Thursday, November 5, 2015

Breast cancer prevention strategies

When you hear health messages about cancer or any disease do you find yourself filtering it out?  If you do, this next sentence might cause you to stop reading, but please continue because there's a point I'm hoping to make. One out of eight women will get breast cancer in their lifetime (American Cancer Society). Are you still reading? That's good, because the purpose of sharing that statistic was to illustrate that even though we frequently hear these kinds of health messages, we don't always feel connected to them.

Perhaps you might be thinking as I did when hearing those numbers, wow, that sounds like a lot, but I'm not going to be the one.  Unfortunately, this kind of thinking often translates into inaction. Statistical health data, although sometimes shocking and troubling, may not be meaningful enough to inspire change for some of us.

If you find that you aren't motivated by statistics, you're not alone. Evidence suggests that health messages which highlight health consequences and the numbers of people who get disease aren't as effective as was once thought.

What can be more successful in motivating change in health behaviors are messages that focus on causes and solutions for disease (McKenzie).

Obviously there is no clear solution to breast cancer at this point in time. However, there is a great deal of data available that is linking lifestyle factors with increased risk.

There may be no sure way to prevent breast cancer yet. However, this doesn't mean we're powerless. Our best prevention strategy is to take steps to reduce our risk factors as much as possible. So, let's take a closer look at the modifiable risk factors.  In other words, the things we can do to lower the probability of  becoming one out of eight women who will get breast cancer.

A few Prevention Strategies
  • Excercise- Enough said.
  • Avoid weight gain and obesity - Exercise and healthy nutrition are the keys. According to the National Cancer Institute (NCI), a gain in body mass index (BMI) may substantially increase a women's risk for breast cancer, especially after menopause.The NCI states, " In a recent analysis, women who reported a gain in BMI of five points  or more between age 20 and postmenopausal age (ages 55-74) had nearly twice the risk of developing postmenopausal breast cancer compared to women who maintained their BMI during the same time period." You can read more about BMI in this post here.
  • Eat plenty of fruits and vegetables - Preferably organic.  Organically grown produce lowers exposure to pesticides which can effect hormone levels, particularly estrogen dominance.
  • Have your vitamin D levels checked -  A low level of Vitamin D is linked to increased risk for breast cancer. 
  • Reduce chronic inflammation - I've blogged about this very important element of cancer prevention here, but simply put, if our immune system is preoccupied and overwhelmed responding to environmental and food stressors, it's possible that it can miss the angiogenesis of a sneaky cancer cell. 
Here's some additional information from Dr. Fuhrman's informative website which explains how to support our wellness with healthy nutrition. The foods we eat can either support or oppose our bodies. Experts now agree that there are even so-called power foods that do an especially good job of restoring our bodies. 

So, rather than tuning out messages about disease, consider the strategies that you can incorporate into your lifestyle that will help prevent illness from starting in the first place - because "an ounce of prevention is worth a pound of cure."

McKenzie, J. An Introduction to Community Health, 5th ed.

Wednesday, July 30, 2014

Weight loss success: nutrient dense foods cut calories and control hunger

When it comes to maintaining or reducing body weight, the key to long term success is to choose foods with a low energy density. What is energy density in foods? The Center for Disease Control defines it as “the amount of energy or calories in a particular weight of food.” This is generally represented as the number of calories in a gram (kcal/g). This brings me to the law of thermodynamics, or energy balance equation, which I’ve discussed in a past post here.

Energy balance - Understanding this concept is important to successful weight loss, gain or maintenance.  So, here’s a brief review: if you consume more calories than you burn, you will gain weight. If you burn more calories than you consume, you will lose weight. However, a big caveat: while a calorie is a calorie, the nutrients you consume affects metabolic and hormonal secretions which may cause you to store fat instead of utilize the fat for energy, and vice versa. The types and varieties of food and beverages you ingest effect weight management, but more importantly, they are essential to your total wellness.

Understanding caloric need - Exercise is a variable that increases caloric expenditure and metabolism. In order to determine an estimation of the calories you need to consume to gain, maintain or lose weight, it's helpful to calculate your total daily energy expenditure (TDEE). You can use the calculator found here, which calculates basal metabolic rate (BMR) using the Mifflin-St Jeor equation, and then applies an activity multiplier. It's best to underestimate your acitivity level when using the calculator if you're looking to lose weight because this puts you on the conservative side of daily caloric needs. Then, if you want to calculate how many calories you should eat daily to achieve weight loss at a steady, healthy pace, you subtract 15-20% from your TDEE number. Conversely, if you're looking to gain weight, add 15-20% to the TDEE. It's not recommended that you subtract more than 25% from your TDEE calculation. You don’t want your calorie intake to drop to an unhealthy and unsustainable level.

The amount of calories you eat is important, but not the whole picture in a healthy diet. Good nutrition includes a balance in the macronutrients listed below and the way you accomplish this is in the way you combine the foods you eat in a meal. For example, rice and beans.  These two foods are considered a complete protein when eaten together. If you're a vegan. In general, try to get your total daily caloric intake from a variety of whole foods as follows: 
  • Protein: 1 gram per pound of body weight
  • Fat: .45 grams per pound of body weight
  • Carbs: The remaining number of calories left will be filled with carbs

Nature counts the calories Back to our discussion of low energy dense foods and how they help with weight loss.  It seems Mother Nature really does know best because “foods with a lower energy density actually provide fewer calories per gram than foods with a higher energy density (CDC).”  Also, low energy dense foods are typically more nutrient dense. Nutrient density is a measure of the nutrients provided per calorie of food, or the “ratio of the amount of a nutrient in foods to the energy provided by these same foods (Nestle).”

So, it’s a win/win situation when you choose low energy/high nutrient dense foods because not only do they contribute fewer calories to the energy balance equation, they also provide greater nutritional value per calorie, which is especially beneficial for our health. These foods are the best of both worlds so to speak. 

Let’s look at a simple example of a higher nutrient/lower energy density food and a lower nutrient/higher energy dense food containing the same amount of calories per serving:   

Nutrient Dense
Energy Dense
171 calories/serving

2 wedges of watermelon (approximately 1/8 of a whole watermelon)

14 ounces of Dr. Pepper
Nutritional Facts
per serving
Calories 171
Calories from Fat 7
Total Fat 0.743g
Saturated Fat 0.371g
Polyunsaturated Fat 0.371g
Monounsaturated Fat 0.371g
Cholesterol 0mg
Sodium 7mg
Potassium 636mg
Carbohydrates 43.086g
Dietary Fiber 2.229g
Sugars 35.286g
Protein 3.343g
Vitamins & Minerals:
Vitamin A 67% · Vitamin C 78%
Calcium 4% · Iron 7%
Calories 175
Calories from Fat 0
Total Fat 0g
Saturated Fat 0g
Polyunsaturated Fat 0g
Monounsaturated Fat 0g
Cholesterol 0mg
Sodium 70mg
Potassium 0mg
Carbohydrates 46.2g
Dietary Fiber 0g
Sugars 44.8g
Protein 0g

Arguably, it might not seem equitable to compare a beverage with a food, but watermelon is 91% water by weight, so it's not too biased of a comparison. Remember, we are comparing identical calories per serving here. The numbers speak for themselves. If I’m trying to consume fewer calories in an effort to lose weight, watermelon is the better food choice by far. Where’s the Vitamin A and C in the soda? The numbers indicate a lot of sugar, no fiber or protein. The soda simply contains what are referred to as "empty calories" which provide energy, but no nutrition.  So after I drink my soda my body gets an injection of simple sugars and a blast of salt. Ironically, the salt can make me thirsty and this leads me to drink another soda later, but that's for another post!

On the other hand, the 2 wedges of watermelon provide 67% of the daily requirement of Vitamin A and 78% of Vitamin C.  That’s some good stuff! Plus, the 2.3 grams of fiber in the watermelon will help me feel fuller for a longer period of time than the soda, which has 0 grams of fiber. I might even feel full after eating 1 wedge of watermelon. Therefore, I can eat less of this food and decrease my calorie intake while keeping my hunger satisfied for longer than I could with a soft drink. This brings me to my next point, which can be pivotal to weight loss success.

Eat more to lose weight?Really?! Usually losing weight is equated with starving oneself and eating minuscule portion sizes, right? However, foods with a low energy/high nutrient density typically contain fewer calories per serving than the same amount of a high energy/low nutrient density food and they provide more vitamins, minerals and also phytochemicals. You can read more about phytochemicals and their amazing health benefits here

Now, let’s look at another example comparing the nutritional information for servings of an nutrient dense food with a calorie dense food, but of differing calorie content:

Nutrient Dense Food
Energy Dense Food
Food choice

French Fries

Calories per serving
1 cup chopped
33 calories
1 medium serving (117 g)
365 calories
Nutritional facts per serving
Total Fat 0.6 g   
Saturated fat 0.1 g          
Polyunsaturated fat .2 g              
Monounsaturated fat 0 g             
Cholesterol 0 mg             
Sodium 25 mg   
Potassium 329 mg           
Total Carbohydrate 6 g  
Protein 2.9 g
Vitamin A 133%
Vitamin C 134%
Calcium 10%     
Iron 5%
Vitamin D 0%     
Vitamin B-6 10%
Vitamin B-12 0%              
Magnesium 7%
Total Fat 17 g    
Saturated fat 2.7 g          
Polyunsaturated fat 6 g  
Monounsaturated fat 7 g             
Trans fat 0.1 g   
Cholesterol 0 mg             
Sodium 246 mg 
Potassium 677 mg           
Total Carbohydrate 48 g
Dietary fiber 4.4 g           
Sugar 0.4 g         
Protein 4 g         
Vitamin A 0%
Vitamin C 9%
Calcium 2%        
Iron 5%
Vitamin D 0%     
Vitamin B-6 20%
Vitamin B-12 0%              
Magnesium 10%

Once again, the data doesn’t lie. As the above comparison shows, I would have to eat a whopping 11 cups of chopped kale to equal the amount of calories I would consume in a medium serving of fries! If I’m trying to lose weight, the good news is that I can eat more kale while consuming far fewer calories than I would if I were to eat the French fries. This means I will feel fuller for a longer period of time. I’m also fueling my body with less unhealthy fats and far more nutritional value. Like I said before, it’s a win/win.

Move over vegetarian, I'm a nutritarian -  So are you ready to transition to a nutritarian diet which is eating more low-energy/nutrient dense foods? If you said yes, congratulations! You're making a good choice for your health. Are you unsure how to decide which foods to choose? A good starting point to help you in your search to find the most nutrient dense foods is to check out the ANDI guide. ANDI stands for aggregate nutrient density index and was developed by Dr. Joel Furhman.

This is from Dr. Furhman's site: "Adequate consumption of micronutrients – vitamins, minerals, and many other phytochemicals – without overeating on calories, is the key to achieving excellent health. Micronutrients fuel proper functioning of the immune system and enable the detoxification and cellular repair mechanisms that protect us from chronic diseases. A nutritarian is someone whose food choices reflect a high ratio of micronutrients per calorie and a high level of micronutrient variety."

With this in mind, the ANDI guide categorizes whole foods and then scores them on a scale from 1 to 1000 based on an extensive range of micronutrients, including vitamins, minerals, phytochemicals and antioxidant capacities. In addition, Dr. Furhman's original ANDI guide has been updated to reflect a more accurate picture of each food's nutritional qualitywhich now considers certain beneficial phytochemicals, such as angiogenesis inhibitors (i.e. cancer prevention, read more here), organosulfides (found in onion, garlic and cruciferous veggies), isothiocyanates (organosulfur compounds found in cruciferous veggies and are among the most effective cancer-prevention agents known), and aromatase inhibitors (suppress the synthesis of estrogen and thought to aid in the prevention of breast cancer).

The ANDI guide can be a useful tool in your determining healthy food choices, but it isn't the holy grail. I like what Dr. Furham says and I believe his suggestion is the best advice when it comes to choosing foods.  He says: “…nutrient density scoring is not the only factor that determines health benefits… if we ate only foods with a high nutrient density score, our diets would be too low in fat. For that reason we have to pick some foods with lower nutrient density scores.” Also, he notes that if thin individuals or those who are very active ate only foods with the highest nutrient density, they would become so full from fiber that it's likely they would be unable to meet their caloric needs. Remember my kale example above? One can only eat so much fiber. Balance and variety are key to consuming the greatest number and variety of micronutrients.

You may already know that kale is a better food choice than French fries, so if you operate on the simple premise that your diet should emphasize fruits, vegetables, and whole grains and not prepackaged, processed or fast food, you probably don’t need the ANDI guide to tell you where to get the most nutritional bang for your buck. However, if you’re uncertain as to whether or not you’re making the best food choices for your health, the ANDI rankings are a good starting point. 

Nutritarian Food Pyramid

I really like Dr. Weil's anti-inflammatory "diet" approach and I have incorporated some of his wisdom into my lifestyle as well. I've blogged about the health benefits of reducing the risk for chronic inflammation in an earlier post. Look for more on that in a future post.  In the meantime, I'll leave you with this food for thought:

  • CDC Low energy dense foods and weight management -
  • Nutrient Density, Clemson Cooperative Extension -
  • Food and Nutrition, Nutrient Density -
  • Sports Science Exchange, Energy Balance and Weight Reduction -
  • Simple Science Fitness, Energy balance and law of thermodynamics - 
  • Whole Foods Market uses ANDI guide -
  • Nutrient Rich, ANDI Guide -

Saturday, June 15, 2013

Should we avoid GMO's? I listen to my gut.

Istockphoto/Eraxion - via Scientific American
There's an English language idiom that's used to encourage someone to trust their instincts or intuition. It's "go with your gut." This expression is often used figuratively, but  I've come to think of it in a more literal sense. When it comes to my health, I am finally learning to listen to my gut and give it the credence it deserves. How about you? Is your gut trying to tell you something?

What's in your gut? -  Although the word gut sounds short and simple, the system it describes is actually very complex and is also absolutely critical to our survival. In fact, the gut is so important that it has its own "brain" - the enteric nervous system (ENS) (3). The gut, or gastrointestinal (GI) system includes the stomach, large intestine and colon, among other things. The major events of digestion and food absorption occur in the small intestine, which is covered in tiny little projections called villi that aid in the absorption of nutrients from the foods we eat (3). Problems can occur when these villi and the gut lining become compromised (3).

Wellness and the gut - When it comes to diagnosing disease, it seems wisdom dictates the symptoms are related to the location where they are present. For example, my Mom had eczema when she was a child. Since the rash was on her skin, the doctors called this a skin disorder. Thankfully, Western medicine has progressed since then and recognizes that there is more to the picture. The diagnosis of disease is now taking a more holistic approach, recognizing that the body is an integrated system and a symptom in one location could actually stem from something occurring in another location.  Applying this understanding to my Mom's eczema, doctors now see a link between eczema and the immune system, even though the symptoms appear on the skin (1). So, clearly this isn't just a skin disorder.

What's all this have to do with the gut? Well, experts are making connections between our gut health and a variety of diseases outside of the GI system itself. I imagine Hippocrates (460-377 BC), who is often referred to as the father of western medicine and is quoted as saying, "all disease begins in the gut" would be amused by modern medicine's reluctant acceptance of his ancient wisdom! (2)

GE foods  - Let's take a moment to discuss the nomenclatures used to describe these
foods. The terms genetically modified (GM) foods, genetically modified organisms (GMOs),  genetically engineered (GE) foods, and bio-engineered foods, all describe products that have had "foreign genes (genes from other plants or animals) inserted into their genetic codes" (5) "creating  combinations of plant, animal, bacterial and viral genes that cannot occur in nature or in traditional crossbreeding" (4).

From the USDA Economic Research Service
I'm not eating GE foods, am I? - You may be surprised by just  how much of the food in US grocery stores comes from GE crops. I know I was! In the US there are 4 commonly grown GE crops: corn, soy, canola and cotton.  The USDA’s Economic Research Service estimates that 90 percent of the corn grown in the United States is genetically modified (7). So, if you're eating corn that was not organically grown you are eating GMO's. Maybe you're careful to not eat GE corn. Good! However, if you eat animals that eat feed that contains GE corn, you are consuming GMO's. Maybe you don't eat meat or GE corn? Well, if you are eating processed foods (which usually contain high fructose corn syrup) you are consuming GMO's. In fact, about 70 percent of processed food in US supermarkets contains GE ingredients, according to the Center for Food Safety (8).

GM Foods and our gut health - Before we talk about our gut health, we need to look at one genetic modification in particular occurring in certain US crops, that is the insertion of a short sequence of genes from Bacillus thuringiensis (Bt) into plants like corn and potatoes for example. Bt "is a Gram-positive, [naturally occurring] soil-dwelling bacterium" and is now "commonly used as a biological pesticide." (10)  You can read more about it at the University of California - San Diego's webpage here, but here's the shorter explanation:
Image from UCSD 

"Bt has to be eaten [by the insect] to cause mortality. The Bt toxin dissolve in the high pH insect gut and become active. The toxins then attack the gut cells of the insect, punching holes in the lining. The Bt spores spill out of the gut and germinate in the insect causing death within a couple days." Organic farmers have used Bt topically as a pesticide for years. Splicing the Bt genes into a plant is a relatively new occurrence.

What does Bt have to do with our gut health? There is compelling evidence from a study done in the early part of last year that indicates consuming GE foods containing Bt toxin has a detrimental effect on humans. For the first time, researchers have found Bt toxin in the blood stream of people. The doctors who did the study wondered why this would be the case if the Bt toxin were being destroyed in the human stomach during digestion as was originally believed. They argue in their research that "modified Bt toxins are not inert on nontarget human cells and that they can present combined side effects with other residues of pesticides specific to GM plants." (9)

Not too surprisingly, this French study was criticized and attempts were made to discredit it. However, a new study released this year from the University of Brazil reinforces the concerns highlighted by the earlier research and raises disturbing new issues of potential toxic affects to our blood. You can read the details here. (11)

This subject is too lengthy to discuss in one post, so I will wrap this up for now and conclude next time with a discussion of what the recent research reveals about how consuming GE foods impacts our gut and overall health.  In the meantime, consider this quote from another Greek power thinker named Aristotle - "Intuition is the source of scientific knowledge." What do you think? Are you going with your gut? 

UPDATE: The Research paper referenced above has been retracted by the Journal Food and Chemical Toxicology. The following is a segment of their statement.  You can read it in it's entirety here:
"The journal Food and Chemical Toxicology retracts the article “Long term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize,” which was published in this journal in November 2012. This retraction comes after a thorough and time-consuming analysis of the published article and the data it reports, along with an investigation into the peer-review behind the article. The Editor in-Chief deferred making any public statements regarding this article until this investigation was complete, and the authors were notified of the findings."
In what sounds like a low budget film title, this has come to be known as the Seralini affair. I will leave the determination of whether or not this study was faulty to minds much more scientific than mine. I will say that my gut reaction is to remain skeptical regarding the safety of eating GMO's.  No one really knows the long term effects. The biggest study being conducted is occurring in real time among the general population who consume GMO's. Profit and greed seem to trump health and safety these days. Given the power of the chemical industry in America it doesn't surprise me.  I'll leave you with these facts:
"The U.S. Chemical Industry - The chemicals industry is one of the United States’ largest manufacturing industries, serving both a sizable domestic market and an expanding global market. It is also one of the top exporting sectors of U.S. manufacturing. Accounting for 15 percent of global chemical shipments, the United States is a world leader in chemicals production and exports. The industry’s more than 10,000 firms produce more than 70,000 products. In 2012, the U.S. chemicals industry had sales of $769.4 billion and directly employed more than 784,000 workers, with additional indirect employment by industry suppliers of more than 2.7 million. With investment of $57 billion in research and development in 2012, and strong enforcement of intellectual property rights, one-fifth of all patents granted in the United States are chemistry-related." (Select USA)

Sources -
1) Nature Immunology, Cutaneous immunosurveillance and regulation of inflammation by group 2 innate lymphoid cells, Ben Roediger,,
National Institutes of Health, Medline Plus -
2) Hippocrates - Wikipedia from
3) Understanding Nutrition, Ellie Whitney, 11th edition, Thomson, 2008
4) GE foods and health -
5) GMOs -
6) University of Maryland Medical Center -
7) USDA Economic Research -
8) Center for Food Safety -
9) Cytotoxicity on human cells of Cry1Ab and Cry1Ac Bt insecticidal toxins alone or with a glyphosate-based herbicide -
10) Bt -
11) Hematotoxicity of Bacillus thuringiensis as Spore-crystal Strains Cry1Aa,
Cry1Ab, Cry1Ac or Cry2Aa in Swiss Albino Mice -
12) Serafini affair -
13) Select USA - US Chemical Industry -

Friday, May 31, 2013

Nutritional powerhouses: raw kale and chard chips

Hankering after a crunchy, savory snack? When this craving hits me I usually try to satisfy it with some organic air-popped popcorn, tossed with a little truffle oil and topped with truffle salt. However, this spring my friend Ann’s amazing organic garden has produced a serious crop of rainbow Swiss chard and kale, and she generously shares her bounty with me. Just look at the size of those rainbow chard leaves!
Plus, I received a food dehydrator for Mother’s Day which I’m excited to break in. So, today I thought I’d try my hand at making some raw kale and chard chips.

I knew that kale and Swiss chard were healthy food choices, but I didn't realize the magnitude of their nutrient value. Kale and Swiss chard are leafy greens that are truly nutritional powerhouses. To say that their health benefits far surpass popcorn is putting it mildly! If you’re trying to eat more nutrient dense foods, these are two greens you must not pass up. Here are a few reasons why: Swiss chard, for example, has been found to help regulate blood sugar in studies done on animals (1).  It’s also been shown to help pancreatic cells regenerate (1). Swiss chard is an antioxidant, an anti-inflammatory and supports bone health as well because of its high supply of calcium, magnesium and Vitamin K (1).

Kale is a cruciferous vegetable. Research suggests that we should include cruciferous vegetables in our diet "2-3 times per week, and make the serving size at least 1-1/2 cups. Even better from a health standpoint, enjoy kale and other vegetables from the cruciferous vegetable group 4-5 times per week, and increase your serving size to 2 cups" (1). Included among the many nutritional benefits of kale are its: antioxidant, anti-inflammatory, cardiovascular support and anti-cancer properties which are due to nutrients in the form of glucosinolates (1).

So, adding raw kale and chard chips to your list of healthy raw snacks is definitely a smart choice. Each is low in fat and cholesterol, but an excellent source of fiber. Besides calcium, iron and vitamins A and C, these greens also supply vitamins E, K and B6, thiamine, folate, riboflavin, magnesium, manganese and potassium (3). If you want to learn more about the nutritional value of the foods you're eating, check out these excellent sites - USDA Nutrient Data Lab (NDL) and the World's Healthiest  For more detailed information about the nutrients found in raw kale and chard, click here for kale and here for chard. Compare with air-popped popcorn here.

So here's the recipe:

  1. I started with about 12 leaves of kale and a big bunch of chard. 
  2. I cut the large center ribs out of the kale and chard and saved the kale ribs to grind in my Vita-mix smoothie and the chard ribs for another recipe.  I enjoy these sautéed in olive oil with some chopped fresh garlic.  
  3. Next, I washed the kale and chard leaves and laid them out on paper towels to dry. 
  4. Then I put the kale leaves in a large bowl, along with 1 T (15 ml) grapeseed oil, 1 t (5 ml) garlic powder and ground in some pink Himalayan sea salt to taste.
  5. Sort of hand kneaded the leaves in this mixture and then spread them on the lower tray in the dehydrator trying not to overlap too much.  I’m using a Nesco dehydrator.

  6. Now, for the chard leaves – I cut these into approximately 3 inch square pieces and put them in a large bowl with 2 T (30 ml) truffle oil, (since I had more chard leaves I used more oil, but I will use less next time), 1 t (5 ml) garlic powder and ½ t (2.5 ml) truffle salt.
  7. Tossed the leaves with my hands to mix and then spread them on the remaining trays.
  8. Set the temp to 115 degrees F or (46 C) and set the timer for 6 hours. 
  9. Check for crispness.
Note: A few food bloggers had mentioned that dehydrating certain foods can really stink up the house. So, as a prevention I put the dehydrator in the utility room, closed the door, and turned on the exhaust fan.  I didn’t find the odor to be overly offensive, but there was definitely a smell.

Next time I make these chips I'd like to try nutritional yeast for a cheesy chip and maybe include some turmeric for extra health benefits and nutritional value. Studies show that turmeric may help fight infections and some cancers, reduce inflammation, and treat digestive problems.

Food really is our best medicine! Enjoy.

6/18/13 Update:  These didn't store well for me.  I put them in a sealed glass container, but they didn't stay crispy, so I ended up chopping the chips up and putting the into a frittata.  I also think they were a little to oily and salty so I will reduce both of these ingredients next time.

World's Healthiest Foods - Swiss chard
World's Healthiest Foods - Kale
USDA Nutrient Data Lab
University of Maryland Medical Center - turmeric

Friday, October 5, 2012

Breast Cancer Awareness Month: Seeing red over pink!

image of pink lit White House from CBC News
It's that time of year when I see red, even though October is all about the color pink. That's because it's Breast Cancer Awareness Month. Here in the states it's referred to as National Breast Cancer Awareness Month (NBCAM), and even the White House is wearing pink! This whole pink thing is really getting old and frankly, since going through my own breast cancer experience, I find I'm actually angered by it all. Now that I've gotten that off of my, er, dare I say, chest - I'll get straight to the issue. How could a positive thing like raising awareness about cancer rouse me to anger?

Well, before I tackle that question, I want to be clear that this isn't going to be a post bashing America, or medical experts, researchers, charities or any others that have made a positive difference in the diagnosis and treatment of breast cancer or any cancer. My family and I have personally benefited from these things, and I am especially grateful for early detection. My hope is that this post will provide some food for thought.

Experts agree that an increased awareness about a disease may encourage a person to receive medical screening that can lead to early detection (6). Obviously, this is a good thing. But after more than 25 years of raising awareness, is NBCAM actually impacting the early diagnosis of breast cancer? A recent study published in the Journal of Health Economics researched this question and they found the answer is no, not any more (1). So, if NBCAM is no longer effectively raising public awareness about breast cancer or encouraging early detection via screening, than why is it we are seeing more pink than ever? I believe it's because breast cancer has turned into a profit generating industry, and I'm not alone in this thinking.

Profiteering of breast cancer? -
What ever happened to the thinking that:

"An ounce of prevention is worth a pound of cure." Benjamin Franklin 

Benjamin Franklin's quote holds true for those of us health seekers doing our best to prevent disease. But how does this resonate with, for example, a pharmaceutical company, whose bottom line is to make a profit? Let's face it, there's just not much money to be made in preventing breast cancer, or any cancer for that matter. Consider the primary breast cancer treatments to date: slash, burn and poison, otherwise known as surgery, radiation and chemotherapy. In a previous post I discussed an instance where a pharmaceutical company that produced a chemotherapy drug also made a bovine growth hormone being used in dairy cows. This hormone has been linked to an increased risk of breast cancer (5). But, hey, we've got a drug for that.

Whose interests are being served here? This is just one sad example of how some corporations have turned breast cancer into a profitable industry. Breast Cancer Action explains it this way:
 "The cancer industry consists of corporations, organizations, and agencies that diminish or mask the extent of the cancer problem, fail to protect our health, or divert attention away from the importance of finding and working to prevent the disease. This includes drug companies that, in addition to profiting from cancer treatment drugs, sometimes produce toxic chemicals that may be contributing to the high rates of cancer in this country and increasing rates throughout the world. It also includes the polluting industries that continue to release substances that are known or suspected to be dangerous to our health, and the public relations firms and public agencies that protect these polluters. The cancer industry includes organizations like the American Cancer Society that downplay the risk of cancer from pesticides and other environmental factors, and that historically have refused to take a stand on environmental regulation. " (3). 
More to NBCAM than meets the eye?-
So what does National Breast Cancer Awareness Month (NBCAM) have to do with this? Well, let's see. According to Wiki, NBCAM "is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. The campaign also offers information and support to those affected by breast cancer. As well as providing a platform for breast cancer charities to raise awareness of their work and of the disease, BCAM is also a prime opportunity to remind women to be breast aware for earlier detection." This sounds great doesn't it?

Well, if we look a little deeper, we find that NBCAM was formed by Imperial Chemical Industries, the creator of Tamoxifen, a breast cancer treatment drug. In the 90's, Imperial Chemical Industries spun off Zeneca Group. Then Zeneca merged with Astra and became Astra Zeneca, which formed a non profit arm that is known today as AstraZeneca Healthcare Foundation, one of the largest financial contributors to NBCAM.  Astra Zeneca also created and markets Arimidex, another breast cancer treatment drug. CancerCares was also involved in the formation of NBCAM. A look at their donors reveals several pharmaceutical companies as well. So, what message would you want to spread if you were a drug manufacturer financially invested in breast cancer treatment medications? Probably not prevention.

I do want to acknowledge again that cancer treatment drugs are not bad. I'm just saying that it's a fact that pharmaceutical companies spend a lot of money on the research and development of new drugs. Forbes  published an article earlier this year that puts the dollar amount between a high of $12 billion and a low of $55 million (4). Considering the magnitude of expense to produce a drug, pharmaceutical companies must be under an enormous amount of pressure to deliver a drug that will generate revenue and for that they need a disease to treat. As I said earlier, there's no profit in prevention.  

Pink washing -
This brings me to what has come to be known as the "pink washing" of breast cancer. You can read more about this here. The term "pink washer" has been used to describe a company "that purports to care about breast cancer by promoting a pink-ribboned product, but manufactures products that are linked to the disease" (Breast Cancer Action) (2). The point is non-profit organizations accepting donations from companies that stand to gain from their philanthropy seems to represent a conflict of interest to me. It's no wonder that little focus is being placed on breast cancer prevention! It's much more profitable for these powerful industries to keep the emphasis on looking for the so-called "cure", which is really just another word for drug treatment.

Awareness, screening and a cure are NOT prevention -
Let's face it,  awareness, screening and early detection is a means to find disease, not prevent it. A cure is defined as the "restoration of health; recovery from disease" (7). Primary prevention of disease is about avoiding or reducing the risk factors for disease. After over 25 years of seeing pink, I think it's safe to say we are aware of breast cancer. I can't help but wonder where we would be now if that focus had been directed toward the prevention of breast cancer.

Well, we can't go back, but we can take action going forward! Let's think before we let our emotions be swayed by all things pink. Let's do some due diligence when donating to a charity.  Where does our money go?  How much of what is spent on that pink colored item will go toward breast cancer prevention research? What chemicals are in my pink marketed cosmetics or foods that my be adversely affecting my body? What's my elected official's stance on this topic? Let's tell those in government how we feel about these issues. Going forward we can shift the focus from awareness to prevention, because the only way we can be cancer free is by preventing cancer from occurring in the first place! 


(1) Health awareness campaigns and diagnosis rates: Evidence from National Breast Cancer Awareness Month
Grant D. Jacobsena, Kathryn H. Jacobsen, Journal of Health Economics
(2) Breast Cancer Action,
(3) Breast Cancer Action, 
(6) Planning Implementing and Evaluating Health Promotion Programs, James McKenzie, et al, 4th ed., Pearson, 2005.
(7) The Free Dictionary

Tuesday, March 6, 2012

Increase weight loss by working out less?

Really? -
Judging from the ever rising overweight/obesity rates in the United States, I think it's safe to assume that a majority of Americans subscribe to the work out less plan. I find it a bit alarming when scientific data is released and the news takes a portion of a study's findings out of context and reports on it. Typically we can end up misguided and confused. That's why it's so important to understand the bigger picture surrounding "sound bites" like this post's title. This reminds me of a radio ad that would, ironically, air while I was training at the gym.  The advertisement was pushing a diet pill which promised weight loss without the "unhealthy stress and strain of exercise"! I'll spare you a rant, but I will say that the ad was eventually changed so that it did not include the word unhealthy.  Calling exercise unhealthy is blatantly inaccurate. Yet, unfortunately this isn't obvious to everyone. But I digress...

What's going on? -
Saying that we can increase weight loss by working out less is ambiguous because this statement tells only part of the story. So, before you scratch that workout off your to-do list, please read on. According to a study published in the American College of Sports Medicine's (ACSM) Journal of Medical Science and Sports Exercise, it's possible to burn more calories and spend less time working out. However, the key to this result lies in how intensely you workout. Before I go on, it might be helpful to recall the caloric balance equation and its role in weight maintenance, and you can read more about this in a past post found here.
Image from CDC website
Consider a typical day of food consumption and energy expenditure. Simply put, if calories eaten exceed calories burned, we end up with a calorie surplus for that day and over time this leads to weight gain. On the other hand, if we burned more calories than we ate, than over time this leads to weight loss. If  calories in are equal to calories out, the scale is in balance and weight is maintained. Another thing to keep in mind is that we are always expending energy, even while we're resting.

Back to the study - The researchers wanted to see what the energy expenditure at rest of males, aged 22 to 33, would be on a day when they performed a vigorous indoor cycling exercise bout vs. on "a controlled resting day" when they performed no exercise at all.  I underlined and bold faced the word vigorous because this is very important to note. In this case vigorous exercise is defined as performing a physical activity at a level that causes you to be too out of breath to talk. Working out at this intensity level "resulted in a significant [emphasis added] elevation in post exercise energy expenditure, that persisted for 14 hours" after the exercise bout ended (ACSM).

Wow! This sheds some much needed light on that rather ambiguous statement that implies we can increase weight loss by working out less. Now we understand that it's possible to decrease the amount of time we spend working out, but this must be accompanied by an increase in the intensity of our workout to a vigorous level. This is because the research suggests that we can burn additional calories above and beyond what we burned during the workout, even while we're at rest! This is sometimes referred to as caloric after burn.

Here's the data: During the vigorous cycling bout these guys expended 520 calories (kcal).  This isn't surprising because we all know exercise expends calories. We also know that vigorous exercise burns more calories than low and moderate intensity exercise. However, what is really exciting is that after the men finished exercising, and with their post exercise activity level restricted and monitored, they continued to  burn an additional 190 calories (kcal)  during the 14 hours after their workout, as compared with control days when the men were inactive. "The 190 calories burned after exercise above resting levels represented an additional 37% to the net energy expended during the 45-min cycling bout." 

Bottom Line - 
The study's test subjects were young men, so the results may not be the same for women, or for an older population.  Also, we might not be able to workout at a vigorous level for 45 minutes. Given this and other studies on vigorous intensity exercise which show the added benefit of caloric after burn, it seems beneficial to try to incorporate little bouts of vigorous intensity exercise in our workouts. But if you've never exercised, or haven't worked out in years - BEGIN SLOWLY and always consult your physician before beginning any exercise program. Obviously any exercise is better than none, but I like the idea of putting in a little more effort, giving it a little less time and reaping bigger rewards from my workout.  It seems like a win/win to me and that's no sound bite.

In the next post there will be some suggestions for vigorous intensity bout exercise programs and also a discussion relating to another study that shows bouts of vigorous intensity exercise have been shown to be beneficial in reducing inflammation in overweight and obese men. Chronic inflammation is linked to all kinds of health problems.

In the meantime, keep moving! 

ACSM - American College of Sports Medicine -
chronic inflammation -

Saturday, January 21, 2012

Try a new f-word while exercising - FUN!

How's that New Year's resolution you made to exercise coming along? Maybe you've doubled down on your efforts, but are wondering if it's really worth it. Why does something that we know is good for us and that seemed so exciting just a few weeks ago, turn into a lackluster chore we begin to avoid? Rather than dreading it, slugging it out half-heartedly or abandoning your goal altogether, how about considering a different strategy? Try putting a little fun in your exercise program!

Yes, you read that right. FUN! Okay, so, maybe for you another F-word comes to mind when thinking about exercising, but, before you discount the idea as absurd, think about it for a minute... Can exercise really be fun and if so, what could make it fun? I think our response to this question might be influenced by our past experiences with physical activities.  Reflect back to when you were a kid. Did you ride a bike, a skateboard, or a scooter? Did you play tag, hide and seek, jump rope, and run races? What about shooting hoops, roller-blading or hula-hooping? You get the idea. These are all physical activities that for most of us are associated with fun. Now, what comes to mind when you think about your next workout on the treadmill, elliptical trainer or recumbent bike? If you said fun, good for you, but you're definitely in the minority.

The bottom line is for many of us is that physical activity has lost this element of fun. So, if your wondering why you're struggling with waning motivation, or you've moved past that stage to just giving up altogether, take a look at your workout and ask yourself - is this fitness routine boring and uninspiring? Case in point, faced with taking the stairs or the escalator, which would you choose? Well, not surprisingly, an experiment conducted by Volkswagen found that the majority of people would use the escalator - that is until they made the stairs fun.  Check it out:


 If you're wondering, how do I make my workouts fun?  Here are a few suggestions:
  1. Revisit some of the childhood activities you once liked to do, although you may have to scale them back to accommodate your current fitness level
  2. Know what you like and reward yourself for doing it. If you find being outside exhilarating, than choosing a form of indoor exercise isn't going to work for you.  Consider hiking through a local park, planting a garden or walking the dog.  Commit to it and reward yourself when you reach a predetermined goal. See SMART goals post here on how to set specific, measured, attainable, realistic and time-targeted goals, another key to being successful.
  3. Progress g r a d u a l l y. This prevents pain and injuries. Remember, we had to learn to crawl before we walked. This applies to everyone. Even if you were a super athlete in college. If you've not exercised in a few years - you need to take it slowly. A few words about exercise and pain. Now, don't get me wrong, there will be a measure of discomfort, but this isn't pain and it will decrease over time. Exercise shouldn't be torture.  The old "No pain no gain" thinking has been replaced with the much wiser - "Train, don't strain."
  4. Mix up your activities.  Variety is the spice of life, so they say and in this case it helps to prevent overuse injuries, as well as boredom and monotony.
  5. Enlist the help of a buddy. Exercise is more fun if you have the support of a like minded friend. Mutual encouragement is a wonderful motivator.
  6. Make exercise less like a "routine" and more like a game - a mental game that is.  Set a little "contest" for yourself for each physical activity you undertake.  For example, today when I perform the plank I'm going to hold this position for 10 extra seconds.  Make this  mini-challenge attainable, but not too easy, and then make sure you congratulate yourself when you win. 
Of course, always check with your physician before beginning any exercise program.

So, are you ready to stop cursing those dreaded workouts and put some fun back into fitness? Just give these ideas a try and perhaps you'll find a new attitude about your exercise resolution. You've got nothing to lose, right? Well, except maybe the few pounds you've resolved to lose already.   I look forward to hearing all your success stories. Happy new year!

Association for Applied Sports Psychology - Exercise Adherence -
The Fun Theory -