Public health

• Yvonne Batson


  PhD, MPhil, MSc, CSN, RD, Consulting Nutritionist/Dietitian, Specializing in Nutritional Injury, Medical Nutrition Therapy, Sports Nutrition and Nutrition for Healthy Lifestyle
• Statistics –Cancer and CVD in Trinidad and Tobago
• Diet and cancer


  Research and conclusion: International Agency for Research on Cancer (IARC)

  
• Diet and CVD


  Research and conclusion- Emphasis on Mediterranean Diet and Dash Eating Pattern

  
• A look at dietary fat and its relationship to CVD

  
• Cardiovascular disease (CVD) accounts for 33% ~1/3 of all NCD's deaths per year in Trinidad and Tobago

  
• Cancer accounts for 15% of NCD deaths per year in Trinidad and Tobago
• 9 of the 10 countries with the highest NCD mortality rates in the Americas are from the Caribbean
• NCD mortality rates >500/100,000 population, 2016
• NCDs: 5 diseases x 5 risk factors
• Eating processed meat regularly

  Increases your risk for colorectal cancer
• Eating red meat regularly

  Probably increases your risk for colorectal cancer
• Red meat consumption


  Some evidence to suggest a link between and prostate cancer and pancreatic cancer but more research is needed
• Processed meat


  Meat that's been somehow modified, often for taste, texture, or shelf life. This might be done by salting, curing, or smoking meat.

  
• Processed meat


  • Hotdogs, salami, bacon and ham, corned beef, Vienna sausage

  
• Risk increases when large quantities of processed meat eaten regularly eg. eating 50 grams processed meat (1 hot dog or ~4 slices deli) per day increases your risk by 18%
• Unprocessed Red meat


  Beef, veal, pork, lamb, mutton, venison and goat

  
• Charring meat while grilling, broiling, frying, BBQ

  Forms unhealthy heterocyclic amines and other hydrocarbons which is suggested to increase the risk of several cancers including breast and pancreatic cancer
• Cooking Suggestions


  1. Gentler methods of cooking- Stewing, baking, steaming and boiling or even currying

  2. When cooking at very high heat, flip the meat frequently

  3. Don't expose meat directly to a flame and minimize cooking at temperatures above 150°C/300°F

  4. Marinating meat in olive oil, lemon juice, garlic or red wine is suggested to reduce HCAs by up to 90%

  5. Use high quality red meat and limit servings to 3-4 ounces (85-113 gms) couple times per week

  
• Unprocessed red meat


  • Can be part of a mixed diet as it provides nutrients as protein, vitamins eg B6 and 12, minerals eg iron, selenium and zinc

  
• Vegetables and fruits


  • Contain cancer-fighting antioxidants and phytochemicals
• Cruciferous vegetables


  • Broccoli, cauliflower and cabbage
• Sulforaphane


  A substance found in cruciferous vegetables that has been shown to be beneficial
• Other vegetables


  • Tomatoes and carrots, linked to a decreased risk of prostate, stomach and lung cancer
• Processed foods that are high in sugar and low in fiber

  Have been linked to a higher cancer risk
• Diet that causes blood glucose levels to spike


  Associated with an increased risk of several cancers, including stomach, breast and colorectal cancers
• One study in over 47,000 adults found that those who consumed a diet high in refined carbohydrates were almost twice as likely to die from colon cancer than those who ate a diet low in refined carbohydrates
• Higher levels of blood glucose and insulin


  Are cancer risk factors
• Insulin


  Has been shown to stimulate cell division, supporting the growth and spread of cancer cells and making them more difficult to eliminate
• Limit or avoid foods that boost insulin levels


  Such as foods high in sugar and refined carbohydrates
• 8.3% prevalence of diabetes in the Americas, highest in Caribbean countries (11.8%), 9 of the 10 countries with the highest prevalence in the Americas are from the Caribbean, Women more affected than men
• Spices that maybe beneficial

  • Flax seed, Cinnamon, Curcumin found turmeric, Garlic
• Cardiovascular Disease


  • Often coincides with multiple co-morbidities, such as obesity, diabetes, hypertension, dyslipidemia, chronic renal failure
• In as early as 1970, Ancel Keys reported in his Seven Countries Study that the Mediterranean Diet was associated with lower risk of major chronic diseases and highest life expectancies

  
• Western dietary patterns-meat based, high consumption of salt, added sugar, high saturated and trans fat


  Compared to healthier dietary patterns, such as the "Mediterranean Diet" is associated with a reduction of the synthesis of anti-inflammatory markers

  
• Mediterranean Eating Pattern


  • Is a diet that's rich in antioxidant compounds and bioactive elements that have anti-inflammatory effects, high fat intake from extra virgin olive oil, low in saturated fat, high in nutrients and dietary fiber- fruits, vegetables, legumes, cereals, dried fruits and nuts, has a low glycemic index, wine in moderation

  
• Main protective mechanism of the Mediterranean Diet

  
• Caribbean six food group plate model in percentages, Adapted from PAHO The eat well plate
• Glycemic index of some local foods

  
• Saturated fat


  Well established that it adversely effects serum cholesterol levels with increased risk of heart disease, stroke, and even cancer, Solid at room temperature, Animal derived with the exception of the "tropical" oils, i.e., coconut, palm, and palm kernel oil