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Prevention of Cancer PART – 4


(All the articles published in past are available at

Question:  In part 2, we discussed about contents of Diet. But very important and interesting discussion in last part was about HOW WE EAT – and how it affects risk of cancer and other diseases. Diet is vastly different between countries and cultures. And yet cancer risk has increased substantially in last several decades for all cultures. With some variations in site of cancer. Hence more than the content of diet, there are other important factors that seem to matter much more. And some of them have to do with How We Eat. This factor also affects risk of obesity – obesity itself accounts for 40% of cancers in USA. This factor also affects our hormone balance, GI system functioning and our mind too! Don’t eat alone is the most important take away point. Avoid television, phone etc gadgets; eat slowly, chew well; with positive thoughts; after cleaning hands and feet; after a prayer; smaller portions; maintain same time; dinner should be light, and before sunset; a little walk after meal. We also discussed that large majority of these points were followed by our grandparents as a routine.

Ans: Yes, and as we have moved away from the lifestyle our grandparents followed, we have increased mental and physical health issues including many serious ones. Apart from cancer, heart disease, stroke, diabetes, osteoarthritis, osteoporosis, dementia and others, One important issues is Depression, a huge problem in developed countries. – practically whole Europe and USA. And now in India as well. Most physician friends mention that they are prescribing a lot of antidepressants. And the official research on market size also shows rapidly increasing use every year.

Que: I am sorry to interrupt, but how is this topic related to Cancer Prevention?

Ans: Research has clearly shown that patients with Depression have a 50% risk of developing obesity. And obesity as we have discussed, is a very important risk factor for cancers (and of course many other common diseases like heart attack, diabetes etc). Means mental health is equally important. Please note this point as this would be more clear later on.  Vice versa is also true. Obese people have about 50% risk of developing depression.

Thus we cannot look at health as in separate boxes. Holistic health is the only way. Physical, mental, social, financial, and spiritual health are all connected. For an individual, weightage may be more or less for these 5 areas. Our focus is however on how lifestyle can affect health as a whole. And how modern science, with ancient science and wisdom can guide us today.

Que: Amazing, and sobering too! Never ever would I have guessed that mental health is so important for prevention of most common and serious diseases that I see every day. And yes, in my practice too, use of antidepressants have increased substantially compared to 10-20 years ago.

Ans: Before we continue further, let me complete what we started related to Diet contents earlier. Most people are aware that more fruits, vegetables is healthy. Dry fruits we briefly mentioned. Today I find many people worried about eating dry fruits as they look at calorie count. Yes dry fruits are high in calorie but 1. We need to only about 30-50 g per day. 2. Large population based studies have shown that people who eat dry fruits regularly are generally lean. Means there are substances in dry fruits that actually help reduce obesity. Additionally, dry fruits have substances that reduce cardiovascular risk, and certain cancers. There is a substantial reduction in risk of colon cancer recurrence for those who add dry fruits in their diet after colon cancer diagnosis. Magnitude of this reduction is almost as big as what we obtain from chemotherapy. This does not mean we don’t give chemotherapy, but advise dry fruits as well, thus achieving additional benefit.

Specific dietary substances are difficult to evaluate in large trials. However, vegetarian diet, meditarranean diet etc patterns have been studied better. And are found to reduce risk of several cancers substantially. Vegetarian diet also improves overall survival by reducing risk of other major diseases too.

Dietary fiber intake has been shown to be healthy as noted above, using fruits, vegetables, grains. However it is still not clear as to which source of fiber is more important. Data in this area is not very clear. Until further clarity, it is definitely recommended to follow vegetarian diet, and more fibers in diet. A balanced diet as per ancient wisdom is the best way to go.

Que: Fiber in diet has no vitamins or known micronutrients. Then why is it so healthy? Be it modern research or ancient wisdom, both have praised fiber in diet.

Ans: Very interesting question, right? To know this answer, we have to go to the very new field of Brain Gut Microbiota axis. And its connection to the Neuro-Endocrine-Immune pathway. As you can imagine from these words, an axis that affects Brain function, Endocrine glands, and Immunity must be a very powerful axis. There is a growing understanding that many diseases, and health, including mental health as well is affected by this axis. That intestines, and the 40 trillion bacteria within intestines (and likely additional ones in skin, mouth etc) also produce many hormones and neurotransmitters (same as produced by endorcrine glands and brain and more) is a very new knowledge. We will see more next time.

April 10, 2022 Dr Chirag A. Shah; M.D. Oncology/Hematology (USA), 9998084001. Diplomate American Board of Oncology and Hematology. Ahmedabad.

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