It is not a new realisation that we are getting bigger and bigger, less and less active and being overweight or obese is the new norm in the modern society. Australia is doing badly in this new game, but it is far from alone. The epidemic proportion of obesity is common in all developed, so called first world countries. It is a result of multiple factors, the main one being high caloric density of food. Indiscriminate use of additives, explosion of use of highly refined sugar and processed food are among many other offenders. This type of food is relatively cheap for its caloric value and easily accessible even to the lowest socioeconomic class. On top of this, there has been dramatic decrease in our activity, increase in sedentary employment and entertainment, with most young people spending hours and hours in front of the computer playing games being active only in virtual world.
The most negative effects of being overweight or obese are well known, diabetes mellitus, cardiac and vascular diseases including heart attack and stroke being in forefront. There are many others however, related to wear and tear of musculoskeletal system thus indirectly leading to even less activity and closing the vicious circle.
In last few years however even more threatening facts became obvious, once the data from cancer registers and databases have been analysed.
Being overweight or obese increases dramatically risk of getting cancer and dying as a result of it. This is despite the apparent success of treatment because the obesity significantly increases risk of relapse and subsequent failure of further treatment and death.
The reason this is the case is complex and relates to the metabolism of fat with factors like an insulin-like growth factor stimulation of cancer growth, chronic inflammatory mechanism playing role in weakening the immune system and cancer surveillance and many others.
Higher overall mortality was reported in all cancers apart from lung in both men and women. There is particular increase in women with breast cancer, gynaecological and kidney cancers and in men with prostate, liver, stomach and pancreatic cancer as major examples. The major increase in recurrence rates however is seen in women with breast cancer, which is by far the most common malignancy in this group. There is also significant difference in prognosis in comparable stages of cancers across the board.
The prognosis and survival is also influenced in gastrointestinal cancer in both sexes again with negative correlation of prognosis and increase in BMI (Body mass index).
On top of the increased risk, worse prognosis and outcomes of treatment and much lower survival rate, there are also technical problem with delivering treatments to overweight or obese patients with any modern methods being that chemotherapy, targeted therapy or immunotherapy. Generally speaking, there are many more complications due to so called co-morbidities (other illnesses decreasing the resilience and immunity), more side effects and complications of the treatment.
The major emphasis of the last conference of the European Society of Medical Oncology in Copenhagen in 2016 was impact of these statistics on prevention, treatment and policies directed towards curbing this trend and gradually reversing it.
The strategies of reducing the weight, increasing the activity and as such improving general health and fitness of population is beyond scope of this article, but gaining major traction in social and public policies of developed countries. One would hope, that we will see some effective strategies developed over next few years. We can take campaigns against use of tobacco or sun protections policies as an example of effective public health policies and can remain optimistic into the future.
Meanwhile, there are many strategies available to us, which are cheap, effective and long term beneficial for us, well before we would even develop cancer.
People spend thousands of dollars for popular diets, supplements, special strategies with accompanying books, recipes and elaborate schemes. They are companies specialising in this type of weight reduction making it a major industry, that offers in my and many other professionals’ opinions very little real value. Billions of dollars are spent with fleeting but no long term measurable results.
My favourable approach is fasting, caloric restriction and general mindfulness with eating. There is a saying which goes something like “my body is my temple”. Therefore, we should be very careful, what do we put into our mouth and digest. We should be mindful, that whatever we eat is if possible fresh, simple, not processed and perhaps seasonal and local. We all well know what is the classical food pyramid with vegetables, fruits, fish and similar being the solid base. This information is totally accessible to everyone and is free.
We have been created to eat fresh food, not to swallow supplements. We have been created omnivores and as such we should eat all types of food in moderation. Any particular restriction is not natural in the same way as any particular emphasis on extra nutrient or supplement which usually acts as a fertiliser and may simply stimulate the cells we do not wish to grow into excess. There are many scientifically proven negative effects of supplements and vitamins in cancer. There is also nothing wrong with occasional piece of chocolate or moderate amount of alcohol. It is all about moderation. Just like in life, so in the diet.
On top of that all, we should try to be happy, balanced and strive for fulfilment in life.
We should take time to eat, care about the environment we eat in and perhaps have a positive company when eating main meals. That is what Epicurus was advising his pupils more than two thousand years ago. All old cultures placed great emphasis on the eating in a similar vein. Fasting was also an integral part of life. Eating in this way will make us more satisfied, more nourished and happier. But inadvertently, we will eat more mindfully, slowly and better. Ultimately then, we will live longer.
