In part one of this series I outlined some facts and figures in understanding cancer risk for those that have Lynch Syndrome. As I mentioned in that article there is not a huge amount of research specific to Lynch Syndrome and environmental risk factors, at least not compared to general population risk factors. That being said, there is no doubt that the same factors that reduce cancer risk in the general public will be the same for those with Lynch Syndrome. Actually, addressing these factors in those with Lynch Syndrome could arguably cause greater risk reduction than that of the general population. This is simply because individuals with Lynch Syndrome are more susceptible to poor lifestyle since their bodies have less of an ability to deal with cancer promoting environmental conditions. So, today’s post will focus on some dietary and lifestyle factors that will notably reduce cancer risk for everyone, particularly those with Lynch Syndrome.
Cancer and the Immune System
Let’s first understand one of the underlying causes of cancer that is emerging exponentially in the scientific literature, dysregulated immune function and chronic inflammation (1). While cancer is a very complicated enigma, we do know it’s intimately tied to immune function. For instance, acute inflammation reduces tumor growth and cancer formation while chronic inflammation promotes cancer and tumor formation (1). So, let’s take a look at the many lifestyle factors shown to reduce cancer risk and/or chronic inflammation.
Diet and Cancer Risk
Arguably the biggest factor impacting cancer risk and chronic inflammation is diet. We already know that a Western diet is strongly linked to cancer because it contains many pro-inflammatory foods (2, 3). In fact, one study revealed that individuals with colorectal cancer were more likely to be consuming pro-inflammatory diets (Western type diet) (4). Now let’s look at more specific dietary components and how they connect to inflammation and cancer.
Gluten and Cancer risk
Sorry bread lovers, I have to put this as one of the main culprits of an inflammatory diet. There is continued growing evidence that gluten can cause intestinal, systemic, and neuroinflammation in the celiac and non-celiac population (5, 6) and evidence from animal studies is beginning to tie gluten consumption to cancer (7).
While the evidence against gluten free cereal grains in not as damning as gluten, there is indication that they can also disrupt our immune system (8). Furthermore, some grains show gluten cross re-activity potential, meaning that if you are sensitive to gluten you may likely be sensitive to other grains (9).
Another major culprit of inflammatory diets are bad fats. Contrary to popular belief, saturated fats are not the bad guys and evidence that whole food saturated fats cause inflammation is not consistent (10). Furthermore, we know that high fat, low carbohydrate diets reduce inflammation, and red meat (high in saturated fat) is also not a cause of abnormal inflammation. I won’t bother discussing synthetic trans fat because everyone and their bird (or is that dog?) knows that it is terrible for you and increases the risk of everything bad! But there are other bad fats, namely excess Omega 6, and oxidized polyunsaturated fats. While some Omega 6 fat in our diet is essential, too much of it can be inflammatory. It is estimated that the ideal dietary Omega 6 to Omega 3 ratio is 1:1 or 2:1, anything over this amount increases inflammatory risk and the subsequent risk of all chronic disease including cancer (11). Sadly, the lowest estimated ratio in Western diets is a whopping 15:1!
Polyunsaturated fats (ie. Omega 6 and 3) are not as stable as saturated and monounsaturated fats and not only undergo a level of peroxidation in the body, increasing inflammation via the production of reactive oxygen species (ROS) (11), but also undergo this same process when used for cooking, particularly deep frying. So instead of ROS being produced in your body, you eat them directly from the rancid/oxidized frying oil. In case you did not know, oils high in Omega 6, trans, and other unstable fats are canola, cottonseed, safflower, sunflower, peanut, margarine and any other industrial seed oil you want to throw into this list. Read the ingredients and avoid them all.
Carbohydrate Amount and Type
Aside from gluten and other grains, the type and amount of dietary carbohydrates are another major contributor to inflammatory diets. Poor carbohydrate sources include added sugars, particularly fructose, as well as other refined carbohydrates. High sugar and fructose consumption are very inflammatory and excessive fructose intake is considered a contributor to non alcoholic fatty liver disease (12, 13, 14). Aside from inflammation, these foods are also linked directly to cancer risk (13).
Furthermore, high carbohydrate and glycemic load diets are inflammatory and also linked to cancers (15, 16). Conversely, low carbohydrate and ketogenic diets reduce inflammation and are shown to be therapeutic for cancer (17, 18, 19). Lucky enough, if you avoid the above noted foods and eat plenty of vegetables, you will automatically reduce your carbohydrate and sugar intake, assuming you are not eating processed foods, bringing me to my next point.
The final major culprit of an inflammatory Western diet is processed food. Aside from the clear evidence that a processed Western diet, as a whole, is inflammatory, there is much evidence linking common food additives such as anti-caking agents, flavourings, colourings, preservatives, and emulsifiers to inflammation, gene toxicity, and cancer (20, 21, 22, 23, 24). Furthermore, there is some significant concern regarding the lack of rigorous regulation and testing of food additives, at least in the USA (25)
Eat more fibre, it reduces your chances of colorectal cancer and other chronic disease! This has been driven into our brains over and over and over again. While there is evidence from epidemiological studies, that more fibre intake means less cancer, this doesn’t always play out in a clinical setting. The reality is that people who eat more fibre are likely to do many other healthy things in their lives that reduce the risk of cancer. Also, people who eat more fibre have higher intakes of vegetables and fruit and studies mainly show a link between fibre intake from vegetables and fruit and cancer risk reduction (26, 27, 28). Is this result because of fibre or because of the nutrient density of fruits and vegetables, unfortunately we cannot tell based on epidemiological studies.
That being said, fibre reducing the risk of cancer and disease is still controversial in the scientific literature and some evidence indicates that insoluble fibre is useless and can actually be detrimental to colon health, increasing stool size and decreasing transit time (constipating) (29). The ultimate goal here is to limit wheat and grains and make sure you are eating plenty of whole fruits and vegetables which are chalked full of vitamins minerals and a natural balance of soluble and insoluble fibre.
I would be remiss not to mention red meat since everyone and their dog (or is that mother?) believes that it is inflammatory and causes cancer and heart disease. Reality is that there is no reliable evidence that red meat is anywhere near bad for us. Sure processed crappy red meat has been transformed from a nutritious food to a nutritionally devoid, chemical filled pile that is terrible for us. But, we cannot lump processed and whole food meats together. People who eat more red meat typically participate in other activities that are bad for health (smoking, not eating vegetables, etc.) and studies simply cannot fully control for this variable (30). Furthermore, red meat consumption has actually been shown to have no relation to cancer risk in the general or Lynch Syndrome populations (30, 31, 32). The key point here is to just eat real, unprocessed meat.
I previously outlined how important DNA expression/regulation is in Lynch Syndrome (see post on epigenetics and Lynch Syndrome Part 1). Basically, for those with Lynch Syndrome it is essential that DNA is properly replicated and read to produce normal new cells and functional proteins as this is the mechanism impacted by Lynch Syndrome. Not surprisingly nutritional factors regulate DNA expression. For instance, deficiency in B-vitamins, vitamin A, potassium, iron, resveratrol, curcumin, quercetin, other antioxidants, the short chain fatty acid butyrate, selenium, sulforaphane (in broccoli), and multiple compounds in garlic have been shown to negatively alter DNA expression (33).
It goes without saying that a Western type diet full of processed food is nutrient poor, lacking the necessary vitamins and minerals our body need to function properly. But don’t worry, if focus is put on eating whole foods and limiting the above noted foods, sufficient nutrient density will be automatic.
Lifestyle and Cancer Risk
Aside from diet there are many other environmental factors that can directly and indirectly influence cancer risk. Avoiding exposure to chemicals and carcinogens, including pesticides and food additives, is obvious so I will not discuss this any further. However, there are 2 major lifestyle factors that can also significantly influence risk: stress and physical activity.
Continuing with the inflammation-cancer connection, surprise surprise, chronic psychological stress causes chronic inflammation (34). This connection has been shown in the literature time and again, and recent information is connecting chronic stress with cancer risk and progression (35): basically, stress causes and makes cancer worse. Some epidemiological evidence indicates that there is a negative correlation between the amount of stress reduction events (ie. meditation) and cancer occurrence, meaning that the more you reduce stress, the less risk of cancer you have (36).
Stress reduction is an individual thing, so whether you meditate, read, write, draw, do yoga or Tai Chi, golf, or simply change your reaction to perceived stress, the evidence is clear that you should do something to reduce stress as much as possible…adult colouring book anyone?
While this may not be a surprise to everyone, an appropriate amount of physical activity reduces/prevents chronic inflammation and is linked to a lower risk of cancer (37, 38). Furthermore, someone who is physically fit prior to a cancer diagnosis has a higher survival chance.
So, no shocker here, get out and exercise.
In conclusion, the best way to naturally reduce our risk of cancer is by following the below steps:
- Avoid Gluten
- Limit all grains
- Avoid bad fats
- Avoid poor quality carbs like added sugars
- Avoid very high carbohydrate diets
- Avoid processed foods
- Don’t eat processed meats (the ones that have additives other than meat and spices)
- Reduce/control stress
- Get physically active
Once successful, other natural interventions can be done such as supplementation with adaptogenic herbs, but they will not have the same impact without implementation of these dietary and lifestyle suggestions. I hope you have all found this helpful and I would love to hear you thoughts….please comment below.
The Barefoot Golfer