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:
In 2007, the International Agency for Research on Cancer|World Health Organization (IARC|WHO) concluded that the effects of shift work on the disruption of normal circadian rhythm had a probable link to breast cancer. IARC suggest that our endogenous 24-hour body clocks may be subject to interference by factors such as exposure to light at night, and it’s impact on melatonin levels may be linked to breast cancer. However, a recent meta-analysis led by Dr Ruth C. Travis published in the Journal of the National Cancer Institute concludes that night shift work may actually have very little effect on breast cancer risk.
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.
Colorectal cancer is the fourth most common cancer in the UK and its incidence is increasing. However, survival rates are also increasing. In Scotland, age-standardised, five year survivorship rates have increased from 42.9% in 1987-91 to 64.7% in 2007-11. More people surviving after a bowel cancer diagnosis is fantastic news, but there is considerable room for improvement in both quantity and quality of years; multi-modal treatment pathways, risk of complications and the possibility of a stoma can cause prolonged physical and psychological recovery.
The World Cancer Research Fund with the American institute for Cancer Research have recently published the most comprehensive review on breast cancer and it’s relation to diet, nutrition and physical activity. Click on the following link to read this compelling review in order to find out how certain lifestyle choices may increase or decrease risk of breast cancer.
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!
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.
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?
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:
- Make unprocessed or minimally processed foods the basis of your diet
- Use processed culinary ingredients in small amounts for seasoning and cooking foods and to create culinary preparations
- Limit consumption of processed foods
- Avoid ultra-processed products
- Eat regularly and carefully in appropriate environments and, whenever possible, in company
- Shop in places that offer a variety of natural or minimally processed foods
- Develop, exercise and share cooking skills
- Plan your time to make food and eating important in your life
- Out of home, prefer places that serve freshly made meals
- 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.
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.
The role of obesity in cancer is too big to ignore.
What is agreed is that Scotland needs a bold and brave strategy for tackling obesity. There will be no “one size fits all”. In our blog published on January 1st, we reflected on what has happened in 10 years and where we might progress. This week we are continuing this theme and have asked SCPN friends who have many years experience in the obesity field to give us their top 5 aspirations for the forthcoming obesity strategy? Continue reading “Scotland Obesity strategy – Scottish voices”