Cancer Prevention

Cancer Prevention in the General Population-Eating well and Staying active.

By Sharina Macapagal, MD

– Walk more and sit less
– Eat a diet rich in whole grains, vegetables, fruit, and beans.
-Limit consumption of fast foods and other processed foods high in fat, starches, or sugars.
– Limit consumption of sugar sweetened drinks’, and ‘limit alcohol consumption
– Focus on what to limit to reduce risk of cancer or of weight gain, overweight and obesity

Video: Cancer Prevention in the General Population-Eating well and Staying active

Transcript: Cancer Prevention in the General Population-Eating well and Staying active

  • Today, I will discuss the recommendations on cancer prevention. These recommendations will promote a diet likely to provide adequate energy and nutrients, and promote health through the life course. Each recommendation is intended to be one in a comprehensive package of behaviors that when taken together, promote a healthy pattern of diet and physical activity conducive to prevention of cancer.
  • This presentation does not provide medical advice. The information, including but not limited to text, graphics, images, and other material contained in this presentation are for informational purposes only. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.
  • The two recommendations that follow  ‘Walk more and sit less’ and ‘eat a diet rich in wholegrains, vegetables, fruit, and beans’ promote positive changes that can be made to reduce the risk of cancer.
  • The next four recommendations ‘Limit consumption of fast foods and other processed foods high in fat, starches, or sugars, ‘limit consumption of sugar sweetened drinks’, and ‘limit alcohol consumption’ focus on what to limit to reduce risk of cancer or of weight gain, overweight and obesity. 
  • A good guide is to keep your weight within a healthy range. For Asians, the normal BMI is 18.5 to 22.9. For non-Asians, its 18.5-24.9. Achieving and maintaining a healthy weight is one of the most important things that you can do. Too much body weight typically indicates a higher amount of body fat. Higher amounts of body fat can create a more cancer friendly environment. It can release chemicals that can make cancer cells grow more easily.
  • The recommended calorie intake for adult women ranges from 1,600 calories per day to 2,400 calories per day, according to the 2020-2025 Dietary Guidelines for Americans. For men, the amount is slightly higher, ranging from 2,200 to 3,200 calories per day. For teenagers and children, the recommended caloric intake is lower. If you are somewhat sedentary or older, your calorie needs are likely toward the bottom of the range. If you are fairly physically active, pregnant, or breastfeeding, you may be closer to the higher range.
  • Here is a more specific way to determine you recommended caloric intake by using a calorie calculator. You can download an app or visit the mayo clinic website. For me, I am a 29 year old female, 5 feet 4 inches tall, weighing 140 pounds with an active lifestyle. My daily caloric requirement is 2050 calories.
  • The food Pyramid was recently replaced by myplate. You can see the recommended proportion for fruits, grains, protein, gran, vegetables, and dairy.
  • This is a sample of food group targets for a 2000 calorie plan. In general, 1 cup of fruit or 100% fruit juice, or ½ cup of dried fruit can be considered as 1 cup from the Fruit Group. This slide shows specific amounts that count as 1 cup of fruit, vegetables, grains, protein, and dairy  towards your daily recommended intake.
  • Nutrients: The following foods can be considered your primary source of protein in a meal. For Fully plant-based diet. Soy products: Tofu, tempeh, and edamame are all high in protein and are present in a variety of dishes across various cultures. Eggs and egg whites: Chicken eggs are considered one of the world’s most versatile foods, and one of the best vegetarian protein sources. A single egg contains about 6.5 grams of protein, plus minerals like iron and folate, and a healthy dose of vitamins A, E, D, and B12.
  • It is important to include more movement in your daily routine. Be physically active as part of everyday life – walk more and sit less. It is recommended that you do at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week. Now, we are not rigid on 30 mins per day. You can do 10-20 minutes of sustained activity in most days of the week. Even simple exercises like walking, gardening, yoga, or housework can help you achieve your goals. Exercise helps you manage weight and reduces hormone levels that may promote cancer growth
  • Here is an infographic from MD Anderson Cancer Center to help you judge your exercise intensity. Moderate activity feels somewhat hard. Here are clues that your exercise intensity is at a moderate level. You can carry on a conversation, but you can’t sing. To perform the talk test, see if you can talk or sing while performing the activity. If you’re doing a moderate exercise you should be able to talk, but not sing. If you’re doing vigorous exercise, you shouldn’t be able to say more than a few words. Vigorous activity feels challenging. Here are clues that your exercise intensity is at a vigorous level: You can’t say more than a few words without pausing for breath. Your breathing is deep and rapid. You develop a sweat after only a few minutes of activity.
  • Another way to gauge your exercise intensity is to see how hard your heart is beating during physical activity. You can calculate your maximum heart rate by subtracting your age from 220. For example, if you’re 45 years old, subtract 45 from 220 to get a maximum heart rate of 175. This is the average maximum number of times your heart should beat per minute during exercise. Once you know your maximum heart rate, you can calculate your desired target heart rate zone — the level at which your heart is being exercised and conditioned but not overworked. The American Heart Association generally recommends a target heart rate of: Moderate exercise intensity: 50% to about 70% of your maximum heart rate Vigorous exercise intensity: 70% to about 85% of your maximum heart rate If you’re not fit or you’re just beginning an exercise program, aim for the lower end of your target heart rate zone. Then, gradually build up the intensity. If you’re healthy and want to exercise at a vigorous intensity, opt for the higher end of the zone
    • Moderate-intensity activities include: walking, cycling, household chores, gardening, swimming, dancing
    • Vigorous-intensity activities include: running, fast swimming, fast cycling, aerobics, team sports
  • Plant foods like whole grains, vegetables, fruits, and beans have many healthy ingredients that can help prevent cancer. They are rich in dietary fiber, vitamins, minerals, and phytonutrients. These foods are also naturally low in calories to help you maintain a healthy weight. It is helpful to eat a variety of colorful plant foods.
  • No single food can protect you against cancer by itself. But research shows that a diet filled with a variety of vegetables, fruits, whole grains, beans and other plant foods helps lower risk for many cancers.  Apples, asparagus, blueberries, brocolli, brussel sprouts, cauliflower, cherries, coffee, cranberries, flaxseed, grapefruit, grapes, kale, oranges, beans, lentils.
  • Limiting processed foods helps control calorie intake and maintain a healthy weight. These processed foods are typically high in calories but lack nutrition. Example of Processed foods that are high in fat, starches, or sugars include: Potato products such as chips (French fries) and crisps (chips), products made from white flour such as bread, pasta, pizza, cakes, pastries, biscuits (cookies), and confectionery (candy).
  • Red meats include beef, pork, and lamb. It is recommended you eat no more than 12 to 18 ounces per week for the prevention of colon cancer. Processed meats include ham, sausage, bacon, salami, and hot dogs. It is best to avoid these since even small amounts can increase cancer risk. Your single serving of meat should be about the size of a deck of cards…or the palm of your hand. For example, An average chicken breast is 6-8 ounces – so that should be 2 servings. 2 serving of meat a day is plenty for the average person.
  • Weighing and measuring is always best, but once you “learn” what a serving is, it gets easier to estimate. Here is a guide on the amount of serving using our hands: 
    • 1 teaspoon= tip of the finger
    • 1 tablespoon= tip of thumb
    • 1 ounce= 2 fingers
    • 3 ounce= palm size
    • 1 cup= fist size.
  • Sugar sweetened drinks are liquids with free sugars such as sucrose, high fructose corn syrup and fruit juices which can be found in soda, sports drinks, energy drinks, sweetened water, coffee or tea with sugar. You should drink mostly water and unsweetened drinks because Sugar sweetened drinks are not healthy and usually provide unneeded calories without added nutrition. Drinking too many unneeded calories from sugar-sweetened beverages can cause weight gain and impaired oral health such as dental caries especially in children. In this picture, you’ll see how much sugar is in a popular drink like redbull which has 27g of sugar.
  • For cancer prevention, it’s best not to drink alcohol. Alcohol in any form – beer, wine, or liquor – has been linked to different cancers of the mouth, pharynx, larynx, liver, colorectum, and breast. Those who choose to consume alcohol should limit these beverages to no more than 1 drink per day for a woman and 2 drinks per day for a man. Although there are uncertainties about the effects of alcohol on non-cancer outcomes at moderate levels of consumption, drinking alcohol is not recommended for any health benefit.
  • A dietary supplement is a product that contains a ‘dietary ingredient’ intended to achieve levels of consumptions of micronutrients. It is recommended that A healthy diet rich in colorful fruits, vegetables, grains, beans, and lean protein is the best way to get nutrition. Randomized controlled trials of high dose supplements have not been able to demonstrate protective effects of micronutrients on cancer risk. If you think that you are unable to meet your nutritional needs with diet alone, talk with your health care team before trying any new over-the-counter supplement. However, supplementation may be needed to achieve adequate intake of nutrients in people with nutrient deficiency, For people with dietary anemia, they may need iron or folic acid supplements. To promote bone health, they need calcium and vitamin D. For vegetarians, they may need iron or vitamin supplements. It is best to check with a doctor first before taking supplements.
  • Multiple vitamin overdose occurs when someone takes more than the normal or recommended amount of multivitamin supplements. This can be by accident or on purpose. Iron overdose may include vomiting, diarrhea (which may be bloody or dark), or weakness. People with severe overdoses may develop coma, low blood pressure, liver failure, lung injury, and death. Calcium overdose can impair the functioning of the kidneys, increase the pH of the blood, and can cause nausea and vomiting, confusion or changes in thinking or mentation, itching, and in extreme cases irregular heartbeat. Vitamin D overdose can contribute to high levels of calcium in the blood. Vitamin A overdose can cause nausea and vomiting, dizziness, and blurry vision.
  • The best way to get the nutrients you need is by consuming a well-rounded diet.  The following chart outlines both the recommended daily intake (RDI) and tolerable upper intake levels (UL) for fat-soluble and water-soluble vitamins. 
  • Keep in mind that in certain circumstances, your healthcare provider may recommend that you take more than the UL for certain nutrients to correct a deficiency. For example, vitamin D deficiencies are often treated with high-dose vitamin D injections or supplements that deliver over 50,000 IU of vitamin D, which is much more than the UL.
  • The recommended daily intake of B12 is 2.4 in the general population. Unfortunately, there are limited vitamin B12 sources as plant based foods do not naturally contain this vitamin. Animal products including meat, chicken, fish, eggs and dairy products are rich in this vitamin. Vegetarian vitamin B12 food sources include: 
    • Shellfish
    • Eggs
    • Whole milk
    • Swiss cheese
    • For vegans:
    • Nutritional yeast
    • Marmite or yeast spreads
    • Fortified soy or almond milk
    • Plant based meat
    • Fortified cereal
  • In addition, Not smoking and avoiding any other exposure to tobacco and excess sun are also important in reducing cancer risk. Following these recommendations is likely to reduce intakes of salt, saturated and trans fat, which together will help prevent other non-communicable diseases.
  • Thank you for listening to the lecture. I hope you can incorporate these recommendations on your lifestyle to reduce cancer risk.
  • For more information, you can visit these websites.