Eighty percent of cancers are due to factors that have been identified and can potentially be controlled, according to the National Cancer Institute. And not only can we potentially prevent most cancers, we can also improve the survival rates of people who have cancer. Cancers of the breast, prostate, and colon have received more research attention than other forms of the disease, but, as we will see, certain principles apply to many forms of cancer.
Cancer starts when one cell begins to multiply out of control. It begins to expand into a lump that can invade healthy tissues and spread to other parts of the body. But there is a lot we can do about it. Thirty percent of cancers are caused by tobacco. Lung cancer is the most obvious example, but by no means the only one. Cancers of the mouth, throat, kidney, and bladder are also caused by tobacco.
Dietary factors also play a significant role in cancer risk. At least one-third of annual cancer deaths in the United States are due to dietary factors.1 A review on diet and cancer estimates that up to 80 percent of cancers of the large bowel, breast, and prostate are due to dietary factors. 1
In 2008, excess body weight was responsible for over 124,000 new cancer diagnoses in Europe. These results were presented at a major European cancer conference in 2009 and showed endometrial (uterine) cancer, postmenopausal breast cancer, and colorectal cancer were the most common weight-related cancers. These three cancer types accounted for 65 percent of all cancers due to excess body weight. The effects of obesity also appear to increase mortality from several other types of cancer including gallbladder, pancreas, kidney, cervix, and ovary, as well as non-Hodgkin’s lymphoma in women with the highest BMIs compared to those with a healthy BMI.2 Previous studies including the Adventist Health Study-2 show that following a vegan diet results in the lowest BMI of any group (lacto-ovo-vegetarian, pesco-vegetarian, semivegetarian, nonvegetarian), making them less susceptible to obesity-related cancers. 3
The link between diet and cancer is not new. In January 1892, Scientific American printed the observation that “cancer is most frequent among those branches of the human race where carnivorous habits prevail.” Numerous research studies have shown that cancer is much more common in populations consuming diets rich in fatty foods, particularly meat, and much less common in countries eating diets rich in grains, vegetables, and fruits. One reason is that foods affect the action of hormones in the body. They also affect the strength of the immune system and other factors. While fruits and vegetables contain a variety of vitamins, minerals, antioxidants, and phytochemicals to protect the body, by contrast, recent research shows that animal products contain potentially carcinogenic compounds which may contribute to increased cancer risk. 5
In addition to tobacco use and diet, other factors, including physical activity, reproductive and sexual behavior, 4 bacterial and viral infections, and exposure to radiation and chemicals, may also contribute to the risk of certain forms of cancer. 4,6
Estimated Percentages of Cancer Due to Selected Factors 5,6
Diet 35% to 60% Tobacco 30% Air and Water Pollution 5% Alcohol 3% Radiation 3% Medications 2%
sources: 1. American Cancer Society. Cancer Facts and Figures—1997. Atlanta, GA: 1999. 2. Renehan A. Obesity and overall cancer risk. Presented at the Joint ECCO 15-34th ESMO Multidisciplinary Congress. Berlin, Germany, September 20-24, 2009. Abstract I-327. 3. Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009;32:791-796. 4. Minamoto T, Mai M, Ronai Z. Environmental factors as regulators and effectors of multistep carcinogenesis. Carcinogenesis. 1999;20(4):519-527. 5. Skog KI, Johansson MAE, Jagerstad MI. Carcinogenic heterocyclic amines in model systems and cooked foods: a review on formation, occurrence, and intake. Food and Chem Toxicol. 1998;36:879-896. 6. Cummings JH, Bingham SA. Diet and the prevention of cancer. BMJ. 1998;317:1636-1640.
Welcome to a new year filled with hopes for a healthy, happy 2017. The same resolutions are thrown around each year – lose weight, save money, and spend more time with family, for example.
Canadians from coast-to-coast may want to lead a healthier life, but don’t know where to get started. Global News asked leading health experts and organizations to pick the top priority they’d like Canadians to focus on for the year ahead.
Focus on your behaviours, not the numbers on the scale
Hide the scale. Losing weight and keeping it off is always a challenge. However, simply focusing on improving your diet, increasing your physical activity levels, getting enough sleep and feeling better about yourself can lead to important health improvements even with no – or very little – weight loss.
But remember, it is easier to achieve and sustain behavioural goals when they are specific, realistic, and measureable.
Also, it is better to focus on changing one behaviour at a time rather than trying to change everything at once.
– Arya Sharma, scientific director of the Canadian Obesity Network
Get a pulse on your mental health and well-being
Mental health is key to well-being. It affects every single aspect of your daily life. Maintaining your mental health is a lot like staying physically fit: it requires a little effort, but the rewards are worth it.
Get into the habit of learning to recognize and express your emotions – without awareness it’s difficult to pinpoint why you are so stressed or having problems coping.
– Patrick Smith, national CEO of the Canadian Mental Health Association
Break a sweat
A healthy lifestyle helps prevent 80 per cent of premature heart disease and stroke – leading killers of Canadians. The easiest way to reduce your risk is to get moving. Walk, dance, play a sport, take the stairs – make it fun! Even if you don’t have extra time, short rounds of exercise add up: 10 minutes is enough to get real cardiovascular benefits. Over time, you’ll work up to 30 minutes of daily physical activity at a moderate intensity. Repeat five days a week.
– Diego Marchese, CEO of Heart & Stroke
Think of the mental health of your loved ones
Operate on the statistically safe assumption that someone you know – a family member, friend, neighbour, fellow student, or coworker – is currently struggling with some form of mental illness. Take a moment to think about who that person is and then reflect on how you have responded to their experience of illness. Ask yourself if your response was different than it would have been if he or she had a broken leg or a cancer diagnosis. And if there is indeed a difference, then consider how you might support them differently.
The reality is that mental illness can be an isolating, even humiliating experience, but it doesn’t have to be. Connecting makes a difference and enriches a relationship – it can relieve the sense of being alone and provide comfort, help and reassurance.
– David S. Goldbloom, senior medical advisor at the Centre for Addiction and Mental Health
Add healthy cues to your environment
Look around your workplace, car or anywhere you might be eating. Are there cues like candy bowls and cookie jars? Redesign your environment to nudge yourself towards nourishing choices. For example, put a bowl or fruit or cut up vegetables on the counter and keep all other foods in the fridge or cupboards. Keep a reusable water bottle on your desk so it’s ready for sipping instead of sugary drinks.
– Andrea D’Ambrosio, registered dietitian and spokesperson for the Dietitians of Canada
Plan your meals
Meal planning is a vital part of healthy eating and makes you happy as there will be less stress around weekday meals. It saves time by eliminating the deliberation when you’re trying to decide what’s for dinner. It will also save you money as you’ll only shop for ingredients you need on your plan. Finally, it saves calories.
When you arrive home from work, you’re less likely to mindlessly munch when you know what is planned for dinner. Keep menu planning simple – set aside 30 minutes before grocery shopping to survey the family. Bookmark favourite meals and reuse them weekly.
– Jaclyn Pritchard, registered dietitian at Cleveland Clinic Canada in Toronto
Schedule quality time with your family
Spending time with the family is essential to the health and well-being of both children and adults. Focus on your children by playing their favourite games with them, encouraging conversation by asking about their day at school, and showing interest in their ideas and activities. Share mealtime as an important way to connect and unwind at the end of a busy day.
Even when family members are off in different directions with school, work and activities, be sure to come together at the table at least once a week.
Decide on specific times when everyone’s electronic devices will be turned off. When you’re unplugged, get active – play games like tag, go for a walk, or sled in park.
– Staff at the Canadian Paediatric Society
Reduce your alcohol consumption
Lower your long-term health risks by staying within average levels of alcohol consumption. For women, the recommended daily serving is less than 10 ounces. With today’s wine glasses, your pour should be less than a third of the glass. For men, if you like to try the latest craft beers, keep it to two tall cans.
Always have some non-drinking days each week to minimize tolerance and habit formation.
– Dr. Granger Avery, president of the Canadian Medical Association
Quit smoking for one week
Quit smoking for a week, and then a month, and then a year and beyond. But start with that first week. Setting that small goal can help you with your longer-term goals, and everytime you quit – even if you don’t succeed – you learn more about how to quit successfully. Research shows that if you can quit for one week, you are nine times more likely to quit for the long haul. In some provinces, it could even win you $500 from the Smokers’ Helpline’s First Week Challenge Contest.
Quitting smoking is the single best thing you can do for your health. Within 10 years of quitting, an ex-smoker’s overall risk of dying from lung cancer is cut in half.
– John Atkinson, director of the Canadian Cancer Society’s Smokers’ Helpline
Don’t fall for gimmicks
Rather than fall prey to this year’s crop of fad diets, or worrying about a particular probiotic, nutrient or scary sounding chemical, focus instead on the bigger picture. Set a goal of cooking more from fresh whole ingredients and eating them around a table free from distraction. Reduce your restaurant usage. Aim for better nights’ sleeps. Cultivate healthy relationships with your friends and family. Don’t drink alcohol to excess and reduce your consumption of all sources of liquid calories. Do those things well and avoid news about the latest fad diet.
– Yoni Freedhoff, medical director of the Bariatric Medical Institute
Feed your brain
Do more physical activity, not for your waistline but for your brain. It gets blood pumping which helps your brain to function as well as possible. The increased blood flow nourishes your brain’s cells with nutrients and oxygen. It also encourages the development of new cells, all factors in reducing your risk of stroke.
Your brain is like your heart. They’re both muscles that need to be given a workout to stay healthy. Challenge your mind with exercise training, learning a new language or joining a book club, as examples.
– Larry Chambers, scientific advisor for the Alzheimer Society of Canada
Take a small step, master it, then take on another
Many of us are familiar with the best intentions of starting off the year with lofty goals when it comes to living a healthy lifestyle – followed by the enthusiasm of resolutions declining a few weeks after.
Take a step back and think of something you can realistically and comfortably accomplish when it comes to exercise, your diet, weight management or stress – and you will be more likely to stick to it.
Try incorporating 15 minutes of physical activity to your routine just a few days a week, and as you progress, move to 30 minutes. When you’ve made that into a habit, remove sugar-sweetened beverages from your diet, for example.
– Joanne Lewis, director of healthy eating and nutrition programming at the Canadian Diabetes Association
Ease your mind and treat yourself
Pace yourself at work. Try not to check your work emails after hours, truly disconnect.
Just like the 12 days of Christmas, practice 12 days of self-care in 2017.
Go for a walk, ski or snowshoe in the woods, treat yourself to a latte, book a massage, take a yoga class or volunteer. Don’t forget that doing something for others not only makes them feel good, but can lift your spirits.
– The Mental Health Commission of Canada
By Carmen Chai
National Online Journalist, Health Global News
carmen.chai@globalnews.ca
North Americans seem very afraid of cancer, with good reason. Unlike other things that kill us, it often seems to come out of nowhere.
But evidence has increasingly accumulated that cancer may be preventable, too. Unfortunately, this has inflamed as much as it has assuaged people’s fears.
As a physician, I have encountered many people who believe that heart disease, which is the single biggest cause of death among North Americans, is largely controllable. After all, if people ate better, were physically active and stopped smoking, then lots of them would get better. This ignores the fact that people can’t change many risk factors of heart disease like age, race and family genetics.
People don’t often seem to feel the same way about cancer. They think it’s out of their control. A study published in Science in January 2015 seemed to support that view. It tried to explain why some tissues lead to cancer more often than others. It found a strong correlation between the number of times a cell divides in the course of a lifetime and the risk of developing cancer.
In other words, this study argued that the more times DNA replicates, the more often something can go wrong. Some took this to mean that cancer is much more because of “bad luck” than because of other factors that people could control.
Unfortunately, this simple explanation is not really what the study showed. Lung cells, for instance, divide quite rarely, and still account for a significant amount of cancer. Cells in the gastrointestinal tract divide all the time and account for many fewer cancers. Some cancers, like melanoma, were found to be in the group of cancers influenced more by intrinsic factors (or those we can’t control), when we clearly know that extrinsic factors, like sun exposure, are a major cause.
Further, this study was focused more on the relative risks of cancer in one type of tissue versus another. What we really care about is how much we can reduce our own risk of cancer by changing our behavior.
A more recent study published in Nature argues that there is a lot we can do. Many studies have shown that environmental risk factors and exposures contribute greatly to many cancers. Diet is related to colorectal cancer. Alcohol and tobacco are related to esophageal cancer. HPV is related to cervical cancer, and hepatitis C is related to liver cancer.
And you’d have to be living under a rock not to know that smoking causes lung cancer and that too much sun can lead to skin cancer.
Using sophisticated modeling techniques, the researchers argued that less than 30 percent of the lifetime risk of getting many common cancers was because of intrinsic risk factors, or the “bad luck.” The rest were things you can change.
Most recently, in JAMA Oncology, researchers sought to quantify how a healthful lifestyle might actually alter the risk of cancer. They identified four domains that are often noted to be related to disease prevention: smoking, drinking, obesity and exercise.
health lifestyle concept on blackboard
They defined people who engaged in healthy levels of all of these activities as a “low risk” group. Then they compared their risk of getting cancer with people who weren’t in this group. They included two groups of people who have been followed and studied a long time, the Nurses’ Health Study and the Health Professionals Follow-up Study, as well as national cancer statistics.
Of the nearly 90,000 women and more than 46,000 men, 16,531 women and 11,731 men fell into the low-risk group. For each type of cancer, researchers calculated a population-attributable risk, which is the percentage of people who develop cancer who might have avoided it had they adopted low-risk behaviors.
About 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors. About 29 percent of women and 20 percent of men might have prevented colon and rectal cancer. About 30 percent of both might have prevented pancreatic cancer. Breast cancer was much less preventable: 4 percent.
Over all, though, about 25 percent of cancer in women and 33 percent in men was potentially preventable. Close to half of all cancer deaths might be prevented as well.
No study is perfect, and this is no exception. These cohorts are overwhelmingly white and consist of health professionals, who are not necessarily like the population at large. But the checks against the national data showed that if anything, these results might be underestimating how much cancer is preventable by healthy behaviors.
This also isn’t a randomized controlled trial, and we can certainly argue that it doesn’t prove causation.
A bigger concern to me is that people might interpret these findings as assigning fault to people who get cancer. You don’t want to get into situations where you feel as if people don’t deserve help because they didn’t try hard enough to stay healthy. Much of cancer is still out of people’s control.
I was especially worried because, in this study, “low risk” status required all four healthy lifestyles. Failing in any one domain put you in the high-risk category, and that seemed like a lot to ask of people.
On further reading, though, I discovered that the requirements weren’t overly burdensome. Not smoking was defined as never having smoked or having quit at least five years ago. That’s clearly good for health. Moderate alcohol consumption was defined as no more than one drink a day on average for women, and no more than two for men. That’s pretty much what I have argued for in writing about this issue in the past; it in no way requires abstinence.
Adequate weight was defined as a B.M.I. of at least 18.5 and no more than 27.5. The cutoff for “overweight” is 25, meaning that you don’t have to be thin; you just have to be less than obese (B.M.I. 30). Finally, exercise was defined as 150 minutes a week of moderate-intensity activity or 75 minutes of vigorous-intensity activity. That’s a reasonable and quite achievable goal.
I was surprised to realize that I’m already “low risk.” I bet many people reading this are “low risk,” too.
As we talk about cancer “moonshots” that will most likely cost billions of dollars and might not achieve results, it’s worth considering that — as in many cases — prevention is not only the cheapest course, but also the most effective.
Simple changes to people’s behaviors have the potential to make sure many cancers never occur. They have a side benefit of preventing health problems in many other areas, too. Investment in these efforts may not be as exciting, but it may yield greater results.
Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine.
The Upshot provides news, analysis and graphics about politics, policy and everyday life. Follow us on Facebook and Twitter.
A version of this article appears in print on July 7, 2016, on page A3 of the New York edition
with the headline: Small Lifestyle Changes Can Sharply Cut Cancer Risk. Aaron E. Carroll THE NEW HEALTH CARE JULY 5, 2016
This year, pick one of these worthy resolutions, and stick with it. Here’s to your health!
New Year, healthier you
New Year’s resolutions are a bit like babies: They’re fun to make but extremely difficult to maintain.
Each January, roughly one in three Americans resolve to better themselves in some way. A much smaller percentage of people actually make good on those resolutions. While about 75% of people stick to their goals for at least a week, less than half (46%) are still on target six months later, a 2002 study found.
It’s hard to keep up the enthusiasm months after you’ve swept up the confetti, but it’s not impossible. This year, pick one of the following worthy resolutions, and stick with it. Here’s to your health!
Lose weight
The fact that this is perennially among the most popular resolutions suggests just how difficult it is to commit to. But you can succeed if you don’t expect overnight success. “You want results yesterday, and desperation mode kicks in,” says Pam Peeke, MD, author of Body for Life for Women. “Beware of the valley of quickie cures.”
Also, plan for bumps in the road. Use a food journal to keep track of what you eat and have a support system in place. “Around week four to six…people become excuse mills,” Dr. Peeke says. “That’s why it’s important to have someone there on a regular basis to get you through those rough times.”
Stay in touch
Feel like old friends (or family) have fallen by the wayside? It’s good for your health to reconnect with them. Research suggests people with strong social ties live longer than those who don’t.
In fact, a lack of social bonds can damage your health as much as alcohol abuse and smoking, and even more than obesity and lack of exercise, a 2010 study in the journal PLoS Medicine suggests.
In a technology-fixated era, it’s never been easier to stay in touch—or rejuvenate your relationship—with friends and family, so fire up Facebook and follow up with in-person visits.
Quit smoking
Fear that you’ve failed too many times to try again? Talk to any ex-smoker, and you’ll see that multiple attempts are often the path to success.
Try different methods to find out what works. And think of the cash you’ll save! (We know you know the ginormous health benefit.)
“It’s one of the harder habits to quit,” says Merle Myerson, MD, director of the Cardiovascular Disease Prevention Program at St. Luke’s and Roosevelt Hospitals, in New York City. “But I always tell people to think of how much money they will save.”
Save money
Save money by making healthy lifestyle changes. Walk or ride your bike to work, or explore carpooling. (That means more money in your pocket and less air pollution.)
Cut back on gym membership costs by exercising at home. Many fitness programs on videogame systems like Nintendo’s Wii Wii Fit Plus and Microsoft’s Xbox Kinect Your Shape Fitness Evolved can get you sweating.
Take stock of what you have in the fridge and make a grocery list. Aimless supermarket shopping can lead to poor choices for your diet and wallet.
Cut your stress
A little pressure now and again won’t kill us; in fact, short bouts of stress give us an energy boost. But if stress is chronic, it can increase your risk of—or worsen—insomnia, depression, obesity, heart disease, and more.
Long work hours, little sleep, no exercise, poor diet, and not spending time with family and friends can contribute to stress, says Roberta Lee, MD, an integrative medicine specialist at Beth Israel Medical Center, in New York City, and the author of The Super Stress Solution.
“Stress is an inevitable part of life,” she says. “Relaxation, sleep, socializing, and taking vacations are all things we tell ourselves we deserve but don’t allow ourselves to have.”
Volunteer
We tend to think our own bliss relies on bettering ourselves, but our happiness also increases when we help others, says Peter Kanaris, PhD, coordinator of public education for the New York State Psychological Association.
And guess what? Happiness is good for your health. A 2010 study found that people with positive emotions were about 20% less likely than their gloomier peers to have a heart attack or develop heart disease. Other research suggests that positive emotions can make people more resilient and resourceful.
“Someone who makes this sort of resolution is likely to obtain a tremendous personal benefit in the happiness department,” Kanaris says.
Go back to school
No matter how old you are, heading back to the classroom can help revamp your career, introduce you to new friends, and even boost your brainpower.
A 2007 study found that middle-age adults who had gone back to school (including night school) sometime in the previous quarter century had stronger memories and verbal skills than those who did not. What’s more, several studies have linked higher educational attainment to a decreased risk of Alzheimer’s disease.
“You are gaining a sense of accomplishment by gaining new knowledge, and you are out there meeting people and creating possibilities that were never there before,” Kanaris says.
Cut back on alcohol
While much has been written about the health benefits of a small amount of alcohol, too much tippling is still the bigger problem. (In fact, binge drinking seems to be on the rise.)
Drinking alcohol in excess affects the brain’s neurotransmitters and can increase the risk of depression, memory loss, or even seizures.
Chronic heavy drinking boosts your risk of liver and heart disease, hypertension, stroke, and mental deterioration, and even cancers of the mouth, throat, liver, and breast.
Get more sleep
You probably already know that a good night’s rest can do wonders for your mood—and appearance. But sleep is more beneficial to your health than you might realize.
A lack of sleep has been linked to a greater risk of obesity and type 2 diabetes. And sleep is crucial for strengthening memories (a process called consolidation).
So take a nap—and don’t feel guilty about it.
Travel
The joys and rewards of vacations can last long after the suitcase is put away. “We can often get stuck in a rut, and we can’t get out of our own way,” Kanaris says. “Everything becomes familiar and too routine.”
But traveling allows us to tap into life as an adventure, and we can make changes in our lives without having to do anything too bold or dramatic.
“It makes you feel rejuvenated and replenished,” he adds. “It gets you out of your typical scenery, and the effects are revitalizing. It’s another form of new discovery and learning, and great for the body and the soul.”
(Reuters) – Children exposed to tobacco smoke at home are up to three times more likely to have attention deficit hyperactive disorder (ADHD) as unexposed kids, according to a new study from Spain.
The association was stronger for kids with one or more hours of secondhand smoke exposure every day, the authors found. And the results held when researchers accounted for parents’ mental health and other factors.
“We showed a significant and substantial dose–response association between (secondhand smoke) exposure in the home and a higher frequency of global mental problems,” the authors write in Tobacco Control.
According to the Centers for Disease Control and Prevention, two of every five children in the US are exposed to secondhand smoke regularly.
Alicia Padron of the University of Miami Miller School of Medicine in Florida and colleagues in Spain analyzed data from the 2011 to 2012 Spanish National Health Interview Survey, in which parents of 2,357 children ages four to 12 reported the amount of time their children were exposed to secondhand smoke every day.
The parents also filled out questionnaires designed to evaluate their children’s mental health. According to the results, about eight percent of the kids had a probable mental disorder.
About seven percent of the kids were exposed to secondhand smoke for less than one hour per day, and 4.5 percent were exposed for an hour or more each day.
After taking the parent’s mental health, family structure and socioeconomic status into consideration, children who were exposed to secondhand smoke for less than one hour per day were 50 percent more likely to have some mental disorder compared to kids not exposed at all.
And children who were habitually exposed to secondhand smoke for an hour or more each day were close to three times more likely to have a mental disorder.
In addition, kids exposed less than one hour per day were twice as likely to have ADHD as kids who weren’t exposed, and children exposed for an hour or more on a daily basis were over three times more likely to have ADHD.
“The association between secondhand smoke and global mental problems was mostly due to the impact of secondhand smoke on the attention-deficit and hyperactivity disorder,” the authors write.
The study looks at a single point in time and cannot prove that secondhand smoke exposure causes mental health problems, the study team cautions.
Frank Bandiera, a researcher with the University of Texas Health Science Center in Houston who was not involved in the study, liked that the researchers “controlled for parents’ mental health in the new study because that could be a confounder.”
But, he added, the study might be limited because, although the questionnaires are thought to be valid, the mental disorders were not actually diagnosed by physicians.
“We’re not sure if it’s causal or not,” Bandiera told Reuters Health. “I think (the research) is still in the early stages and the findings are inconclusive.”
But, he said, since secondhand hand smoke has been related to a lot of physical diseases, parents should avoid smoking around their kids.
“We need to sort it out more, so we’re not sure yet, but just as a precaution, I don’t think parents should smoke at home – they should keep their kids away from secondhand smoke,” Bandiera said.
Lucy Popova, from the Center for Tobacco Control Research and Education at the University of California, San Francisco, said there is a lot of evidence about the harms of secondhand smoke on physical wellbeing.
“But research on effects of secondhand smoke on mental health have been really just emerging and this study really contributes to this growing body of evidence that exposure to secondhand smoke in children might be responsible for cognitive and behavioral problems,” she said.
Popova, who wasn’t involved in the study, said no amount of secondhand smoke is safe – any exposure is bad.
“So parents should not expose their children – the best thing to do is quit,” she said. “And this will not only not expose their children to the secondhand smoke, but will also let them enjoy their life with their children longer.”
Our Better Health 