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Frequently Asked Questions, From A-Z

Forums: General Discussion on Cancer: [Sticky]
Created on: 01/30/09 10:11 AM Views: 1174 Replies: 3
Frequently Asked Questions, From A-Z
Posted Friday, January 30, 2009 at 10:11 AM

Appendix C
Questions and Answers about Foods and Cancer Prevention and Survival
By Jennifer Reilly, RD, PCRM Senior Dietitian

ALCOHOL

How much alcohol is safe to consume?

Although we occasionally hear of the reputed benefits of moderate alcohol consumption for reducing risk heart disease, even one drink per day, if consumed every day, increases breast cancer risk. A recent review of alcohol consumption and cancer risk also showed increased risk for liver and colorectal cancer.

Possible mechanisms by which alcohol may exert its cancer-causing effects include the toxic effect of alcohol metabolites, the production of free radicals, and disruption of folic acid’s protective mechanisms. Polycyclic aromatic hydrocarbons, which are known carcinogens, have also been found in alcoholic beverages. In addition, alcohol consumption may lead to nutritional deficiencies, affecting the absorption of cancer-fighting nutrients.

CAFFEINE

Does drinking coffee or other caffeinated beverages increase cancer risk?

Probably not. Interest in this topic persists because coffee is such a popular beverage. In early 2006, a study suggested that coffee is responsible for as much as a third of daily consumption of the cancer-causing chemical acrylamide, possibly as a result of the roasting of coffee beans. Earlier studies linked coffee consumption to increased risks of bladder and pancreatic cancers and a decreased risk of colon cancer. Subsequent studies have not supported the link to pancreatic cancer. In addition, cigarettes may be the real culprit in the link between coffee consumption and bladder cancer since smokers generally drink more coffee, compared with the average consumer. Studies on colon cancer, while mixed, lean toward a possible protective effect from coffee.

Regarding breast cancer, there is no evidence linking coffee consumption to an increased risk. However, caffeine may increase symptoms of fibrocystic breast disease, a common but benign breast condition.

According to a 2007 report by the American Institute for Cancer Research/World Cancer Research Fund, “Most evidence on coffee suggests that coffee drinking has no relationship with cancer risk.”

For bone health, heavy coffee use may be a problem. Excess caffeine consumption causes calcium to be leached from bones and excreted in the urine. Caffeine can also increase the heart rate, a concern in individuals with certain types of cardiac arrhythmias.

CALCIUM

How much calcium is absorbed from plant foods?

The table below gives the absorption percentages for calcium-rich plant foods. For comparison, 32% of the calcium from milk is absorbed. Calcium-rich plant foods also contain many cancer-fighting nutrients that are not present in dairy products.

Food Sources   Calcium Absorption
% Rate
Beans, white   17%
Broccoli   52 %
Brussels sprouts   63 %
Kale   58%
Mustard greens   57%
Orange juice, calcium-fortified   37%
Soymilk, calcium-fortified   24%
Tofu, calcium-set   31%
Turnip greens   51%


How much calcium should a person get per day?

Scientific evidence suggests that calcium intake should be at least 500 to 600 mg per day. Evidence of benefit from higher intakes is poor. It also makes sense to get plenty of exercise and to have about 15 minutes sunlight exposure daily for vitamin D.

One reason for being cautious about higher calcium intakes is that epidemiologic studies have linked high calcium intakes to an increased prostate cancer risk. Good calcium sources include beans, figs, sweet potatoes, and especially dark green leafy vegetables, such as collard greens, kale, broccoli, mustard greens, and Swiss chard. Fortified soymilk and rice milk and calcium-fortified juices provide a great deal of calcium as well. It is also important to avoid calcium depleters--smoking, animal protein, excess sodium, and excess caffeine. In addition, eating lots of fruits and vegetables, excluding animal proteins, and limiting salt intake all help the body retain calcium.

CHILDHOOD and ADOLESCENCE

Does a vegan diet provide adequate nutrition for growing children?

Yes. It is important to remember that eating habits are set in early childhood. Choosing a vegetarian diet can give your child—and your whole family—the opportunity to learn to enjoy a variety of nutritious foods. Children raised on fruits, vegetables, whole grains, and legumes grow up to be slimmer and healthier, and live longer than their meat-eating friends. It is, in fact, much easier to build a nutritious diet from plant foods than from animal products, which contain saturated fat, cholesterol, and other substances that growing children can do without. As for essential nutrients, plant foods are the preferred source because they provide sufficient energy and protein packaged with other health-promoting nutrients such as fiber, antioxidant vitamins, minerals, and phytochemicals.

Naturally, children need protein to grow, but they do not need high-protein, animal-based foods. A varied menu of grains, beans, vegetables, and fruits supplies plenty of protein. The “protein deficiencies” that our parents worried about in impoverished countries were the result of starvation or diets restricted to very few food items. Protein deficiency is extremely unlikely on a diet drawn from a variety of plant foods. Very young children may need a slightly higher fat intake than adults do. Healthier fat sources include soybean products, avocados, and nut butters. Soy “hot dogs,” peanut butter and jelly sandwiches, seasoned veggie burgers, and avocado chunks in salads, for example, are very well accepted. However, the need for fat in the diet should not be taken too far. American children often have fatty streaks in the arteries—the beginnings of heart disease—before they finish high school. In contrast, Japanese children traditionally grew up on diets much lower in fat and subsequently had fewer problems with diabetes, heart disease, obesity, and other chronic diseases.

Parents will want to make sure their child’s diet includes a regular source of vitamin B12, which is needed for healthy blood and nerve function. Deficiencies are rare, but when they happen, they can be a bit hard to detect. Vitamin B12 is plentiful in many commercial cereals, fortified soy and rice milks, and nutritional yeast. Check the labels for the words cyanocobalamin or B12. It is strongly advisable for all children to take a daily multiple vitamin. It will provide adequate B12. An alternative is to take a B12 supplement of 5 or more micrograms per day. Spirulina and seaweed are not reliable sources of vitamin B12.

The body also requires vitamin D, which is normally produced by sun on the skin. Fifteen to twenty minutes of daily sunlight on the hands and face is usually enough for the body’s skin cells to produce the necessary vitamin D. Children in latitudes with diminished sunlight may need the vitamin D found in multivitamin supplements or fortified non-dairy milks. Good calcium sources include beans and green vegetables, including collards, kale, broccoli, mustard greens, and bok choy as well as dried figs and sweet potatoes. Fortified soymilk, rice milk, almond milk, oat milk and calcium-fortified juices provide a great deal of calcium as well. In addition, eating lots of fruits and vegetables, excluding animal proteins, and limiting salt intake all help the body retain calcium.

Growing children also need iron, which is found in a variety of beans and green, leafy vegetables. The vitamin C in vegetables and fruits enhances iron absorption, when eaten together with an iron-rich food. One example is an iron-rich bean burrito eaten with vitamin C-rich tomato salsa. Few people are aware that cow’s milk is very low in iron. It also reduces iron absorption and can induce a mild, chronic blood loss in the digestive tract, which can reduce iron and cause an increased risk of anemia.

How important is nutrition for young girls in families with a history of breast cancer?

The foods girls eat while in pre-school and grade school appear to have an important effect on breast cancer risk later in life. Researchers at Harvard University discovered that girls who eat more protein from animal sources and less protein from plant sources tend to reach menarche earlier. Younger age at first menstruation is connected with increased risk of breast cancer later in life. In addition, diet during puberty—while breast tissue is forming—also seems to have a significant influence on breast cancer risk in adulthood. Plant-based diets right from the start not only establish healthy lifelong eating habits, but also appear to be helpful in reducing breast cancer risk.

COOKING FOOD

Does cooking destroy the cancer-fighting compounds in vegetables?

For the most part, no. In a 2004 medical research review evaluating the effect of raw and cooked vegetables on cancer risk, both raw and cooked vegetables were related to reduced cancer risk.

Water-soluble nutrients such as vitamin C and B vitamins do tend to seep out of foods during boiling or steaming. However, if you reuse the cooking liquid in soups or to cook grains, you will get all the nutrients that have seeped out of the vegetables.

On the other hand, some antioxidants are actually released or activated by cooking, including the lycopene in tomatoes and the beta-carotene in carrots and sweet potatoes. Researchers have found that you can multiply the antioxidant power of carrots by cooking and puréeing them before eating. It turns out that cooking and puréeing releases cancer-fighting compounds from the carrot cells. To reap the full cancer-fighting benefits from the carrot you prepare, wash them thoroughly, but avoid peeling them as the skins are rich with cancer-fighting compounds.

What is the safest cookware?

The various types of cookware all have their pros and cons. It is important that all cookware be replaced when dented or worn. If you see any chipping, throw it out.

Stainless Steel- Stainless steel is really a mixture of several different metals, including nickel, chromium and molybdenum, all of which can leach into foods if your cookware is nicked or damaged. However if you take care of your pots and pans, this is probably one of the safest choices of cookware.

Cast Iron –Cast Iron can help ensure that you are getting enough iron—as it is transferred from the cookware into food in small amounts. In large quantities, however, iron becomes a pro-oxidant, causing stress and oxidation in the body that can lead to disease. Most cast iron pans need to be seasoned with oil after use.

Teflon- It is important to not leave Teflon cookware on a burner or in an oven without liquid; this will release a group of chemical toxins called PFOA (perfluoroctanoic acid). Heating Teflon to extremely high temperatures releases these toxins. Studies show that these chemicals can be released when heated to as little as 464 degrees Fahrenheit.

Aluminum- Aluminum contact should be limited or avoided as much as possible, because of its possible link with Alzheimer’s disease and its potential of having estrogen-like effects in the body. Anodized aluminum cookware is a safer alternative.


COST

Doesn’t healthy eating cost more?

Surprisingly, choosing healthy foods over high-fat and processed foods is a much more economical way to eat. Below are the costs comparing a chicken and cheese tortilla to a vegetarian tortilla. As you can see, the healthier vegetarian version costs nearly half as much.

Chicken and Cheese Tortilla (Serves 4):
Nutrition facts: 690 calories, 56 grams protein, 44 grams fat, 17 grams carbohydrate (per serving)
8 small corn tortillas: $1.29
1 pound Kraft shredded cheddar cheese: $3.29
1 pound chicken breast: $3.48
1 4-ounce jar salsa: $1.50
Total Cost for Chicken and Cheese Tortilla Meal: $9.56 ($2.39 per serving)

Vegetarian Tortilla (Serves 4):
Nutrition facts: 485 calories, 12 grams protein, 7.6 grams fat, 93 grams carbohydrate (per serving)
8 small corn tortillas: $1.29
16 ounces brown rice: $1.19
1 15-ounce can of vegetarian refried beans: $0.69
1 4-ounce jar of salsa: $1.50
(1/2 head) fresh shredded lettuce: $0.99
Total for Vegetarian Tortilla: $5.66 ($1.42 per serving)


DIETARY FAT

Is it good to avoid using oils in cooking? And what about nuts?

By avoiding the use of added oil and minimizing use of nuts, you can greatly reduce the fat content of your diet. Although vegetable oils and nuts generally contain less saturated fatty acids compared with animal fats (with the exception of coconut and palm oil), when it comes to calories and possibly even hormone production, total fat is what matters—regardless of whether or not it’s a “good” or “bad” fat. There are many ways to prepare foods without oil, such as using water or vegetable broth for stir-fries and substituting applesauce, banana, or soy yogurt for baked goods and desserts.


Aren’t there essential oils that you need to get from fish? Can plant sources provide these essential oils?

Two essential fatty acids cannot be synthesized in the body and must be taken in the diet. Their names— linolenic and linoleic acid—will never show up on a food label and are not important to remember. What is important is that these basic fats are used to build specialized fats called omega-3 and omega-6 fatty acids.

Omega-3 and omega-6 fatty acids are important in the normal functioning of all tissues of the body. Deficiencies are responsible for a host of symptoms and disorders including abnormalities in the liver and kidneys, changes in the blood, reduced growth rates, decreased immune function, and skin changes including dryness and scaliness. Adequate intake of the essential fatty acids may also reduce the risk of atherosclerosis, heart disease and stroke, and symptoms associated with ulcerative colitis, menstrual pain, and joint pain.

Alpha-linoleic acid, the primary omega-3, is found in many vegetables, beans, and fruits. More concentrated sources include flax seeds, soybean products, walnuts, and wheat germ. Adding flaxseed oil to your salad or grinding flax seeds for your breakfast cereal are simple ways to incorporate extra omega-3 fatty acids to your diet. Corn, safflower, sunflower, and cottonseed oils are generally low in omega-3 and high in omega-6.

The preferred source of omega-6 fatty acids, such as gamma-linolenic acid, can be found in more rare oils, including black currant, borage, evening primrose, and hemp oils.

Some people eat fish and use fish oils for omega-3s. However, plant-derived omegas-3s have none of the potential contaminants nor do they have the fish odor that can be apparent in the perspiration of people using fish oil. They also tend to be lower in saturated fats. Between 15 and 30 percent of fish oil is saturated fat, which is about double that of plant oils. Fish make their omega-3 oils from linolenic acid in plankton, just as mammals—including humans—synthesize omega-3s from land plants.


EGGS

Is there evidence linking the consumption of eggs to cancer risk?

While egg consumption has not been studied as thoroughly as the consumption of meat and dairy products in relation to cancer risk, there is still enough evidence to encourage dietary alternatives to both egg whites and egg yolks. About 70 percent of the calories in eggs are from fat—a big portion of which is saturated fat. They are also loaded with cholesterol—about 213 milligrams for an average-sized egg. Eggs have no dietary fiber and are devoid of cancer-fighting antioxidants.

The most convincing evidence points to egg consumption as increasing risk for colorectal cancer and bladder cancer. The World Health Organization analyzed data from 34 countries and determined that egg consumption was significantly correlated with mortality from colon and rectal cancers in both men and women. A case-control study done in Argentina found that people consuming approximately 1 ½ eggs per week had nearly 5 times the colorectal cancer risk compared with individuals consuming less than 11 eggs per year. Moderate egg consumption also tripled the risk of developing bladder cancer as determined by a case-control study of 130 newly diagnosed bladder cancer patients published in the journal International Urology and Nephrology.

Eggs are often used in baked products because of their binding and leavening properties. But smart cooks have found good substitutes. See Appendix B, “Planning Healthy Meals” for tips on replacing eggs in recipes.

FOOD SAFETY

How do you ensure proper food safety when cooking for someone undergoing chemotherapy?

A clean and safe food supply is important for everyone, but is essential for people with compromised immune systems. Older persons and individuals undergoing cancer treatment are especially at risk from bacteria, viruses, or other foreign substances that can turn up in food. To keep your meals safe and clean, follow these simple practices:

•   Wash hands with soapy water before and after preparing food and before eating.
•   Avoid preparing or eating all types of meat, eggs, and dairy products, as these foods are commonly contaminated with bacteria. Poultry products are especially likely to be contaminated. Raw milk and home-prepared ice creams or mayonnaise, as well as cake and cookie batter made with eggs, may easily contain infectious bacteria.
•   Keep cold foods cold (below 40°F) and hot foods hot (above 165°F).
•   Wash fruits and vegetables thoroughly under running water before using them.
•   Wash the tops of cans before opening.
•   During food preparation, if you taste the food you are making, use a different utensil from the one used for stirring or serving.
•   Do not taste food that looks or smells strange.


GENERAL NUTRITION

If a completely plant-based isn’t possible for me, is it ok if I eliminate red meat and cheese and eat a low-fat diet with egg whites, chicken, fish, and skim milk in addition to lots of fruits and vegetables?

Eliminating red meat and cheese is a start. However, you’ll want to go further, and base your diet on whole grains, legumes, vegetables, and fruit. Your diet will be much richer in cancer-fighting vitamins, minerals, fiber, and phytochemicals. Chicken and fish contain fat—including significant amounts of saturated fat—as well as cholesterol and other harmful compounds, so the healthiest diets avoid them completely. Skim milk and egg whites contain animal protein and cholesterol and no fiber, vitamin C, or healthful complex carbohydrate.

An easy way to shift to a completely plant-based diet is to do it 100% for three weeks. In the process, you will adjust to new flavors and tastes. As those 21 days fly by, see how you feel. You’ll realize that you feel a lot better (and perhaps lighter!) and that you don’t miss the high-fat foods.

JUICES and JUICING

How do fruit and vegetable juices compare to eating these foods whole?

As a rule of thumb, it’s important to shoot for consuming at least 3 servings of fruit and 4 servings of vegetables every day. Since juice is not as high in fiber as whole fruit or vegetables, it's always best to consume the whole food whenever possible. It has been shown that diets higher in fiber are not only beneficial for protecting against a number of cancers and chronic illnesses, but also help you fill up so that you don't "fill out." Maintaining a healthy weight helps reduce cancer risk.

For people who don’t enjoy eating lots of fruits and vegetables, juicing can be a way to bring these healthy foods into their routine. One-half cup (4 ounces) of juice can be considered the equivalent of a single serving of fruits or vegetables. Juicers that keep the fiber in the foods are best. Or, the fibrous end-product that juicers produce can be re-used (instead of discarded): shredded carrot roughage make a salad topping, for example, or can be added to soups, stir-fries, or pasta sauces.

LUNG CANCER

Are there any dietary factors that help reduce risk for lung cancer?

Of course, it is essential to avoid tobacco. However, diet may play a role, too. A study published in the Lancet in 2000 suggested that the natural chemicals in broccoli, cabbage, bok choy, and other cruciferous vegetables may reduce lung cancer risk. Of 18,000 men studied, those with detectable isothiocyanates, in their blood had a 36 percent lower chance of developing lung cancer, compared with those with none.

Food sources of these compounds are far preferable to supplements. In fact, beta-carotene taken in doses higher than those which occur naturally in plant foods can actually increase cancer risk. The lesson is simple: vegetables and fruits should be a generous part of the diet.

MACROBIOTIC DIETS

Are macrobiotic diets helpful in cancer prevention and survival?

The word macrobiotics means “long life,” and refers to healthful lifestyle, diet, and eating environment recommendations that are good for overall well-being, as well as being effective in cancer prevention and survival. Macrobiotic diet guidelines are largely drawn from traditional Chinese medical principles and emphasize balance, focusing especially on grains, vegetables, and beans and bean products. The diet generally excludes animal products, although some macrobiotic practitioners include fish. People following macrobiotic diets who wish to include higher-protein foods while avoiding fish can choose beans or tofu dishes.

Numerous epidemiological studies have shown that a low-fat, plant-based diet is effective for cancer prevention and survival. There have been a great many remarkable case reports of individuals whose bleak cancer prognoses were dramatically improved though macrobiotics.

ORGANIC FOOD

How important is it to choose organic foods?

Buying organic produce is a good idea. It helps you avoid toxic chemicals and improve the nutritional value of the foods you eat. Going organic is an especially good idea when it comes to apples, bell peppers, celery, cherries, grapes, nectarines, peaches, pears, potatoes, raspberries, spinach, and strawberries – the produce containing the highest concentration of pesticide residues, according to the Environmental Working Group. Produce with lower levels of pesticides includes asparagus, avocados, bananas, broccoli, cauliflower, sweet corn, kiwi, mangos, onions, and papaya.

Organically grown plant foods are not only more flavorful than conventionally grown crops, but more nutritious and richer in cancer-fighting antioxidants and other phytochemicals.

Depending where you live, you may find organic produce at your regular grocery store. You can also look for affordable organic food at a farmers market in your area or join a Community Supported Agriculture (CSA) group to receive local seasonal harvests. Not all organic farms are certified organic because certification can be cost-prohibitive for smaller farmers. However, by buying local produce, you can learn personally from farmers about their farming practices and ensure that you are getting safe and fresh produce.

“Organic” meat is another story. Buying organic meat does not necessarily mean that you are eliminating the health risks associated with the consumption of animal products. For instance, heterocyclic amines (HCAs), a family of mutagenic compounds, are produced during the cooking process of chicken, beef, pork, and fish. Meat that is cooked under normal grilling,temperatures commonly contains significant quantities of these carcinogens. The longer and hotter the meat is cooked, the more these compounds form. There is also significant evidence that consuming dairy products, conventional or organic, may increase blood levels of IGF-I, a hormone in the body that has been associated with increased cancer risk. And both meat and dairy, regardless of whether or not they are organic, can provide considerable amounts of saturated fat and cholesterol.

Choosing a plant-based diet that is also low in pollutants and pesticide residues will enable you to control some of the major factors that have been linked to the risk of cancer and other degenerative diseases.

PROTEIN

How do you get enough protein on a vegan diet?

It’s easy. Here’s what you need to know: Protein is used for the building, maintenance, and repair of tissues in the body. Amino acids, the building blocks of protein, are synthesized by the body or ingested from food. There are 9 essential amino acids that cannot be produced by the body and must be obtained from the diet. A variety of grains, legumes, and vegetables easily provides all of the essential amino acids our bodies require. It was once thought that various plant foods had to be eaten in specific combinations to get their full protein value. We now know that intentional combining is not necessary. When the diet contains a variety of grains, legumes, and vegetables, protein needs are easily met.

On average, North Americans consume about double the amount of protein they actually need. Because North Americans tend to rely on animal products, they get a significant amount of saturated fat and cholesterol along with their protein. The recommended daily intake of protein for the average, sedentary adult is only about one third of a gram (0.36 gram to be exact) of protein per pound of your body weight. For those using metric weights, this is 0.8 grams per kilogram of body weight.

To calculate your recommended amount, simply multiply your weight (in pounds) by 0.36. This value has a large margin of safety, and the body’s true need is actually lower for most people. Protein needs are somewhat higher for women who are pregnant or breastfeeding, compared with other women. In addition, needs are also higher for very active persons. As these groups require additional calories, increased protein needs can easily be met through larger intake of food. Extra servings of legumes, tofu, meat substitutes, or other high-protein sources can easily meet needs that go beyond the recommendation for sedentary adults.

RAW FOOD DIETS

What about raw food vegan diets? Are they even better than vegan diets that include cooked foods?

Few studies have evaluated the health benefits of raw-food diets. However, a low-fat diet that is rich in raw or cooked vegetables, fruits, and other plant-based foods is loaded with antioxidants, and other cancer-fighting nutrients. There are significant advantages to having vegetables and fruits in their raw form because cooking sometimes causes the loss of some nutrients that are powerful antioxidants and help protect us from developing cancer.

SALT

Does salt increase cancer risk? How do table salt, sea salt, and kosher salt differ?

Studies in Asia suggest that consuming foods preserved by salting and pickling is associated with increased risk for stomach cancer. Also, when salt intake exceeds about two grams per day, the risk of hypertension increases, as does the loss of calcium through the kidneys. However, using modest amounts of salt in cooking or for flavoring foods does not appear to increase risk of health problems.

Table salt, sea salt, and kosher salt have all the same sodium content, but differ in taste and texture. Sea salt comes from evaporated seawater, whereas table salt and kosher salt come from rock salt from inland deposits. Sea salt can be either fine or coarse and often has a flavor different than table or kosher salt because of additional minerals it contains. Table salt is fine in texture and often has added iodine, necessary for proper thyroid function. Other additives in table salt may include: sodium hexacyanoferrate II, tricalcium phosphate, calcium or magnesium carbonates, fatty acid salts (acid salts), magnesium oxide, silicon dioxide, calcium silicate, sodium alumino-silicate, and alumino-calcium silicate. Kosher salt is coarse-grained and usually has no additives.

SOY

Do the phytoestrogens in soy foods prevent cancer? Are they helpful or risky for cancer survivors? What about the estrogens in soy for men and boys?

Soy products, such as miso soup, tofu, and tempeh, contain very weak plant estrogens called phytoestrogens that block the body's natural estrogen from attaching to cells. (The prefix "phyto" simply means "plant.") Normally, estrogens hook onto tiny receptor proteins on your cells that allow them to influence the cell's chemistry.

Think of it this way: An estrogen molecule is like a jumbo jet that attaches to the Jetway of an airport. It discharges passengers into the terminal, which is suddenly a busy, noisy place. Phytoestrogens, being weak estrogens, are like small, private planes with few passengers and no cargo, yet they still occupy the Jetway after landing. When phytoestrogens occupy the cellular receptors, normal estrogens cannot. So while plant estrogens do not eliminate all of estrogen's effects, they do minimize them, apparently reducing breast cancer risk and menstrual symptoms.

Like all foods, soy products have advantages and disadvantages. Soybeans are rich in essential omega-3 fatty acids, but tend to be higher in fat, compared with other beans. Many soy products derive roughly half their calories from fat, while black beans, pinto beans, or other varieties are only about 4 percent fat. Also, soy extracts, such as genistein, may not have the same beneficial effects as products made with the whole bean.

In Asia, where tofu, soymilk, and other soy products are commonly consumed, not only is the population healthier overall, but cancer and heart disease are much rarer than in the North America and Europe, and longevity is greater. However, these populations differ in other ways, aside from their use of soy products. Asians eat much less meat and dairy products and generally exercise more, compared to Americans, but they also smoke more cigarettes and eat more salt. It has therefore been difficult for researchers to tease out the effects of soy itself.

Also, it is possible that the more processed soy products such as veggie burgers and veggie hot dogs, and particularly isolated soy protein products, are not as beneficial as the less processed soy products such as whole soy beans, tofu, and tempeh traditionally consumed in Asia. Replacing processed soy products such as veggie burgers and veggie hot dogs with tofu, tempeh, beans, and lentils may provide you with a more healthful diet.

In human research studies, soy products have been shown to lower blood cholesterol levels , in part due to their rich content of soluble fiber, and their isoflavones also play a role in bone formation. Soy products have been shown to reduce estrogen activity, at least in premenopausal women, which, over the long run, reduces cancer risk. The evidence is not as clear for postmenopausal women.

Research findings are not clear on whether soy products are safe for women who have had breast cancer. Some researchers believe that two servings per day of soy products such as soymilk, tofu, or tempeh are fine for these women, while others discourage soy consumption completely. It is also not yet clear whether the effects of soy products differ for women with estrogen-receptor-positive breast cancer, compared with those with estrogen-receptor negative cancers.

For men and boys, the phytoestrogens in soy do not appear to have any adverse effect on hormone levels and have not been shown to affect sexual development or fertility. Research studies show that men consuming soy have less prostate cancer and better prostate cancer survival.

However, it’s also important to remember that a vegan diet of beans, vegetables, grains, and fruits does not have to include soy products to be nutritionally complete. Soy products make convenient substitutes for meat and other unhealthy foods that people, quite rightly, are looking to avoid. However, the benefits of complete protein and soluble fiber can easily be found in an array of plant foods.

SUGAR

How important is it to steer clear of sugar? I’ve heard that sugar feeds cancer cells.

Simple sugars (syrup, honey, white sugar, brown sugar, soda) provide calories but no nutritional benefit when it comes to cancer prevention and survival. It is easy to overdo it with simple sugars because they are not filling. They can promote weight gain, which increases the risk for certain cancer types. In addition, there’s some evidence that the elevated insulin levels resulting from the consumption of simple sugars may increase cancer risk, and potentially impair survival. For these reasons, it’s important to limit your intake of simple sugars and choose healthier sweet foods, such as fruit, that have cancer-fighting nutrients and fiber such.

SUPPLEMENTS

Do you recommend taking the popular “green food” supplements that are on the market now? Will they help prevent cancer?

Vegetable-based supplements are increasing in popularity and often come with a variety of health claims. Whether or not they have benefit, it is important to consider, however, that no single supplement can replicate all the healthful components found in a variety of whole plant foods, including those that ward off cancer. Vegetables, fruits, whole grains, and legumes are packed with healthful substances beyond vitamins, such as fiber, minerals, and cancer-protective phytochemicals. Increasing your fruits and vegetables can be almost as simple as popping a pill, and is far more beneficial.

Try these simple ideas to get your five (or more) servings a day:
•   Add vitamin-rich veggies to salads, like bell peppers, broccoli, carrots, tomatoes, and spinach.
•   Add puréed, cooked pumpkin to soups and stews as a thickener.
•   Take a bowl of fruit to work each week (apples, bananas, pears, oranges) and snack on them when hunger calls.
•   Pack raisins and other dried fruits in your purse, briefcase, or backpack to keep you fueled with healthy foods.

One supplement that is important, however, is vitamin B-12, which is needed for healthy blood and healthy nerves. It is found in any common multiple vitamin, as well as in simple B-12 supplements. It is also found in fortified cereals (e.g., Product 19, Total, Kellogg’s Corn Flakes), fortified soymilks, and some brands of nutritional yeast.

TEA

Is tea beneficial for cancer prevention?

Perhaps. A recent study followed 69,000 Chinese women age 40-70 and found that the more green tea consumed, the lower the risk of developing colorectal cancer. The same effect has not been found for oral cancer, gastric cancer, and perhaps on cancer in general. However, it appears that there is a lower mortality rate among regular green tea consumers. Some have suggested that the health benefits of green tea stem from the antioxidant properties of catechins, or polyphenolic compounds that are especially high in green tea due its unique preparation. Catechins can be found in many different types of teas, not just green tea, however the concentrations are inconsistent and variable.

Catechins make up 30% of the weight of dried leaves. It is known that antioxidant levels increase in the blood after green tea consumption, but the implications of this for health are unclear. More research is needed to understand green tea and its antioxidant activity in the human body. However, some clinical trials investigating green tea consumption by cancer patients found potential benefits that may prove promising. 58

TREATMENT

Is a vegan diet recommended for patients who have just been diagnosed with cancer and are not under going therapy yet but are about to have surgery?

The information in this book is intended for individuals interested in prevention and those who are done with treatment. While a vegan diet can be healthy and beneficial at all stages of life, anyone undergoing medical treatment should talk with his or her doctor about any major diet changes.

WEIGHT CONTROL

I’m underweight and having trouble keeping weight on. What are some healthy plant-based snacks that will prevent me from losing weight?

Dry beans and peas, nuts, and seeds are examples of foods can help. They supply both calories and protein, among other nutrients. Shakes can be made with rice milk, almond milk, soymilk, tofu, and non-dairy frozen desserts and can be flavored with frozen or fresh fruit, vanilla or other extracts to make tasty, calorie-rich treats. Also, dried fruit is rich in calories and nutrients, but low in fat, and many varieties of trail mix are easily available and great for high-energy snacking.

For an overweight breast cancer survivor, is it important to just focus on eating healthfully, or is weight loss important too?

You’ll want to focus on both. Evidence suggests you can improve your chances of surviving breast cancer and reduce recurrence by achieving a healthy weight. The best way to lose weight is to choose healthy, low-fat meals built from legumes, grains, vegetables, and fruit, and incorporate more physical activity into your lifestyle. Of course, it's important to check with your doctor first to get the green light on type and level of exercise you'd like to do. You'll feel better for it!

Caroline Trapp, MSN, APRN, BC-ADM, CDE
Director of Diabetes Education and Care
Physicians Committee for Responsible Medicine
Moderator

Edited 01/30/09 10:13 AM
RE: Frequently Asked Questions, From A-Z
Posted Tuesday, June 2, 2009 at 9:33 AM

I was wondering where this came from? I see it is labelled 'appendix c' ... I'm thinking I would like to read the other material from its source. thank you.

RE: Frequently Asked Questions, From A-Z
Posted Wednesday, December 30, 2009 at 3:16 PM

This comes from "The Cancer Survivor's Guide" which can be purchased or downloaded from:

http://cancerproject.org/resources/guide.php

RE: Frequently Asked Questions, From A-Z
Posted Wednesday, May 26, 2010 at 9:36 AM

A healthy lifestyle is needed even when you already won over your sickness. Prevention is always better than cure.

Edited 07/01/10 8:25 AM
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