Food for thought: Relationship between nutrition and cancer prevention

Our organs and our cells set course of our body functions. We mistreat them in anyway and we will pay for it if not in the short term then definitely the long term. We need to be kind to our cells and respect them because as we all know “we are what we eat”. Nutrition has long been suspected to play an important role in cancer etiology, both in the development and prevention of cancer. This article is specifically directed towards the role of nutrients in cancer prevention. The biologic properties of nutrients make them major candidates to help in cancer prevention. Indeed, early epidemiologic cancer studies seemed to confirm the relevance of diet with cancer. Diet is one of the major causes of premature death and disability in developed and underdeveloped countries and contributes to the burden of cancers. Current treatment options for cancer include surgery, radiotherapy, and chemotherapy, which impose a large financial burden not only on health care systems but also on patients themselves. Therefore, nutritional interventions could serve as a cost-effective and safe aid to standard medical treatments.

Numerous observational studies have been conducted over the past decades to explore the role of diet in cancer development and prevention. Many of them support an association between diet and cancer. These studies indicated, for example, an increase in the risk of breast cancer associated with fat intake, and a decrease in colorectal cancers associated with a high consumption of fruits, vegetables and dietary fiber. Researchers found that dietary antioxidants, including beta-carotene, can reduce the risk of several cancers. After a comprehensive review of the available evidence, the World Cancer Research Fund concluded in 1997 that “it is now established that cancer is principally caused by environmental factors, of which the most important are tobacco; diet and factors related to diet, including body mass and physical activity; and exposures in the workplace and elsewhere.”

Literature has repeatedly quoted the examples that reconfirm the association between nutrition and its role in cancer prevention.

1. Maintain a Balanced Diet:

Consume a well-balanced diet that includes a variety of foods from all food groups, such as fruits, vegetables, whole grains, lean proteins, and healthy fats. A diverse diet ensures we get a wide range of nutrients that can help support the immune system and overall health. Having too much sugary food and drink, or food high in calories (including fast food), can make it easier to gain weight and obesity is a cause of different types of cancer. Having a healthy diet helps you keep a healthy weight, or lose weight, which can reduce the risk of cancer.

2. Embrace Antioxidant-Rich Foods:

Include foods rich in antioxidants, such as berries, citrus fruits, leafy greens, and nuts. Antioxidants can help protect cells from damage caused by free radicals, potentially reducing the risk of cancer. Antioxidants are protective molecules naturally found in our bodies and in the foods we eat. Examples of some important antioxidants are Vitamin A, C, E, Lycopene, Polyphenols, including flavonoids, Selenium and Carotenoids, etc. Their role is to protect our bodies from the damage that free radicals can cause, which are molecules that lead to oxidative stress and potentially inflammation and cellular damage. The cellular damage can be the sowing seed for the beginning of the cancer. Eating a diet rich in fruits and vegetables will be rich in antioxidants and other phytonutrient, which could potentially decrease the risk of cancer.

3. Fiber for Digestive Health:

Opt for high-fiber foods like whole grains, legumes, and vegetables. Dietary fiber promotes digestive health and may lower the risk of colorectal cancer. A large body of the literature suggests that eating a variety of foods containing high fiber has a protective effect against colon cancer. Evidence also shows that a high fiber-containing diet may be protective against breast, ovary, endometrial, and gastrointestinal cancer.

4. Limit Red and Processed Meats:

Reduce intake of red (mutton, lamb and beef) and processed meat (deli meats, hot dogs). High consumption of these meats has been associated with an increased risk of certain cancers, particularly colorectal cancer. To mitigate this risk, it is advisable to replace red and processed meats in one's diet with healthier alternatives. Lean sources of protein like poultry, fish, legumes, and plant-based protein sources, such as lentils, chick pea, oats and legumes can be excellent choices. Additionally, increasing the consumption of fruits, vegetables, whole grains, and fiber-rich foods can further help reduce the risk of colorectal and other cancers.

5. Healthy Fats and Omega-3:

Choose sources of healthy fats, such as avocados, olive oil, and fatty fish like salmon. Omega-3 fatty acids, found in fish, flaxseeds, and walnuts, have anti-inflammatory properties that may help reduce the risk of cancer. Literature has repeatedly shown the advantage of Omega-3 in cancer prevention. Omega-3 fatty acids can enhance immune system function, improving the body's ability to recognize and destroy cancer cells. They also support the production of anti-inflammatory molecules, which can help modulate the immune response. Omega-3 fatty acids have been shown to play a role in DNA repair mechanisms. These healthy fatty acids work in synergy with other nutrients found in a healthy diet. For example, they can enhance the anti-cancer effects of certain antioxidants found in fruits and vegetables.

6. Adequate Vitamin D:

Vitamin D deficiency is currently afflicting South Asia and has developed into an endemic condition in this region. It is extremely concerning that Pakistan has the highest incidence of adult vitamin D deficiency in South Asia at 73%. When it comes to cancer prevention, many studies suggest that vitamin D may play a role in reducing the risk of breast, prostate, and colorectal cancers. We as a nation, need to ensure we have adequate vitamin D levels. Sunlight, fortified foods, and supplements can help maintain appropriate levels. Scientifically, Vitamin D inhibits the formation of new blood vessels that tumors need to grow, restricting their blood supply. Not only this, it has shown to help in DNA repair, reducing the chances of genetic mutations that can lead to cancer.

7. Calcium for Bone Health:

Low calcium levels have been associated with an increased risk of cancer development. Inadequate calcium intake can disturb several cellular mechanisms, potentially leading to uncontrolled cell division and the promotion of cancer growth. However, the relationship between calcium levels and cancer risk is complex and influenced by various factors, including dietary habits and individual susceptibility. While maintaining adequate calcium intake is important for overall health, it's just one piece of the puzzle in cancer prevention. Individuals shouldconsume enough calcium through dairy or fortified sources, not only to support bone health but as conscious effort to prevent cancer since low calcium intake may contribute to the development of gastric, pancreatic and ovarian cancer and to some extent endometrial and lung cancer.

9. Avoid Sugary Beverages:

Sugary beverages have been associated with an increased risk of cancer development. Consuming these drinks regularly can contribute to weight gain and obesity, which are established risk factors for various types of cancer, including breast, colon, and pancreatic cancer. Additionally, the high sugar content in these beverages can lead to elevated insulin levels and inflammation, both of which have been linked to cancer development and progression. Limiting the consumption of sugary beverages is advisable as part of a healthy lifestyle to reduce the risk of cancer and promote overall well-being.

11. Stay Hydrated:

Staying hydrated is essential for overall health and helps support various bodily functions. Dehydration can potentially play a role in cancer development by affecting various bodily processes. Inadequate hydration can impair the body's ability to flush out toxins. Chronic dehydration may lead to cellular stress and DNA damage, increasing the risk of mutations that can trigger cancerous growth. Moreover, dehydration can hinder the immune system's effectiveness in detecting and fighting abnormal cells. While dehydration alone is not a direct cause of cancer, staying well-hydrated is crucial for overall health and can help support the body's natural defenses against cancer and other diseases. 

12. Smoking Cessation and Tobacco Avoidance:

Tobacco use is a leading cause of preventable cancers. It stands as a daunting enemy in the realm of public health, and has emerged as a principal cause of preventable cancers. This devious habit, including smoking, chewing, and various forms of tobacco consumption, imposes profound damage on the human body. The carcinogenic chemicals contained in tobacco products imposes a relentless assault on vital organs, including the lungs, mouth, throat, and esophagus. Consequently, tobacco use not only elevates the risk of developing cancer but also worsens its severity and diminishes the prospects for survival. The WHO report claims that the high incidence of oral cancer in Pakistan is linked to the use of smokeless tobacco, which is a culturally acceptable habit. If we smoke or use tobacco products, we need to seek assistance to quit.

13. Regular Screenings and Check-ups: 

Lastly, undergo regular cancer screenings and check-ups, as recommended by the healthcare provider. Early detection and timely intervention are crucial for effective cancer prevention and treatment.

Being a scientific, factual, and health-related person, yet compassionate and caring person, I have a powerful realization that people take their days, months, and years too casually and carelessly. Most of us know right and wrong in our daily routines in terms of our actions, our eating habits, what we are taking in, and how much we take, but we tend to ignore things. What if we are told that we have one month to live and an extension of life after that relying on what we eat? Will that help us realize the enormous impact that our diet and nutrition have on our health and life?

Life is unique, precious, and unpredictable. When I was young, I hardly knew anyone with cancer, but with the years passing, I came across loved ones, close friends, relatives, and neighbors, suffering and dying from this disease. Paul Kalanithi has said in his book “When breath becomes Air”, “Death may be a onetime event, but living with a terminal illness is a process” and “Grand illnesses are supposed to be life-clarifying”. Seeing the suffering of people with cancer around us, should be able to awaken the realization that we need to make conscious efforts to keep ourselves away from the menace of cancer. Genetics, lifestyle, and environmental exposures are all factors that contribute to cancer risk. By adopting a healthy and balanced diet, we can significantly reduce our risk of developing cancer and support overall well-being.

Writer Shazia Asim is a professor of pharmacology in a private medical college in Lahore. She has written several articles in daily newspapers about different aspects of nutrition.

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