Food as cancer fighter
by Amar Chandel
IN the first part of the report prepared by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF), which appeared on this page last week, you read that plant-based diets may prevent a variety of cancers while those containing substantial amounts of red meat probably increase the risk of cancer.

Cold exposure can be life-threatening
by Dr S.K. Jindal
COLD weather is generally pleasant and healthy but a nightmare for those with weak body defences. Elderly senior citizens and individuals with pre-existing diseases are in particular likely to suffer the onslaught of winter, especially when it is severe. The worst affected are the poor and the homeless who are poorly clothed and exposed to cold.

Food as cancer fighter
by Amar Chandel

IN the first part of the report prepared by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF), which appeared on this page last week, you read that plant-based diets may prevent a variety of cancers while those containing substantial amounts of red meat probably increase the risk of cancer.

The report uses the terms "probably" and "possibly" repeatedly, but I can assure you from my 30-year experience of helping hundreds of people get rid of numerous supposedly incurable diseases purely by making dietary changes that the conclusions are 100 per cent dependable. You don't have to turn vegetarian, but only control the intake of meat.

What needs to be noted is that there is no essential lower limit of intake of any type of meat, and diets including no meat are not only compatible with good health and low cancer risk, but may also be preferred in some settings, especially when plant foods are abundant, reliable and varied.

When meat and fish are eaten, encourage relatively low temperature cooking. Do not eat charred food. Diets containing substantial amounts of grilled (broiled) or heavily cooked meat and fish possibly increase the risk of cancer of the stomach; diets containing substantial amounts of grilled, barbecued or fried meat possibly increase risk of cancer of the colon and rectum. Diets high in processed meats possibly increase the risk of cancers of the colon and rectum. Meat and fish eaters should avoid burning of meat juices. Consume meat and fish grilled (broiled) in direct flame, cured and smoked meats only occasionally.

One recommendation very relevant to desi ghee loving India is to limit the consumption of fatty foods, particularly those of animal origin. Choose modest amounts of appropriate vegetable oils.

Diets high in fat possibly increase the risk of cancer of the lung, colon and rectum, breast, and prostate. Diets high in saturated or animal fat possibly increase the risk of cancer of the lung, breast, colon and rectum, endometrium and prostate.

The innocuous salt is essential for health but can be risky if taken in excess. Diets high in salted foods probably increase the risk of stomach cancer.

The report recommends that salt from all sources should amount to less than 6 g/day for adults. So, limit consumption of salted foods and use of cooking and table salt.

Use herbs and spices to season foods.

Store perishable food in ways that minimise fungal contamination. Do not eat food which, as a result of long storage at ambient temperatures, is liable to contamination with mycotoxins.

This recommendation has special application in parts of Africa and Asia where primary cancer of the liver is common, and cereals (grains), pulses (legumes) and other crops may be stored for long periods in warm damp conditions.

There is convincing evidence that refrigeration decreases the risk of stomach cancer, by reducing the need for salt as a preservative and enabling year-round availability of vegetables and fruits.

So, perishable food, if not consumed promptly, should be kept frozen or chilled.

When levels of additives, contaminants and other residues are properly regulated, their presence in food and drink is not known to be harmful.

However, unregulated or improper use can be a health hazard, particularly in economically developing countries.

For those who follow these recommendations, dietary supplements are probably unnecessary, and possibly unhelpful, for reducing cancer risk.

The evidence that diets high in carotenoids and vitamin C possibly protect against cancer of a large number of sites should not be taken as suggesting that supplements of these or any other dietary microconstituents might reduce the risk of cancer.

Evidence from intervention trials using supplements in varying combinations and doses is confused and, in some cases, has shown increased cancer rates in those being supplemented.

Quite expectedly, alcohol consumption is strongly discouraged. If consumed at all, limit alcoholic drinks to less than two drinks a day for men and one for women.

Pregnant women, children and adolescents should not drink alcohol at all. A drink is defined as 250 ml (one small glass) of beer, 100 ml (one glass) of wine, 25 ml (one measure) of spirits or equivalent.

The recommendations are food based. But the fact remains that tobacco is the chief cause of lung cancer. It is probably the most important single cause of cancers of the upper aerodigestive tract, and drinkers who also smoke greatly increase the risk of these cancers. It also contributes to cancers of the pancreas, cervix and bladder. Tobacco is a cause of cancer whether smoked, chewed or consumed in other ways. So, quit smoking and drinking and eat sensibly for a cancer-free life. (Concluded)

Cold exposure can be life-threatening
by Dr S.K. Jindal

COLD weather is generally pleasant and healthy but a nightmare for those with weak body defences. Elderly senior citizens and individuals with pre-existing diseases are in particular likely to suffer the onslaught of winter, especially when it is severe. The worst affected are the poor and the homeless who are poorly clothed and exposed to cold.

Skin and lungs are the two most directly affected systems in the body. Factually speaking, lungs are affected even in well-clothed individuals from breathing cold air.

The colder temperature of the surroundings results in the loss of body heat from the skin surface. To conserve body-heat, the blood vessels in the skin contract thereby lowering the surface temperature and causing a feeling of chill. Continued exposure of the skin to the colder temperature results in injury to the superficial surface as well as the loss of body heat. Such a phenomenon can be prevented by adequate clothing and covering the body surface. What is not commonly realised is the fact that the major source of heat exchange is the lung surface which cannot be easily protected.

Breathing is one physiological function which must go on for the preservation of life. The air we breathe gets equilibrated with body temperature almost immediately after it passes in the respiratory tract. If the air temperature is low, a lot of heat is required to warm the air to the body temperature and it is, therefore, lost to the atmosphere when breathed out. Continuous breathing of cold air results in a massive loss of body heat, lowering the body temperature.

It is the cold-air breathing therefore which, when persistent, creates problems of cold exposure by lowering the inner (or core) body temperature — a condition called hypothermia. The problem gets compounded due to the inhalation of dry air since the moisture content in cold air is rather scanty. Hypothermia and dehydration, therefore, are the two important effects of cold exposure. They are highly injurious to different body systems and the compensatory mechanisms soon fail to cope up with the problem. Consciousness is soon impaired and sedation sets in.

In prolonged exposure, the effect may prove to be serious and even fatal. This is how people in the streets die. Similar consequences await the patients exposed to a cold atmosphere whose thermo-regulatory mechanisms are already impaired, such as hypothyroid patients and those who are drunk. The small children in whom the regulatory mechanisms are not fully developed and the elderly in whom there is waning of these functions are also affected more frequently than others.

All this is aimed at underlining the importance of avoiding prolonged exposure. The effects are almost directly proportional to the duration and severity of cold exposure vis-a-vis the protective measures adopted. Milder forms of cold effects are common and equally troublesome. These may vary from simple watering of the nose and eyes to cough and asthma, from chillblains and frost-bite to the gangrene of fingers and toes.

Irritating cough is common in winters. As earlier explained, inhalation of cold and dry air causes drying of the respiratory tract and stimulation of cough reflex. This is a simple and relatively innocuous form of cough. But cold exposure may also cause severer forms of cough and adversely affect the patients suffering from respiratory diseases. Asthma patients may suffer frequently from acute spasmodic attacks in the cold and foggy weather.

Patients with chronic bronchitis would suffer from acute exacerbations and respiratory infections. These problems are common in smokers who suffer from chronic bronchitis. The argument that smoke inhalation keeps the respiratory system warm is a myth. One does not have to inhale smoke containing over 4000 harmful constituents to feel warm and cosy.

Protection from cold is essential in spite of all the difficulties. Adequate clothing, gloves and socks are important, but they do not protect the inhalational exposure. Therefore, avoidance of prolonged periods of outdoor exposure is the most important step. Early morning and late evening or night walks must be avoided. This is particularly crucial for the vulnerable groups.

Avoiding dehydration is another important caution. Frequent intake of fluids, preferably warm, helps a lot to conserve heat energy. Sips of brandy or other forms of alcohol are commonly employed. It is counter-productive and soon tends to aggravate the lowering rather than raising of the body temperature.

The heat generated by alcohol is temporary due to internal combustion. Further, the tendency to consume more and more alcohol to keep oneself warm impairs judgement and loss of the sense of the risk, ending in prolonged and unprotected exposure.

If there is exposure to cold by accident or by intention, warming up should be done gradually and gently. Direct heat, for example sitting in front of a heater, may cause aggravation of symptoms. We need to raise the internal body temperature, which is best achieved by the warming of the inspired air — heating the room air and covering the body with multiple blankets, etc. Hot tea, milk or water are also helpful. In severer forms of hypothermia, administration of warm saline may be required through the rectum and/or intravenously under medical guidance.

Specific problems require specific steps and treatments. In general, however, suffice it to say that a lot of problems of cold exposure are avoidable provided one is careful and cautious.

The writer is Professor and Head, Department of Pulmonary Medicine, PGI, Chandigarh.