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Kelly Brittain: Dieting for the right reasons

July 11, 2018

Kelly Brittain is a registered nurse and an associate professor in the College of Nursing.

Cancer remains one of the top chronic diseases in the world. Many cancers are not preventable. However, it is possible to be proactive in risk reduction when it comes to breast cancer, prostate cancer, colorectal cancer and a few others. One way we can actively work to reduce cancer risk is by the foods we eat.

Earlier this year, U.S. News and World Report made a list of the Best Diet Rankings of 2018 to help people choose the diet that best meets their needs. These diets were ranked with nine categories in mind, including ease of compliance, likelihood of losing significant weight in the short and long term and effectiveness against cardiovascular disease and diabetes.

Inspired by this list of the Best Diets, I decided to examine how the top five U.S. News and World Report Best Diets stack up in terms of reducing cancer risk.

Each diet is ranked from one to five, based on four factors.

  • Does the diet include nine servings of fruits and vegetables per day that are associated with lowering your cancer risk? Fruits and vegetables like oranges, berries, watermelon, carrots, brussel sprouts, spinach and bell peppers are important to cancer risk reduction.
  • Is the diet high in fiber as high fiber diets are associated with preventing colorectal cancer and other digestive cancers?
  • Does the diet recommend foods that are low fat, low sugar, low salt and minimally processed? Reducing these types of foods from one's diet helps reduce the risk of cancer.
  • Does the diet recommend foods that are high in Omega 3 fatty acids that reduce inflammation, which is associated with cancer risk reduction?

The following diets are the top five Best Diets, according to U.S. News and World Report and my cancer risk reduction score follows the brief description of each diet.

#5: The MIND Diet

MIND stands for the Mediterranean-DASH Intervention for Neurodegenerative Delay. This diet is a hybrid of the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and is touted as a diet that can delay Alzheimer’s Disease.

The diet has 10 brain-healthy food groups: green leafy vegetables, all other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine.

The five unhealthy groups: red meats, butter and stick margarine, cheeses, pastries and sweets, and fried or fast food.

A typical day following this diet consists of a salad, a vegetable and at least three servings of whole grains. Every other day, chicken and a half a cup of berries. At least once a week, fish. For snacks, nuts, and every other day, a half a cup of beans.

Olive oil is used to cook with and/or to season food. As for the unhealthy foods, the diet allows for fewer than four servings of red meat per week; fewer than five servings of sweets or pastries of any kind per week; less than one tablespoon of butter a day; and less than a serving of cheese, fried food or fast food each week.

Cancer risk reduction score: 4.

The MIND Diet seems to cover all of the bases in terms of the foods to eat and the foods to avoid. However, the diet itself hardly seems foolproof. Vegetables are key in reducing cancer risk. In fact, the United States Dietary Agency recommends that most men have 2.5 to 3 cups of vegetables a day and that women have 2 to 2.5 cups of vegetables per day. Since many vegetables like spinach, broccoli, carrots, green peas, collard greens, artichokes, parsnips, lima beans and acorn squash are high in fiber, eating more of them can reduce one’s risk for cancer. The cancer risk reduction benefits cannot be achieved by eating one salad per day as the MIND diet suggests.

#4: Weight Watchers Diet

Weight Watchers is based on a point system calculated according to one’s sex, height, weight and age. Foods that are healthier are worth fewer points, and foods that are considered to have little health benefits have a higher point value. Essentially, one can eat whatever one wants — just don’t eat more “points” than allotted each day.

Cancer risk reduction score: 2.

Since you can basically eat what you want, there is no emphasis on guiding you to eat the recommended daily amounts of vegetables, fruits, lean meats and other cancer risk reducing foods. In other words, you could spend all of your daily points on a high fat and low fiber meal if you choose, which is definitely not a cancer risk reducing diet.

#3: The Flexitarian Diet

The Flexitarian Diet is a combination of being flexible and vegetarian. This means that you can be a vegetarian and sometimes eat meat when you feel like it. The Flexitarian Diet is a five-week meal plan (breakfast, lunch, dinner and snack recipes) that emphasizes more plant-based proteins and less animal protein to an already healthy diet.

Recommended plant-based proteins include tofu, beans, lentils, peas, nuts and seeds. For example, instead of cow’s milk, the diet recommends soy or another plant-based milk and, instead of yogurt or cheese as snacks, you would have an apple with peanut butter. Tofu, veggie burgers/meat or beans are used in place of meat.

Also, part of the diet is red wine (in moderation), if it is okay with your health care provider. Experts have not given red wine a seal of approval because the same health protective benefit may be obtained by drinking red or purple grape juice — also in moderation.

The Flexitarian Diet includes "Flex Swap" suggestions for changing vegetarian recipes to one that has meat in it. Due to the limitation of certain foods, taking a multi-vitamin is suggested when following this diet.

Cancer risk reduction score: 4.5.

The Flexitarian Diet is good because it provides a vehicle for adding more plant-based proteins into your diet. By replacing meat with plant-based proteins and increasing fruits and vegetables, you are decreasing your cancer risk.

Concerns about the effect of soy on women are unfounded as there is no evidence that women who eat soy develop breast cancer more often than women who do not consume soy. The rule here is to eat soy as naturally as possible and in moderation. A moderate amount of whole soy foods is up to three daily servings. One serving of soy includes: 1 cup of soy milk, one-half cup cooked soy beans, one-half cup of edamame or one-third cup of tofu. In other words, say "yes" to edamame and not so much to soy nuggets and soy hot dogs. Remember reducing or eliminating processed foods, like the seemingly healthy soy nuggets or soy hot dog, are important to lowering your cancer risk.

#2 Mediterranean Diet

The Mediterranean Diet emphasizes eating mostly plant-based foods, like whole grain foods, fruits and vegetables, beans, nuts and peanuts and limit eating red meat to only eating lean cuts of red meat (pork, beef, lamb, mutton or goat) and sweets to a few times a month.

The Mediterranean Diet recommends eating fish, seafood and poultry at least twice a week, and eating plain or Greek yogurt, cheeses (Brie, Chevre, Corvo, Feta, Haloumi, Manchego, Parmigiano-Reggiano, Pecorino, Ricotta), and eggs in moderate portions either daily to once a week.

Cooking with olive oil or canola oil and seasoning with herbs and spices is permitted. Drinking red wine in moderation is an option as described in the Flexitarian Diet.

Cancer risk reduction score: 4.75.

The Mediterranean Diet is a wise option because it is balanced, guides you to eat nine fruits and vegetables and most people are already eating the foods that are part of this diet.

#1 DASH Diet

The Dietary Approaches to Stop Hypertension Diet was developed with help from the National Lung, Blood and Heart Institute of the National Institutes of Health. How much one should eat is based on one’s age and activity level with an emphasis on reducing the salt in one’s diet.

According to the DASH diet, a moderately active woman who walks about 1.5 to 3 miles a day at 3 to 4 miles per hour and does light physical activity and a sedentary man over 51 years of age should consume 2,000 calories per day.

Calories should consist of six to eight servings of grains; four to five servings of fruit and four to five servings of vegetables; two to three servings of fat-free or low-fat dairy; six or fewer servings of lean meat, poultry and fish, with one serving equivalent to an ounce, and two to three servings of fats and oils. Having four to five servings of nuts, seeds and legumes every week and five or fewer servings per week of sweets is recommended.

Avoiding salt by not eating pickled, cured or smoked items is a must; also, limiting ketchup, mustard, hot sauce and other condiments that are high in sodium is emphasized, and choosing fruits or vegetables instead of soup is the preferred alternative.

Cancer risk reduction score: 5.

The DASH Diet is another well-balanced diet that emphasizes more fruits and vegetables and limiting processed food. This diet goes one step further than the Mediterranean Diet in that the DASH Diet calculates the amount of food and types of food recommended according to one’s age and activity level, which is a plus and would likely lead to weight loss. Weight loss is important because maintaining a healthy weight is another way to reduce one’s risk of cancer.

What about physical activity?

I would be remiss not to mention the impact of physical activity on lowering the cancer risk. Experts recommend daily physical activity as part of a cancer risk reduction plan. In fact, all of the diets I've covered, recommend physical activity as part of the diet.

The Takeaway Message

Changing your diet can lower your chance of developing cancer. For many people, those changes are not drastic. They include increasing the daily amount of fruits and vegetables, which increases fiber and naturally occurring vitamins, minerals and antioxidants and limiting processed foods (decreasing trans-fat, sugar and salt). The key is to find a diet that is balanced and that you believe you can do. Then, make it a lifestyle choice.