1. Nutritional Health For Your Wellbeing Diarmuid Duggan Senior Dietitian Bon Secours Hospital Cork

2. Introduction Defining health The Science The Guidelines The Tools (an introduction to CBT and mindful eating)

3. What does health and wellbeing mean to me?

4. The Science Second expert report 2007 200 scientists and other experts – global Nine teams from universities and research centres – thousands of leading research studies –17 different types of cancer World class panel 21 scientists – observed by UN and other international bodies Graded- convincing, probable, limited-suggestive, limited-no conclusion Recommendations- convincing or probable

5. Be as lean as possible without becoming underweight BMI 18.5 – 24.9 ( not suitable for certain populations) Waist: women 80cm, men 94cm

6. Be physically active for at least 30 minutes every day 3 x 10 minute bouts Include some resistance activities Make it inclusive and enjoyable

7. Avoid sugary drinks Limit consumption of energy dense foods Particularly processed foods high in added sugar, high in fat, low in fibre

8. Eat more of a variety of vegetables, fruits, wholegrains, and pulses Vitamins, minerals and phytochemicals Cell Protection Strengthen Immune system- Gut Speed up gut transit time NB. Do not eat mouldy cereals (grains) or pulses (legumes) -Aflatoxins

9. Limit Consumption of red meats and avoid processed meats Convincing – Bowel cancer Haem- damages colon lining More meat means less plant based foods Preserving meats: carcinogens are formed 500g(18oz) of cooked or 750g(27oz) of raw meat.

10. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day Convincing: mouth, pharynx, larynx, oesophagus, breast, and bowel (men) Probable: liver and bowel (women) May directly damage DNA Particularly harmful when combined with smoking

11. Limit consumption of salty foods and foods processed with salt 6g or 2.4g of sodium Probable: stomach cancer Processed foods high in salt, fat, and sugar

12. Don’t use supplements to protect against cancer Probable: high dose supplements can effect the risk of different cancers More research needs to be done

13. It is best to breastfeed exclusively for up to 6 months. Convincing: breast cancer Probable: protects the child from being overweight and obesity

14. After treatment Ca survivors should follow these recommendations Best available advice: ongoing research in this area Recommendations can also reduce the risk of chronic diseases like heart disease and diabetes

15. And always remember – do not smoke or chew tobacco Tobacco causes 90% of lung cancers Implicated in cancers of the mouth, pharynx, larynx, oesophagus, pancreas, cervix, kidney and bladder Particularly harmful when combined with alcohol

16. Using the WCRF guidelines. Any evidence? Study looking at WCRF guidelines and risk of death. 378,864 participants 9 European Countries Score 0-6 for men Score 0-7 for women 12.5 year follow up 5-6 for men, 6-7 for women Associated with 34% lower hazard of death Included cancer, heart disease and lung disease Same for all 9 countries Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study Am J Clin Nutr May 2013 vol. 97 no. 5 1107-1120

17. Is it all about the weight? ?Body composition/ Metabolic Health

19. Cognitive Behavioural Therapy

20. Unhelpful thinking styles

24. Mindful eating

25. Mindful Eating Calm relaxed environment. Am I Hungry? Body Mind Heart Scan See, smell, taste mindfully. Eat without guilt Eat with intention and attention Use hunger and satiety to guide when and how much Use principles of balance variety and moderation

26. Hunger

27. Useful information Websites www.cancer.ie (Irish Cancer Society)www.cancer.ie www.healthpromotion.ie (HSE health promotion)www.healthpromotion.ie www.wcrf-uk.org (World Cancer Research Fund)www.wcrf-uk.org www.dietandcancerreport.org (WCRF Evidence)www.dietandcancerreport.org www.indi.ie (Irish Nutrition and Dietetics Association)www.indi.ie