HOW TO PREVENT CANCERS

While lifestyle contributes substantially more to risk of cancer (and other chronic diseases) than genetics alone, the interplay between genetics and lifestyle is a subject of increasing interest. That's what makes a new study out of the UK, published in PLoS Medicine so exciting.

The researchers took 12 genetic mutations that had previously been found to be associated with obesity risk and examined how they combined to be associated with risk of weight gain. The presence of each additional mutation increased risk of weight gain -- the more mutations, the greater the risk. The mutations significantly increased the risk of obesity by 16%. The researchers then did something quite novel, using the data the participants reported about how physically active (or not) they were, the researchers re-examined the associations. In the inactive men and women, the association was stronger than in the inactive people. What this means is that the effect of genes were stronger in the people who were inactive - or - that physical activity "erased" some of the genetic predisposition - about 40% of it.

What does this mean for those of us who have no idea how "genetically predisposed" we might be to obesity? Physical activity has benefits for everyone, but for individuals who are genetically predisposed to obesity, physical activity is especially important. It also means that a genetic predisposition to obesity isn't cause for "doom and gloom" - there ARE things you can do to counter it - notably, being physically active!

On Friday, the federal government announced that effective immediately Medicare would cover the cost of smoking cessation counseling. Anyone covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare-recognized practitioner who can work with them to help them quit. (All people with Medicare will continue to have access to tobacco cessation prescription medication through the Medicare Prescription Drug Program.)

This is great news on several fronts:
- there is great evidence for the value of this kind of coverage so it is nice to see the goverment implementing evidence-based medicine
- other insurers typically follow what Medicare does
- it keeps tobacco in the news - an issue we've discussed before

1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            
1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            
1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            

Today I hopped over to Forbes.com to review their "most stressful cities" list (and was relieved that St Louis wasn't topping another "bad" place to live list -- I think topping the syphilis list is enough). While I was there, a link to a list of "10 foods you should be eating" caught my eye. I'm always wary of such lists, and this one provided a nice reminder of why:

The list starts out with three great foods - cherries, blueberries and kiwi. All three are great choices because they are fruit and eating a lot of fruits and vegetables have been shown to decrease risk of several diseases, including cancer. The problem, to me, is that most Americans don't come anywhere near to eating enough fruit, regardless of the type. Also, the three fruits are in season for a pretty short period of time, making their cost pretty high the rest of the year. Add to that, the fact that berries tend to top lists of fruits that absorb the most pesticides, so other lists are telling you to only buy organic and you've got a major cost issue on your hands. For most people, just starting to eat 2-3 servings of fruit a day, of ANY fruit, is going to be a big step.

The list then moves on to proteins -- grass-fed beef, wild salmon, flax seed and whey protein powder. While I certainly see the merit of choosing grass-fed beef over industrial beef for the reasons listed (omega-3 content being a big one, environmental impact being another), the context is missing here. Grass-fed beef is expensive and most Americans eat too much red meat of all kinds and certainly don't need beef appearing on a list of things they need more of. If you want to up your omega-3 intake, replace your meat intake with other sources of protein rich in omega-3, like fish and flax seed and aim to reduce your meat intake in general.

The list ends with dark chocolate. With overweight and obesity rates topping 60% in the US, I don't think anyone needs encouragement to eat more chocolate. Granted, the fine print suggests looking for chocolate with at least 60% cocoa content (ruling out most candy bars in the checkout aisle), but portion size and frequency of intake are big issues here and neither is mentioned.

Also overlooked in the discussion is that much of the data supporting the "superfood" concept don't come from studies of people eating those foods. The data come from studies of human cell lines or of extracts of a single component/nutrient that the food is high in. The problem with these studies is 1) that flesh and blood humans are very different from a collection of cells in a petri dish and 2) that the volume of intake needed to reach the dose given to the cells or extracted and given to humans is difficult to achieve through consumption of the food itself.

So, the cold reality is that there are no real "superfoods," just like there are no magic bullets.  It's simply a title dreamed up by magazine editors or folks who don't have a good understanding of the science linking diet and human health.

Of course, overall diet can have a large impact on chronic disease, and making simple, largely inexpensive, changes to what we eat can have big benefits.  Eating a diet rich in fruits, vegetables, whole grains, and healthy fats (like poly and monounsaturated fats); and low in red meat and unhealthy fats (like saturated and trans) will trump any collection of "superfoods" when it comes to health benefits, and it'll likely save you a lot of money along the way.

I wonder if by suggesting that people need to go spend $30 on organic blueberries and eat chocolate to be healthy we actually encourage the status quo as so few people have the ability to spend at this level and so few read the fine print of the message? What do you think? Do these lists help you make healthy choices or confirm that you are/aren't healthy already?

In previous posts, we’ve talked about implementing the weekday vegetarian plan or moving from your farm share box to a meal plan. For those who don’t have a big pile of recipes in the kitchen (or who are at work trying to figure out what to make for dinner that night), the internet is a GREAT resource for just this type of meal planning.

Last week I realized I had a bunch of eggplant from my farm share that I needed to use up. I was at the office, so on my lunch break (of course), I went to a few of my favorite websites for recipes using eggplant. On Smitten Kitchen, I found a recipe for an eggplant and barley salad. I looked through the ingredient list to see how it aligned with my recipe goals:

- Whole grains? Yes – the recipe base is barley, a tasty whole grain. I think you could also substitute brown rice if that’s what you have, but we always have barley in the freezer (which helps keep it from going rancid in the sweltering swampy summer heat of St. Louis).

- Vegetables? YES! In addition to eggplant, the recipe calls for zucchini and tomatoes. Both are in season and were looking fantastic at the Washington University School of Medicine Farmer’s Market last Thursday so I grabbed both.

- Color? Lots of it! Nothing makes a healthy dish less appetizing than a sea of drab brown colors. But Deb’s recipe is full of color – green (zucchini and lots of fresh herbs), red (tomato), purple (red onion, eggplant and olives)

And of course, the ultimate test was the taste – which was delicious. I scaled back the oil, salt and sugar by about half and skipped the cheese and thought the result was fantastic.

Knowing that I was going to make this on the weekend and that my husband would appreciate some meat after a week of delicious meatless meals, I headed over to another favorite website, One Hungry Mama, for some ideas. I’ve found that one of the keys to keeping my sanity when cooking family dinners is to focus on one dish and keep everything else simple. Since the barley salad had a good amount of chopping involved, I was looking for a main course dish that involved little to no effort. As usually happens, Stacie had the perfect option – slow cooker ribs. While ribs aren’t appearing on any “healthy living” list anytime soon, they are a fine “occasional” food, particularly if that is your only red meat for the week! I’d never thought to do ribs in the slow cooker before but the ability to drop them in and forget them was hugely appealing. And, as Stacie notes, the slow cooker is a great resource for hot summer days when you don't want to turn on the oven (see above). My family’s favorite barbeque sauce isn’t sold in stores around here (hint hint Dinosaur guys), but thankfully, they have a cookbook that includes the recipe for their Mutha sauce. I like to cook up a batch at the beginning of summer and freeze it in 2 cup portions. Since I still have a bit left, I decided to use that instead of Stacie’s Asian BBQ sauce recipe (that I’m hoping to try another day). I knew I’d want to throw the ribs on the grill at the end as Stacie suggests to get that nice crisp edge so I scaled back the sauce I put in the slow cooker to about one cup (the sugars in barbeque sauce will burn on the grill and you’ll get too much char). When the ribs were done in the slow cooker (perfectly cooked, falling off the bone), I slathered a tad more sauce on them (about ¼ cup) and put them on the grill for about 3 minutes. When I took them off, I slathered on another 1/3 cup of sauce and served the rest on the side.

Last, I took some gorgeous sweet corn I picked up at the farmer’s market and cooked that. It was a great summer meal – full of flavor, whole grains and vegetables.

The health making headline this morning is the latest data out of the CDC indicating that obesity rates are continuing to rise across the country – topping 30% of the population in nine US states. Yet, just a few months ago, weren’t we celebrating the headline that obesity rates had plateaued and stopped rising based on data from the CDC?

In a word, yes.

How is this possible? Does it mean the CDC doesn’t know what is going on? Not at all! The data are based on two different sources of information under the purview of the CDC – the Behavioral Risk Factor Surveillance System and the National Health and Nutrition Examination Survey. The two studies, unfortunately, do provide different estimates of the prevalence of health behaviors (including physical activity) and health outcomes in the US. In part this is due to different sampling strategies. Simply put, they are both trying to sample a group of people representative of the entire US, but each go about it in different ways.

But the headlines surrounding the NHANES data that came out earlier this year masked the important data that the BRFSS data highlights today – that 30% of the US is obese. Whether or not the trends are going up or leveling off, that is an alarmingly high figure. And remember, that doesn’t include the percentage of the population who are overweight – which correspond to another 30-35% of the population.

For tips on making some of the healthy choices than can help with weight management, check out our tips on healthy cooking, eating fruits and veggies, being sedentary, being active, the context of weight loss and perhaps most important – making time for those healthy choices.

This week, the Wall Street Journal reported on the launch of a new scoring system in grocery stores developed by the company, NuVal, which worked with a panel of (reputable) nutrition and health experts to create a scoring system that can be used to evaluate the nutritional value of products. While creating a perfect scoring system isn’t going to happen, NuVal does a pretty good job. Here are a few of the reasons why we think so:

1) “Healthy” is a pretty ambiguous word these days and some food items or nutrients may be more or less beneficial depending on your goal. For example, lycopene may reduce risk of prostate cancer, but for the 50% of us (i.e. women) without a prostate, that may not be a real priority when making food choices. Despite the limitations inherent in any scoring or valuation system, NuVal is pretty good at highlighting items that would fall under the “healthy” category for just about any “health” outcome. Unlike, say, the manufacturer produced labels trying to entice me to buy sugar-laden cereals because they threw in a scoop of whole grains. For example, even though Kashi brand cereals all contain whole grains, the Strawberry Fields cereal gets a score of 11 as compared to the 7 Whole Grain Flakes that gets a 29.
2) It provides a sense of magnitude of “healthiness” (I’m starting to feel a bit like I’m diving into Colbert’s “truthiness” here, but stick with me). I think most people would accurately guess that shredded wheat (unfrosted) is “better” than cocoa whatevers, but I think seeing the difference between shredded wheat and a cereal plenty of people I know think of as being “okay” (certainly not the healthiest cereal in the aisle but not a demon either) like Life (91 vs 25) might push folks to reconsider the Life and look for a cereal with a bit more fiber. My guess is that it will also help many parents look a little closer at the items marketed to kids. There are plenty of kids yogurt products in my local grocery store with as much added sugar as a candy bar. For someone rushing through the store with a tired, hungry (and thus, cranky) kid, the single number in front of the shelf might push a healthier choice when full label reading isn’t feasible.
3) That said, I’m still intrigued by the system and curious how iceberg lettuce gets the same score as canned spinach. I think other shoppers will be too and hopefully their curiosity will get them to read the labels (does that canned spinach have added salt perhaps?)

I’m sure the NuVal system will continue to evolve and alternates are surely on the way. I can easily see someone combining the UPC reader app on my iPhone with an eating guide app. What do you think? Anyone have NuVal in their local grocery? Is a system like this helpful or do the “huh?” moments make you wonder about the whole thing? Would you rather have a topic specific rating system? Perhaps that eating guide app would let you pick your goal – cancer prevention, weight management, cardiac rehab or general health?