1. Preventing Cancer . Nutritionally Speaking

2. Cancer Statistics
1.2 million new cases of cancer will be diagnosed in 2002
600,000 deaths each year are due to cancer
Diet is second only to smoking as the most important risk factor that can be controlled
One-third of all cancer deaths could be prevented if everyone followed a healthy diet
More than 1.2 million new cases of cancer were diagnosed in America in 2002, and about 600,000 deaths each year are due to cancer. Diet is second only to smoking as the more important cancer risk factor you can control. In fact, if everyone would follow a healthy diet, as many as one-third of all cancer deaths could be prevented. Of course, not every case of cancer can be controlled through diet, but healthier diets can have a dramatic impact on the occurrence of cancer and death rates from cancer throughout the world. We have the potential in our daily food and lifestyle choices to make a major impact on the cancer risk we face every day.
Cancer is not a single disease but a generic name used for more than 100 diseases. All of these diseases result in uncontrolled reproduction of abnormal cells. Cancer is a growing health problem not only for the United States but also for many other countries. Increases in life expectancy, along with growing urbanization, industrialization and changes in diets and lifestyles, are leading to substantial increases in cancer rates around the world.

3. Cancer and Nutrition Statistics
30% of all cancers are related to lifestyle choices
Eating 5 servings of fruits and vegetables could reduce cancer rates by 20 percent
It is estimated by eating healthfully:
Half of all breast cancers could be prevented
1 in every 3 cases of lung cancer could be prevented
3 in every 4 cases of colon and rectal cancers could be prevented
The food we eat each day plays a major role in cancer risk, the cancer process and cancer prevention. Research shows that 30% of all cancers are directly related to our lifestyle choices, including the food we eat, the exercise we get and the weight we maintain. For most Americans who are nonsmokers, dietary choices and physical activity are the most important controllable risk factors. Research has show that if the only lifestyle change we made was to eat five or more servings of fruits and vegetables each day, overall cancer rates could decline by as much as 20%. This one action could have amazing results.
For certain cancers, improvements in diet offer even better results. It is estimated that through healthier diets:
Half of all breast cancers could be avoided
One in every three cases of lung cancer could be prevented
Three in every four cases of colon and rectal cancers could be prevented

4. Fruits and Vegetables
Eating more fruits and vegetables reduces your risk for cancer
Eat dark green, yellow and orange fruits and vegetables, vegetables in the cabbage family, soy products and dried beans/peas
Lack of folate may increase your risk for colon cancer.
Folate can be found in legumes, fruits and vegetables
Fruits and vegetables are complex foods with more than 100 beneficial vitamins, minerals, fiber and other components. Many scientific studies show that eating more fruits and vegetables reduces the risk of cancer of the gastrointestinal and respiratory tracts, especially if you eat dark green and yellow and orange fruits and vegetables, vegetables in the cabbage family, soy products and legumes.
Recent evidence shows that a lack of the B-vitamin folate may increase the risk for colon cancer. Folate is found in legumes, vegetables and fruits, including green, leafy vegetables, asparagus, broccoli, cauliflower, cabbage, oranges, strawberries, melons and fortified grain products.

5. Antioxidants For Prevention
Are found in fruits and vegetables
Protect your body from chronic diseases (heart disease, cancer)
Include vitamins C and E, selenium, carotenoids and other phytochemicals
Lower cancer risk
Eat at least 5 servings of fruits and vegetables each day
Fruits and vegetables also have food components called antioxidants. There components appear to protect the body against damage to tissue that constantly occurs as part of normal body functioning. Consuming antioxidants can help prevent some of the damage of free radicals. Free radicals are substances produced in our bodies that attack healthy cells and damage them, causing them to be more susceptible to cancer, heart disease and other chronic conditions.
Antioxidants include vitamin C, vitamin E, selenium, carotenoids, and many other phytochemicals (chemicals from plants). Studies show that people who eat more vegetables and fruits, which are rich food sources of these antioxidants, have a lower risk for some types of cancer. To increase your consumption of antioxidants and reduce your cancer risk, eat at least five servings of fruits and vegetables on a daily basis.

6. Antioxidants – Food Sources
Vitamin E
Vegetable oils, nuts, spinach, apricots
Vitamin C
Citrus fruits, kiwi, cantaloupe, strawberries, green and red peppers, potatoes, broccoli, cauliflower
Flavonoids
Tea, soybeans, fruits, vegetables
Carotenoids
Tomatoes, carrots, broccoli, spinach, sweet potatoes
Try to consume each of the following:

7. What is Fiber? Found in plants, such as fruits, vegetables, grains
Two types – insoluble and soluble
Beneficial to digestive system by helping to regulate bowel movements
Good sources:
Beans, fruits, vegetables, whole grains, nuts, seeds
Fiber is a substance found only in plants, such as fruits, vegetables, and grains. The part of the plant fiber that is eaten is called dietary fiber and is an important part of a healthy diet. Dietary fiber is made up of two main types—insoluble and soluble. Both types of fiber are important in the diet and provide benefits to the digestive system by helping to maintain regularity. Good sources of fiber are beans, vegetables, fruits and whole grains; nut and seeds, in moderation.

8. Benefits of Fiber Diets high in fiber are generally low in fat
A high-fiber diet prevents cancers of the breast and colon by:
Increasing the movement of digested food through the intestine
Holding water and diluting toxins
Binding to harmful substances, preventing them from being absorbed
Lowering levels of circulating estrogen (a hormone)
Diets high in fiber also tend to be low in fat and high in other nutrients. A high-fiber diet is very effective in preventing cancers of the breast and colon by:
Increasing the movement of digested food through your intestine. This reduces the time your large intestine (colon) is exposed to cancer-promotion substances formed during digestion.
Holding water. This increases digestive bulk and dilutes potential toxins.
Binding to some harmful substances and preventing them from being absorbed by the body.
Lowering the levels of circulating hormones such as estrogen. This prevents breast cancer.

9. High-Fat Diets
Are high in calories and contribute to obesity and increased cancer risk
Increase rates of colon, rectal, prostate and endometrial cancers
Promotes cancer by causing irregular cells to form
Diets high in fat also are high in calories and contribute to obesity. This, then, leads to an increase cancer risk. Studies have shown that people who eat a high-fat diet have increased rates of colon, rectal, prostate, and endometrial (lining of the uterus) cancers. Dietary fats may promote cancer by causing irregular cells to form.

10. High-Fat Diets Saturated fats are the most harmful type
Some fats may cause the body to produce free radicals, contributing to aging and cancer
Omega-3 fatty acids found in fish actually may reduce cancer risk
Saturated fatty acids are through to be most harmful, some fats may product free radicals—toxic molecules that can damage cells, contributing to aging and certain diseases such as cancer. However, omega-3 fatty acids found in fish actually may reduce cancer risk.

11. Weight and Body Fat
More than 50 percent of American adults are overweight or obese
Excess weight and obesity increases cancer risk
Double to triple chances of endometrial cancer
Double chances of breast cancer after menopause
Increase risk of developing cancer of the colon, esophagus, gallbladder, pancreas and kidneys
Recent national data shows that obesity has reached alarming proportions in the United States, with more than 50% of American adults being overweight or obese. Being obese or overweight often is viewed as more of a social or cosmetic problem than a medical one. But its importance as a major contribution to chronic diseases cannot be underplayed.
In women, excess weight and obesity, weight gain and increased amounts of fat at the waist or around the body’s mid-section double to triple the chances of getting endometrial cancer. These factors also double the chances of getting breast cancer after menopause and increase the risk of developing cancer of the colon, esophagus, gallbladder, pancreas, and kidneys. Losing weight if you are overweight and balancing food intake with physical activity can help decrease your risk for these cancers.

12. Weight and Body Fat
Increased cancer risk due to excess weight may result from an increase in estrogen
More estrogen in overweight postmenopausal women
High levels of estrogen increase cancer risk
Obese women have a 55 percent greater risk of dying from cancer
Obese men have a 33 percent greater risk of getting cancer
The link to weight is thought to result from the increase in sex hormones, such as estrogen, that occurs in overweight postmenopausal women. There is more estrogen in overweight and obese women, and high levels of estrogen increase cancer risk, especially after menopause. Obese women have been found to have a 55% greater risk of dying from cancer than average-weight women. Obese men have a 33% greater risk of getting cancer.

13. Weight and Body Fat Insulin and obesity
Excess weight can lead to increased insulin levels
Increases risk of colon cancer
Overweight and obese people have greater difficulty converting blood sugar into energy
Body compensates by producing more insulin
Causes tissues to be exposed to higher levels of insulin for a longer period of time
Too much insulin can lead to cell changes that can lead to cancer
Being obese or overweight also can lead to an overproduction of the hormone insulin, which can increase your risk of cancer, particularly colon cancer. Obese and overweight people have greater difficulty using insulin to convert blood sugar into energy, and the body makes up for it by simply producing more and more insulin. This causes the body tissues in overweight and obese people to be exposed to higher than normal levels of insulin for an extended period of time. And too much insulin can lead to cell mutation that can lead to cancer. Colon cells have been shown to likely have higher amounts of insulin. This could explain the increased colon cancer risk in obese and overweight people.

14. Alcohol
Damages cells, depresses immune response or changes the actions of vitamins
Cancer risk increases with as few as two drinks a day
One serving: 12 ounces regular beer, five ounces wine, 1.5 ounces 80-proof liquor
Excessive alcohol consumption has been linked to cancers of the mouth, throat, voice box, esophagus, liver and breast
Alcohol plays a role in cancer by acting as a cell toxin, depressing the immune response or changing the actions of vitamins. Your cancer risk increases with the amount of alcohol you consume and increases with as few as two drink a day.
Heavy alcohol consumption has been linked to cancers of the mouth, pharynx (throat), larynx (voice box), esophagus, liver, and breast. This risk is multiplied for drinkers who also smoke.

15. Exercise
Unfit men are more than twice as likely to die from any cancer than fit men
Exercise is linked to a 50 percent lower risk of colon cancer
Exercise reduces the cancer risk linked to being overweight and obese
Studies show that unfit men are more than twice as likely to diet of any cancer as fit men are. Both vigorous and moderate levels of physical activity are linked to a 50% lower risk of getting colon cancer. Exercise protects against colon cancer by stimulating bowel movement and reducing the length of time that the bowel lining is exposed to harmful substances. Physical activity at all ages also is important to reduce the cancer risk linked to being overweight and obese by helping to lower weight and maintain a healthy weight.

16. Exercise
General health benefits can be gained by including a moderate amount of physical activity on most days of the week
Even more health benefits can be gained by increasing the amount of physical activity from moderate to vigorous
According to a U.S. Surgeon General report, “Significant health benefits can be obtained by including a moderate amount of physical activity on most, if not all, days of the week. Additional health benefits can be gained through greater amounts of physical activity. People who can maintain a regular regimen of activity that is on longer duration or more vigorous intensity are likely to derive greater benefit.”

17. Smoking Cigarette smoking causes 30% of U.S. cancer deaths each year
More than 85% of lung cancer deaths result from smoking
Each year, ~3,000 nonsmoking adults die from lung cancer as a result of secondhand smoke
Cigarette smoking is the most preventable cause of death in the United States. Smoking causes 30% of all U.S. cancer deaths each year and is the leading cause of lung cancer deaths—more than 85% of lung cancer deaths result from smoking. And secondhand smoke contains numerous toxins for which there is no safe level of exposure. Each year, about 3,000 nonsmoking adults diet from lung cancer as a result of breathing secondhand smoke.

18. Smoking
Cigarette smoking also causes cancers of the voice box, mouth, throat esophagus, bladder, pancreas, kidneys and cervix
Cigar smoking causes cancers of the voice box, oral cavity, esophagus and lungs
Cigarette smoking also causes cancers of the larynx (voice box), mouth, esophagus, pharynx (throat) and bladder. Also, it plays a role in cancers of the pancreas, kidneys, and cervix. Cigar smoking has been found to cause cancers of the larynx (voice box), oral cavity (lip, tongue, mouth and throat), esophagus and lung.

19. Benefits of Not Smoking
You will live longer than someone who continues to smoke.
Ten years after quitting, your risk of getting lung cancer is ~1/3 to ½ that of someone who continues to smoke.
You are less likely to get lung cancer if you quit before 50. If you quit at 30, this will lower your risk even more.
If you smoke, quitting is the single most important step you can take to reduce your cancer risk. The benefits of not smoking:

20. Ways to Reduce Cancer Risk
Now that you know which factors increase your risk of cancer, you need to know how to use that knowledge to positively reduce your risk of cancer. Choosing healthy foods, maintaining a healthy weight and staying physically active are important in protecting your body against cancer. The following recommendations explain the best methods nutrition experts currently know to prevent cancer. Remember that it is your OVERALL diet and lifestyle choices that affect your risk of developing cancer. The key to a healthy diet is variety and moderation.

21. Eat a variety of healthy foods with an emphasis on plant sources
Recommendation 1
Eat a variety of healthy foods with an emphasis on plant sources
Vitamins, minerals, fiber and phytochemicals in plant foods are linked to lowering your cancer risk
Instead of making meat products the focus of your meal, emphasize grains, salads and legumes
Choosing foods from plant sources is an important dietary change you can make to reduce your risk for many cancers. Eating more fruits, vegetables, and whole grains reduces the risk for cancers of the gastrointestinal and respiratory tracts. The vitamins, minerals, fiber, phytochemicals (chemicals from plants) and other beneficial substances in these foods are linked to lowering your cancer risk. Instead of making meat products the focus of your meal, emphasize grains, salads and legumes.

22. Eat 5 or more servings of a variety of fruits and vegetables each day
Recommendation 2
Eat 5 or more servings of a variety of fruits and vegetables each day
A serving is equal to:
½ cup for most fresh and cooked vegetables
1 cup of leafy vegetables
1 piece of medium-sized fresh fruit
6 ounces of 100-percent fruit juice
½ cup of canned fruit
Eat citrus fruits for vitamin C and deep yellow and dark green vegetables for vitamin A
Eat a variety of fruits and vegetables daily. Include vegetables and fruits at snacks and meals. A serving of fruits and vegetables is equal to:
Limit your intake of fried vegetables products, such as French fries. Choose 100% juice if you drink fruit of vegetable juices. Emphasize citrus fruits for vitamin C and deep yellow and dark green vegetables for vitamin A. Turnip greens provide folate; and brussel sprouts, broccoli and cabbage contain a variety of substances that may protect against cancer.
While five or more servings of these wonderful foods may sound like a lot, a generous helping of dinner salad or a large baked potato may well by more than just one serving.

23. Recommendation 2 cont’d.
You cannot get the nutritional equivalent of fruits and vegetables from a supplement
Supplements may be beneficial for some people but should not be used as a substitute for a healthy diet
Choose a balanced supplement containing no more than 100 percent of the “daily value” of most nutrients
Many of you may be wondering if you can get the nutritional equivalent of vegetables and fruits from a supplement. The answer is no! As we examine the many components of foods and the ways they prevent cancer, complex interactions are shown between vitamins, minerals, fiber and phytochemicals. A diet rich in fruits, vegetables and other plant foods is still the best way to help reduce your risk of cancer. Many healthy compounds that are found in vegetables and fruits are not included in supplements. Also, the small amount of powder in the supplement that is supposedly equal to vegetables and fruits often contains only a small fraction of levels in the whole foods. Food, therefore, is the best source of vitamins, minerals, phytochemicals and other potential cancer-reducing components.
Supplements, however, may be beneficial for some people, such as pregnant women, women of childbearing age and people with restricted dietary intakes. If a supplement is taken, the best choice is a balanced multivitamin/mineral supplement containing no more than 100% of the “daily value” of most nutrients.

24. Choose whole grains instead of refined grains and sugars
Recommendation 3
Choose whole grains instead of refined grains and sugars
Increase intake of whole grains
Whole grain bread and cereal, brown rice, whole wheat pasta
Avoid heavily processed carbohydrates and foods high in refined sugars
Pastries, sweetened cereals, soft drinks, sugar
The key to making fiber and complex carbohydrates part of a healthier diet is in choosing those that are not heavily processed and limiting your consumption of foods high in refined sugar, such as pastries, sweetened cereals, soft drinks and sugars. Processing can destroy nutrients, fiber and other food components that are important in fighting cancer. Also, the addition of nutrients to processed foods does not completely restore their original nutritional value—that is why brown rice or whole grain bread are more nutritious options than white bread or rice.

25. Recommendation 3 cont’d
Aim for 25 to 35 grams of fiber daily
Peas, dried beans and lentils contain up to four grams of fiber in half a cup
Starchy foods high in fiber contain other beneficial nutrients
Carotenoids in sweet potatoes
Folate in legumes
Vitamin E in whole grains
Vitamin C in potatoes and sweet potatoes
Aim for 20 to 35 grams of fiber daily. Fruits and vegetables, especially legumes such as peas, dried beans and lentils, contain up to four grams of fiber in half a cup. Starchy foods that are high in fiber also contain other nutrients that offer protection against cancer, including carotenoids in sweet potatoes, folate in legumes, vitamin E in whole grains and vitamin C in potatoes and sweet potatoes.

26. Recommendation 4
Limit the consumption of red meats, especially those high in fat and processed meats
Dietary fat
Limit to 25 to 30 percent of total calories
Saturated fat
Limit to less than 10 percent of total calories
Limit dietary fat to 25-30% of your total calories and saturated fats to less than 10% of your total calories by choosing foods low in fat:

27. Recommendation 4 cont’d.
Choose fish, poultry, beans
Select leaner cuts of meat
Eat smaller portions of meat
Replace high-fat snacks with fruits, vegetables, grain products
Bake, broil, poach meats
Select nonfat, low-fat dairy products
Reduce or avoid consumption of preserved meats (lunchmeats, ham, hot dogs)

28. Choose foods that help maintain a healthy weight.
Recommendation 5
Choose foods that help maintain a healthy weight.
Balance your food intake with physical activity
Lose weight if you are overweight or obese
“low-fat” or “fat-free” does not mean “low-calorie” or “calorie-free”
Substitute vegetables, fruits, other low-calorie foods for high-calorie foods
Follow the FGP recommendations.
When you dine out, choose foods low in fat, calories and sugar and avoid large portions.
Eat smaller portions of high-calorie foods. Be aware that “low-fat” or “fat-free” does not mean “low-calorie” or “calorie-free.”
Substitute vegetables, fruits and other low-calorie foods for calorie-dense foods such as French fries, cheeseburgers, pizza, ice cream, doughnuts and other sweets.

29. Adopt a physically active lifestyle
Recommendation 6
Adopt a physically active lifestyle
The American College of Sports Medicine:
30 minutes or more of moderate-intensity exercise on most days of the week
Moderate-intensity exercise includes:
Walking, jogging, swimming, gardening, yard work, housework, dancing
Gain greater benefit if you can maintain a longer and more intense exercise routine
The ACSM recommends engaging in 30 minutes or more of moderate-intensity exercise on most days of the week. (The American Cancer Society recommends five or more days of the week.) Moderate-intensity exercise includes activities such as walking, jogging, swimming, gardening, yard work, housework, and even dancing. You are likely to gain greater benefit if you can maintain a regular exercise routine that is longer or more intense.

30. Recommendation 6 cont’d.
Use the stairs instead of the elevator
Park your car farther from your work-site entrance
Exercise at lunch
Take a 10-minute exercise break at work
Walk to visit a co-worker instead of sending an
Go dancing
To be successful in using exercise to stay healthy, look for some formal physical activity you enjoy. You need to work toward your exercise goals in ways that suit you. If you cannot walk for long or just don’t like to walk, there are many other activities that can meet your needs and preferences. It also is important to note that any increase in physical activity is beneficial.
Here are some ways to incorporate more activity into your life:

31. Recommendation 6 cont’d.
Plan active vacations
Wear a pedometer and watch your daily steps increase
Join a sports or fitness program
Use a stationary bicycle or treadmill while watching television
Gradually increase the days per week and minutes per exercise session

32. Limit the intake of alcoholic drinks
Recommendation 7
Limit the intake of alcoholic drinks
Alcohol is not recommended for cancer prevention
Some evidence suggests that a modest alcohol intake may protect against heart disease
Limit consumption to:
Men: less than two drinks a day
Women: less than one drink a day
While alcohol is not recommended for cancer prevention, there is some evidence that a modest alcohol intake (particularly of red wine) may protect against heart disease. Limit consumption to less than 2 drinks a day for men and 1 for women.

33. The Power of Prevention
3 to 4 million cases of cancer could be prevented by:
Eating healthfully, Losing weight and, Exercising
Half a million people each year would not die from cancer if they maintained healthy lifestyles
Eating right, exercising and maintaining a healthy weight can cut cancer risk by 30 percent
The key message I hope you all take home with you today is that 3 to 4 million cases of cancer could be prevented worldwide by eating healthfully, losing weight and exercising. That would mean that half a million people each year in America alone would not face the tragedy of cancer. Remember these powerful statistics:
Eating right, exercising…

34. The Power of Prevention
Eating right and not smoking can reduce cancer risk by 50 to 75 percent
Eating 5 servings of fruits/vegetables each day can reduce cancer rates by 20 percent
Through healthy dietary choices:
33 to 50 percent of breast cancers could be prevented
33 percent of lung cancer and 75 percent of colon and rectal cancers could be avoided

35. Ways to Reduce Your Cancer Risk
Eat a variety of healthy foods, with an emphasis on plant sources
Eat five or more servings of a variety of fruits and vegetables each day
Choose whole grains instead of refined grains and sugars
Now that you know the science, keep the recommendations in mind with these simple action steps:

36. Ways to Reduce Your Cancer Risk
Limit consumption of red meats, especially those high in fat and processed
Choose foods that help maintain a healthy weight
Adopt and maintain a physically active lifestyle
Limit alcoholic drinks to less than two drinks a day for men and one for women

37. Questions?
The choices you make about diet, exercise and smoking can be powerful tools in the fight against cancer. Make cancer prevention your goal and the guidelines we discussed here today your strategy for a longer, healthier life.