There are few shortcuts on the path to good health; it's a road made smooth with a reasonable exercise program and by eating a variety of foods that cannot be adequately replaced with nutritional supplements. Barbara LeGardeur, a registered nurse who has a master of public health degree and is an assistant professor in the nutrition section of the Department of Medicine at Louisiana State University Health Sciences Center, discusses how food affects your health and your risks of diseases such as cancer.
Q: Lately I've heard discussion about how what you
eat can influence not only your overall health, but specifically your chances
of getting cancer. What foods are we talking about?
A: We're not talking specific foods as
much as dietary patterns. We're concerned about an epidemic of obesity in this
country among both the young and old. You're talking about an imbalance between
the food we eat and the exercise we get.
Q: Does obesity cause cancer?
A: You can't actually say it causes cancer
... (but) obesity is associated with a greater incidence of certain cancer.
We're looking at what factors are associated with an increased risk in the population.
The obesity and sedentary lifestyle are the two things that seem to be the most
dominant in terms of cancer and cardiovascular disease.
Q: We've always been told that it takes both diet
and exercise to be healthy, but what kinds of foods should we definitely include
a lot of and what should we exclude to lower our health risks?
A: The American Cancer Society's dietary
guidelines for 2002 talk about eating a variety of foods -- with an emphasis
on "variety." You need to eat fruits, vegetables, whole grains, and limit our
consumption of red meat, especially those that are high in fat or processed
with saturated fat.
Q: So this is nothing particularly new?
A: Right. Unfortunately if we go back
to food patterns, our genes haven't changed as rapidly as our environment has.
An abundance of food and labor-saving devices has added to the problem. We've
increased calories and decreased activities.
Q: Does how foods are prepared make a lot of difference?
A: Our wisest choice would be picking
up an apple or carrot and eating them, if not raw, then intact, as opposed to
highly processed. Instead of cookies, we'd be better off picking up fruit, eating
whole-wheat bread instead of white bread. As far as preparation goes, we would
be better off not preparing things with high-fat ... or high-calorie items added
like we do here in New Orleans. Legumes -- beans -- are not bad for you, but
we like to add high-fat sausage to our red beans.
Q: What other patterns are adding to the obesity
problem?
A: We tend to go overboard on portion
sizes. The food pattern I see is the biggie sizes. We're an economically minded
country and like to get a lot for our money. The portions are large in restaurants.
We tend to see that when we're out and bring that into the home.
Q: Are there some foods that are better than others
in terms of things like antioxidants?
A: Fruits and vegetables do contain antioxidants
and other compounds that may be protective, but we're not to the point where
we can identify or recommend intake of supplement X or vitamin X [for, say,
preventing cancer]. We're much better off eating fruits and vegetables that
have an abundance of these compounds.
Q: What would those foods be?
A: The (American Cancer Society) guidelines
emphasize the word "variety" -- fruits and vegetables, leafy greens, citrus
fruits, melon, kale, broccoli, spinach, nuts, low-fat dairy products. Part of
the problem is that sometimes people see one food that has been identified in
one study as being good for one thing, but they tend to overlook the need for
variety. If you're eating a variety of fruits and vegetables and whole grains,
it is unlikely you are eating a diet high in saturated fats.
Q: Are there foods that work specifically on keeping
cells healthy so they don't become abnormal or cancer cells?
A: There are experimental models and animal
studies that talk about a cellular level, but that is way beyond the scope of
this discussion right now. Most important for this are prospective studies,
where you identify the food habits of a group of people and wait until they
develop the disease or disorder and try to identify what they did for the past
20 years to increase the risk of cancer. The studies going on right now that
tell us what we should be doing are the clinical trials (in which medications
or other interventions are used on one group and not another). You wait seven
to eight years and then you compare the group that had the intervention and
those that didn't have the intervention so you can show conclusively that it
made a difference.
Q: But we tend to want quick answers and speedy results
from trials.
A: Food behavior is very difficult to
change, and it's difficult to measure. We're humans, we're not an animal model
where everything can be controlled. It's also eating, so it's not like you can
take a pill (and determine differences among groups). It's very difficult to
measure.
Q: Where do we start?
A: Parents are important, and parents
setting an example is probably one of the most important things they can do
for their children -- giving them the right food choices, which probably means
more meals at home. ... Also, read labels; there is a lot of information at
the store site on the product. Look at the ingredients.
Q: Talk about nutritional supplements in preventing
disease and cancer.
A: As far as a one-a-day multiple vitamin
supplement, there is not added insurance to that, but if your diet is inadequate,
it is not harmful. There is no scientific proof that taking supplements can
lower anyone's risk. ... There are other substances that have been identified
in food that can lower one's risk, but it's not just one item or one compound
that works; we need a very varied diet.
