Lowering Your Risk of Cancer

by Nathan Zassman March 19, 2019

Published as a series in the Manitoba Post and Lifestyles55.

Cancer is the second leading cause of death in the United States and Canada. As additional countries adopt a more 'Western' lifestyle, estimates are that the number of new diagnoses of cancer will increase to 21 million, with up to 13 million deaths by 2030. Over 1.6 million people are diagnosed with cancer each year in the United States alone (4,600 daily or about three people every minute).

What we eat, weigh, and expose our body to can all influence our health, as can sleep, exercise, and stress. The typical Western diet often incorporates exposure to many risk factors including overconsumption of sugar as well as refined, processed, and preserved foods. We tend to eat fewer vegetables and fruits, consume too much omega 6 essential fatty acids (compared to omega 3), and have more nutrient deficiencies. Lifestyle factors also contribute -- heating foods to high temperatures, sleep disruptions, oral infections, increased stress, and a more sedentary way of life all take their toll. Research has also found there are foods associated with an increase in some aggressive cancers, and The Journal of the National Cancer Institute found that blood donors have a significantly decreased cancer risk, and a lower mortality following cancer diagnoses.

Modifiable Lifestyle Factors

While genetics play a role in all disease, the field of epigenetics, one of the most active areas of research in life sciences, is showing we can change our genetic tendencies through dietary and lifestyle changes. There's a saying in the field of nutrition: 'Genetics loads the gun, but it's our diet and lifestyle that pull the trigger'. Diet, exercise, sleep (quality and quantity), social interactions, and stress can all affect gene expression (positively or negatively). Healthy lifestyle choices can reduce or increase the risk of many diseases including cancer.

Combined with effective stress, sleep, and exercise strategies, the human body has an amazing ability to maintain good health when we supply it with the required macronutrients (carbohydrates, protein, and fat), and micronutrients (vitamins, minerals, essential fatty acids, antioxidants, phytochemicals, and amino acids).

I've identified a series of actionable steps shown to improve health and reduce the risk of cancer:

(1) Stop Smoking.

This link to cancer is well-known for a reason: about 30% of all cancer deaths are caused by the use of tobacco products. In the United States, about 443,000 die from tobacco-related illnesses each year -- more than AIDS, vehicle accidents, alcohol, suicides, illegal drugs, and homicides combined. Smoking is a key factor in oral cancers and cancer of the lungs, larynx, esophagus, stomach, cervix, kidney, bladder, and colon. I'm amazed that about 20% of Americans still smoke. Research confirms that only 1 to 4 cigarettes per day can lead to heart disease and cancer.

(2) Breathe Clean Air.

Exposure to particulates in the air can increase mortality and morbidity, especially in the elderly or those with existing lung and heart issues. While smokers expose themselves to a higher risk of lung cancer, air pollution affects everyone. According to the International Agency for Research on Cancer (IARC), indoor and outdoor air pollution increases the risk of lung cancer, and evidence suggests it may also increase the risk of other respiratory and heart diseases. A Canadian study found that portable HEPA filters can reduce fine particles inside homes by 60%, improving circulation and systemic inflammation. The study found that reducing air pollution provided health benefits even when levels of particulates were low. One 2013 Danish study showed just two days of breathing HEPA-filtered air resulted in a significant improvement in microvascular function and a reduction in inflammation.

(3) Avoid Junk Food.

Reduce your sugar consumption and avoid fried, refined, and processed foods -- just about everything found in a supermarket's inner aisles.

(4) Maintain a Healthy Weight.

Even a few extra pounds increases the risk. Overweight and obese people see a more rapid proliferation of cancer cells and worse outcomes from treatments. Over 70% of US adults are overweight, and close to 40% are obese. Obesity is linked with premature death, hypertension, heart disease, arthritis, depression, diabetes, and other diseases (including many types of cancer).

Being overweight is predicted to soon surpass smoking as the number one risk factor, increasing the risk of developing many types of cancer including liver, ovarian, uterine, prostate, oral, stomach, bowel, breast, gallbladder, kidney, and pancreas. In a recent study published in the journal Cancer Research it was shown that losing even 10 pounds resulted in lower markers of inflammation. Men who are overweight (especially in the abdominal area) are 50% more likely to die from prostate cancer than men with a normal weight, and obese men have a 150% higher risk of dying. Obesity is thought to be a direct cause of 20% of cancer deaths.

Fat located in the abdominal area (surrounding many vital organs) is especially dangerous. This belly fat releases hormones, fatty acids, and other chemicals that increase the risk of diabetes and contribute to inflammation. Even if you're not obese but have extra weight in the belly area, you can make a significant health improvement by implementing a weight loss program combined with exercise.

(5) Eat More Vegetables and Fruits.

You don't have to be a vegetarian or vegan, but try to focus on a plant-based diet and aim to eat at least 30 grams of fibre per day.

While all vegetables have health benefits, cruciferous vegetables like broccoli, Brussels sprouts, cabbage, cauliflower, rapini, kale, and bok choy all contain glucosinolates -- compounds with potent anti-cancer properties. Chop cruciferous vegetables and let them sit for five minutes, this allows the important anti-cancer phytochemicals to convert to more bioavailable forms.

(6) Reduce Inflammation.

Chronic inflammation is now considered to be a key cause of just about every health concern including arthritis pain, cardiovascular disease, dementia, and degenerative diseases like cancer. Our diet and lifestyle choices are critical to preventing chronic inflammation.

Inflammation isn't always a bad thing. When you’re injured or have an infection, the inflammatory process helps the body heal and protect itself. This is 'acute' inflammation, which can last mere moments or up to a few days, and it dissipates once healing is underway. But continuous 'chronic' inflammation is the primary cause of pain (including arthritis, back pain, and fibromyalgia) and can potentially lead to cardiovascular disease, cognitive impairment, and cancer.

Foods and Inflammation

While both omega-3 and omega-6 fatty acids are important to our health, the standard North American diet and our use of traditional vegetable oils result in an imbalance. Omega-6 fats have inflammatory properties, while omega-3 fats are anti-inflammatory. Specific foods including sugar, refined grains, fried foods, and most vegetable oils (canola, soybean, corn, grape seed, and peanut, among others) contribute to this imbalance, fueling inflammation. To help separate 'fat from fiction', I recommend the fabulous book The Big Fat Surprise. Nina Teicholz details how saturated fats including butter, lard, beef tallow, and coconut oil have many health benefits.

The ideal ratio ranges from 3-1 (three parts omega-6 to one part omega-3) to a 1-1 ratio, but packaged and processed foods with their high levels of sugar, refined grains, and the omega-6 fats used to fry foods can all trigger inflammation.

Sugar (and anything that is quickly converted to sugar including white flour and other refined grains) is called a 'high glycemic index food'. These foods spike blood sugar levels and drive inflammation to higher levels. When you consume sugar or simple carbohydrates the pancreas produces the hormone insulin to push the sugar into our cells where it can be used as a quick source of energy or stored for future needs. But if our cells are already saturated with sugar, it stays in the blood, inciting the pancreas to make more insulin, raising blood sugar levels even higher. More insulin is then produced as blood sugar spikes, with the excess glucose being stored as fat. This condition is called insulin resistance, syndrome X, or metabolic syndrome, and can lead to type 2 diabetes.

Blood sugar spikes and the metabolism of sugar also induces sugar molecules to attach to various proteins. This creates 'advanced glycation end products' (AGEs), which can result in injury to blood vessel walls, and chronic inflammation. Research has shown AGEs contribute to the development of diabetes, cardiovascular disease, renal failure, arthritis, neurodegenerative disorders, early cancer development, and a progression to more aggressive forms of cancer.

Dietary Recommendations

Eliminate highly-processed, refined, sugary, and fried foods which promote inflammation. Don’t eat any proteins that have been breaded and fried. Avoid potato chips, fast foods, donuts, cookies, cakes, candy, crackers, commercially-prepared salad dressings, breads, packaged meals, granola bars, and deli meats. Just about everything found in a supermarket’s inner aisles contains sugar and artificial preservatives that can adversely affect your health. Eliminate soda and any drinks with added sugar (including fruit juices which can contain as much sugar as sweetened soft drinks).

Focus on fresh vegetables, whole foods, and healthy fats which can lower inflammation and the risk of cancer. During the summer months, visit farmers markets and buy locally grown produce. Herbs, berries, and spices with strong anti-cancer and anti-inflammatory effects include curcumin, ginger, aronia berries, blueberries, and green tea.

(7) Use Healthier Cooking Methods.

Carcinogenic AGE compounds form when foods (particularly meat and fish) are heated to high temperatures. Temperatures above 212 °F (100 °C) increase production of these chemicals, including polycyclic aromatic hydrocarbons (PAHs), and heterocyclic amines like PhIP (HCAs) and acrylamide. These potent carcinogens may promote the growth of tumors and trigger colon, breast, and other cancers. I recommend either avoiding, or at least greatly reducing foods that have been grilled, barbecued, broiled, or prepared using high-temperature methods. Safer means of cooking include steaming, pressure cooking, slow cooking, and sous vide. Preferred by world-class chefs, sous vide cooks vacuum-sealed ingredients in a super-precise temperature-controlled water bath to enhance texture and flavour. Producing safe, healthy, consistent, and top quality results, sous vide can turn the least experienced cook into a gourmet chef.

(8) Know What to Cook and Why.

It's important to research which plant foods should be cooked and which are best consumed raw to maximize their nutritional value and anti-cancer properties. The most beneficial antioxidants in plants are found in blue, yellow, orange, purple, and red fruits and vegetables. These foods contain polyphenols including carotenoids like lycopene and beta-carotene. Anthocyanins are found in blueberries, blackberries, cherries, cranberries, and eggplant. I recommend the book Eating on the Wild Side by Jo Robinson which outlines how to shop for the most nutritious varieties of produce, as well as the best methods of preparation to ensure that nutrients are retained and available in their most absorbable form. I knew that lycopene (the red pigment in tomatoes) was best consumed cooked (as in a tomato sauce), but like most antioxidants (which are fat soluble), you can increase absorption by eating them with a healthy fat. This is why tomato sauce prepared with olive oil increases lycopene absorption. This important antioxidant is associated with lower rates of prostate, breast, lung, pancreas, colon, oral, and cervical cancer.

(9) Exercise.

The sedentary work environments most of us have do not promote optimum health. Try to establish and maintain a routine that incorporates more movement throughout the day. Walk more, and sit less. Exercise for at least twenty minutes every day and avoid sitting for extended periods when possible. If your job requires sitting for long periods of time, be sure to stand up and move around every 20-30 minutes.

Exercise helps protect us not only from cancer, but from just about every disease. It reduces the risk of heart attacks, strokes, diabetes, Alzheimer's disease, cognitive impairment, and depression. Regular exercise will reduce the risk of death more than any other single treatment, with none of the adverse effects of drugs. Erik Richter, professor of human physiology at the University of Copenhagen calls exercise a 'wonder drug', and says 'there's probably not a single organ in the body that's unaffected by it'.

In the 1990s, Grahame Hardie at the University of Dundee found exercise has the potential to reverse obesity and diabetes and help prevent cancer. Earlier studies have shown that physical activity was associated with a decreased risk of colon, breast, and endometrial cancer. More recent studies published in JAMA Internal Medicine have shown that physical activity lowers the risk of esophageal, liver, stomach, and kidney cancers. Regular exercise has also been shown to decrease the risk of myeloma (a blood cancer), as well as head, neck, rectal, bladder, and lung cancer in current and former smokers.

Researchers aren't yet sure of all the mechanisms that tie exercise to reduced cancer risk, but simply losing weight has been shown to lower the risk of postmenopausal breast cancer. Hormones are stored in fat cells, and it's been theorized that hormone imbalances triggered by being overweight are a factor in the development of many cancers. Circulating hormones, growth factors, and inflammatory substances are all reduced when there are fewer fat cells present.

Men with an accumulation of fat in the abdominal area have a significantly increased risk of prostate cancer. Additionally, a Michigan State University study found that a protein called FGF-2 released from body fat can cause cells to turn cancerous. Irisin, a protein released from muscles during exercise, facilitates the self-destruction of breast cancer cells while increasing the effectiveness of chemotherapy drugs.

Exercise can help prevent the recurrence of cancer, and for those who already have it, exercise has been proven to extend life, especially for patients with breast or colon cancer. Cancer patients who exercised during treatment showed improved mental and emotional health, less anxiety, a more positive outlook, and a better quality of life. Patients that were over 80 years old and exercised also reported less memory loss.

While aerobic activity (including brisk walking) is the most common form of exercise for cancer patients, studies have shown a greater benefit when aerobic exercise is combined with resistance exercises like lifting weights or using resistance bands. The greatest benefits were seen in those who walked three to five hours weekly, but even one hour per week resulted in improvements when compared to those who were inactive.

(10) Get More Sleep.

Getting seven to nine hours of quality sleep each night is critical for healing, as insufficient sleep can compromise immune function. Researchers have found a higher rate of breast and prostate cancer for those who work night shifts, which may be due to a disruption in the natural circadian rhythm and suppression of melatonin production.

(11) Supplement Your Diet.

According to Dr. Bruce Ames, professor of biochemistry at the University of California, we need about 40 essential vitamins, minerals, essential fatty acids, and amino acids each day, as nutrient deficiencies are the primary cause of the four major diseases of aging: cancer, heart disease, dementia, and immune system dysfunction. I recommend a quality multivitamin supplement, at least 5000 iu of vitamin D, 180 mcg of vitamin K2 (as MK7), and two to three grams of omega-3 (as EPA and DHA) daily, in combination with a healthy diet that ensures sufficient protein and plant phytonutrients.

As Michael Pollan so beautifully stated in his book In Defense of Food, 'Eat food. Not too much. Mostly plants'. He refers to eating 'real' food like fruits, vegetables, whole grains, fish, and meat. Pollan suggests avoiding highly-processed packaged foods of any kind, which he calls 'edible food-like substances'.

Specific herbs and supplements that have been shown to reduce the risk of many cancers include lignans from flax and sesame seeds, garlic, ginger, and curcumin, the antioxidant component found in turmeric. Sulforophane is a plant compound found in cruciferous vegetables including broccoli and has been shown to inhibit the spread of tumours. Also found in broccoli, DIM helps balance estrogen and prevent the progression of prostate cancer cells. In one study of almost 5,000 women, supplementation with DIM was linked to a 35% lower risk of developing breast cancer, and a 62% lower risk of dying from cancer.

(12) Boost Good Gut Flora.

(13) Maintain Oral Health.

(14) Eat Healthy Fats.

The role of health-promoting fats is now becoming better known. Saturated fat, which used to have an unhealthy reputation, has been exonerated through research. An eighteen country, five continent study of over 135,000 individuals aged 35-70 linked saturated fat intake to a 20% reduced risk of stroke. I've written many articles on the anti-inflammatory benefits of heart-healthy fats including omega-3 (marine sources are best), saturated (animal fats, coconut, palm kernel, butter, lard), and monounsaturated (avocado, macadamia nut, olive).

Unsaturated fats like vegetable oils that are high in linoleic (omega-6) fatty acids were once widely promoted. However, the recommendations for these pro-inflammatory fats (and increased grain consumption) were based on flawed studies in the 1950s that aimed to promote grain agriculture. And while we do need some omega-6 in the diet, excess consumption of these vegetable oils fuels inflammation in the body, contributing to a host of health problems, including asthma, neurological disorders, cardiovascular disease, and various cancers.

I highly recommend the book The Big Fat Surprise by Nina Teicholz for more on the history of fats and the financial interests involved in promoting unhealthy fats to support industry at the expense of public health.

Before the introduction of vegetable oils derived from grain and the increased consumption of grains, the ratio of omega-6 to omega-3 in the diet of our ancestors was estimated to be about 1-1. With the increase of omega-6 fatty acids in the contemporary diet, estimates are that the ratio today is about 20-1. It's important that we make dietary choices to lower inflammation by focusing on supplements and foods high in omega-3 and low in omega-6.

Cancers linked to inflammation include colorectal, liver, lung, and prostate. Both in-vitro (test-tube) and in-vivo (human studies) confirm that omega-3 provides anti-cancer benefits by altering the proliferation of tumour cells, and by accelerating cancer cell death.

Omega-3 has also been shown to have anti-angiogenic effects (inhibiting the factors that result in tumour growth). Research indicates that a diet high in omega-3 slows the growth and spread of breast cancer cells in mice.

Omega-3 is vital to the production of resolvins. Enzymatically generated from omega-3 fatty acids, these compounds belong to a class of metabolites called specialized pro-resolving mediators (SPMs). Actively working to reduce cancer-promoting inflammation, SPMs may be effective in helping the body eliminate tumour cells before they are detectable. A new process of extracting resolvins from fish oil has led to the development of more powerful anti-inflammatory supplements. It would take about 5 gallons of fish oil to equal the level of SPMs found in a daily dose of one of the most impressive anti-inflammatory supplements, SPM Active. SPMs can be effective in treating a wide variety of other inflammatory conditions including rheumatoid and osteoarthritis, irritable bowel syndrome, and Crohn's disease.

In addition, omega-3 fatty acids activate autophagy, where the body eliminates unnecessary proteins or dysfunctional components within cells, with powerful anti-inflammatory effects. The Nobel Prize in Physiology or Medicine was awarded to Yoshinori Ohsumi in 2016 for his research into the genes that control autophagy, a natural process that is also 'turned on' by fasting.

For cooking and food preparation, I recommend avoiding oils produced from seeds and grains high in omega-6 fatty acids including corn, rice bran, sunflower, soybean, safflower, hemp, peanut, canola, walnut, and grapeseed oil. Recent mouse studies indicate canola oil may be linked to memory impairment and weight gain. Use oils that are high in: (1) monounsaturated fats (macadamia nut, avocado, olive): (2) saturated / medium chain triglycerides (palm kernel, coconut, butter, lard): and (3) omega-3 (camelina, flax, chia, Ahiflower). Foods / Healthy Fats

I also recommend eating fatty fish, especially the SMASH fish (salmon, mackerel, anchovies, sardines, and herring). Eating about 100 grams of fish high in omega-3 at least twice a week is recommended, or choose a supplement that has at least 3 grams of combined EPA and DHA per day.

In addition to healthy fats, I want to stress the importance of regularly eating fruits, vegetables, seeds, nuts, and spices that have anti-cancer properties. Spinach is a good choice, as are vegetables from the cruciferous (broccoli, kale) and allium (garlic, onion) families. Flax contains lignans with anti-cancer properties that help strengthen the immune system (look for sprouted flax which is enzymatically active and higher in nutrition). Spices including turmeric, ginger, Ceylon cinnamon, coriander, and cloves, and fruits high in anthocyanins like blueberries, cranberries, blackberries, and prunes should also be a major part of an anti-cancer diet.

(15) Know the Risks of Drugs

While the risk of cancer is associated with body mass index, smoking, excess alcohol, and anabolic steroid use, some prescription pharmaceuticals have also been linked to cancer. ACE Inhibitors (drugs used to treat high blood pressure) may increase the risk of lung cancer. In women, short-acting calcium channel blockers prescribed to treat high blood pressure were shown to increase the risk of developing pancreatic cancer by 66%. Postmenopausal women that took this class of drug for over three years had double the risk of pancreatic cancer. Consult your health professional before starting or changing medications.

(16) Eat Fewer Eggs

In a study of 27,067 men who were cancer-free, those who ate 2.5 or more eggs per week saw an 81% higher risk of developing aggressive prostate cancer compared to those who ate fewer than 0.5 eggs. This was a prospective study with a number of limitations, but it does appear that the mechanism may be due to the high choline content of eggs. Another study found that men with the greatest choline intake had a 70% higher risk of lethal prostate cancer, compared to those with the lowest consumption. A Swedish study also found that men with the highest blood levels of choline had a 46% higher risk of prostate cancer.
It’s important to watch what eat.

Often, it takes a health scare to make us realize we need to be proactive and take responsibility for our health. It's important to take control of your health when you have the opportunity, it's always easier to do what we can to maintain and improve our health while healthy. Preventative measures and integrating healthy lifestyle choices can help reduce the risk of all diseases, including cancer. Regaining lost health can be incredibly challenging and isn't always possible.

Health Disclaimer. As with any serious illness, we strongly recommend that your discuss any and all changes to your treatments (including natural remedies) with your healthcare professional.