(Primary Prevention)
So here we have a critically important topic, critically important for
several reasons. There is an epidemic of cancer; we believe that the majority
of these cases are preventable, and we know a good deal about etiology, the
cause and prevention of cancer. A huge, burgeoning industry has built up around
treating cancer; at the same time, the focus on prevention and the resources
dedicated to the prevention of cancer is growing a bit, but grossly inadequate.
Will the disease of cancer soon take the place of heart disease as the number
one killer in our country?
Yes, more than 40 years has elapsed since the war on cancer was
officially declared by Pres. Nixon. And, we are no closer to winning that war
than we were when it was declared!
This topic is not only legitimate, complex, and important, but it is
part of a bigger picture, the whole issue of the epidemic of chronic diseases
in general. As a culture and within the health care system in general we are
struggling with a full spectrum of chronic diseases including dementia and
other brain diseases including stroke, heart disease, cancer, autoimmune
disorders, diabetes and prediabetes, obesity, addictions, and a rising
incidence of suicide. A pivotal issue in this discussion has to do with the
idea of synergy and a growing body of knowledge indicating that many if not
most of these chronic medical conditions have common causation. So, if I
consume a plant strong eating regimen, it is likely that my risk for these
diseases will decrease dramatically. The environmental factors and dietary
issues that help prevent cancer also act to prevent many of the other chronic
diseases.
Yes, it is also true is that statistically, most people do not get
cancer; however, the majority of people do contract one or more chronic diseases
that make up the total disease burden in our country and in the western world.
In the primary prevention of disease our goal is to avoid contracting serious
illness for a lifetime and, that would include the disease of cancer. But, I
must add that adherence to even ideal lifestyle practices is not a guarantee of
optimal health or extended longevity; this is because there remains a series of
issues that are outside of our control:
· There are many toxic environmental exposures
over which we have little or control.
· Having a sunburn at age 15 may result in a
skin cancer at age 50.
· Certain cancers like breast, uterine, ovarian
and prostate can be triggered in part by the food our mothers ate and the
chemicals in their environments.
· Despite an ideal food intake and a dedicated
exercise regimen, they cannot insulate us from dangerous working conditions
that may perhaps include exposure to asbestos or other high-risk situations.
· And finally, it is also true that our
understanding of lifestyle factors is evolving; and, this understanding is
therefore not perfect. In our culture in past decades we used to strongly
advocate the consumption of dairy products, but now we understand the role that
dairy products play in the onset of cancer, in part, because of increased
levels of insulin growth factor one (IGF-1).
It is instructive to note that several
specific people groups discussed below appear not to contract cancer at all, or
have a remarkably low incidence of cancer
Blue Zones
The five Blue Zone people groups have been spared this troublesome
disease. A Blue Zone is a geographic
area where there has been exceptional longevity and an extraordinary low
incidence of most all disease, including cancer. Some of these people may live to be
centenarians or even super centenarians (100-110 years or longer).
· The Okinawans: This is home to the world’s healthiest
documented elders, to the world’s longest recorded life expectancies, and to
the highest concentration of verified centenarians in the world! Okinawan
elders have incredibly young arteries, lower risk for heart disease and stroke,
low risk for hormone dependent cancers,
strong bones, sharp minds, slim bodies, natural menopause, healthy levels of
sex hormones, and excellent psycho-spiritual health. They eat squash, papayas,
greens, tomatoes, leaks, melons containing cancer fighting antioxidants, sea
vegetables, and soy that is mostly from relatively unprocessed soy products
like tofu, edamame, miso, soy flour, and soy milk. They avoid eating junk food
that creates inflammation. Compared to someone in the United States, an elderly
Okinawan is 85% less likely to die from breast cancer, 88% less likely to die
from prostate cancer, 70% less likely to die from ovarian cancer, and 70% less
likely to die from colon cancer.
· The Seventh-day
Adventists: As a group, they currently lead the nation in
longest life expectancy. Over 9,000 Seventh-day Adventists live in and around
Loma Linda, California, 60 miles east of Los Angeles. There are approximately
24 million Adventist adherents worldwide and about 1 million Adventists in the
United States and Canada combined. This blue
zone group has been the focus of exhaustive, multi-decade long research
concerning their health and longevity. Some of their cultural characteristics
include:
1.) They find a
sanctuary in time; their 24-hour Sabbath allows time to focus on family, God,
nature, time to relieve stress, and participate in social activities.
2.) They seek to
maintain a healthy body mass index (BMI), to keep active, and, if they consume
meat, do it sparingly. They have lower blood pressure, lower blood cholesterol
and less cardiovascular disease than heavier Americans with higher BMIs. To
reduce the odds of having heart disease and certain cancers they get regular
moderate exercise like low intensity daily walking.
3.)
Tendency wise, Adventists tend to
spend lots of time with other Adventists. They find well-being in this by
sharing values and supporting each other’s habits.
4.)
They snack on nuts and find that
those who consume nuts at least five times a week have about half the risk of
heart disease and live about two years longer than those who do not.
5.)
These people focus on helping others
and volunteering as a way to find a sense of purpose and to give something back
to their church and community.
6.)
Many Adventists adhere to a vegetarian diet as
consuming fruits, vegetables and whole grains appears to be protective against
a wide variety of cancers. For those who do consume meat they recommend eating
small portions as a side dish rather than as a main part of the meal.
7.)
The Adventist tendency is to eat an
early, lite dinner that avoids flooding the body with calories during the
inactive parts of the day; this seems to promote better sleep and a lower BMI.
8.)
Non-smoking Adventists who ate fruit
daily, consumed legumes three times a week, and consumed tomatoes three or four
times weekly, had significant health benefits including reduction in cancers.
9.)
Finally, the Adventists drink plenty
of water every day, 5 to 6 glasses and believe that this resulted in a
substantial reduction in the risk of fatal heart attacks.
· Sardinians: For the most
part it would never occur to these people to be bored; they love their life,
their animals, their farming and their families. Their families are their
purpose in life, la famiglia is considered the most important thing in
their lives. Their diet consists of mastic oil that has antibacterial and
antimutagenic properties, barley, fava beans, chickpeas, tomatoes, almonds,
sheep’s milk, milk thistle tea, cheese, potatoes, onions, zucchini, onions, and
Sardinian wine that is a potent source of flavonoid nutrients that may protect
against cancer and heart disease.
·
Costa Rica, Nicoya Peninsula: These
centenarians on the Nicoya Peninsula in Costa Rica have some important lessons
to share with us about longevity and disease prevention that warrant them having
the distinguished status of being a Blue Zone people. These folks have a
physically active lifestyle, an excellent diet, and, importantly, they have
succeeded in achieving lifelong happiness; this very positive ingrained mood
state, happiness, can add a decade to a person’s health span. Their food
consumption includes exotic fruits, lime-soaked corn tortillas, bananas,
papayas, beans, onions, garlic, fresh tomatoes, jalapeno peppers, corn,
cilantro and cheese. In many instances, their tap water has very high levels of
healthy calcium and magnesium.
· Ikaria, Greece: On average,
these people live an astounding 8 to 10 years longer than Americans and they
are included in the elite blue zone category. They consume a diverse Mediterranean
diet that includes vegetables, legumes, greens, olive oil and olives,
hummus, tea from local herbs, goat’s milk, potatoes, coffee, wine in
moderation, local honey and fish. They consume no processed food and little or
no sugar. Beans and pulses are clearly one of the most important aspects of
traditional Ikarian eating; fava or broad beans, chickpeas, black-eyed peas and
lentils are core food items. Each of these legumes are packed with fiber,
minerals, cholesterol free protein, antioxidants and other phytochemicals, and
vitamins such as folate.
Cold
Spots
Cold Spots are places where we find very few cases of a specific
disease like heart disease, cancer, osteoporosis or diabetes. But, these groups do have other illnesses.
· Cameroon, West
Africa: These people had superior bowel health and
avoided colon cancer. They soak their Manioc (cassava or yucca) to
remove toxic residues. This clearly contributes to their bowel health by
minimizing exposure to harmful toxins. They consume a minimum of 35 grams of fiber
daily from foods such as fruits, vegetables, beans, nuts, and whole grains.
Secondly, they consume foraged greens such as collard greens, mustard greens,
dandelion greens and spinach that are rich in folate and many other
phytonutrients. Thirdly, they consume African grains such as millet, sorghum,
and teff and soak these grains overnight in order to increase the
bioavailability of the nutrients. Finally, their people do some form of aerobic
exercise for at least 30 minutes six days a week.
· Hispanics: They have less
cancer of the prostate, breast, and colon that is associated with
consumption of all sorts of legumes; and, also consume a good deal of corn,
tomatoes, chili peppers, rice and corn.
· Papua New Guinea
Highlanders and Kitavans: This is a cold
spot for dementia, cancer and
stroke. Refined
sugar, vegetable oils and other processed foods were virtually nonexistent; primarily
they eat a variety of tubers including yams, sweet potatoes, taro and cassava.
· Tarahumara
Indians: This group has an
extremely low incidence of heart disease and cancer. They are probably the most efficient and fastest runners in
the world! There diet it is primarily complex carbohydrates like beans, corn
and squash.
Other Long-live Groups
** Note that the elderly in each of these
three groups have extremely low rates of cancer and all of the other major
chronic diseases.
· The Abkhasians: The Abkhasian people reside in the Caucasus Mountains in southern Russia. Their land is bordered on the north by Russia and on the south by Georgia. Abkhasia covers 3,000 square miles between the eastern shores of the Black Sea and the crest line of the main Caucasus Mountain range. Many of these people are thought to live to be over 100 years of age and several of them are believed to be over 130 years old. They hike up and down steep hillsides and they actively work in the orchards and gardens. They have a relentless sense of humor and dislike being rushed. They tend to be lacto-vegetarians who rarely eat meat. They consume a fermented beverage called Matzoni that is made from the milk of goats, cows or sheep. For breakfast they often have freshly picked vegetables; at all three meals they eat their beloved Abista that is a cornmeal porridge. They do not consume leftover foods; if the food is not totally fresh they consider it harmful and they discard it. The average total cholesterol reading among the Abkhasian centenarians is 98!
· The Hunzans: The Hunza people
are also known as the Burusho, and inhabit the Hunza Valley in the
Gilgit-Baltistan region of northernmost Pakistan, where Pakistan meets Russia
and China. These people live in an area where mountain peaks soar to 20,000
feet and where they live in a very fertile valley that has sustained the
population of 10 to 30,000 people for 2,000 years. There are no overweight
people. It is thought that some of the men can father children at 100 years of
age. Their fertile planting terraces have been called one of the great wonders
of the world. They grow many varieties of fruit and have a multitude of wild
berries. Their food supply includes more than 20 varieties of apricots and the
roof of every building is covered with drying apricots. They consume a lot of
whole-grains including wheat, barley, millet, and buckwheat and they eat the
seeds of a grass called ‘Job’s Tears.’ Much of their diet is consumed
raw, including corn on the cob. They do not overcook their vegetables which are
often lightly steamed in order to save water and preserve nutrients.
Interestingly, they consume highly nutritious ground flaxseed frequently. Their
apples are very large, weighing more than a pound each! The percent of their
calories from carbohydrates is about 73%, from fat is about 17%, and from
protein is about 10%. They have a
shortage of fuel so they eat much of their food raw. Their air, water, and soil
is very healthy and this would appear to be a major contribution to their
longevity and health status. They tend to be a happy and passionate people who
work in the fields until their most senior years.
· The Vilcabambans: This people group
lives in a very small and inaccessible town in southern Ecuador’s Andes
Mountains called Vilcabamba which means Sacred Valley. This area is not
far from the Peruvian border and is about 100 miles inland from the Pacific
Ocean. Their land is lush and in a subtropical region. Some people have
described their area as the Lost Paradise, because of the area’s
serenity, clean air, wonderful blue sky and pure drinking water. They are quite
lean, have a very healthy diet, low cholesterol levels, and they are very
physically active. The Vilcabambans are known to live for a very long time,
many of them being centenarians. They
are almost entirely vegetarian consuming a lot of whole grains, vegetables,
fruit, seeds, beans, and nuts. It is a rare occasion when they consume milk,
eggs, meat or butter. Their protein comes from vegetables, whole grains and a
variety of beans. Their fat comes from avocados, seeds and nuts. Their
carbohydrates include whole grain cereals such as corn, quinoa, wheat, and
barley; they also consume tubers in the form of white potatoes, yucca and sweet
potatoes. Regular exercise is an integral part of their culture and a very
important part of their daily lives. They know the value and healing power of
walking great distances and they have a famous saying: ‘Each of us has two
doctors, the left leg and the right leg.’ They often negotiate very hilly
terrain, perhaps even daily, and as a result, they have a high degree of
cardiovascular fitness. And again, they have extremely low rates of cancer and
other chronic diseases.
Summary
of Some Select Dietary and Lifestyle Issues in Indigenous Populations
As
we study the characteristics of healthy indigenous cultures to include their
dietary habits, their relationships, and the level of their physical activity,
we see a picture of lifestyles that lead to optimal health, including the
avoidance of cancer. Here are some of those characteristics:
- When possible, eat foods that are local, fresh, and in season. Avoid canned goods and foods that have been shipped long distances.
- Follow through with food cultivation techniques and recipes that are passed down through the generations.
- Practice communal eating, eat for satiety rather than fullness, and fast periodically.
- Use sugar that comes from whole plant foods such as honey, fruits, vegetables and whole grains.
- Use salt that comes from natural unprocessed sources such as fish, sea greens and vegetables.
- Consume meat in very small quantities and get your protein mainly from plant sources such as nuts, legumes and grains. Consume fish sparingly. As these people transition from small amounts of animal-based foods to significant amounts, we see more heart disease and cancer.
- Consume non-meat dietary fats from whole nuts, seeds, grains and fatty fruits. Some fish also contain healthy fat. Avoid bottled oils, margarine, saturated animal fats and cholesterol.
- Eat fermented and pickled foods.
- Consume a diverse selection of healing spices like turmeric and ginger that have anti-inflammatory properties.
- Eat a plant-based diet that is low in overall calories and high in nutrients.
- Eat a diet high in complex carbohydrates including plenty of whole grains, vegetables and fruits.
- Consume whole plant foods and eat very little if any processed or refined foods, sugar, corn syrup, preservatives, artificial flavors or other chemicals. Consume at least 75% of your calories from unrefined plant-based foods.
- Consume plenty of high starch plant foods including corn, beans, potatoes and squash.
- Eat an assortment of small dishes in order to optimize variety in the diet. In Crete these are called mezes; in Okinawa they are Okazu; and in Spain they are tapas.
- Light alcohol consumption.
- Eat slowly.
- Get sufficient sleep and rest; many take naps, some regularly, a practice that reduces stress and may lower the risk for heart disease.
- Nurture all of your relationships within your family, circle of friends, neighbors, community, and place of worship. Maintain a strong sense of belonging to your community and strong ties with your friends.
- Engage in daily activities that relieve stress including daily, regular exercise.
- Fast when you feel poorly.
- Minimize exposure to toxins in the air, water, and food; minimize use of medications when possible.
- Remain sexually active into your latest years.
- Be active in faith-based activities.
- Maintain a strong sense of purpose in life. (Zahler, 2018)
References
Buettner, Dan: ‘Blue Zones,: lessons for living longer from
the people who’ve lived the longest,’ National Geographic Society, 2008.
Campbell, T.C.: ‘Whole, Rethinking the Science of Nutrition,’
Ben Bella Books, 2013.
Popper, Pamela: ‘Solving America’s health care crisis,’ PB Industries, Inc., 2012.
Robbins, John: ‘Healthy At 100,’ Ballantine Books, 2006.
Zahler, William: ‘Health, Inertia, and Information: Why Are We
Sick?’ Create Space, March 2018.
Zahler, William: ‘Synergy and the Dynamics of Lifestyle Change,’
Create Space, January 2019.
William Zahler, MSW,
ACLM
April, 27, 2019
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