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Scottish Cancer Prevention Network | Putting Prevention First

Breastfeeding reduces risk of breast and other female cancers and has other benefits for women

IMG_0808In Scotland, this is national breastfeeding week- a celebration of what has been achieved but also a call to reflect on how we might do better. With colleagues in the School of Nursing and Midwifery at the University of Dundee and other experts across the UK, I am a signatory to a statement calling for a change in the culture to provide all women with the right support, at the right time, in the right place to initiate and maintain breastfeeding. And yes… breastfeeding is relevant to a cancer prevention network.

ECAC BF

The European Code Against Cancer recommends:

“Breastfeeding reduces the mother’s cancer risk. If you can, breastfeed your baby”.

The background review paper reports:

  • Protective effect against breast cancer at all ages
    • 2% reduction per 5 months breastfeeding
    • The longer breastfeeding is continued the better
    • Exclusive BF impacts on ER- and ER+ cancers
  • Modest protective effect against ovarian and endometrial cancer

Breastfeeding_and_Breast_Cancer_Risk

And there is more ….

Breast feeding is associated with

  • More rapid return to pre-pregnancy weight
  • Lower incidence of the metabolic syndrome for mother (and decrease risk of type 2 diabetes)
  • Lower body weight in later life

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Everyone knows about the nutritional benefits of breast milk and the amazing immunological benefits but the long term effects (largely associated with reduced exposure to oestrogens) should not be forgotten.

Supporting our daughters and granddaughters to appreciate the lifelong effects of breast feeding must be central to women’s health which is why we call for education for children, through to support from health professionals as a key part of health for all.

Professor Annie S. Anderson

Breast Cancer and Lifestyle – what do we know about alcohol?

The World Cancer Research Fund with the American institute for Cancer Research have recently published the most comprehensive review on breast cancer and diet, nutrition and physical activity http://www.wcrf.org/sites/default/files/CUP_BREAST_REPORT_2017_WEB.pdf.

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The work is exemplar because it does not simply take estimates derived from one source but brings together an international panel of experts to review all available evidence. WCRF estimate that around 38% of the disease is due to lifestyle (and that is before we think about smoking!), which is similar to estimates of around 30% reported by Howell et al https://www.ncbi.nlm.nih.gov/pubmed/25467785.

The report makes interesting reading, and to highlight some of the findings we thought you might like to test your knowledge on some key topics starting with alcohol and breast cancer.

Menopausal status

  • Alcohol is implicated in both pre- and post- menopausal breast cancer
  • In pre-menopausal cases there was a 5% increase risk per 10g alcohol per day (one small glass of wine)
  • In post-menopausal cases there was a 9% increase risk per 10g alcohol per day
  • In post-menopausal cases there were significant associations between alcohol intake and different hormone receptor cancers (ER+PR+ and ER+PR-)

Units Infographic

The mechanisms of how alcohol influences breast cancer are complex

  • The content of overall diet e.g. a low intake of dietary folic acid
  • Alcohol is metabolised to acetaldehyde which can cause DNA damage
  • Alcohol can act as a solvent which increases the ability of carcinogens to enter cells
  • Alcohol may increase circulating oestrogen levels
  • The impact of alcohol in breast cancer may be affected by a range of genetic factors which alter the sensitivity of breast cells to carcinogens

For more information and further details we recommend http://www.wcrf.org/sites/default/files/CUP_BREAST_REPORT_2017_WEB.pdf

Interested in research into cancer prevention and management in relation to nutrition and physical activity?

The WCRF/AICR work on diet, physical activity and alcohol highlights that around 25% of all cancers are due to these lifestyle factors. Research on how we can change these health behaviours for primary prevention and cancer recurrence is challenging but internationally there is a growing number of investigators working in this area.

I have just returned from the annual meeting of the International Society of Behavioural Nutrition and Physical Activity (ISBNPA) in Canada where our special interest group (SIG) on cancer prevention and management provides a great forum for sharing research findings on lifestyle interventions. Continue reading “Interested in research into cancer prevention and management in relation to nutrition and physical activity?”

Scottish Curriculum for Plant-Based Living: Brazilian aspirations

Our last blog by Anna Strachan (@obesityactionsc) left us thinking how we can start to change our Scottish diet high in processed foods. I have previously written about the new Scottish diet but the Brazilian challenge focuses the mind!

The European Code Against Cancer supports the concept of a plant based diet and we need to think creatively about how we can help Scots put that in place. “Inspiration and directions” from our amazing Scottish food heritage doesn’t need to use foods grown exclusively in Scotland – we have fabulous opportunities to create fusion cuisine from many unprocessed ingredients. The joy of cooking doesn’t need to be about cake baking, supermarket recipes or designing pizza, but simple pleasures from simple ingredients.

It is encouraging to see the Brazilian dietary guidelines promoting the development of cooking skills. For many years, we [University of Dundee] carried out a trial on the impact of cooking skills on dietary intake and reported a modest effect on food choice and cooking confidence. We focused on cooking skills people wanted to learn, but what if we had focused on what we thought might be most worthy ?

If the SCPN was asked for a curriculum for school children, or students or adults or anyone…here would be our starting points for the skills for a Scottish plant based diet (skills like preparing fish, meat and other Scottish exotics can come at a later date). The value of food classes come not just from preparation, but the time taken to share, enjoy and appreciate. Readers, would you support a curriculum for plant based living?

  • Making, serving and eating Porridge

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    • Served straight
    • Served with added fruits and nuts
  • Creating and eating home-made breakfast cereal mix

    • Start with oats and add (barley flakes, dried, fresh or frozen fruit, seeds)
  • Planning, making and tasting seasonal soups (2 sessions)

    • Broths
    • Veggies based soups
    • Barley based winter soups
    • Chilled soups
  • Designing, preparing and chomping seasonal salads (2 sessions)

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    • Starting with base ingredients
  • Cabbage, kale, lettuce, salad greens

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    • Adding colour mix
  • Tomatoes, carrots, cucumber

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    • Adding the seasons – herbs, fruits and the colours – red, purple, yellow
  • Baking bread, rolls and bases

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    • Wholemeal, wholegrain, mixed fours, seeds – endless combination and creative opportunities

So there are the first eight, with more to follow of course – fish, wee meat portions (and no one needs to know about sausages and other processed meats) but let’s get the basics done first!

What shall I eat in Brazil and in Scotland?

Who has recently opened their fridge, contemplated the contents and pondered: “What shall I eat?” Naturally, you can only eat what is in there. What was in there? If you have been inspired by the SCPN’s #HealthyShelfie campaign, there is a good chance you could pick from fresh wholesome foods. If you really nailed it, the contents of your fridge could tell the season of the year or even which country, or part of a country, you live in.

01 - A Green Start To The Year

F Marian McNeill described the times pre-Agrarian Revolution (pre 1750s) in her book The Scots Kitchen:  Its Tradition and Recipes: “In the olden times, when the population was small and parse – by the beginning of the sixteenth century it did not exceed half a million – the means of sustenance were on the whole plentiful. The moors and forests abounded with game; elsewhere ‘herds of kye nocht tame’ with flesh of a marvellous sweetness, ‘of a wonderful tenderness, and excellent delicateness of taste’ ranged the hills. Rivers, lochs, and seas teemed with fish. Sheep were valued mainly for their wool, cows for their milk. Butter and cheese were in use in the earliest times and the oat and barley crops have always provided the staple bread”.

She painted a beautiful picture of the Scottish food heritage. Two centuries later, Lord Boyd Orr, director of the Rowett Nutrition Institute gave a different account of the Scottish diet: “Up until the middle of the last [nineteenth] century, the people of Scotland were eating natural foodstuffs. With the introduction of machinery, this has been changed… Natural foods have been changed into artificial foodstuffs, with the very best substances purified away that the Almighty put there to keep us in perfect health.”

Today, Scottish land, waters and resources combined with a reviving food culture and cutting edge research have the potential to make the Scottish diet one of the healthiest in the world. Unfortunately, this is not the case. In Scotland, diets are shaped on the one hand by eating too little nutritious food, such as fruit and vegetables, oil-rich fish, nuts and seeds, and high-fibre carbohydrates, and on the other by eating too much fat, sugar and salt. The outcome is an overconsumption of energy and nutrient-poor foods such as heavily promoted confectionery, cakes, biscuits, pastries, savoury snacks and sugary drinks. These foods, historically considered as treats, are now eaten frequently as snacks. Sadly, many Scottish adults do not recognise the problem believing their diets to be healthy. The question is: What can we do about it?

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© World Obesity

In 2014, the Brazilian government introduced very different dietary guidelines which focused on environmental sustainability and in which food was framed as a cultural and social value. The guidelines categorise foods according to the extent of processing rather than recommending levels of separate nutrients. This approach encourages fresh and minimally processed foods and actively discourages consumption of ultra-processed foods and drink products. The guidelines recommend traditional, healthy foods and give ideas for healthy breakfasts, lunches and dinners. They give ten recommendations and one Golden Rule: “Always prefer natural or minimally processed foods and freshly made dishes and meals to ultra-processed products.”

Anyone, when asked ‘What to do to eat healthily?’ could come up with most of the Brazilian dietary recommendations:

  1. Make unprocessed or minimally processed foods the basis of your diet
  2. Use processed culinary ingredients in small amounts for seasoning and cooking foods and to create culinary preparations
  3. Limit consumption of processed foods
  4. Avoid ultra-processed products
  5. Eat regularly and carefully in appropriate environments and, whenever possible, in company
  6. Shop in places that offer a variety of natural or minimally processed foods
  7. Develop, exercise and share cooking skills
  8. Plan your time to make food and eating important in your life
  9. Out of home, prefer places that serve freshly made meals
  10. Be wary of food advertising and marketing

Could we use a similar guide in Scotland? Would it be more effective at improving national diet or perhaps the contents of your fridge?

One thing is certain: Scottish diet is poor and we need to do whatever we can to improve it. Getting inspiration and directions from our amazing food heritage and culture could lay the foundation to Scottish diet becoming one of the healthiest in the world.

6 Ways To Reduce Your Risk Of Bowel Cancer

by Sarah Toule, Head of Health Information at World Cancer Research Fund UK

Bowel cancer is the UK’s second biggest cancer killer. However, by making a few simple lifestyle changes, we have the power to significantly lower our risk of developing this common disease.

Continue reading “6 Ways To Reduce Your Risk Of Bowel Cancer”

Raising awareness of the causes of bowel cancer and making a difference!

Is your glass half full or half empty? Around 50% of bowel cancer is related to lifestyle – most notably eating too much red and processed meat, drinking too much alcohol, consuming too many calories, taking too little fibre and not doing enough physical activity. Excess body weight is an important cause too – especially in men. Around 50% of the disease is due to other causes – genetics, environment, unknowns.

Continue reading “Raising awareness of the causes of bowel cancer and making a difference!”

Finally, the FIT Revolution is Here

April is Bowel Cancer Awareness Month, which again offers us the opportunity to further publicise all aspects of bowel cancer screening, diagnosis and prevention. It is the UK’s second biggest cancer killer. However, if detected early, this cancer is eminently treatable and curable and almost all people diagnosed at the earliest stages will survive.

Continue reading “Finally, the FIT Revolution is Here”

Early Cancer Diagnosis? Good News!

Why should receiving a diagnosis of early cancer be good news?  Well the reason is simply that, in most instances, early cancer is completely curable.

This of course calls into question the definition of curable, but if we accept that a reasonable definition is dying of an unrelated cause, with no evidence of the “cured” disease in question, then the majority of cases of early cancer are truly curable.

Continue reading “Early Cancer Diagnosis? Good News!”

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