Timothy J Key and colleagues describe the evidence linking diet and nutrition to cancer risk, concluding that obesity and alcohol are the most important factors

Scientists have suspected for decades that nutrition has an important influence on the risk of developing cancer. Epidemiological studies as early as the 1960s showed that cancer rates varied widely between populations and that cancer rates in migrants moving from low to high risk countries could rise to equal or sometimes exceed the rates in the host population.12 These observations implied the existence of important environmental causes of cancer, and other studies showed strong correlations between many types of cancer and dietary factors; for example, countries with high intakes of meat had high rates of colorectal cancer.3 Furthermore, experiments in animals showed that cancer rates could be altered by manipulating diet, with compelling evidence that restricting energy intake causes a general reduction in cancer development.45

Cancer is predicted to be the leading cause of death in every country of the world by the end of this century.6 Although dietary factors are thought to be important in determining the risk of developing cancer, establishing the exact effects of diet on cancer risk has proved challenging. Here we describe the relatively few dietary factors that clearly influence risk of cancers along the digestive tract (from top to bottom) and of other common types of cancer,78 as well as challenges for future research.

Nasopharyngeal cancer is common in a few populations around the globe, such as the Cantonese population in southern China and some indigenous populations of South East Asia, the Arctic, north Africa, and the Middle East.9 Consumption of foods preserved with salt has been linked with this cancer, and the mechanism might be through nitrosamine formation or reactivation of the Epstein-Barr virus.10 Based on case-control studies, Chinese style salted fish has been classified as a carcinogen by the International Agency for Research on Cancer (IARC), part of the World Health Organization.10

For oral and pharyngeal cancers overall, eating more fruits, vegetables, and related micronutrients such as vitamin C and folate is associated with lower cancer risk (boxes 1 and 2). These associations, however, might be influenced by residual confounding by smoking (a major non-dietary risk factor714) and alcohol consumption, so the evidence is only suggestive of a protective effect.814

Early case-control studies indicated that higher intakes of fruit and vegetables were associated with a lower risk of several types of cancer.11 But subsequent prospective studies, which are not affected by recall or selection bias, produced much weaker findings. In the 2018 World Cancer Research Fund report neither fruits nor vegetables were considered to be convincingly or probably associated with the risk of any cancer.8 There was suggestive evidence for protection of some cancers, and risk might increase at very low intakes. Specific components of certain fruits and vegetables might have a protective action.

Vegetarians eat no meat or fish and usually eat more fruit and vegetables than comparable non-vegetarians. The risk of all cancer sites combined might be slightly lower in vegetarians and vegans than in non-vegetarians, but findings for individual cancers are inconclusive. 12

By definition, deficiencies of vitamins and essential minerals cause ill health; this might include increased susceptibility to some types of cancer, but establishing the details of any such effects has proved difficult. High dose vitamin or mineral supplements have not reduced cancer risk in well nourished populations and might increase risk; for example, high dose carotene might increase the risk of lung cancer.13 Vitamin and mineral supplements should not be used for cancer prevention, although they can be important for other aspects of health, such as folic acid supplements for women before conception.

There are two types of oesophageal cancer: squamous cell carcinoma and adenocarcinoma. The squamous form predominates in most of the world, whereas adenocarcinoma is relatively common only in Western countries, where rates have recently increased. Obesity is an established risk factor for adenocarcinoma, probably partly owing to reflux of stomach contents into the oesophagus.1516 Alcohol increases the risk of squamous cell carcinoma but not of adenocarcinoma.17 Smoking increases the risk of both types, with a larger effect for squamous cell carcinoma.17

Oesophageal cancer incidence rates are very high in parts of eastern and southern Africa, Linzhou (China), and Golestan (Iran).617 People in high risk populations have often consumed a restricted diet, low in fruit, vegetables, and animal products, so deficiencies of micronutrients have been postulated to explain the high risk (boxes 1 and 2). Despite several observational studies and some randomised trials, however, the relative roles of various micronutrients are not yet clear.17181920 In Western countries early case-control studies indicated a protective role for fruit and vegetables,2122 but more recently published prospective studies show weaker associations, which might be due to residual confounding from smoking and alcohol consumption.16

Consumption of drinks such as tea and mate when scalding hot is associated with an increased risk of oesophageal cancer,232425 and drinking beverages above 65C is classified by IARC as probably carcinogenic to humans.26

Stomach cancer is the fifth most common cancer worldwide, with the highest rates in eastern Asia.6 Eating large amounts of salted foods, such as salt preserved fish, is associated with an increased risk27; this might be caused by the salt itself or by carcinogens derived from the nitrites in many preserved foods. Salted food might increase the risk of Helicobacter pylori infection (an established cause of stomach cancer)28 and act synergistically to promote development of the disease.29 Some evidence indicates that eating large amounts of pickled vegetables increases the risk of stomach cancer because of the production of N-nitroso compounds by mould or fungi, which are sometimes present in these foods.3031

The risk of stomach cancer might be decreased by diets high in fruit and vegetables and for people with high plasma concentrations of vitamin C (boxes 1 and 2).32 A trial in Linzhou, China, showed that supplementation with carotene, selenium, and tocopherol resulted in a significant reduction in stomach cancer mortality,18 and other trials have indicated enhanced regression of precancerous lesions with the use of supplements of vitamin C, carotene, or both.3334 Prospective studies in Japan have also shown an inverse association between stomach cancer risk and green tea consumption in women (the majority of whom are non-smokers), perhaps related to polyphenols.35 These studies indicate a protective role of antioxidant micronutrients or other antioxidant compounds, but these associations need clarification.

Colorectal cancer is the third most common cancer in the world.6 Overweight and obesity increase risk,83637 as do alcohol and smoking.7

Ecological analyses show striking positive correlations between eating meat and colorectal cancer rates.338 In 2015 IARC classified processed meat as carcinogenic to humans and unprocessed red meat as probably carcinogenic,3940 partly based on a meta-analysis reporting an increase in risk of 17% for each daily 50 g increment in consumption of processed meat and 18% for each 100 g increment in consumption of red meat.41 More recent systematic reviews have reported smaller increases in risk for unprocessed red meat.842

The chemicals used to preserve processed meat, such as nitrates and nitrites, might increase exposure of the gut to mutagenic N-nitroso compounds.40 Both processed and unprocessed red meat also contain haem iron, which might have a cytotoxic effect in the gut and increase formation of N-nitroso compounds. Cooking meat at high temperatures can generate mutagenic heterocyclic amines and polycyclic aromatic hydrocarbons.40 Whether any of these putative mechanisms explain the association between eating red and processed meat and risk for colorectal cancer is unclear.3940

Higher consumptions of milk and calcium are associated with a moderate reduction in risk of colorectal cancer.8434445 Calcium might be protective by forming complexes with secondary bile acids and haem in the intestinal lumen. Higher circulating concentrations of vitamin D are associated with a lower risk,46 but this might be confounded by other factors such as physical activity. Mendelian randomisation studies of genetically determined vitamin D have not supported a causal relation.4748

In the 1970s Burkitt suggested that the low rates of colorectal cancer in parts of Africa were caused by the high consumption of dietary fibre.49 Prospective studies have shown that consuming 10 g more total dietary fibre a day is associated with an average 10% reduction in risk of colorectal cancer; further analyses suggest that cereal fibre and wholegrain cereals are protective, but not fibre from fruit or vegetables.5051

High dietary folate intake has been associated with reduced risk of colorectal cancer, and adequate folate status maintains genomic stability,8 but high folate status might promote the growth of colorectal tumours.52 Whether folate or folic acid have any material impact on the risk of colorectal cancer is uncertain. Most randomised trials of folic acid supplementation have found no effect,5354 and although studies of the gene for methylenetetrahydrofolate reductase have indicated that lower circulating folate is associated with a slightly lower risk, the interpretation of these genetic data is not straightforward. 55

Alcohol is the main diet related risk factor for liver cancer, probably through the development of cirrhosis and alcoholic hepatitis.7 Overweight and obesity also increase risk.8 Aflatoxin, a mutagenic compound produced by the fungus Aspergillus in foods such as grains, nuts, and dried fruit when stored in hot and humid conditions, is classified as a carcinogen by IARC and is an important risk factor in some low income countries (for people with active hepatitis virus infection).56 The major non-dietary risk factor is chronic infection with hepatitis B or C viruses.

Some studies indicate an inverse association between coffee drinking and risk of liver cancer.8 Coffee might have a true protective effect because it contains many bioactive compounds,5758 but the association might be influenced by residual confounding, as well as by reverse causation if subclinical liver disease reduces appetite for coffee.

Obesity increases risk of pancreatic cancer by about 20%.8 Diabetes is also associated with increased risk, and a mendelian randomisation analysis indicates that this is due to raised insulin rather than diabetes itself.59 Studies of dietary components and risk have been inconclusive.8

Lung cancer is the most common cancer in the world, and heavy smoking increases risk around 40-fold.67 Prospective studies have indicated that diets higher in fruits and vegetables are associated with a slightly lower risk of lung cancer in smokers, but not in never smokers.6061 The weak inverse association of fruit and vegetables with lung cancer risk in smokers might perhaps indicate some true protective effect, but it might simply be due to residual confounding by smoking (box 1). Trials that tested supplements of carotene (and retinol in one trial) to prevent lung cancer showed an unexpected higher risk of lung cancer in participants in the intervention group.1362

Breast cancer is the second most common cancer in the world.6 Reproductive and hormonal factors are key determinants of risk.63 Obesity increases breast cancer risk in postmenopausal women, probably by increasing circulating oestrogens, which are produced by aromatase in adipose tissue.64 Most studies have shown that obesity in premenopausal women is associated with a reduction in risk, perhaps due to lower hormone levels related to an increased frequency of anovulation. 65 Alcohol increases risk by about 10% for each drink consumed daily866; the mechanism might involve increased oestrogens.

Much controversy has surrounded the hypothesis that a high fat intake in adulthood increases breast cancer risk. Early case-control studies supported this hypothesis, but prospective observational studies have overall been null,8 and two randomised controlled trials of a reduced fat diet were also null.6768

Studies of other dietary factors including meat, dairy products, and fruit are generally inconclusive.8 Some recent studies have indicated an inverse association between vegetable intake and risk of oestrogen receptor negative breast cancer86970 and between dietary fibre and overall risk.871 Isoflavones, largely from soya, have been associated with a lower risk of breast cancer in Asian populations.72 These associations are potentially important and should be investigated for causality.

Prostate cancer is the fourth most common cancer in the world.6 The only well established risk factors are age, family history, black ethnicity, and genetic factors.73 Obesity probably increases the risk for more aggressive forms of prostate cancer.8

Lycopene, primarily from tomatoes, has been associated with a reduced risk, but the data are not conclusive.8 Some studies have indicated that risk might be reduced with higher levels of other micronutrients including carotene, vitamin D, vitamin E, and selenium, but the findings from trials and mendelian randomisation analyses are overall null or inconclusive.47747576

Isoflavones, largely from soya foods, have been associated with a reduced risk for prostate cancer in Asian men,77 and plasma concentrations of the isoflavone equol might be inversely associated with prostate cancer risk in men in Japan.78

Substantial evidence shows that prostate cancer risk is increased by high levels of the hormone insulin-like growth factor 1, which stimulates cell division, and further research is needed to determine whether dietary factors, such as animal protein, might influence prostate cancer risk by affecting production of this hormone.79

Given the huge variation in diets around the world and the large number of cancers that diets can influence, how do we know which foods or diets should be avoided and which should be recommended? The World Cancer Research Fund (WCRF) and IARC have reviewed the carcinogenic risk of foods and nutrients using systematic reviews of the evidence and evaluation by expert panels. As with much nutritional research the topic is complex, but the WCRF and IARC have identified nutritional factors with convincing evidence or probable evidence of cancer risk.

WCRF and IARC concluded that obesity and alcohol cause cancer at several sites (fig 1). For overweight and obesity, increases in risk for every 5 kg/m2 rise in body mass index (BMI) vary from 5% for colorectal cancer to 50% for cancer of the endometrium (IARC also considered the evidence to be sufficient for meningioma, thyroid cancer, and multiple myeloma).80 For alcohol, risk increases for each 10 g rise in consumption a day vary from 4% for liver cancer to 25% for squamous cell carcinoma of the oesophagus.

Body mass index (BMI), alcohol, and cancer risk. Convincing associations according to the World Cancer Research Fund8 or the International Agency for Research on Cancer (marked by asterisks), or both,1080 with relative risks from meta-analyses.8 We also consider the association between BMI and risk of breast cancer in premenopausal women to be convincing.65 RR, relative risk (plotted with squares proportional to amount of statistical information); CI, confidence interval

Processed meat was judged to be a convincing cause of cancer by both WCRF and IARC; in the most recent WCRF report the relative risk for colorectal cancer was 1.16 (1.08 to 1.26) for each 50 g/day increment.8 IARC judged Chinese-style salted fish to be a carcinogen (with a relative risk of nasopharyngeal cancer of 1.31 (1.16 to 1.47) for each additional serving per week), 810 as well as foods contaminated with aflatoxin.56 Neither expert body judged any dietary factor to be convincingly protective against cancer.

WCRF and IARC judged some associations between nutritional factors and cancer risk to be probably causal or protective (table 1). Some researchers might think that the criteria for probable are not stringent enough. Further evidence might change the conclusions, and this should be kept in mind when using the reports to estimate the likely effects of diet or to make dietary recommendations. Notably, WCRF also categorised adult and young adulthood body fatness as probably protective for premenopausal breast cancer; with new evidence65 we consider this convincing, so the association is shown in figure 1 rather than table 1.

Still uncertain: dietary and nutritional factors that expert groups have classified as probable causal or protective factors for cancer

Obesity probably increases the risk of cancers of the oral cavity and pharynx and of aggressive prostate cancer. Alcohol probably increases the risk of stomach cancer but is inversely associated with the risk of kidney cancer, which might indicate a true biological effect or reflect residual confounding or bias.81 Very hot drinks probably increase the risk of cancer of the oesophagus, foods preserved by salting probably increase the risk of stomach cancer, and several dietary factors probably reduce the risk of colorectal cancer. The expert panels also concluded that the risk of endometrial cancer is probably increased by a diet with a high glycaemic load. Coffee was judged to probably be protective for liver and endometrial cancer, but some of the current authors think that this conclusion is too strong and that the data on coffee and endometrial cancer might be affected by selective publication of only part of the evidence.82

Independently from overweight and obesity, greater adult height is associated with the risk of several cancers (box 3).

The risk for most types of cancer increases with height. A WCRF systematic review showed that increases in risk for each 5 cm increment in height ranged from 4% for prostate cancer to 12% for malignant melanoma.83 The mechanism is uncertain but might be related to taller people having more stem cells at risk of cancer or a factor such as insulin-like growth factor 1 having effects on both height and cancer risk.84 Undernutrition causes restricted growth, and some aspects of adequate nutrition during childhood and adolescence, such as an ample intake of energy and protein, might lead to relatively greater height and a higher overall cancer risk.83 It is not clear, however, whether better understanding of this pathway could lead to strategies for reducing cancer risk.

Acrylamide, a chemical produced during high temperature cooking and in the manufacture of many types of carbohydrate-rich foods (such as potato chips, cereal crispbreads, and coffee), is classified by IARC as probably carcinogenic to humans.85 This conclusion was based largely on studies in experimental animals; epidemiological studies have been mostly null or inconclusive86 but are limited by the difficulty of estimating long term exposure and by confounding owing to smoking. Recent research on possible mutational signatures of this chemical indicate that it might contribute to risk.87

Figure 2 shows recent estimates of the proportions of cancer cases in the UK attributable to modifiable risk factors, including dietary factors classified by WCRF or IARC as convincing causes of cancer. 88 Overweight and obesity is the second largest attributable cause, responsible for 6.3% of cancers in the UK, and is the largest cause in non-smokers. Alcohol (3.3%), dietary fibre (3.3%), and processed meat (1.5%) are also among the top 10 causes (although dietary fibre is currently classed by WCRF as only probable). Analyses from some other countries have produced broadly similar estimates; recent estimates for Brazil were 4.9% for overweight and obesity, 3.8% for alcohol, 0.8% for dietary fibre, and 0.6% for processed meat. 89 In Japan, however, where the prevalence of obesity is lower, estimates were 1.1% for overweight and obesity and 6.3% for alcohol (and 1.6% for salt). 90

Percentages of cancer cases in the UK attributable to different exposures.88

Research into the effects of nutrition on health is difficult. 91 We have summarised here the relatively few well established clear links between nutrition and cancer, but future research might show further important risk factorsperhaps for specific food components or for broader dietary patterns, such as so called plant based diets. To move forward, the new generation of studies needs to improve estimates of long term exposure with, for example, repeated dietary records, which are now feasible using web based questionnaires.92 Biomarkers of dietary intake and nutritional status can be used more extensively, and new biomarkers might be found through metabolomics, for example, but they will need to be validated and interpreted in the light of possible confounding and reverse causation. For some exposures, both for intake and nutritional status, mendelian randomisation will help to clarify causality,93 and randomised trials will be needed to test specific hypotheses. It will also be important to attempt to coordinate systematic analyses of all the data available worldwide, to reduce the risk of publication bias.94 For public health and policy, the top priority should be tackling the known major diet related risk factors for cancer, particularly obesity and alcohol.

Obesity and alcohol increase the risk of several types of cancer; these are the most important nutritional factors contributing to the total burden of cancer worldwide

For colorectal cancer, processed meat increases risk and red meat probably increases risk; dietary fibre, dairy products, and calcium probably reduce risk

Foods containing mutagens can cause cancer; certain types of salted fish cause nasopharyngeal cancer, and foods contaminated with aflatoxin cause liver cancer

Fruits and vegetables are not clearly linked to cancer risk, although very low intakes might increase the risk for aerodigestive and some other cancers

Other nutritional factors might contribute to the risk of cancer, but the evidence is currently not strong enough to be sure

Contributors and sources: All authors contributed to the first draft of the manuscript and provided critical revisions. All authors gave intellectual input to improve the manuscript and have read and approved the final version. TJK is the guarantor. The authors all have experience in nutritional epidemiology, with particular expertise in cancers of the gastrointestinal tract (KEB, RS, ST), breast cancer (TJK), prostate cancer (TJK, APC), cancer in Asia (RS, ST), and mendelian randomisation (KKT). Sources of information for this article included published systematic reviews and primary research articles based on prospective observational studies and randomised controlled trials.

Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

This research was partly supported by Cancer Research UK (C8221/A19170) and the Wellcome Trust Our Planet Our Health (Livestock, Environment and People, LEAP 205212/Z/16/Z). KEB is supported by the Girdlers New Zealand Health Research Council Fellowship. KKT is supported by WCRF (2014/1180).

Chang ET, Adami HO. Nasopharyngeal cancer. In: Adami H-O, Hunter DJ, Lagiou P, Mucci L. Textbook of Cancer Epidemiology, Third edition. Eds, Oxford, UK: Oxford University Press, 2018:159-181.

Rider JR, Brennan P, Lagiou P. Oral and pharyngeal cancer. In: Adami H-O, Hunter DJ, Lagiou P, Mucci L, eds. Textbook of Cancer Epidemiology, 3rd ed. Oxford, UK: Oxford University Press, 2018:137-157.

Abnet CC, Nyrn O, Adami HO. Esophageal cancer. In: Adami H-O, Hunter DJ, Lagiou P, Mucci L, eds. Textbook of Cancer Epidemiology, 3rd ed. Oxford, UK: Oxford University Press, 2018:183-211.

Ye W, Nyrn O, Adami HO. Stomach cancer. In: Adami H-O, Hunter DJ, Lagiou P, Mucci L, eds. Textbook of Cancer Epidemiology, 3rd ed. Oxford, UK: Oxford University Press, 2018:213-241.

Bamia C, Stuver S, Mucci L. Cancer of the liver and biliary tract. In: Adami H-O, Hunter DJ, Lagiou P, Mucci L, eds. Textbook of Cancer Epidemiology, 3rd ed. Oxford, UK: Oxford University Press, 2018:277-307.

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Diet, nutrition, and cancer risk: what do we know and what is the way forward? - The BMJ

Anyone who turned on the radio in the 2000s has probably heard of JoJo. She was a young singer who became popular with hit songs like Leave (Get Out) and Too Little Too Late.

However, after a few years of immense fame, JoJo seemingly disappeared from the limelight. She recently made a triumphant return to the music industry. The singer also opened up about what happened during those years when fans did not hear much from her, which included a dangerous diet and some substance abuse.

JoJo was recognized for her musical talent in the late 1990s when she was just a kid. She competed onAmericas Got Talent Kids and attracted the attention of executives at Blackground Records. After she auditioned for them, she was signed to the company and started recording music professionally.

In 2004, JoJo released her first single, Leave (Get Out), which quickly became an international success. The song peaked at number 12 on the Billboard Hot 100 but landed in the top five in several countries.

Two years later, JoJo returned with her second album,The High Road. It included the song Too Little Too Late, which became her next hit single. The track charted at number 3 on the Billboard Hot 100 and became JoJos most successful song to date.

JoJo seemed like she was heading for superstardom in the late 2000s. She was also making herself known as an actress in movies like Aquamarine(2006) andRV (2006).However, after a while, JoJos name practically disappeared off of the radio.

JoJo was recording a lot of songs after her second album, but her record label was keeping them from being released. At the time, JoJo did not understand why and she attributed the reason to her body.

She shared in a recent interview with Uproxx: I thought that maybe it was the way that I looked because when I was 18, I remember being sat down in the (now defunct Blackground Records)office and the president of the label being like, We just want you to look as healthy as possible.'

JoJo did not understand it because she believed that she looked like a healthy girl who eats and is active. However, JoJo also knew that in showbiz, being healthy was not the only thing that mattered. Thus, she agreed to be put on a diet of just 500 calories a day.

I was on these injections that make you have no appetite, JoJo revealed. I was like, Let me see how skinny I can get, because maybe then theyll put out an album. Maybe Im just so disgusting that no one wants to see me in a video and that they cant even look at me. Thats really what I thought.

It was later revealed that Blackground Records was going through difficult times as it was losing important distribution rights. JoJos career was being severely affected, and this had a lot of negative impacts on her self-esteem.

She shared with Uproxx that she turned to other places for affirmation. The star said: I started getting really (expletive) up, drinking, making out with strangers, looking for validation and attention and looking to feel pretty, looking to feel good, looking to feel worthy. I mean, there were definitely nights that I stumbled out of clubs and that I blacked out and was just completely reckless, did not care I need to be buzzed to feel OK.

JoJo decided to change when she realized that she did not want to end up like her father, who died from substance abuse in 2015.

Since JoJo admitted that she was not in a cushy situation with a home that she could return to, she decided to strengthen herself and learn how to work out problems on her own.

In February 2019, JoJo released the song Say So with singer PJ Morton. It put JoJos name back on the map as the pair won a Grammy Award for Best R&B Song.

JoJo has plans to release her album,Good to Know, in May of this year. She will also embark on a tour in April.

The rest is here:
'Leave (Get Out)' Singer JoJo Reveals the Dangerous Diet that Led to Substance Issues - Showbiz Cheat Sheet

Ive recently stumbled upon a few articles touting a return to the diets of the 1950s, which were influenced by war-time rationing. They say people ate healthier. What are the pros and cons of following a typical diet from that era?

Sincerely,

Rick

Dear Rick,

These days there are several ways to eat healthy and sometimes this can be confusing for people. Recently, there has been an interest in returning to a 1950s style of eating, but did people really eat healthier back then?

While it is true that foods were rationed, whether or not this led to healthier eating is unclear. Careful planning was in place so that everyone was allowed enough to eat, with men having a 3,000 calorie per day allotment, which is more than is recommended today. While rations were meant to be used by the named recipient, a bartering system developed so that people were sure to obtain the commodities they felt they needed. Even though sugar was restricted, corn syrup was substituted in recipes. It is more likely the difference in lifestyle that contributed to a healthier diet than rationing of goods.

There are several differences in American life today as compared to the 1950s. For starters, the median American household income was $5,000. That means that half the population made more than $5,000 a year and half made less.

In 2019, the median household income was $63,000. For every dollar spent on food in 1955, 25 cents went to restaurants; now it is more than half. Much of this includes high-calorie foods like pizza, burgers and fries, which brings us to another big difference: portion sizes. Compare portion sizes of foods from the 1950s to today:

Interestingly, there are some areas of diets that are actually healthier today than back then. Vegetables were often overcooked, decreasing their nutritive value. Today people are careful to prepare vegetables al dente in order to preserve nutrition. The public has also been educated to choose lean proteins, even if sometimes they prefer not to. Seldom is animal fat used as a seasoning. When I was growing up, people kept a tin of bacon grease on the stove to season vegetables and fry meats. There is no such tin in my kitchen today.

People could definitely benefit from getting back to the basics. Enjoy a home-cooked meal for dinner with fruits and vegetables filling half the plate. Eat dinner as a family; it is one of the most important activities you will share with your children. Dine out as a treat instead of a convenience. And as always, keep it simple and be healthy!

-

Leanne McCrate, RDN, LD, CNSC,

aka Dear Dietitian, is an award-winning

dietitian based in Missouri.

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Diets of the 1950s pros and cons | News, Sports, Jobs - Marshalltown Times Republican

An animal expert has warned pet owners could bekilling their dogs and cats byfeeding thema vegan diet.

TV and radio dog guru, Anna Webb, has issued the stark warning after some pet food brands released vegan ranges claiming that it is nutritious to feed dogs and cats in this way, and helps to reduce their 'carbon pawprint'.

Anna has studied natural nutrition and therapies with the College of Integrated Veterinary Therapies (CIVT).

She said:You would never give a rabbit a steak, and its the same thing.

Dogs and cats are carnivores and by feeding them diets which dont contain meat, instead of being ethical you are actually being very unethical, and putting your pets at risk of health issues overtime.

All of these products are very processed, and just like humans are being discouraged to eat processed foods, the same logic applies so are our pets.

Obesity related conditions like heart disease and diabetes in dogs is at record levels and that is because most complete pet food is 30 to 70 per cent grains, which dogs cannot metabolise.

"These foods are bulked out with ingredients like rice, barley and beet pulp, which are all sugars. Not only bad for their teeth, these grain heavy foods pile on the pounds, evident with one in two dogs now considered obese or overweight in the UK ."

Anna advocates feeding dogs and cats a biologically appropriate raw food diet, and practices what she preaches with her own pet dogs, Mr Binks and Prudence, and her cat, Gremlin.

The animal guru,who is a vegetarian herself, added: You should feed a natural diet to dogs and cats, ideally organic meat.

"Vegans think that they are giving a vegan diet to their pets because they love animals, but the irony is they are being unethical, even cruel to their own canine best friends.

I cannot bear the thought of the unethical treatment of animals, and Im not a fan of industrial farming. I choose to be a vegetarian, but I wouldnt impose my diet choices onto my dogs as I understand that were different species.

Dogs have to eat meat, and we dont. Humans consume 75 per cent of the meat produced globally, so if every human became a vegetarian or a vegan we just might make a difference and save the planet.

Meat is actually bad for humans, because it causes high cholesterol, but dogs - because they are carnivores - cannot get high cholesterol.

Anna advises that, if vegans feed plant-based diets to their dogs and cats for long periods of time, the pets will lack key fatty acids and amino acids only found in meat and be prone to disease.

She continued:Cats in particular will die being a vegan because they are obligate carnivores and they need taurine in their diet, which they can only get from meat.

You would think they were fine for a year, maybe longer but eventually they will begin to fall apart.

Excerpt from:
Anna Webb: Dogs and cat owners who feed their pets a vegan diet could be killing them - Glasgow Times

Plenty of attention has been paid to the ketogenic diet in recent yearsits supporters have touted its potential health benefits when it comes to weight loss, cardiovascular health and even brain health. A new study explores this idea further when it comes to the brain, and has delved into whether a low-carb diet could potentially reverse, or at least slow down, aging in the brain.

The study, led by Stony Brook University professor Lilianne Mujica-Parodi, suggests that early signs of aging in the brain can be prevented by a low-carb diet, or whats commonly referred to as the ketogenic diet.

The ketogenic diet aims to release ketones into the bloodstream for the body to use stored fat as its main source of energy, rather than blood sugar or glucose from carbohydrates. Once the body starts breaking down ketone moleculesa process called ketosisit begins to run on the energy provided by fat, rather than glucose.

The ketogenic diet needs to be pretty substantial with fats and proteins in order to be sustainable. It typically includes things like grass-fed meats, eggs, cheese, butter, oils and avocados, and almost entirely avoids common carbs like bread, wheat or rice.

In the latest study, Mujica-Parodi and her team wanted to examine whether the effects of a low-carb diet could be seen in the brains of people who may be showing some early signs of aging, but who were presymptomatic.

First, the researchers found that aging in the brain, seen in the form of destabilized communication between brain regions, typically starts to set in when a person is in their late 40s, particularly around age 47. This tends to be associated with weaker cognition.

They identified brain network stability as a biomarker for aging, and found that having type 2 diabetes increased this destabilization of brain networks. They then tested how the brains network stability would respond to diet changes.

One group of participants was placed on a standard diet, which metabolizes glucose as its primary fuel. The second group was given a low-carb diet, meaning they were only eating things like meat or fish with saladand no sugar, grains or starchy vegetables. In the low carb diet, the main fuel source was ketones.

The researchers found that the people who were metabolizing ketones on the low-carb diet saw increased brain activity and stabilized networks in brain regions.

The bad news is that we see the first signs of brain aging much earlier than was previously thought, Mujica-Parodi said in a news release.

However, the good news is that we may be able to prevent or reverse these effects with diet, she continued, by exchanging glucose for ketones as fuel for neurons.

Part of the power behind ketones, Mujica-Parodi argues, is that the brain eventually loses its ability to use glucose as fuel, something known as hypometabolism.

Therefore, if we can increase the amount of energy available to the brain by using a different fuel, the hope is that we can restore the brain to more youthful functioning, she said.

The medical consensus on the ketogenic diet is varied. Some experts note that it can be restrictive and possibly even dangerous for people with certain conditions, while other research has shown it may hold protective benefits when it comes to the brain and overall health.

In the Alzheimers research world, ketones are actually being explored for their potential as a therapeutic pathway for the disease. One recent study conducted by a researcher at the National Institute on Aging found that increasing the number of ketones in the body may help fight Alzheimers.

Diet, overall, has been examined in various studies to better understand how its linked to improved brain function and mental health. Some experts say that a healthy diet and exercise are some of the most effective interventions for preventing, or slowing down, the progression of neurodegenerative diseases.

Mujica-Parodi says her next steps are to examine brain fuel further, and to extend the research to older populations.

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Could a Low-Carb Diet Reverse Aging in the Brain? - Being Patient

The specialists of the European medical Institute of obesity compared diet of the presidents of Russia and USA Vladimir Putin and Donald trump, German Chancellor Angela Merkel and Prime Minister of Spain Pedro Sanchez. It is reported by the El Models.

According to the publication, the 67-year-old Russian President uses lean meats, fatty fish and low-fat varieties, fruit, vegetables, cereals and eggs, and he tries not to eat the products of deep processing and drinking alcohol. If necessary selects the wine or beer. For Breakfast, Putin prefers eggs, in scrambled eggs or raw quail, fruit and dried fruit, buckwheat porridge with the addition of millet and honey. For dinner he has milk or dairy products. In addition, to maintain good physical shape head of the Russian state to help sports, including swimming, martial arts, skiing and hockey.

The American President suffers from a mild form of obesity. At 73, he still loves fast food. His food is burgers, sandwiches with eggs and cheese, bacon and sauces, the Buffalo wings with fries, pizza, etc. However, trump does not drink alcohol, he prefers Coca-Cola light with caffeine and chocolate shakes. He is not as active lifestyle as the Russian counterpart.

German Chancellor Angela Merkel prefers German food. In her diet sausages with gravy and mashed potatoes, cheese fondue and beer. For dinner she eats vegetables.

Spanish Prime Minister Pedro Sanchez chose a balanced Mediterranean diet: greens, salads, meat and grilled fish. In addition, the Prime Minister firmly eat Breakfast, drink lots of water, from alcoholic beverages drinking sparkling or red wine.He also leads an active lifestyle, three times a week, runs or rides a Bicycle.

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European experts told about the diet of Putin, trump and Merkel - The Saxon

There is a significant correlation between type 2 diabetes mellitus and chronic kidney disease (CKD); up to 40% of patients with diabetes develop CKD as a direct result of diabetic complications. Patients with CKD have a need for a disease-specific diet, making management of diabetes challenging. Patients with CKD also face increased risk of complications associated with malnutrition, necessitating dietary needs and nutritional requirements tailored to individual patients.

Researchers led by Nourhan Khaled Hassan, MD, recently conducted a systematic review to examine nutritional requirements for patients with type 2 diabetes and chronic renal failure. The researchers screened 85 articles; of those, 22 were analyzed and included as per the study criteria. The data search included PubMed using medical subject headings terms, and a literature review through the Cochrane library and the British Medical Journal. Results were reported online in Current Diabetes Reviews [doi:10.2174/15733998166662000211120402].

The review highlighted nutrients and minerals needed to be maintained within a specified range defined by a patients needs and conditions. Dietary restrictions to prevent disease progression were also necessary. Patients receiving hemodialysis required vigorous monitoring of blood glucose levels as well as strict management of dietary intake. Risk-to-benefit ratios were utilized to determine optimal protein intake in patients on hemodialysis.

Dietary requirements should be individualized based on the patients disease severity and progression. Assessment of the patients previous and current diet, as well as matching it with their dietary requirements and preferences is crucial, the researchers said.

Excerpt from:
Nutritional and Dietary Requirements in Patients with Type 2 Diabetes and CKD - DocWire News

Sat, Mar 07, 2020 - 5:50 AM

STROKE and heart disease (cardiovascular disease) remain the major causes of morbidity and mortality all over the world. The best way to prevent cardiovascular disease is to make the right choices for your health; prevention is better than cure. Smoking cessation and good control of your blood pressure are two measures that can be implemented if you want to reduce your risk of cardiovascular disease. Importantly, your food choices can make a major impact on your risk of cardiovascular disease.

Benefits of a healthy lifestyle

Lifestyle behaviour can determine your risk of cardiovascular disease. Studies, including the US Health Professionals study, the Nurses' Health Study, and the Swedish Primary Prevention Lifestyle Study (September 2014, Journal of the American College of Cardiology) showed that adherence to good lifestyle measures such as not smoking, maintenance of normal body mass index, daily exercise, healthy diet and avoidance of excessive alcohol can reduce cardiovascular disease by up to 80 per cent or more when compared to those who did not achieve any of these five healthy behaviours.

Impact of diet

The trend of decreasing whole grain, vegetable and fruit consumption and marked increase in meat and egg consumption in China over a 10-year period (2003 to 2013) has been associated with about a 27 per cent increase in stroke and more than 200 per cent increase in death from heart artery disease.

The current trend of many guidelines emphasises a reduced intake of animal fat and an increased intake of fruits and vegetables. Among the diets recommended, the Mediterranean diet has the strongest evidence for stroke risk reduction. The Mediterranean diet is low in sugar, high in fat (with 40 per cent of the calories from "good" fats such as olive and canola oil), high in plant-based foods (such as whole grains, vegetables and legumes), and favours fruits as desserts.

In a comparison of the impact of dietary patterns on risk of heart artery disease, the Seven Countries Study reported that the risk of heart artery disease for a Mediterranean diet was about 7 per cent of that in Finland and about 40 per cent of that in Japan.

Even if you consider yourself healthy and have not had heart disease or stroke, you can benefit from a healthy diet. Data from the Spanish Primary Prevention of Cardiovascular Disease with a Mediterranean Diet (PREDIMED) study showed a reduction of stroke by 47 per cent in five years when compared to a low-fat diet.

Benefit is seen also in those with a past history of heart attack or stroke. Interestingly, in the prevention of stroke and heart artery events for those with a past history of heart attack (secondary prevention), when comparing the results of the Lyon Diet Heart Study (using the Mediterranean diet) with the landmark Scandinavian Simvastatin Survival Study (using the cholesterol-lowering medication called simvastatin), those on a Mediterranean diet for four years had about a 70 per cent reduction in heart events and stroke as compared to about a 40 per cent reduction in recurrent heart events after six years of simvastatin.

Eggs and health

The question that is often asked is whether it is good to eat eggs. The view that regular egg intake is harmless is based on data from two USA studies which reported that there was no downside from egg consumption except for diabetics, for whom an egg a day doubled the risk of heart disease. However, this should be interpreted in the context that more than 90 per cent of US participants in the study had a poor healthy diet score and hence, it is difficult to assess the incremental effect of eggs alone as the baseline diet was unhealthy. In a population such as in Greece, where the predominant diet is the Mediterranean diet, it was reported that an egg a day increased the risk of heart artery disease fivefold among persons with diabetes.

Red meat and the gut

The latest US dietary guidelines published in 2016 emphasises the importance of reducing saturated fat intake. Compared to white meat (chicken, fish), red meat (beef) has more saturated fat, and has about four times as much carnitine. The yolk of a 65g egg contains about 237mg of cholesterol and 250mg of carnitine.

In humans, when gut bacteria digest foods containing carnitine (red meat and egg yolks) or choline (egg yolk), a metabolite called trimethylamine (TMA) is produced and this metabolite is then further processed in the liver to become trimethylamine n-oxide (TMAO). While the consumption of red meat has been linked to an increased risk of heart disease, diabetes mellitus, and premature death, recent studies on TMAO have shown that beyond the detrimental effects of saturated fat, there are other mechanisms which increase the risk of stroke and heart disease.

An article in the Journal of The American Association of Medicine published in June 2019 reported that studies have shown that people with higher blood levels of TMAO have more than twice the risk of heart attack, stroke, or other serious cardiovascular problems, as compared to those with low levels of TMAO.

What kind of bacteria you have in your gut is dependent on your diet. If more red meat is consumed, the gut will adjust to produce more "meat-eating" bacteria. For long term vegans who start eating red meat, the bacteria may initially not be able to produce TMA in the gut, and hence TMAO levels will not be high. If the vegans keep on consuming red meat, more "meat-eating" bacteria will be produced and more TMA will be produced and TMAO levels will increase.

Consumption of alcohol

While mild to moderate consumption of alcohol appears to reduce the risk of stroke and heart attack, heavy consumption increases the risk, especially for stroke, and in particular bleeding in the brain. Heavy drinking is also associated with sudden cardiac death, failure of the heart pump function, stroke, and disease of the lower limb arteries but a lower risk of heart attack. In particular the increase in stroke risk is likely to be due to the increase in blood pressure and the development of an abnormal heart rhythm, atrial fibrillation. Atrial fibrillation is an important cause of stroke.

Keeping the doctor away

Those at risk of cardiovascular disease should consider a mainly plant-based diet with plenty of whole grains, vegetables, fruits and legumes, more polyunsaturated oils (olive and canola), and consumption of fish and poultry rather than red meat or processed meat. Avoidance of deep-fried food and food with trans fats, reducing intake of sugar and potatoes, and eating fewer egg yolks will contribute to a more healthy diet. Hence, if you want to keep the doctor away, start making the right choices for food today.

This series is produced on alternate Saturdays in collaboration with Singapore Heart, Stroke & Cancer Centre

Originally posted here:
The right diet can prevent strokes and heart attacks - The Business Times