Let your food be your medicine and let your medicine be your food.
HIPPOCRATES

Without question, a good diet is essential for good health. Mounting scientific evidence makes it clear that poor dietary habits cause or contribute to many diseases, including cancer. By the same token, a nourishing diet can minimize the risk of cancer and may actually prevent many forms of the disease. What’s more, certain food offer benefit to people with cancer, either because they help treat the condition or because they boost the effectiveness of other therapies. And finally, just as critical as the food you eat is how your body breaks down absorbs, and eliminates what is ingested. All these issues will be discus in this chapter as we strive to help you create an environment will your body that is hostile to the development of cancer.

 Seven Key Principles of the Cancer-Prevention Diet

By following seven important guidelines, you’ll give your body its best chance of avoiding not just cancer but a range of other chronic diseases as well

• Eat a “rainbow” assortment of fruits and vegetables.
• Reduce exposure to pesticides.
• Reduce the intake of meat and other animal foods.
• Eat the right type of fats by increasing the intake of omega-3 fatty acids.
• Avoid high-calorie, low-nutrient foods such as junk foods, candy, and soft drinks.
• Keep salt intake low, potassium intake high.
• Choose foods that help your body detoxify and eliminate waste.

1. Eat a rainbow” assortment of fruits and vegetables

A diet rich in fruits and vegetables is your best bet for preventing can cer. That fact has been established time and again in scientific studies on large numbers of people. The evidence in support of this recommen! dation is so strong that it has been endorsed by U.S. government health agencies and by virtually every major medical organization, including! the American Cancer Society. By rainbow, we simply mean that by se lecting foods of different colors-red, orange, yellow, green, blue, and purple you’ll be giving your body the full spectrum of cancer-fighting! compounds as well as the nutrients it needs for optimal function and protection against disease.

Why are fruits and vegetables so important in fighting cancer?

The simplest answer–and the one that is most deeply rooted in history has to do with the way humans evolved. We are omnivorous, which means we can digest foods from both plant and animal sources. In prehis. toric times, our survival as a species depended on our ability to get food both by hunting other animals and by gathering fruits and vegetables.

Examples of Anticancer Phytochemicals

The carotenes are the best-known pigments and the ones found most widely in foods. These are the red and yellow pigments found in vegetables such as carrots, peppers, yams, and tomatoes, and in fruits such as apricots. watermelons, and cherries. Carotenes are also found in green leafy vegetables, such as spinach, and in legumes, grains, and seeds. Over carotenes exist in nature, including perhaps 50 that the body can tra form into vitamin A Beta-carotene is the most active of the carotenes cause more of it is converted to vitamin A), but several other carote such as lutein and lycopene, may exert greater anti cancer effects.

The leading sources of carotenes are the dark green leafy vegetables kale, collards, and spinach. The deeper the green color, the greater the concentration of carotenes.

Another important group of plant pigments are the flavonoide These are sometimes called nature’s biological response modifiers because of their anti-inflammatory, antiallergic, antiviral, and anticancer properties. Good dietary sources of Havonoids include citrus fruits. berries, onions, parsley, legumes, green tea, and red wine.

 HOW TO EAT A RAINBOW ASSORTMENT

Everyone knows it’s important to eat fruits and vegetables. In 1992, the National Cancer Institute launched a campaign called “Five a Day for Better Health” to get people to eat more of these essential foods.

But Americans still aren’t getting the message. Sad to say, if French fries, potato chips, and the lettuce and tomatoes from hamburgers are taken out of the cquation, less than half of all Americans actually consume even a single serving of a fruit or vegetable in the course of a day! Only about 10 percent of people actually achieve the five-a-day recommendation, and virtually no one is eating enough of the fruits and veg. ctables that are the most important in fighting cancer.”

We cannot stress it enough: The key dietary recommendation for you to reduce your risk of commerr is to consume liberal amounts of cancer-fighting fruits and vegetables. In fact, we go well beyond the five-a-day recommendation. We recommend ten servings a day. That sounds like a lot, but the serving size is actually quite small. Serving size equals 1 cup raw leafy vegetables (such as lettuce or spinach); 1 cup raw nonleafy or cooked veg: etables; a cup cooked green beans or peas; 1 medium fruit or 1 cup small or cut-up fruit, or 100 percent juice, and a cup dried fruit.

In Appendix A, Daily Plan for Preventing Cancer, we will provide additional guidance to help you achieve this goal. Right now, we want to encourage you to choose at least one food per day from the five key color groups–red, dark green, yellow and light green, orange, and purple from Table 2-2.

WHICH IS BETTER-RAW OR COOKED! On one level, the answer to this question is: It doesn’t matter! What’s important is to make sure you’re eating enough fruits and vegetables, in whatever form.

As a rule, we recommend eating fruits and most vegetables in their raw state. But we must note that some of the carotenes (like lycopene and lutein) are better absorbed from cooked foods. In addition, it may not be wise to consume more than four servings per week of raw cabbage family vegetables (including broccoli, cauliflower, and kale),

 Grapefruit-Not Such a Great Fruit?

Citrus fruits are an important part of a cancer-fighting diet because they provide vitamin C, other essential nutrients, and important phytochemicals. But grapefruit contains high levels of a flavonoid (plant compound) called naringin that can be a problem if people are taking certain drugs. Naringin reduces the activity of CYP3A enzymes, part of the P450 enzyme family. These enzymes are the ones your body uses to break down certain drugs, such as calcium channel blockers (used in the treatment of high blood pressure), sedatives (for example, midazolam). and cyclosporin (an immune suppressant given to people who have received organ transplants). If the drugs are not metabolized, they remain in the body in higher concentrations, increasing the risk of unwanted toxic effects.

If you are taking a prescription medication, ask your doctor if you should avoid eating grapefruit or drinking grapefruit juice. Some drugs such as Neoral (oral cyclosporin), already carry a warning. For citrus lovers, there are plenty of other choices. Oranges, tangerines, and tange los do not contain significant amounts of naringin but have lots of other important nutrients and flavonoids.

Because these foods in their raw state contain compounds that can interfere with thyroid hormone production. When you cook vegetables, we recommend lightly steaming them or stir-frying them in olive oil.

If you can’t eat fresh produce, then frozen is the next best thing. We do not advocate eating canned fruit or vegetables, as many of the naturally occurring cancer-fighting phytochemicals are destroyed in the canning process.

It is important to eat at least two of the servings of fruits or vegetables in their raw, fresh state. Many of the compounds with anticancer properties are found in much higher concentrations in raw foods than in their cooked counterparts. For example, ellagic acid, found in fresh apples and raspberries, exhibits significant anticancer activity. 10-12 A potent antioxidant, it protects against damage to the chromosomes. It also blocks the cancer-causing actions of many pollutants, such as polycyclic aromatic hydrocarbons (PAH) found in cigarette smoke and toxic chemicals such as benzopyrene. Ellagic acid is not destroyed by freezing or freeze-drying, but it is deserved by heat. While fresh whole apples and fresh apple juice contain approximately 100 to 130 mg per 100 g (roughly 312 ounces) of ellagic acid, the amount found in cooked or commercial apple products is at or near zero.

DETOXIFICATION: SPOTLIGHT ON GLUTATHIONE Many fresh fruits and vegetables contain glutathione, an important antioxidant found in all tissues in the body. Glutathione is an important anticancer agent that helps detoxify and eliminate toxins such as heavy metals, pesticides, and solvents.” The average glutathione content for various food classes per 100 g is fresh fruit, 4.5 mg fresh vegetables, 6.5 mg red meat, fish, and poultry, 10 mg: walnuts, 15 mg: and breads, cereals, legumes, and nuts other than walnuts, less than 1 mg per 100 g. Fresh fruits and vegetables provide excellent levels of glutathione, but-not surprisingly cooked foods contain far less (Table 2-3). It’s also worth noting that your body absorbs glutathione from foods, but it absorbs very little when glutathione is taken as a supplement.

Glutathione’s combination of detoxification and free radical protection makes it one of the most important cancer and aging fighters in our cells. The greater your exposure to toxins, the faster your body uses up its supply of glutathione. Without the protection of glutathione, your cells die at a faster rate, making you age quicker and putting you at risk for toxin-induced diseases including cancer. People who smoke,

Table 2-3. Glutathione Content of Uncooked vs. Cooked Foods

who are chronically exposed to toxins, or who suffer from inflammatory conditions such as rheumatoid arthritis or chronic conditions such as diabetes, AIDS, or cancer typically have lower levels of glutathione. It’s a vicious circle: Health problems deplete your supply of glutathione and reduced levels of glutathione increase your risk of health problems

Don’t depend on supplements containing glutathione to boost levels of glutathione in the body. While dietary forms of glutathione appear to be efficiently absorbed into the blood, the same may not be true for glutathione supplements in humans. When healthy subjects were given a single dose of up to 3000 mg of glutathione, researchers found, there was no increase in blood glutathione levels.

To boost glutathione levels in your cells, we recommend supplementing your diet with at least 500 mg of vitamin C each day and focusing on the best dietary sources of glutathione, such as fresh fruits, asparagus, avocados, walnuts, and cabbage family foods such as cabbage, broccoli, and Brussels sprouts. You can also step up your body’s production of glutathione by eating foods that contain a compound called limonene, such as citrus, dill weed, and caraway seeds.

Additional recommendations for boosting glutathione in the support of conventional treatment of some cancers are given in Chapter 13.

2. Reduce exposure to pesticides

In the United States, more than 1.2 billion pounds of pesticides and herbicides are sprayed or added to food crops each year. That’s roughly 5 pounds of pesticides for each man, woman, and child. There is a growing corn that in addition to these pesticides directly causing a significant number of cancers, exposure to these chemicals damages your body’s detoxification mechanisms, thereby increasing your risk of getting cancer and other diseases

We all are exposed to pesticides and other toxins in the air that we breathe, the environment, and the food that we eat. To illustrate just how problematic pesticides can be, let’s take a quick look at the health problems of the farmer. The lifestyle of farmers is generally healthy Compared with city dwellers, they have access to lots of fresh food; they breathe clean air, work hard, and have a lower rate of cigarette smoking and alcohol use. Yet studies show that farmers have a higher risk of de

Easy Tips to Reach Your Ten-a-Day Goal

• Buy many kinds of fruits and vegetables when you shop, so you have plenty of choices.
• Stock up on frozen vegetable for easy cooking ,so that you always have a vegetable dish with every dinner.
• Use the fruits and vegetables that go bad easily (peaches, asparagus) first. Save hardier varieties (apples, acorn squash) or frozen goods for later in the week.
• Keep fruits and vegetables where you can see them. The more often you see them, the more likely you are to eat them.
• Keep a bowl of cut-up vegetables on the top shelf of the re frigerator.
• Keep a fruit bowl on your kitchen counter, table, or desk at work.
• Pack a piece of fruit or some cut-up vegetables in your briefcase or backpack; carry moist towelettes for easy cleanup.
• Add fruits and vegetables to lunch by having them in soup or salad, or cut-up raw.
• At dinner, serve vegetables steamed, sautéed in olive oil, or microwaved.
• Choose fresh fruit for dessert. For a special dessert, try a fruit par fait with low far yogurt or sherbet topped with lots of berries.
• Add extra varieties of vegetables when you prepare soups, sauces, and casseroles (for example, add grated carrots and acchini to spaghetti sauce).
• Take advantage of salad bars, which offer ready-to-eat raw vegeta bles and fruits and prepared salads made with fruits and vegetables.
• Use vegetable-based sauces such as marinara sauce and juices such as low-sodium V-8 or tomato juice.

veloping lymphomas, leukemias, and cancers of the stomach, prostate, brain, and skin.”

There is significant evidence linking pesticide use to the risk of nonHodgkin’s lymphoma (NHL). This blood cancer currently accounts for about 3 percent of all cancer diagnosed in the United States and af fects about 55,000 Americans each year. In the last thirty years the incidence of NHL has increased more rapidly than that of any other cancer except for prostate, skin, and lung cancers. Large studies of farmers in Canada, Australia, Europe, New Zealand, and the United States have demonstrated that the greater the exposure to pesticides, the greater the risk for non-Hodgkin’s lymphoma.

But in dealing with cancer risk, it can be difficult to establish a clear link between cause and effect. In addition to pesticide exposure, other suspected risk factors for NHL include use of hair dyes, exposure to toxic chemicals, history of prior blood transfusion, smoking, and several dietary factors, such as a higher intake of meat, animal fats (including butter), soft drinks (especially colas), and milk, and lower intakes of cabbage family vegetables, citrus fruits, dark-green vegetables, vitamin C, and beta-carotene.21-25

Perhaps the most problematic pesticides are those that belong to the halogenated hydrocarbon family, such as DDE, PCB, PCP, dieldrin, and chlordane. These chemicals persist almost indefinitely in the environment. For example, a similar pesticide, DDT, has been banned for nearly thirty years, yet it can still be found in the soil and in root vegetables such as carrots and potatoes. Our bodies also have a tough time detoxifying and eliminating these compounds, so they end up being stored in our fat cells. What’s more, inside the body these chemicals can act like the hormone estrogen. They are thus suspected as a major cause of the growing epidemic of estrogen-related health problems, including breast cancer.26-28 Some evidence also suggests that these chemicals increase the risk of lymphomas, leukemia, and pancreatic cancer as well as play a role in low sperm counts and reduced fertility in men.

The bottom line is that while pesticides may increase risk, they are not necessarily the only factor involved. Overall diet, genetic history, and other factors may come into play (see the cancer risk self-assessment in Chapter 1). We believe that by following the dietary recommendations given in this chapter, you’ll go a long way in overcoming harmful effects of these compounds. A lot of this protection is the result of improved detoxification of these potentially dangerous compounds (discussed more fully below).

Here are our recommendations for avoiding pesticides in your diet.

• Do not overconsume foods that concentrate pesticides, such as animal fat, meat, eggs, cheese, and milk.
• Buy organic produce, which is grown without the aid of synthetic pesticides and fertilizers. Although less than 3 percent of the total produce in the United States is grown without pesticides, organic produce is widely available.
• Develop a good relationship with your local grocery store produce manager. Explain your desire to reduce the exposure to pesticides and waxes. Ask what measures the store takes to assure that pesticide residues are within approved limits. Ask where the store gets its produce, make sure the store is aware that foreign produce is much more likely to contain excessive levels of pesticides as well as pesticides that have been banned in the United States.
• Try to buy local produce, in season.
• Peel off the skin or remove the outer layer of leaves of some produce that may be all you need to do reduce pesticide levels. The downside of this is that many of the nutritional benefits are concentrated in the skin and outer layers. An alternative measure is to remove surface pesticide residues, waxes, fungicides, and fertilizers by soaking the item in a mild solution of additive-free soap such as Ivory or pure castile soap. All-natural, biodegradable cleansers are also available at most health food stores. To use, spray the food with the cleanser, gently scrub, and rinse.

The possible presence of pesticides in fruits and vegetables should not deter you from eating a diet high in these foods. The concentrations in fruits and vegetables are much lower than the levels found in animal fats. meat, cheese, whole milk, and eggs. Furthermore, the various antioxidant components in fruits and vegetables are necessary to help the body deal with the pesticides

3. Reduce the intake of meat and other animal foods

Study after study confirms one basic truth: The higher your intake of meat and other animal foods, the higher your risk of cancer especially for the major cancers, such as colon, breast prostate, and lung cancers.

There are many reasons for this association. Meat lacks the antioxidant and phytochemicals that protect us from cancer. At the same time, it contains lots of saturated fat and other potentially carcinogenic (cancercausing) compounds-including pesticide residues, heterocyclic amines, and polycyclic aromatic hydrocarbons, which form when meat is grilled, fried, or broiled. The more well done the meat, the higher the level of amines.

Some proponents of a diet high in meat claim that we should eat the way our caveman ancestors did. That argument doesn’t really hold up. The meat of wild animals that early humans consumed was much different from the industrially produced, shrink wrapped meat we find in supermarkets today. The demand for tender meat has led to the breeding of cattle whose meat contains 25 to 30 percent fat or more. In contrast, meat from free living animals and wild game has a fat content of less than 4 percent

It’s not just the amount of fat. The composition is also different. Domestic beef contains primarily saturated fats and virtually no beneficial omega-3 fatty acids (discussed on page 40), while the fat of wild animals contains more than 5 times the polyunsaturated fat per gram and has substantial amounts (about 4 percent) of omega-3 fatty acids .

Range-fed animals also contain 10 times as much conjugated linoleic acid (CLA) as grain-fed animals. CLA is a slightly altered form of the es sential fatty acid linoleic acid. It occurs naturally in meat and dairy products. CLA was discovered in 1978 when researchers at the Univer sity of Wisconsin were looking for cancer-causing compounds that result from cooking. Instead, they found CLA, which appears to be an anticancer compound. Preliminary animal and test tube studies show that CLA might reduce the risk of cancers at several sites, including the breast, prostate, colorectal, lung, skin, and stomach. Whether CLA will produce a similar protective effect in humans is yet to be determined.

HIGHLIGHT: NITRATE- AND NITRITE-CONTAINING FOODS

Cured or smoked meats such as ham, hot dogs, bacon, and jerky contain sodium nitrate and/or sodium nitrites-compounds that keep the food from spoiling but that dramatically increase the risk for cancer. These chemicals react with amino acids in foods in the stomach to form highly carcinogenic compounds known as nitrosamines.

Research in adults makes a convincing argument to avoid these foods. Even more compelling is the evidence linking consumption of nitrates to a significantly increased risk of the major childhood cancers deukemias, lymphomas, and brain cancers).

• Children who cat 12 hot dogs per month have nearly 10 times the risk of developing leukemia compared with children who do not cat hot dogs.
• Children who eat hot dogs once a week double their chances of brain tumors, eating them twice a week triples the risk.
• Pregnant women who eat two servings per day of any cured meat have more than double the risk of bearing children who have brain cancer.
• kids who eat the most ham, bacon, and cured sausage have 3 times the risk of lymphoma.
• Kids who eat ground meat once a week have twice the risk of acute lymphocytic leukemia compared with those who eat none; eating two or more hamburgers weekly tripled the risk.

Fortunately, vegetarian alternatives to these standard components of the American diet are now widely available, and many of them actually taste quite good. Consumers can find soy hot dogs, soy sausage, soy bacon, and even soy pastrami at their local health food store as well as in many mainstream grocery stores.

If you choose to cat red meat:

• Limit your intake to no more than 3 to 4 ounces daily about the size of a deck of playing cards. And choose the leanest cuts available( it is important to point out that the USDA allows the meat and dairy industries to label fat content by weight rather than by percent of calories).
• Avoid consuming well-done, charbroiled, and fat-laden meats.
• Don’t eat cured meats (bacon, hot dogs, etc.), especially if you are pregnant or a child under age 12

Table 2-4. Healthier Food Choices

Consider buying free-range meats or wild game such as grass-fed beef or buffalo, venison, and ostrich.

eat the right type of fats by increasing the intake of omega- 3 fatty acids.

There is no room for debate: A diet high in fat, particularly saturated fat and cholesterol, has been linked to numerous cancers. Both the American Cancer Society and the National Cancer Institute recommend a diet that supplies less than 30 percent of calories as fat. However, just as important as the amount of fat is the type of fat you consume. The goal is to decrease your total fat intake (especially intake of saturated fats) while increasing your intake of omega-3 fatty acids and monounsaturated fatty acids.

Some of these terms can be confusing. To help you understand. here’s a quick chemical lesson.

Fat molecules are made of atoms of carbon, hydrogen, and oxygen. Each of the separate atoms attaches to the others only in certain predetermined ways. The backbone of a fat is a chain of carbon atoms (C):

Hydrogen (H) and oxygen (O) atoms can then attach to the carbons. A saturated fat is a fat molecule in which all the available binding sites are occupied with another atom. In other words, the carbons are saturated with all the atoms they can hold:

An unsaturated fat has one or more bonding sites left unoccupied, so the two neighboring carbon atoms will take up the slack by forming a double bond:

A fat molecule with one double bond is called a monounsaturated fat. Molecules with more than one double bond are called polyunsaturated fats. Mono- means “one”: poly- means “many.” When an unsaturated fat contains the first double bond at the third carbon, it is referred to as an omega-3 fatty acid. If the first double bond is at the sixth carbon, it is an omega-6 fatty acid, and if it occurs at the ninth carbon, it is an omega-9 fatty acid.

The human body absolutely requires two essential fatty acids-linolei acid (an omega-6 fat) and alpha-linolenic acid (an omega-3 fat). But most Americans eat way too much of the omega-6 oils found in meats and most vegetable oils, and suffer a relative deficiency of the omega-3 fats found in fish and flaxseed oil-a situation that is associated with an increase risk for cancer and about sixty other conditions, including heart disease, stroke, high blood pressure, skin diseases, and diabetes. Particularly important to good health are the longer-chain omega-3 fatty acids, such as eicosapen taenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish, especially cokl water fish such as salmon, mackerel, herring, and halibut. Although the body can convert alpha-linolenic acid from flaxseed and other vegetable sources, it is much more efficient to get them from the diet.

Essential fatty acids are transformed into regulatory compounds known as prostaglandins. These compounds carry out many important tasks in the body. They regulate inflammation, pain, and swelling they play a role in maintaining blood pressure, and they regulate heart diges tive, and kidney function. Prostaglandins also are involved in blood clotting. They participate in the response to allergies, help control transmission of signals along the nerves, and are used in the production of steroids and other hormones. Prostaglandins derived from the omega-6 fatty acids tend to stimulate cancer cell growth, while those from the omega-3 fatty acids inhibit cancer. Having higher dietary levels of omega-3 and reduced levels of the omega-6 acids can protect against not only cancer but also heart disease and Alzheimer’s disease. All told, fish oils have been shown to benefit about sixty different health conditions, including rheumatoid arthritis and other autoimmune diseases, psoriasis, eczema, asthma, attention deficit disorder, and depression.

What else makes saturated fats and margarine “bad” and omega-3 fatty acids “good”? The answer has to do with the function of fats in cel. lular membranes. Membranes are made mostly of fatty acids. What determines the type of fatty acid present in the cell membrane is the type of fat you consume. A diet composed mostly of saturated fat, animal fatty acids, cholesterol, and margarinc acids results in membranes that are much less fluid in nature than the membranes in a person who con sumes optimum levels of both essential fatty acids.

An alteration in cell membrane function is the main cause of cell injury and death. Without healthy membranes, cells lose their ability to hold water, vital nutrients, and electrolytes. They also lose their ability to communicate with other cells and to be controlled by regulating hormones. They simply do not function properly. Cell membrane dysfunction is a critical factor in the development of cancer. Particularly harmful to cell membrane function are margarine and other foods containing trans fatty acids and partially hydrogenated oils. These “unnatural forms of fatty acids interfere with the body’s ability to utilize important essential fatty acids and have been linked to several human cancers. We strongly urge you to avoid them.

Along with the healthier food choices given in Table 2.4 above, here is a key recommendation for making sure you get higher levels of the beneficial omega-3 fats: Increase your intake of fish. Fish consumption offers significant protection against many forms of cancer. Particularly beneficial are cold water fish such as salmon, mackerel, herring, and halibut, because of their high levels of omega-3 fats. If you don’t eat at least two servings of cold water fish per week, we recommend taking fish oil capsules. Take enough capsules to provide 120 to 360 mg of EPA and 80 to 240 mg of DHA per day.

For women we also recommend taking one tablespoon of organic Flaxseed oil daily. Flaxseed oil is unique because it contains both essential fatty acids: linoleic (omega-6) and alpha-linolenic (omega-3). The level of alpha-linolenic acid is a whopping 58 percent by weight. Flaxseed oil can be used as a salad dressing, or as a bread dip instead of butter), or mixed with yogurt or cottage cheese. We do not recommend Haxseed oil use in men at this time, because researchers report conflict ing information concerning the possible role of alpha-linolenic acid in prostate cancer (discussed more fully in Chapter 4).

HIGHLIGHT: FISH CONSUMPTION, CANCER AND A CAUTION

Fish consumption offers significant protection against many forms of cancer. especially the major cancers like lung, colon, breast, and prostate.”-35 While we are encouraging you to eat more fish, we need to give you some guidelines. Nearly all fish contain trace amounts of methyl mercury. Usually, this is of little concern, because the level is so low. The fish most likely to have the lowest level of methyl mercury are salmon (usually nondetectable levels), cod, mackerel, cold-water tuna, farm-raised catfish, and herring. But certain seafoods–particularly swordfish, shark, and some other large predatory fish-may contain high levels of methyl mercury. Fish absorb methyl mercury from water and aquatic plants. Larger predatory fish also absorb mercury from their prey. Methyl mercury binds tightly to the proteins in fish tissue, including muscle; cooking does not reduce the mercury content significantly

We suggest limiting fish intake to no more than about two pounds (one kilogram) per week. That translates to six 7-ounce servings per week maximum. Limit your intake of swordfish, shark, and warm water tuna to no more than once a week for once a month if you are a woman of childbearing age who might get pregnant).

5. Avoid high-calorie, low-nutrient foods such as junk foods, candy, and soft drinks

High-sugar diets are associated with increased risk of breast, colorectal, biliary, and pancreatic cancers. Refined sugars are quickly absorbed into the bloodstream, causing a rapid rise in blood sugar. In response, the body boosts secretion of insulin by the pancreas. And too much insulin, as it turns out, can promote the growth of certain kinds of cancer cells, including breast, stomach, colon, endometrial, ovarian, lung, and prostate cancer. High insulin levels may be the best predictor of whether a woman’s breast cancer returns after treatment, since high insulin levels increase the risk of recurrence and death at least eightfold.

We’ll make this simple: Don’t eat “junk foods.”

According to the third National Health and Nutrition Examination Survey, which studied eating habits among 15.000 American adults. one-third of the average diet in this country is made up of unhealthy foods, including potato chips, crackers, salted snack foods, candy, gum. fried fast food, and soft drinks. These items offer little in terms of protein, vitamins, or minerals. What they do have, though, is lots of “empty calories in the form of sugar and fat. They fill you up so you don’t have room for the good stuff-the foods that give your body a fighting chance to prevent cancer.

Here are guidelines for making healthier eating choices:

• Read labels carefully. If sugar, fat, or salt is one of the first three in gredients listed, it is probably not a good option.
• Be aware that words appearing on the label such as sucrose, glucose, maltose, lactose, fructose, corn syrup, or white grape juice concentrate mean that sugar has been added.
• Look not just at the percentage of calories from far but also at the number of grams of fat. For every 5 grams of fat in a serving, you are eating the equivalent of one teaspoon of fat.
• If a snack doesn’t provide at least 2 grams of fiber, it’s not a good choice

6. Keep salt intake low, potassium intake high

The electrolytes potassium, sodium chloride, and magnesium-are mineral salts that can conduct electricity when dissolved in water. For optimal health, it’s important for you to consume these nutrients in the proper balance. Too much sodium in the diet from salt, sodium chloride, can disrupt this balance. Many people know that a high-sodium , low-potassium diet can cause high blood pressure, but not as many are aware that such a diet also increases the risk of cancer, including esophageal and colon cancers.”

In our society, only 5 percent of sodium intake comes from the natural ingredients in food. Prepared foods contribute 45 percent of our sodium intake, 45 percent is added in cooking, and another 5 percent is added as a condiment.

Tips for reducing your sodium intake

• Take the salt shaker off the table.
• Omit added salt from recipes and food preparation .
• If you absolutely must have the taste of salt, try the salt substitutes such as NoSalt and Nu-Salt. These products are made with potas sium chloride and taste very similar to sodium chloride.
• Learn to enjoy the favors of unsalted foods.
• Try flavoring foods with herbs, spices, and lemon juice instead of salt.
• Read food labels carefully to determine the amount of sodium. Learn to recognize ingredients that contain sodium. Salt, soy sauce, salt brine, or any ingredient with sodium (such as monosodium glutamate) or baking soda (sodium bicarbonate) as part of its name contains sodium.
• In reading labels and menus, look for words that signal high sodium content, such as smoked, barbecued, pickled, broth soy sauce, teriyaki, Creole sauce, marinated, cocktail sauce, tomato base, Parmesan, and mustard sauce.
• Don’t eat canned vegetables or soups: these are often extremely high in sodium.
• Choose low-salt (reduced-sodium) products when available.

Many of us have already learned to watch our salt intake. We’d like to encourage you to increase your potassium intake as well.

Most Americans have a potassium-to-sodium (K:Na) ratio of less than 1:2. In other words, they ingest twice as much sodium as potassium, Bur experts believe that the optimal dietary potassium-to-sodium ratio is greater than 5:1-ten times higher than the average intake. Even this may not be optimal. A natural diet rich in fruits and vegetables can easily produce much higher K:Na ratios, because most fruits and vegetables have a K:Na ratio of at least 50:1. For example, here are the average K:Na ratios for several common fresh fruits and vegetables:

If you are following the dietary recommendations here and in Appendix A, Daily Plan for Preventing Cancer, there is no question that you are reaching your daily potassium goals.

HIGHLIGHT: POTASSIUM SUPPLEMENTS

The FDA restricts the amount of potassium available in dietary supplements to a mere 99 mg per dose because of problems associated with high-dosage potassium salts. However, so-called salt substitutes (such as NoSalt and Nu-Salt) are in fact potassium chloride that provides 530 mg of potassium per one-sixth teaspoon. Therefore, to boost potassium levels, it is much easier to use one of the salt substitutes than a potassium supplement.

Potassium chloride preparations are also available by prescription in a vast array of formulations (timed-release tablets, liquids, powders, and effervescent tablets) and flavors. Potassium salts are commonly prescribed by physicians at doses of 1.5 to 3 g per day. However, potassium salts can cause nausea, vomiting, diarrhea, and ulcers when givens in pill form in high doses. These effects are not seen when potassium levels are increased through the diet only. This difference highlights the advantages of using foods or food-based potassium supplements to meet the human body’s high potassium requirements.

Most people can handle any excess of potassium without experiencing adverse effects. The exception is people with kidney disease, who are unable to metabolize potassium in the normal way. Such individuals are likely to experience heart disturbances and other signs of potassium toxicity. If you have a kidney disorder, you probably need to restrict potassium intake and should follow the dietary recommendations of your physician.

7. Choose foods that help your body detoxify and eliminate waste

Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in the formation of compounds that can dramatically stimulate cell growth and increase the risk of cancer. Specifically, gut bacteria convert the amino acids arginine and ornithine into compounds known as polyamines, which include the nasty-sounding compounds putrescine and cadaverine, respectively. As their names imply, these compounds are also associated with decaying flesh-a process known as putrefaction. Clearly, we do not want this process occurring within our living body.

The role of polyamines in cancer development and growth has been established best in colon cancer, although there is also research that suggests they play a role in virtually all forms of cancer, including breast, prostate, and brain cancers. 38-40 When cancer cells grown in the laboratory are exposed to polyamines, their already excessive growth rate increases exponentially. And when the formation of polyamines is in hibited, so is the growth of the tumor.

There are a number of natural compounds that can inhibit the formation of polyamines in the gut, such as Bifidobacteria.” vitamin A, selenium, volatile oils from peppermint and other plants, and the alkaloids of goldenseal (Hydrastis canadensis).” But the best way to prevent the excessive formation of polyamines is to ensure optimal digestive function and elimination.

The following questionnaire can be used to determine whether you may be suffering from incomplete protein digestion. Circle the number that best describes the intensity of your symptoms on the following scale:

0 – I do not experience this symptom
1 – Mild
2 – Moderate
3 – Severe

Interpreting Your Score

If you scored higher than 9, we recommend supplementation with protein-digesting (proteolytic) enzymes. These enzymes are discussed fully on page 166. To enhance digestive function, take the enzymes just before meals at the low end of the dosage recommendation (higher doses may be needed by people who have cancer).

PROMOTING ELIMINATION

There are four primary ways the body gets rid of toxins through the feces, the urine, the skin, and respiration.

To assist the body’s elimination of toxic chemicals, it’s important to eat high-fiber diet and drink plenty of bottled, filtered, or purified water .

Fiber is important because it traps the toxins excreted in the bile. each day the liver manufactures approximately one quart of bile, which serves as a carrier that helps eliminate toxic substances from the body Sent to the intestines, the bile and its toxic load are absorbed by fiber and excreted. However, a diet low in fiber means that these toxins are not bound and are more likely to be reabsorbed. Even worse, bacteria in the intestine often modify these toxins so that they become even more damaging and cancer-causing. In addition to eliminating unwanted toxins, the bile emulsifies fats and fat-soluble vitamins in the intestine, improving the body’s ability to absorb them.

Dietary fiber, particularly the soluble fiber found in legumes (beans). fruit and vegetables, is effective in lowering cholesterol levels. Many studies have found that high intake of fiber, especially soluble fiber, is associated with a significant reduction in the level of serum total cholesterol. An intake of 20 g or more typically lowers total cholesterol levels by 10 to 20 percent. Our recommendation is to consume at least 35 g of fiber a day from a variety of food sources, especially vegetables. To help you achieve this goal, we have provided a list of foods and their fiber con tent (see Appendix G, page 344). If you are eating your five servings of fruits and vegetables each day or you are following one of our meal plans. you are probably coming close to meeting these goals, but we urge you to keep a diet diary to calculate your daily fiber intake. Focus on sources of soluble fiber, since that’s the most beneficial kind. Breads, cereals, and pastas that contain bran (wheat, rice, oat, or com bran) supply fiber, but they also supply high amounts of starch and sugar. Again, try to focus on vegetables and legumes as your source of dietary fiber.

Some warning is necessary if you are not used to eating a high-fiber diet. You can have too much of a good thing, Increasing your fiber intake can increase the amount of intestinal gas (flatulence). Don’t worry, this side effect will not be a problem after your body has had a chance to adjust. We suggest that you increase the amount of dietary fiber gradually. Start with small amounts and build up to the recommended level over the course of a few weeks. You’ll know you’re overdoing it if you experience excessive gas or other abdominal symptoms. Cut back until the symptoms resolve, and then proceed more slowly until you reach a level you can tolerate.

PROMOTING DETOXIFICATION

As you’ve learned, the main dietary strategies for preventing cancer are to eat foods containing necessary nutritional substances and to avoid ingesting potentially harmful substances. There’s another vital link in the process, one that’s no less important helping your body neutralize and eliminate toxic substances through detoxification processes involving your own enzymes.

Enzymes are busy little proteins made by your cells. Their role is to promote chemical changes. Typically, enzymes act like chemical scissors, shipping apart larger molecules into smaller chunks. They also act like a needle and thread, stitching the molecules together in different forms. Various enzymes serve different functions, some helping to break down food, allowing nutrients to be digested and absorbed by cells, and others changing harmful compounds into inactive ones; still others repair damage to DNA; and so on.

A family of about 100 enzymes, known as the P450 family, that reside in the liver is responsible for much of the detoxification process. Differences in people’s P450 enzyme levels or activities explain, at least partly, why some people can smoke without developing lung cancer and why certain individuals are more susceptible to the harmful effects of toxic chemicals.” Scientists refer to such differences as biochemical individuality.

Further evidence supporting the critical role of the P450 system in preventing cancer is an imbalance in the manner in which it handles toxins. Detoxification of harmful compounds is usually a two-step process-Phase I and Phase II detoxification. During Phase 1, many toxins are transformed into an intermediate compound that is actually even more damaging than the original toxin. It is important to have an active Phase Il system so that the intermediate compound can be quickly neutralized. Scientific studies are clearly showing that people who have a very active Phase I system but a slow or inactive Phase II system have a substantially increased risk for lung, colon, breast, and prostate cancers.

The first step in supporting detoxification is to supply the body with the necessary building blocks for the manufacture of detoxification enzymes. Nutrients such as proteins, vitamins, and minerals are essential ingredients for making enzymes and their partners, the coenzymes (molecules that help the enzymes do their job). A healthy diet, plus a high-potency multiple vitamin and mineral formula, help ensure that your body will have an adequate supply of hardworking enzymes.

The second step in supporting detoxification is to promote balance between Phase I and Phase Il reactions. The dietary and supplement measures recommended in this chapter and the next go a very long way! to provide balance between the two phases. We want to add a couple more here: Regularly consume certain spices and herbs in your food. Specifically, make sure that you frequently eat foods that contain turmeric, red pepper (cayenne or chili pepper), black pepper, dill, car away, garlic, onion, basil, and oregano. When you regularly consume these spices, toxic intermediate products spend less time in the body and have less of a chance to damage cells. One component thats particularly helpful in this regard is curcumin, the stuff that gives turmeric is yellow color. (Turmeric is a key ingredient in curry.) In animal studies, cur cumin has been found to inhibit carcinogens such as benzopyrene (the carcinogen found in charcoal-broiled meat) and to neutralize toxic com pounds from cigarette smoke. It appears that the curcumin exerts its effects both by making carcinogens less active and by speeding up their detoxification. Curcumin has also been shown to exert many other beneficial actions against cancer and is discussed more fully in Chapter 4.

We suggest that people who smoke, or who are exposed to second hand smoke, eat a lot of curries. The curcumin in the turmeric can help limit the cancer causing activity. In one human study. 16 chronic smokers were given 1.5 g of turmeric daily, while 6 nonsmokers served as a control group. At the end of the 30-day trial, the smokers who received turmeric had a significant drop in the level of cancer-causing com pounds as measured in urine. Their levels were almost the same as those of the nonsmokers.”

THE IMPORTANCE OF WATER

Drink water! Low fluid consumption in general and low water consumption in particular increase the risk for cancers of the breast, colon, and urinary tract. Drinking enough water is another basic axiom for good health that you’ve probably heard a thousand times. But it’s true: You need to drink at least six to eight glasses of bottled, filtered, or purified water (48 to 64 ounces each day. That means having a glass of water every two waking hours. Don’t wait until you’re thirsty; instead, schedule regular water breaks throughout the day.

Water is essential for life. The average amount of water in your body is about 10 gallons. We need to drink at least 48 ounces of water per day to replace the water that is lost through urination, sweat, and breathing. If we don’t, we are likely to become dehydrated.

Even mild dehydration results in impaired physiological and performance responses. Many nutrients dissolve in water, so they can be absorbed more easily in your digestive tract. Similarly, many metabolic processes need to take place in water. Water is a component of blood and thus is important for transporting chemicals and nutrients to cells and tissues. Each of your cells is constantly bathed in a watery fluid. Water also carries waste materials from cells to the kidneys so that they can be filtered out and eliminated. Water absorbs and transports heat. For example, heat produced by muscle cells during exercise is carried by water in the blood to the surface, helping your body maintain the right temperature balance. The skin cells also release water as perspiration, which helps keep you cool.

Several factors are thought to increase the likelihood of chronic mild dehydration: a faulty thirst “alarm” in the brain; dissatisfaction with the taste of water; regular exercise that increases the amount of water lost through swear, living in a hot, dry climate and consumption of the natural diuretics caffeine and alcohol. Diuretics are substances that draw water out of your cells and increase the rate of urination. Surprisingly, if you drink two cups of water and two cups of coffee, cola, or beer, you may end up with a net water intake of zero! Be aware of your “water budget.” If you drink coffee or other dehydrating beverages, compensate by drinking an additional glass of water.

We’ve all heard it said: “An ounce of prevention is worth a pound of cure.” When it comes to cancer, that old saying carries a ton of truth.

Can cancer really be prevented? Thankfully, in many cases, the answer is an emphatic “Yes!” This is true even if cancer runs in your family. As we’ll explain in the first part of this book, by reducing or eliminating as many risk factors as possible and by practicing healthy habits that strengthen your body’s defenses, you’ll greatly reduce your chances of developing the disease.

Your campaign to prevent cancer requires a lifetime commitment, beginning here, now, today. Fortunately, many prevention strategies-a good diet, the right kind of exercise, a positive attitude—are not just good for you, they actually add to your quality of life. You live longer, you’ll live better