I saw an exciting news item for health and cancer risk reduction in the new Government programme for work in 2017-18 (A nation with Ambition). On page 95 (yes, you have to scroll quite far) I saw this announcement:
There aren’t many good things to report about dietary trends in Scotland but one that does stand out is our decreasing consumption of red and processed meat – albeit by a modest amount.
At 50, my youngest daughter made me call the local breast screening centre to ask if I had missed a letter inviting me to attend. She said “the late birthday card from the bowel cancer unit came within weeks of turning 50…” Happily the screening centre staff offered to give me an appointment but said I hadn’t missed an invitation, it was just that my GP area wasn’t being called in at that point in time. I went, got an all clear and had one happy daughter.
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
- 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)
- Veggies based soups
- Barley based winter soups
- Chilled soups
Designing, preparing and chomping seasonal salads (2 sessions)
- Starting with base ingredients
Cabbage, kale, lettuce, salad greens
- Adding colour mix
Tomatoes, carrots, cucumber
- Adding the seasons – herbs, fruits and the colours – red, purple, yellow
Baking bread, rolls and bases
- 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!
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.
Every time I show the slide that says “35% of Scottish women aged over 50 drink more than 14 units of alcohol per week,” I am reminded that this includes me. I would not describe myself as a heavy drinker, but I do drink more than I know is appropriate for my health. From my research on alcohol intake in women and breast cancer risk, I know that I am not alone in being reluctant to discuss the pleasure of red wine consumption with health professionals.
Eat plenty of wholegrains, pulses, vegetables and fruits is a very clear message from the European Code Against Cancer but one that Scots don’t do well on. Despite the familiar 5 a day message our national monitoring programme shows negligible changes in consumption of vegetable from around 126g per day in 2001 to 129g per day in 2012.
The relationship between obesity and cancer has been well described…and well ignored! Exposure to excess body fat will contribute to increased risk of some of the most common cancers including bowel and breast. Yet, few agencies working in the cancer settings (including the NHS) bring this to the attention of the millions of people who are in contact with healthcare every day. Many think it is a duty of care for people to be given advice on how to “stack the odds” against cancer occurrence (and recurrence) and that we deny people the opportunity to be supported to reduce cancer risk.
The association between body fatness and cancer risk varies by cancer site and by body size. What is clear however, is that aiming to achieve a Body Mass Index at the lower end of the healthy weight range is desirable (see WCRF recommendations on body fatness). The European Code Against Cancer guides us to “take action to be a healthy body weight.”