Hedging your bets on cancer


Breast cancer is probably a woman's most feared disease, yet many women fall amazingly short when it comes to taking preventive action. It's time we all did better, either by becoming more active in our own lives or by helping our mothers, daughters, sisters and friends to do a little better.

Regular mammography, for instance, can reduce breast cancer deaths by 30 percent in women over 50, yet only one-third of women over 50 have regular mammograms. Since 1991, even Medicare has reimbursed for biennial mammograms (get yours while the benefit lasts).

Breast cancer, like many other cancers, develops over a long period of time. Some researchers think it takes at least 20 years. Others are looking at diet in childhood as a predisposing factor.

But breast cancer, also like other cancers, develops in two stages. Cells can go through first-step changes and stop there, remaining harmless forever. A second change has to take place before cancer occurs. In a sense, we always have one more chance at prevention.

Many scientists believe nutrition is the key to breast cancer prevention. Although issues remain unresolved, some logical diet improvements may cut cancer risks. The good news: Those same steps can reduce risks for other diseases as well.

The top food concerns:

* Dietary fat -- High-fat diets are the prime suspect, yet the recent Nurse's Health Study didn't confirm this. However, the lowest-fat diets in the group weighed in at 32 percent of calories from fat, and many researchers believe lowering diet to 20 percent to 25 percent of calories from fat is necessary to lower cancer risks. That would be about 40-50 grams of fat a day for a woman eating 1,800 calories. The bonus here -- a diet of 20 percent fat helps weight loss.

In other research, diets high in saturated fat increased breast cancer risks. Increasing olive oil, high in monounsaturated fat, decreased risks in another study. Bonus: Decreasing saturated fat and increasing monos seems to reduce heart disease risks.

* Fruits and vegetables -- A Harvard School of Public Health study compared women who ate five servings of vegetables a day with those who ate only one or two. The first group had a 48 percent lower risk of developing breast cancer. Bonus: Women who eat more fruits and vegetables have lower risks for heart disease and stroke.

Other researchers are touting cruciferous vegetables for breast cancer protection. Broccoli, cauliflower, cabbage, brussels sprouts, kale and collard greens are rich in indoles, the phytochemical most likely responsible for the preventive effect. Bonus: Researchers have long known that diets high in cabbage-family vegetables protect against many other kinds of cancers as well.

* Dairy foods -- Research on laboratory animals shows calcium and vitamin D cut breast cancer risks. A small European study showed low-fat, high-fiber diets rich in yogurt, cheese and buttermilk also reduced risks significantly. Bonus: Dairy foods help strengthen bones and reduce osteoporosis risks.

* Alcohol -- Two drinks a day may increase breast cancer risks by 40 percent, three a day by 70 percent. Bonus? Up to one drink a day might reduce heart disease risks, but health specialists are reluctant to promote alcohol use for health.

Beyond food items themselves, other diet-related factors that might affect breast cancer risk:

* Body fat -- In general, women who carry more body fat have higher breast cancer risks than women who are closer to chart weights, perhaps because fat cells produce estrogen that feeds tumor growth.

If you're overweight, lose some body fat if you can. If not, stay where you are.

* Exercise -- Regular exercise may reduce breast cancer risks by reducing estrogen production. One study found premenopausal women who exercised one to three hours per week reduced breast cancer risks by 20 percent to 30 percent. Four hours per week reduced risks by 60 percent. Bonus: Exercise reduces risks for heart disease, osteoporosis, high blood pressure and diabetes.

Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center and Vanderhorst & Associates in Baltimore.

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