination.

A number of healthy diet tips can help lower the risk of colon cancer. And they're all pretty straightforward.

Eat whole grains
Whole grains are filled with fiber and other healthy nutrients. And eating more of them can help lower the risk of colon cancer. Instead of foods like sugary cereals, white rice, and white bread, choose whole-grain cereals, whole-wheat bread, and brown or wild rice. If you're not used to eating whole grains, add them to your routine a bit at a time - building up to three or more servings a day. They taste great but can take a bit of getting used to.

Limit red meat, especially processed meat
Eating too much red meat – like steak, hamburger and pork – increases the risk of colon cancer. And processed meats – like bacon, sausage and bologna – raise risk even more. Try to eat no more than three servings each week. Less is even better. Fish, chicken breasts and healthy plant-based proteins (like beans) are great alternatives.

Get enough calcium and vitamin D
There is good evidence that getting enough calcium and vitamin D can help protect against colon cancer. Shoot for 1,000 to 1,200 milligrams per day of calcium and about 1,000 international units (IU) per day of vitamin D.

Consider a multivitamin with folate
In addition to calcium and vitamin D, multivitamins also contain folate, which has been shown
in numerous studies to lower the risk of colon cancer. Avoid mega-dose vitamins. A standard multivitamin is best.

Drink only moderately, if at all
Alcohol is a strange thing when it comes to health. It’s heart-healthy in moderation but can increase the risk of colon and other cancers at even low levels. So what does this mean? If you drink moderately (up to one drink per day for women, two per day for men), there’s likely no reason for you to stop. If you don’t drink, though, there’s no reason for you to start. Heavy drinkers should try to cut down or quit.

Maintain a healthy weight
It's not exactly a nutrition tip, but it's closely related. And at least 11 different cancers have been linked to weight gain and obesity, including colon cancer. An ideal goal is to weigh around what you did when you were 18 years old. Realistically, if you’ve put on weight, the first goal is to stop gaining weight, which has health benefits by itself. Then, for a bigger health boost, slowly work to lose some pounds.

Tuesday, February 27, 2018

Short Take: Calories Matter in Weight Loss, Despite Some Recent Headlines

A recently published clinical trial out of Stanford University found that high-quality low-fat and high-quality low-carbohydrate diets could be equally effective for weight loss.

It was a positive finding from a well-designed study.

Many news headlines about the study, however, focused on something else entirely: that calories don't matter for weight loss. Some examples:

The problem is: The study didn't really find that.

In the trial, approximately 600 overweight and obese adults were randomly assigned to one of two diet groups (low-fat or low-carbohydrate) and followed over a 12-month period.  During the study, participants attended regular nutrition classes where emphasis was placed on healthy, high-quality foods – such as whole grains, healthy fats, and minimally processed foods.

Participants were not specifically instructed to lower their calorie intake.

At the end of the study, each group had lost similar amounts of weight. The low-fat group dropped around 12 pounds, and the low-carbohydrate group dropped around 13 pounds. 

So, each group lost weight without being instructed to cut calories:  What's wrong with the "calories don't matter"-themed headlines?

A couple of things.

First, calorie counting was not a subject of study of the trial.   Clinical trials are designed to assess very specific things.  Because calorie counting was not something one group in the study did and another group in the study did not do, no conclusions can be made about its possible impact – or lack of impact –  on weight loss. Any headline implying otherwise is reaching beyond the findings of the current study.  

On top of that, while it’s true that participants were not coached to reduce their calorie intake, that does not mean that they did not eat fewer calories.  In fact, each diet group ate an average of 500 – 600 fewer calories per day during the course of the study than at the start of the study.  That is a large deficit that would lead to weight loss over time. 

For both of these reasons, it's inaccurate to imply that the study found that calories, and counting calories, aren't important for weight loss.

Of course, diet quality is important.  A largely plant-based diet that focuses on fruits, vegetables, whole grains, and healthy fats has long been shown to lower the risk of many diseases and help with weight control.

But diet quantity is key.  To lose weight, we need to take in fewer calories than we expend - whether we count them or not.

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Thursday, February 15, 2018

New Diet Study Finds "Ultra-Processed" Foods May Be Linked to Cancer Risk

by Hank Dart

A new study out of France highlights another possible reason to avoid eating too many highly processed foods:  They may increase the risk of cancer.

The paper, published yesterday in the British Medical Journal, followed close to 105,000 adults for an average of 5 years.  Along the way, participants were asked to regularly report their dietary intake and any health events, such as a diagnosis of cancer.

Foods were then categorized into groups, with an "ultra-processed" group including foods like: soda (diet or sugary); mass-produced sweets; meats with preservatives other than salt; instant noodles and soups; and foods with industrial food additives and agents.

The proportion of participants' diets that was made up of ultra-processed foods was determined by the weight of food, rather than by calories.  This was done to take into account the potential impact of processed foods that have few, if any, calories, like diet sodas.

The researchers found that for every 10 percent increase in the proportion of ultra-processed foods in the diet, the overall risk of cancer increased by 12 percent and the risk of post-menopausal breast cancer increased by 13 percent.  

Risks were more pronounced when comparing high intake of processed foods with low intake. Participants who ate the most ultra-processed foods had a 21 percent higher risk of cancer overall and a 39 percent higher risk of post-menopausal breast cancer.  They also may have had a higher risk of colorectal cancer, but those results were less reliable.

In the analyses, researchers took into account many factors that could have swayed the results because they could be related to both processed food intake and cancer.  These included factors such as physical activity level, body mass index, alcohol intake, tobacco use, and overall diet quality.

In an accompanying editorial, Adriana Monge of the National Institute of Public Health in Mexico City and Martin Lajous of the T.H. Chan School of Public Health at Harvard University praised the researchers for their detailed study but recommended caution in interpreting such initial results.
" with any observational study, confounding by unknown factors common to consumption of ultra-processed foods and cancer outcomes cannot be excluded." 
"Their interesting results require replication and further refinement."
"We are a long way from understanding the full implications of food processing for health and wellbeing."

While more study is needed on the possible links between ultra-processed foods and cancer, well-established dietary recommendations call for limiting certain types of processed foods, which can be high in calories, sodium, refined grains, added sugar, and unhealthy fats -- and low in healthy nutrients.

A largely plant-based diet that is low in unhealthy processed foods and filled with fruits, vegetables, beans, and whole grains is best for overall health and can lower the risk of many important chronic diseases, including cancer.

Wednesday, January 24, 2018

In Practice: What I Learned from Weighing Myself (Almost) Every Day

by Hank Dart

In my many years of writing about and promoting healthy behaviors, I’m happy to say that I’ve at least tried to put into practice just about everything I’ve espoused. Of course, like many people, my success at doing so can be uneven. Some behaviors I do pretty well with - like exercise, olive oil, and fruits & vegetables. And some I admittedly struggle with - like, whole grains and added sugar.

But there’s one behavior I've written about a great deal but have never actually done myself. Regular weighing.  Stepping on the bathroom scale every day (or every week) and logging my weight.

Studies show that regular weighing can be a good tool for maintaining weight, especially in those who have lost weight and are working to keep it off. Because weight gain can creep up on people - a pound here, two pounds there - it's pretty easy to step on the scale after some months or years away and be surprised at the number staring up at you. Regular weighing can keep such jolts at bay and help us make small adjustments to how much we eat and how active we are so we can keep moving toward our long-term weight goals – whether it’s keeping weight steady or trying to slowly lose some weight.

And weight is a struggle for most of us in the United States.  Over two-thirds of the population is overweight or obese, and this has a huge impact on the health of individuals and the nation.  Being overweight is a cause of numerous cancers as well as heart disease, stroke, and diabetes.  It can also hamper mobility and overall quality of life.

So, after years of writing about the benefits of regular weighing, it was time to put down my keyboard and hop on the scale.  On November 18, the week leading into Thanksgiving, I weighed myself for the first time in probably nine months and began my (almost) daily weighing program (see figure).

What did I discover over my first two months of weighing? Here are some highlights:
Routine. Creating a routine makes things easier. Decide when and where you’re going to weigh yourself and really try to stick to it. I chose first thing in the morning – bleary-eyed and before coffee. If you miss some days, don't stress. While I stepped on the scale on most days, I missed 11 weigh-ins over two months. Some days I was feeling too busy to do it.  Some days I just didn't feel like. But overall, I tried to keep missed days as outliers and used them as a time to remind myself that this was a goal I wanted to work on.   When it comes to routine and consistency, find what works best for you. Different approaches work for different people.
Fluctuations. Day-to-day there will be fluctuations in weight. Sometimes up. Sometimes down. That’s natural. Two days after my first weigh-in, my weight was up about two pounds and stayed there on-and-off for the next 10 days. And about 30 days after that, I had a seven-day stretch where my weight changed by over four pounds. And I had no real explanation for either of them. As you get used to these natural ups and downs, you learn to place less importance on them and see them as part of your larger trend. 
Mindfulness. One of the most important parts of daily weighing, I found, was simply the act of stepping on the scale. No matter what number came up, it helped me keep my goal in mind. This doesn’t mean you should obsess about weight. But daily weighing can help you be a bit more mindful about your weight goals throughout the day. The world that surrounds us is filled with cues that entice us to eat – a lot. Daily weighing can be one way that helps counter that influence, helping us be more mindful of our goals and keep an eye on making healthy choices. 
Frustrations. Daily weighing can have some frustrations, especially when the numbers don’t seem to reflect the work we’ve been putting in. In those times, it’s important to stay positive.  By weighing yourself you're gathering information that can help you adjust your approach and successfully work toward your long-term health goals. 
Big picture. While weight is important, it’s not the only important aspect of health. Weighing yourself every day shouldn’t become an obsessive exercise in working toward unrealistic or unhealthy weight goals. Rather, it should be a tool that helps us work toward sensible and healthy weight goals that we can maintain over time. A healthy weight should be one part of an overall healthy lifestyle that includes a good diet, regular exercise, not smoking, and other healthy behaviors.

Tuesday, January 2, 2018

Protect Your Children with the HPV Vaccine

by Dr. Lindsay Kuroki

Parents grow up wanting their kids to be healthy and happy. And taking control of your child’s health may be easier than you think with evolving research. We know that with healthy eating, encouraging exercise, staying safe in the sun, and getting scheduled vaccinations your child is on the right path to having a lower cancer risk later in life.

What’s even better news is that within the past decade, a specific vaccine has also been created to protect against at least five different types of cancers. This vaccine, the Human Papillomavirus (HPV) vaccine, is now recommended for all girls and boys during their annual check-ups. 

HPV is a common sexually transmitted infection with over 100 different types of strands in existence. In fact, HPV is so common that an estimated nine out of 10 sexually active people will at some point be infected with HPV. Often times, HPV does not present with symptoms, which makes it hard to know when someone may be infected. For this reason, it is important to protect your child against HPV, as some forms of HPV can cause multiple cancers. At least two strands of the HPV virus have been shown to cause cervical, vagina, and vulva cancers in women, penile cancer in men, and head and neck cancer in both men and women. HPV can live for a long time in a person’s body, so someone may not know they have HPV, or an associated cancer, until years after being intimate with someone who carried the HPV virus. Sadly, HPV contributes to over 31,000 new cases of cancer each year, but we can reduce that number by protecting our children with the HPV vaccine.

Unfortunately, nationwide only 65 percent of girls initiate the HPV vaccination series and 49 percent receive the two recommended doses, while only 56 percent of boys initiate and 37 percent complete the series.

The good news is now the HPV vaccine is available for boys and girls to protect thems before they become sexually active. It’s also safe and over 90 percent effective. This success rate could prevent over 90 percent of HPV cases, or eliminate 29,000 new cancer diagnoses each year.

The Centers for Disease Control and Prevention (CDC) recommends that both girls and boys be vaccinated with a two-shot vaccine around ages 11 – 12. The second vaccine will be administered within one year after the first dose. The vaccine can be given until age 26, and being vaccinated after exposure to HPV will help reduce their risk of contracting future HPV infections. Adolescents and young adults, starting at age 15, who receive the HPV vaccine will require a three-dose vaccination series.

Protect your family against cancer, as it’s never too early to reduce your child’s risk. Talk with your pediatrician to schedule your child’s HPV vaccination.

Tuesday, October 31, 2017

Room for Improvement: Rates of Cancer Risk Factors in Young Adults

As we've written about before on Cancer News in Context, good evidence points to the important role that behaviors in youth and young adulthood can have on cancer risk later in life.

Health habits started in youth not only have a longer time to impact risk, but they can also have unique and important interactions with the biology of certain developmental stages.  Smoking, for example, seems to have the biggest impact on breast cancer risk when it takes place in the years between a woman's first period and when she first gives birth.  Likewise, sun exposure and indoor tanning has its biggest impact on melanoma risk when it takes place early in life.

Though there is still a lot we don't know about the relationship between early life risk factors and disease risk later in adulthood - largely because the vast majority of studies to date have been done in middle-aged or older populations - it is clear from the studies we do have that the earlier in life we can cement healthy habits, the better.

Yet, a new study of national data shows that there's still great room for improvement in those critical early years. The study, conducted by researchers from the National Center for Chronic Disease Prevention and Health Promotion of the CDC, analyzed results from the 2015 National Health Interview Survey, which asked a random sampling of Americans about a range of health habits and related information.

Across nearly all behaviors reported, there were very few bright spots (see figure below).

Nearly 20 percent of all young adult men and women were obese, meaning they had a body mass index (BMI) of 30 or higher. For someone who is 5 feet, 5 inches tall, that translates to a weight of 180 pounds or more. And these numbers do not even include the percentage of young adults who were overweight (BMI 25 - 29.9) but not obese.  While obesity has the largest weight-related impact on the risk of cancer, simply being overweight also adds to risk.

While smoking rates have dropped dramatically from their high-points, 11 percent of young women and 15 percent of young men still smoke tobacco cigarettes.  And nearly 8 percent of young men use e-cigarettes, despite their short and long-term risks remaining largely unknown.

Though physical activity is one of the best ways to lower disease risk and improve health and overall quality of life, nearly 30 percent of young women and just over 20 percent of young men get little or no physical activity.

Indoor tanning - which can double the risk of deadly melanoma - remains relatively popular in young women.  While, overall, 11 percent of women ages 18 - 24 had used a tanning bed in the past year,  this number kicks up to 17 percent in non-Hispanic whites.  Two percent or less of young men had indoor tanned.

Perhaps the most striking numbers were the very high rates of sugary drink consumption, processed meat consumption, and lack of HPV vaccination.  Over half of men and women drank sugary drinks daily, which increases the risk of weight gain, among other health risk factors.  And over two-thirds of men and over half of women regularly ate processed meat, which increases the risk of colon cancer.

Approximately 58 percent of women 18 - 26 years old and 79 percent of men 18 - 21 years old had not had the HPV vaccine, despite it lowering the risk of multiple cancers - including those of the cervix, anus, penis, and throat (which is becoming increasingly common). (Data not included in figure).

We know that half of all cancers could be prevented with a healthy lifestyle, and that that number is likely higher when healthy behaviors start early in life and are maintained through adulthood.  The results of this new study show that much more work needs to be done to help instill healthy behaviors in childhood that then continue into the teens and early twenties and beyond.

Parents and other family members play a key role in helping children develop healthy habits.  As kids age, and their independence grows, they play an increasing role in their own health.  At all stages, though, neither parents nor kids nor adults exist in a vacuum.  Our health behaviors are influenced by numerous different factors.  Personal choice is just one.  And outside of that, our schools, neighborhoods, workplaces, friends and broader social circles, and local and state governments and policies have an important impact on the health behaviors we make and sustain.

Healthy school meals and daily PE can help lay the foundation for a lifetime of healthful eating and regular activity.  Nice sidewalks and bike paths can make it easier for families to get out for walks and bike rides.  Employers that provide affordable health insurance and allow time off for doctor's appointment make it easier for workers to get important preventive care and screening. Promotion of healthy choices by popular opinion leaders on Snapchat and Instagram can impact attitudes and choices of teenagers influenced by such social media. And targeted taxes on tobacco and sugary drinks can curb purchasing by youth and young adults, who are particularly sensitive to cost.

To make important headway against cancer and other preventable chronic diseases, we need to promote and support prevention on these multiple levels.  The lessons from tobacco show that such broad-based approaches work.  What is lacking in these other areas are appropriate resources and political will to tackle them as we've been able to do tobacco.

The return on the time and resources invested would, no doubt, be many times over.

Thursday, October 26, 2017

Practical Steps to Prevent Breast Cancer

Two years ago during Breast Cancer Awareness Month, we posted over nine days excerpts from our, then, new book TOGETHER:  Every Woman's Guide to Preventing Breast Cancer. Each of the nine days focussed on a single practical step that could help lower the risk of the disease.  With each of the steps still relevant and important - and, we hope, still practical - we thought we'd post the compact list - nine days in one - and let readers click through a la carte.

Practical Steps to Prevent Breast Cancer