Monday, November 23, 2015

A Meaty Topic: Red Meat, Cancer Risk, and the Benefits of a Plant-Based Diet


By Yikyung Park, ScD

A recent report on red and processed meat and cancer risk, written by the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO), sent shockwaves worldwide. After reviewing existing evidence, the report concluded that processed meat consumption is a cause of cancer and red meat consumption is probably a cause of cancer, too. Although the adverse effect of meat on health has been known for quite a while, many people seemed to be surprised by the IARC report.

As a part of IARC’s Monographs Programme, 22 experts from 10 countries reviewed more than 800 different studies on cancer in humans and concluded that high consumption of red and processed meat is carcinogenic to human. Most convincing evidence came from studies on colorectal cancer. For every 100 grams per day of red meat consumption , colorectal cancer risk incased by 17 percent.  One hundred grams is equal to about 3.5 ounces of steak, or a piece of meat about the size of a deck of cards.  Every 50 grams per day of processed meat consumption (about 6 slices of bacon) also increased colorectal cancer risk by 18%.

Although these risks aren't large, they are still important.

Cutting back on red and processed meat offers those at increased risk of cancer (such as those with a family history of the disease or who have previously had cancer) a relatively simple option for helping to lower their risk.

More broadly, the meat/cancer link has huge public health implications simply because so many people eat meat, with consumption increasing worldwide. On average in the United States, people eat about 50–100 grams per day of red meat and some people eat more than 200 grams daily. According to the U.S. Department of Agriculture Commodity Consumption by Population data, in 2012, Americans consumed on average 163 grams of total meat daily, of which 92 grams was red meat and 54 grams was poultry. Red meat consumption was higher in men, younger people, and obese people.

Red meat refers to unprocessed animal meat such as beef, veal, pork, lamb, and goat. Processed meat refers to any meat (such as, beef, pork, chicken, turkey) that has been salted, cured, fermented, smoked, or processed to enhance flavor or improve preservation. Examples of processed meat are hot dogs, luncheon meat, ham, sausages, corned beef, beef jerky, and canned meat. When meat is cooked at high temperatures (e.g., grilling, barbecuing, and pan-frying), it produces heterocyclic amines (HAA) and polycyclic aromatic hydrocarbons (PHA), which are known to cause cancer in animals. Also, meat contains heme iron that increases formation of N-nitroso compounds (NOC), another cancer causing agents. Nitrate and nitrite that are added to processed meats during the processing also forms NOC.

Meat is a good source of protein and B vitamins, which are needed to maintain health, but also high in saturated fat and may contain potentially cancer-causing chemicals mentioned above. Numerous studies have showed that high consumption of red and processed meat was related to an increased risk of colorectal cancer, but also an increased risk of coronary heart disease, diabetes, and premature death.

Furthermore, people who eat high amounts of red and processed meat also tend to eat more high-fat foods, sweet desserts, and refined grains, but fewer fruits and vegetables. This kind of overall dietary pattern has also been linked to an increased risk of cancer as well as other chronic diseases. 

On the other hand, a Mediterranean type-diet that is high in fruit, vegetables, beans, and whole grains and low in consumption of red meat has many health benefits. 

This recent wave of media coverage on the risks of red and processed meat - while a bit overblown - did highlight the important role that a largely plant-based diet has in lowering cancer risk and improving overall health.  Cutting back on red and processed meat by choosing more poultry, fish, and legumes is one step you can take.  Choosing more fruits, vegetables and whole grains while cutting back on refined grains and unhealthy fats (like saturated and trans fats) are others.  

Making such changes isn't always easy but everyone can do it.  The key is to start small and build from there. Change just one thing at a time.  Try out "meatless Mondays."  Or add an extra vegetable to your dinners a few times a week.   When such changes become a habit, add on other healthy options.  

For additional healthy eating and lifestyle tips, see our series - 8IGHT WAYS to Prevent Cancer (website).



References

Bouvarda V et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncology, 2015. Available online 29 October 2015

Micha R et al. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271-83.

Sinha R et al. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med. 2009;169(6):562-71.

Sofi F et al. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337:a1344.

USDA Economic Research Service. http://www.ers.usda.gov/data-products/commodity-consumption-by-population-characteristics.aspx

Thursday, October 29, 2015

Practical Steps to Prevent Breast Cancer: Day 9 - If High Risk: Consider Risk-Reducing Medications


It's the final day in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days.
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If High Risk: Consider Risk-Reducing Medications
Although not commonly thought of as a “healthy behavior,” taking prescription risk-reducing medications – such as, tamoxifen, raloxifene, and possibly exemestane – can significantly lower the risk of breast cancer in women at high risk of the disease. They can also have important side effects, so they aren’t right for everyone.

“High risk” is specifically defined as a woman with a five-year risk of breast cancer of 1.67 percent or higher, typically calculated by the National Cancer Institute’s Breast Cancer Risk Assessment Tool. If you think you’re at high risk, either after estimating your risk or for some other reason, it’s important to talk to a doctor. Together, you can decide if risk-reducing medication or other steps to lower or manage your risk may be right for you.

Tips and Tricks – Tamoxifen and Raloxifine

Talk to a doctor about your risk and your options. Many women who feel they’re at high risk are likely not. And some who feel they aren’t, likely are. So it’s important to talk to a doctor or other qualified health professional about your risk of breast cancer. If you are at high risk, together you can talk about your options for managing that risk and decide which option is likely best for you.

Review the possible benefits and risks of risk-reducing medication. For many high-risk women, tamoxifen, raloxifene, and possibly exemestane are good choices for managing their risk. Though each does have potential side effects, these can be dramatically offset by their ability to cut the risk of breast cancer in half. Talk to a doctor about how these might balance out for you. A huge percentage of women in the United States who stand to benefit greatly from risk-reducing medications choose not to take them – and not always for accurate reasons (more).


Next Steps – Tamoxifen and Raloxifene

American Cancer Society
http://goo.gl/dyHRbS

National Cancer Institute
http://www.cancer.gov/bcrisktool

Your Disease Risk
http://yourdiseaserisk.wustl.edu

Wednesday, October 28, 2015

Practical Steps to Prevent Breast Cancer: Day 8 - Find Out Your Family History

It's day eight in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days.
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Day 8 - Find Out Your Family History



Women with a strong family history of breast cancer can take special steps to protect themselves, so it’s important for women to know their family history of breast and other cancers. You may be at high risk of breast cancer if you have a mother or sister who developed breast or ovarian cancer (especially at an early age) or if you have multiple family members (including males) who developed breast, ovarian and/or prostate cancer. A doctor or genetic counselor can help you understand your family history of the disease.  A doctor is also the best source of information on ways to lower or manage your breast cancer risk.


Tips and Tricks – Family History

Learn your family history. Most women will have a general idea of their family history of breast cancer, but it’s a good idea to spend a little time to get a more detailed idea of your cancer history, especially if it’s pretty clear that breast or other cancers run in your family.  A doctor or genetic counselor can help.

Keep things in perspective. Most women with a family history of breast cancer are not at high risk of the disease. In most instances, family history behaves on par with many other breast cancer risk factors. Of course, women with a very strong family history (multiple family members with cancer or inherited BRCA1 or BRCA2 mutations) have a very strong risk of breast cancer. But even these situations don’t guarantee a woman will develop the disease.


Next Steps – Family History

Looking for more in-depth information on family history? Here are some good sources:

US Surgeon General
http://goo.gl/VTT2yU

Centers for Disease Control and Prevention
http://goo.gl/c2iNuO


Tuesday, October 27, 2015

Practical Steps to Prevent Breast Cancer: Day 7 - Avoid Postmenopausal Hormones

It's day seven in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days.
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Day 7 - Avoid Postmenopausal Hormones


The issue still comes up in the news, and study results still get parsed and discussed, but in the end, the basic conclusion about postmenopausal hormones and breast cancer remains the same: While postmenopausal hormones can effectively treat moderate to severe symptoms of menopause, when it comes to breast cancer, it’s best to avoid them long term.

If women choose to take postmenopausal hormones to relieve menopausal symptoms (like night sweats, hot flashes, and vaginal dryness), it should be for the shortest period of time possible – not more than 1 – 3 years. And they shouldn’t be taken long term with the intent of lowering the risk of chronic diseases like heart disease or osteoporosis.

The best person to talk to about the risks and benefits of postmenopausal hormones is your doctor.


Tips and Tricks – Postmenopausal hormones

Try to deal with menopausal symptoms without postmenopausal hormones. Menopausal symptoms are no fun – to put it mildly. And finding relief from them is key. It’s best, though, to look past postmenopausal hormones and try to find relief in other ways. Physical activity, for example, can help with mood swings, troubled sleep, and forgetfulness. Identifying triggers (and then avoiding them) can help deal with hot flashes, as can some non-hormonal medications. Over-the-counter lubricants can help with vaginal dryness. At a certain point, symptoms may be so bad that it makes sense to consider postmenopausal hormones. Talk to your doctor about the best approach.

Next Steps – Postmenopausal hormones

Looking for more in-depth information on postmenopausal hormones? Here is a good source:

WomensHealth.gov
http://goo.gl/2YL5KE

Monday, October 26, 2015

Practical Steps to Prevent Breast Cancer: Day 6 - Avoid Birth Control Pills - Particularly After Age 35 or If You Smoke

It's day six in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days.
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Day 6 - Avoid Birth Control Pills - Particularly After Age 35 or If You Smoke


There’s no denying that birth control pills have been a fantastic innovation – empowering women by putting them in charge of their own reproductive planning. But, like any medication, no matter how great the benefits, there are some risks that go along with them. For standard birth control pills, the most notable side effects are an increased risk of breast cancer, as well as of stroke and heart attack, particularly if a woman smokes and is over age 35. The good news is that the increase in breast cancer risk is temporary; about 10 years after stopping, risk drops to near that of a woman who has never taken the pill.

Because most women who take birth control pills are young and healthy, the risks linked to their use are usually outweighed in most women’s minds by the benefits – which in addition to preventing unwanted pregnancy also include a lower risk of ovarian, uterine, and colon cancer.

For a small group of women, though, who may be at high risk of breast cancer or simply concerned about breast cancer, avoiding birth control pills is one option to lower risk. The best source of information about the risks and benefits of birth control pills is a health care provider.

Tips and Tricks – Birth Control Pills

Don’t worry too much. For most women, the risks of birth control pills are outweighed by their benefits. Talk to a health care provider to find out how birth control pills may impact your health.

Next Steps – Birth Control Pills

Looking for more in-depth information on birth control pills? Here are some good sources:

National Cancer Institute
http://goo.gl/elLld2

Susan G. Komen
http://goo.gl/EoSMvM
http://goo.gl/Tkh4TW

American Congress of Obstetricians and Gynecologists
http://www.acog.org/For_Patients

Planned Parenthood
http://www.plannedparenthood.org

Sunday, October 25, 2015

Practical Steps to Prevent Breast Cancer: Day 5 - Breastfeed, If Possible

It's day five in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days.
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Day 5 - Breastfeed, If Possible


Breastfeeding for a total of one year or more (combined for all children) lowers the risk of breast cancer. It also has great health benefits for the child. Unfortunately, as natural a thing as breastfeeding is, it doesn’t always naturally fit into today’s modern society. While things are certainly better than they were -- with more understanding workplaces and day care providers -- moms still often need to work hard to make it work.

Tips and Tricks – Breastfeeding

Start early and ask for help. Breastfeeding has the best chance of success when it’s started early, and this usually means beginning an hour or less after the baby is born. Many hospitals help mothers initiate breastfeeding, but it’s also best to let the delivery nurses know your desire to breastfeed your baby. If you have questions, ask. If you have problems, ask. Many hospitals offer great support for new moms who want to breastfeed – not only in the hours after birth, but the days, weeks, and months after as well.

Don’t be shy. Even though there are still a few vocal opponents to breastfeeding in public, put them at the back your mind, and charge forward and breastfeed when and where you need to. Job interviews and work meetings may not be the best venues to do so, but most other places are just fine.

Coordinate with your workplace and day care provider. Going back to work is just a fact of life for most new moms, and balancing work and breastfeeding can be a real challenge. A large percentage of new moms are interested in breastfeeding their children, and employers and day cares have taken note, offering much better resources than they used to. If you’re unsure about the resources available to you, ask. The human resources office is a good place to start.


Next Steps – Breastfeeding

Looking for more in-depth information on breastfeeding? Here are some good sources:

WomensHealth.gov
http://goo.gl/aVElAE

La Leche League
http://www.llli.org

United States Department of Labor
http://goo.gl/TRSEOD

National Conference of State Legislatures
http://goo.gl/y6zNMY

Saturday, October 24, 2015

Practical Steps to Prevent Breast Cancer: Day 4 - Don’t Smoke, and Avoid Other People’s Smoke, Too

It's day four in our nine day series highlighting key steps and practical tips that can help women lower their risk of breast cancer. Previous days  
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Day 4 - Don’t Smoke, and Avoid Other People’s Smoke, Too


This really goes without saying: Don’t smoke, and avoid other people’s smoke, too. 

Smokers and non-smokers alike know how bad smoking (and secondhand smoke) is to their health. On top of lowering quality of life and increasing the risk of heart disease, stroke, and at least 15 cancers – including breast cancer – it also causes smelly breath, bad teeth, and wrinkles. Now that’s motivation to stay smoke-free or quickly get smoke-free. 

Though electronic cigarettes can seem like safe alternatives to standard cigarettes, so much is unknown about their risks and benefits that it’s important to avoid them as well. For help quitting smoking, there are many FDA-approved nicotine-replacement options that have been shown to be safe and to double chances of success.


Tips and Tricks – Smoking

It’s hard to quit, so keep trying. If there’s one thing we all know about quitting smoking, it’s that it’s hard. It takes most people six or seven tries before they quit for good. So, if at first you don’t succeed, try try again. Don’t give up. Over a thousand Americans successfully quit smoking every day.

Talk to a health-care provider. Seeing a doctor or other health care professional may not be the first thing you think of when thinking about ways to quit smoking, but they can be fabulous sources of information and cessation aids that can help you kick the habit. Studies show that seeing a doctor for help quitting can double your chances of success.

Visit smokefree.gov. Whether you are just thinking about quitting, want help quitting, or are looking for information about quitting for a friend of family member, the federal website smokefree.gov is the place for you. They also host the innovative text message cessation program, smokefreetxt, and sites focused on specific groups: smokefreeVET. smokefreewomen, smokefreeteen, and the Spanish-language smokefreeespanol.

Call 1-800-QUIT-NOW. Similar to the federal smokefree.gov, 1-800-QUIT-NOW (1-800-784-8669) will connect you to cessation information and resources in your state.

Talk to your kids about smoking. If you have kids – or grandkids or nieces and nephews – it’s important to with talk them from a young age about the dangers of tobacco and the need to stay away from cigarettes and other tobacco products.

Next Steps – Smoking

Looking for more in-depth information on smoking? Here are some good sources:

Smokefree.gov
http://smokefree.gov

American Cancer Society
http://goo.gl/glMlZx

The Truth Campaign
http://thetruth.com