Life Over Cancer Blog

Planning a BBQ? What you need to know before firing up the grill.

With the unofficial start of the outdoor barbecuing season almost upon us, here’s something to think about before firing up the grill: the food you’re about to cook may very well contain known carcinogens!

Research shows that grilling red meat, poultry, and fish at high temperatures causes the production of two carcinogens to form: heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). These compounds are produced when a combination of creatine (a specific amino acid found in muscle) and sugars, which are both found naturally in meats, are heated during cooking. Grilling is particularly carcinogen-forming because the process involves high heat and long cooking times. And although levels of HCAs increase with heat and time — meaning well-done meat contains more carcinogens than meat less well-cooked — meat need not be well done or charred to contain HCAs. In fact, testing has found HCAs in grilled chicken cooked for just three minutes on each side!

Common diabetes drug, metformin, appears to reduce cancer risk

Metformin, a commonly prescribed drug for the treatment of type 2 diabetes, has been touted in several recent studies as having the potential to reduce the risk of cancer in people taking it to control their disease.

Metformin (Glucophage) helps control both insulin levels and the amount of glucose produced by the liver. It’s given to people with type 2 diabetes who have not been able to control the disease through lifestyle changes – diet and exercise.

Since type 2 diabetes affects millions of people and those numbers continue to rise – even among children and teenagers – there is a lot of scientific interest directed toward this population. It has been observed that those taking metformin to control their disease also seemed to have less risk for certain cancers.

Moreover, lab studies have shown an association between metformin and its ability to cause the death of cancer cells.

Study: Global Effects of Sugar on Diabetes

As if we need another reason to stay away from sugar, an interesting one was recently provided by a team from California that includes Robert Lustig, a professor of clinical pediatrics at the University of California, San Francisco. Because this study concerns sugar and diabetes, it has an important message for cancer patients: type 2 diabetes is one of the major risk factors for getting cancer. In addition, we know that the nutritional processes involved in diabetes have implications for cancer patients.

Lustig and his colleagues assessed the relationship between sugar availability, obesity, economic development and diabetes prevalence in 175 countries around the world between 2000 and 2010; they also included data on several other food types, as well as variables like aging and urbanization. Rather than using data on individual patients, like clinical trials, they used data that applied to entire countries. For instance, the Food and Agriculture Organization has data on availability of sugar (including all types, sucrose, fructose and others), as well as things like fruit, meat or calories eaten per day. Other country-level data that the authors used included: how much of the population was obese or overweight, gross domestic product (a measure of overall economic development), and percentage of elderly people in the country. All these variables have previously been correlated to diabetes.

The study combined all the variables in a statistical model that allowed them to determine how much each of them contributed to diabetes prevalence in a country, which they obtained from the International Diabetes Federation. They checked on the data in several ways to make sure their results made sense. Here is some of what they found:

• Worldwide prevalence of diabetes increased by 27% from 2000 to 2010. That’s a frightening statistic if ever there was one!
• Sugar availability on its own accounted for a quarter of this increase. If a country experienced an increase of 150 calories per person per day in sugar availability (that’s the amount of sugar in a single can of soda!), its rate of people with diabetes increased by 1.1%. This was much more than any other food contributed to diabetes, and more than even total caloric consumption, which increased diabetes by only 0.1% with an increase of 150 calories per day per person of total food consumed.
• The other major contributors to increasing diabetes prevalence were obesity and gross domestic product. 

We know that obesity is related to diabetes, especially type 2 diabetes (this study does not distinguish type 1 from type 2 diabetes, but type 1 makes up only 10% of all diabetes). Gross domestic product is rather interesting: it’s a complex variable that impacts everything from the prevalence of desk jobs to dietary changes to stress. Every increase of 1% in gross domestic product resulted in a 1.07% increase in diabetes prevalence.

Some other interesting findings from the study confirm these major trends:

• In some countries, such as the Philippines, Sri Lanka and Bangladesh, diabetes rose rapidly but obesity did not. In these countries, it turned out, sugar availability rose by at least 20% in the 10 years surveyed in the study.
• The longer a country was exposed to high sugar availability (over 300 calories worth of sugar per person per day), the more its diabetes prevalence increased.
• If a country’s sugar availability decreased (usually due to changes in trade agreements) its diabetes prevalence decreased significantly.

The authors point out that changing the details in the variables used (for instance, adding alcohol or physical inactivity or smoking), did not change the sugar relationship to diabetes, and these variables did not make a statistically significant difference in diabetes prevalence. 

So what can we conclude from this study?

Mainly, we see that sugar consumption contributes much more to diabetes prevalence than we had thought. However, sugar consumption is not the only dietary concern when it comes to diabetes prevention – fiber intake, the consumption of healthy fats, and total caloric intake also play a role. (In addition, it should be noted that regular exercise can also help in the prevention of diabetes.) But if we were to select a single food to target for population-wide reduction or elimination, sugar looks like the one to go after!

If you are a cancer patient, it’s important to know that type 2 diabetes, and even pre-diabetes, can result in high insulin levels in your blood as well as high blood sugar levels. And elevated levels of insulin in the blood have been found to increase the risk of several cancers.

We know it isn’t easy to break long-standing dietary habits, but hopefully understanding the link between sugar and diabetes will help inspire you in your efforts to eliminate unhealthful sugars from your diet!

Reference: Basu et al. PLOS One.  2013; 8(2) e57873.

 

Ask Dr. Block: Preventing Cancer

Would you share suggestions on how to keep from getting cancer? I have had multiple different types of cancer as well as precancerous sites.

I’m not sure whether you have had cancer originating in several different organs, or whether you are discussing one cancer that has gone to several different sites in the body. From your description, I’ll assume it’s the first, such that you could have had, for example, skin cancer, breast cancer and colon cancer.

If this is indeed the case, you should first be assessed for one of the genetic cancer risk syndromes so that your doctors can advise you more accurately about monitoring and prevention. I would also suggest a comprehensive lifestyle program, with a plant-based whole-foods diet, and an exercise and stress management program tailored to your specific needs.

It would also be helpful for you to get a comprehensive assessment of what I have long referred to as your internal “biochemical terrain.” This would allow us to assess for abnormally high levels of inflammation, oxidation, glycemia or other terrain factors that could be contributing to your history of “multiple different types of cancer.”

In my book, Life Over Cancer, the chapters addressing our core diet, prescriptive exercise and personalized mind-spirit programs would be important for helping you put together a more comprehensive regimen for combating your illness. Additionally, I would suggest the chapter on “what to do when treatment ends” which focuses on the first year you are cancer free, as well as the “remission maintenance program,” which details a long term plan for remaining cancer free.

For more information on The Block Center for Integrative Cancer Treatment, visit BlockMD.com.

Preventing Colon Cancer: What You Need to Know

By Keith Block, MD

According to the Colon Cancer Alliance, colorectal cancer is the third most commonly diagnosed cancer in the United States, and the second leading cause of cancer deaths.  The American Cancer Society estimates that in 2012, 143,460 people will be diagnosed and that 51,690 will die from colon cancer in the United States. Appropriate screening is extremely important, as the survival rate for people with colorectal cancers found early is more than 90 percent.

Getting the Most Out of Tamoxifen

By Keith Block, MD

Many women with breast cancer are aware of a recent long-term British study showing that taking the generic drug tamoxifen for five years resulted in a significantly lower risk of their cancer returning when compared to only taking the drug for two years.  In this clinical trial, nearly 3,500 breast cancer patients were studied for over 10 years.  The findings, published in the 1 May 2011 Journal of Clinical Oncology, showed that breast cancer returned in around 40% of those who took tamoxifen for five years, compared to 46% among those who took it for two years.