Author: Marco Capace

Individuals who practice high levels of physical activity have a lower risk of developing lung and colorectal cancer, as well as being more likely to survive if they do get sick, when compared to sedentary individuals. This study was conducted by a team of researchers at the Johns Hopkins School of Medicine in Baltimore, USA, and it was published in the journal “Cancer” in May 2019.

THE LARGEST STUDY CONDUCTED TODAY
The research involved a large sample of 49,143 cancer-free adults aged 40-70 and that underwent stress tests for an average of 7.7 years, from 1991 to 2009. This Henry Ford Exercise Texting cohort was treated at the Henry Ford Health System in Detroit in Michigan, USA, and it was composed of 46% female, 64% Caucasian, 29% Black, and 1% Hispanic, 46-61 years, on average.

Participants performed physical tests classified into two categories: 1) the Corticotropin Releasing Factor (CRF), which indicates cardiorespiratory fitness; 2) the MET, the unit of measurement of physical exertion equivalent to the consumption of O2 at rest. The collected data was analyzed against outcomes of lung and colorectal cancer from a register of the National Death Index regarding cancer and all-cause mortality.

The data revealed that individuals who practiced high levels of physical exercise at the beginning of the survey had a significantly lower risk of developing lung or colorectal cancer than sedentary patients: 77% less for lung cancer and 61% less for colorectal cancer, respectively. In addition, individuals, who exercised but developed lung cancer, had a 44% lower risk of dying from the disease. Those who developed colorectal cancer and exercised had an 89% lower risk of dying from the disease.

Nevertheless, further studies with larger samples are needed. In fact, researchers state that further research is essential to confirm the validity of the results and to determine whether exercise can influence cancer risk and mortality.

FONTI


Catherine Handy Marshall MD et Al. – Cardiorespiratory fitness and incident lung and colorectal cancer in men and women: Results from the Henry Ford Exercise Testing (FIT) cohort – Cancer (May 2019)

In recent years, studies have focused on the correlation between food and disease. Many scientific studies show that certain foods can have negative side effects in cancer patients, even increasing the risk of relapse in some cases. Nevertheless, cancer patients are often served these “bad” foods during hospital stays. Various investigations analyze how a proper diet instead can have a positive effect on recovery. A recent statistical survey from the Karolinska Institute in Solna, Sweden, highlighted how following a correct diet, immediately after undergoing an operation, can speed up recovery and reduce medical costs for patients. Furthermore, a study published in “Plos One” in June 2019 demonstrated that the combination between healthy eating and physical activity are the main contributors in reducing the risk of premature death in post-operative cancer patients.

GUIDELINES VS. REALITY
There are real codified dietary guidelines for doctors and patients that can be used to learn about how a proper diet can complement cancer therapies. In particular, the International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), released the “European Code Against Cancer.” This document included 12 ways to reduce the risk of cancer, as well as indications for a healthy diet: 1) consume whole grains, legumes, fruits, and vegetables; 2) avoid high-calorie foods (high in sugar and/or fat), preserved meats, red meats, salt-rich meats, and alcohol. Additionally, physical activity is recommended.

Another example of guidelines is the report by the World Cancer Research Fund (WCRF) taken from the SmartFood of the IEO-CCM Foundation (European Institute of Oncology and Monzino Cardiology Center), “Ten useful recommendations for prevention cancer through diet and lifestyle.” This report examines how a healthy diet, along with physical activity, can prevent, manage, and treat many diseases.

However, many hospitals have yet to take these indications into account. In reality, they offer a “bad” diet with inflammatory foods and pre-packaged menus that are equal for all patients, even cancer patients. For example, they offer to patients ham or cheese with mashed potato flakes -that can increase blood glucose- and products that are processed and not recommended by the guidelines mentioned above. Furthermore, given that cancer patients are often not given dietary indications when discharged, it is possible that this poor diet will be even worse at home and thus negatively affect their health condition. Not to mention, hospitals have many vending machines with products that are not recommended for cancer prevention, such as snacks and sugary drinks.

GOOD EXAMPLES IN ITALY
In Italy, there are hospitals that have been implementing new ideas. One of these is the EAT Projects (Teen Food Education) Sustainable Nutrition promoted by the San Donato Group Foundation. Here patients (cancer patients, major intestinal surgery patients, elderly, and subjects at risk of malnutrition) are followed by a nutritionist or dietitian or receive ad hoc dietary indications from the staff. Likewise, in the resignation letter there are personalized dietary indications, developed on the basis of diagnosis and course of disease.

On the other hand, the Sant’Orsola Polyclinic in Bologna launched the CRUNCH project (United Kitchen and Catering in Clinical Hospital Nutrition) where a team of chefs, dieticians, and nutritionists, in collaboration with the Clinical Dietetics department and other operative units, create the patients’ diet, combining nutrients, taste, and innovation. They keep in mind cancer patients (reducing animal products and increase vegetables and legumes) and patients suffering from dysphagia (swallowing problems whose foods have to be made soft but without losing flavor).

Another example is the “Chef in the Hospital” program at the Mantua Hospital. Here the menus and dishes are prepared by nutritionists and starred chefs that create healthy and tasty dishes. Additionally, they replace sugary drinks with water and other sugar-free drinks, and implement an information campaign for parents and employees about proper eating habits.

SOURCES:
1) Karavasiloglou N, Pestoni G, Wanner M, Faeh D, Rohrmann S. – Healthy lifestyle is inversely associated with mortality in cancer survivors: Results from the Third National Health and Nutrition Examination Survey (NHANES III) – PLoS One (Jun 2019)

2) Codice Europeo Contro il Cancro – International Agency for Research on Cancer (IARC) World Health Organization (WHO) (data ultimo accesso 01.08.2019)

3) Diet, Nutrition, Physical Activity and Cancer: a Global Perspective – World Cancer Research Fund WCRF (data ultimo accesso 01.08.2019)

4) Dieci utili raccomandazioni per la prevenzione oncologica attraverso dieta e stile di vita – IEO (data ultimo accesso 01.08.2019)

Experts have identified simple and at the same time effective nutritional plans to counter cardiovascular diseases, which can be implemented by the majority of people without having to face drastic changes to their habits.

SUPPORTING CLINCAL STUDIES

Over the past few decades, numerous scientific researches have been conducted to identify the most suitable dietary strategies in case of cardiovascular diseases. Initially, investigations where conducted on Rhesus monkeys, which have 93% of DNA in common with humans, and who fall ill with our same diseases (diabetes, tumors, cardio-vascular pathologies). Two studies have analyzed the impact of a 30% calorie restriction on diseases and longevity.

The two studies where carried out at two institutions: US National Institute of Aging (NIA) and University of Wisconsin. In the research conducted at the NIA, there were no substantial differences in causes of death (for cardiovascular disease, amyloidosis and tumors) and general deterioration of health amongst the group of monkeys undergoing calorie restriction and the control group who followed a “healthy” diet (with vegetable proteins and fish, plus 5% fats, 5% fibers and 3.9% sucrose, vitamins and minerals- eating only twice a day, with a pre-established quantity of food based on age and body weight). In the investigation conducted at the Wisconsin, however, the monkeys subjected to calorie restriction saw mortality rate halved compared to the control group that had continued a “normal” diet (with proteins derived from milk, 10% fats, 5% fibers and 28.5% sucrose- eating how much they wanted, to exemplify the typical Western diet).

Subsequently, numerous human clinical studies have been conducted. The first investigations analyzed the Mediterranean diet in association with the reduced incidences of various diseases, including cardiovascular ones. Some studies revealed that olive oil and nut consumption is associated with a lower incidence cardiovascular events (heart attack, stroke etc.).  Other researches have studied the intake of good fats derived from fruit and fish. Subsequent studies investigated calorie restriction in relation to the reduction of inflammatory states and markers associated to cardiovascular diseases.

THE POSITIVE EFFECTS OF THE FASTING MIMICKING DIET  

Clinical tests conducted on hundreds of patients have revealed, that cycles of Fasting Mimicking Diet lead to positive effects on the main risk factors and markers connected to cardiovascular pathologies, especially in the more predisposed subjects. Body fat is reduced, especially abdominal fat, without loss of muscle mass; blood pressure lowers to adequate levels (- 6 mmHg); fasting blood sugar also drops; triglycerides are reduced (- 25 mg/dl); “bad” cholesterol, LDL, lowers to normal levels (- 20 mg/dl); levels of C-reactive protein (associated with inflammation and cardiovascular diseases) are reduced, as are those of insulin-like growth factor 1 (IGF-1).

SUTABLE NUTRITION IN CASE OF CARDIOVASCULAR DISEASES

The following indications are the result of many clinical investigations in which researchers have conducted tests on hundreds of patients, to identify a tailor-made dietary strategy in preventing and treating cardiovascular diseases. The advice of experts for prevention is, to follow a pescatarian diet combined with the daily practice of physical activities. In addition, with the approval of your doctor, it is possible to undertake a Fasting Mimicking Diet, at a frequency determined by your state of health.

In case of overt cardiovascular problems, experts advise to implement the following nutritional strategy: eliminate the intake of meat(red and poultry) and substitute with fish (2-3 times a week); avoid dairy products; limit protein intake based on your weight (0.7-0.8 g per kilo per day); eat many vegetables and legumes; reduce pasta and white bread, preferring whole grains (less than 100g per day); about one fruit per day; reduce sugar intake to less than 10g per day; dress with raw olive oil (about 80g per day); eat nuts (about 30g per day) intake food within a 11-12 hour window; if the BMI (body mass index) is equal to or higher than 25, which therefore falls into the condition of overweight, eat twice a day, plus a snack; exercise every day.

One recommendation is to always consult your primary care doctor when considering any dietary strategy. Conventional therapies (medicine and surgery) can be supplemented by a tailor-made nutritional plan.

SOURCES 

1. Valter Longo, La dieta della longevità, Vallardi Editore 2016
2. Colman RJ et al.; Caloric restriction delays disease onset and mortality in rhesus monkeys; Science 2009 Jul.
3. Colman RJ; Caloric restriction reduces age-related and all-cause mortality in rhesus monkeys; Nature Communications; 2014 Apr.
4. Mattison JA; Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study; Nature 2012 Sep.
5. Sofi F et al.; Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic rewiev an meta-analysis; The American Journal of Clinical Nutrition 2010 Nov.
6. Sofi F et al.; Mediterranean diet and health status: an updated meta-analysis and proposal for literature-based adherence score; Public Health Nutrition 2014 Dec.
7. Estruch R et al.; Mediterranean diet for primary prevention of cardiovascular disease; The New England Journal of Medicine 2013 Apr.
8. Bendinelli B; Fruit, vegetables, and olive oli and risk of coronary heart disease in Italian women: the EPOCOR Study; The American Journal Clinical of Nutrition 2011 Feb.
9. Bao Y et al.; Association of nut consumption with total cause-specific mortality; The New England Journal of Medicine 2013 Nov.
10. Fontana L et al.; Long-term calorie restriction is highly effective in reducing the risk for atheriosclerosis in humans; PNAS 2004 Apr.

Brandhorst S et al.; A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan; Cell Metabolism 2015 Jul.

To counteract the effects of global warming and the emission of greenhouse gases, it is necessary move towards a plant-based diet: less red meat and more fruits and vegetables. This is the latest warning from the Intergovernmental panel on Climate Change (IPCC), part of the UN Scientific Committee, which released the report “Climate Change and Land” in August 2019.

EATING LESS RED MEAT IS GOOD FOR THE ENVIRONMENT AND OUR HEALTH
Experts suggest a vegetarian or vegan diet in order to save our planet, while having positive effects on our health, as well. The current food systems around the world are no longer sustainable, given that the intensive exploitation of arable land is responsible for 30% of total global emissions. In fact, the report mentions that 50% of total methane emissions, one of the most harmful greenhouse gases, is derived from pastures for cattle breeding and rice paddies. For this reason, it is advised to reduce the consumption of red meat.

To reduce greenhouse gas emissions, it would be enough to change our dietary habits toward healthy and sustainable diets, based on whole grains, legumes, fruit, vegetables, nuts, and seeds. In addition, adopting a plant-based diet would help close the gap between industrialized and poor low-income countries. In industrialized countries, 2.5 in 10 individuals are obese (2 billion worldwide); in low-income countries, 1 in 10 individuals suffer from malnutrition (over 820 million worldwide).

GLOBAL CHANGES CAN SAVE THE PLANET
The extensive exploitation of arable land (approximately 72% of total land surface) to meet food demands to an increasing world population leads to both increasing and decreasing temperatures. In fact, in the last century the exploitation of land has quadrupled the world population from 1.9 to 7.7 billion and contributed to erosion, soil impoverishment, and deforestation. These are risks we can no longer take, since they could potentially lead to desertification. It is therefore urgent to make changes in the processes of food production and food consumption, “free” millions of hectares of land, and reduce CO2 emissions by up to 6 billion tons every year.

It is vital that changes be made to the current food system (from the entire supply chain to food production and consumption) as it generates around 25-30% of all human greenhouse gas emissions. Additionally, greenhouse gas emissions are leading to heat waves that have caused a 1.2C rise in global temperatures compared to the levels recorded in the pre-industrial age. Experts state that exceeding 1.5C would create even more severe consequences. It is safe to say that managing the eating habits of the entire world population should be an important political goal, not only to save the planet but to have a healthier population overall.

SOURCES
The Intergovernmental Panel on Climate Change IPCC – Climate Change and Land – An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems