The foods we eat can affect our risk of developing certain types of cancer. High energy and high fat diets can lead to obesity and are generally thought to increase the risk of some cancers. Plant-based diets high in fresh fruits, vegetables, legumes and wholegrain foods may help to prevent cancer.

Diet is just one of the lifestyle factors that influence the risk of developing cancer. Smoking, obesity, alcohol, sun exposure and physical activity levels are also important. Although some foods can affect cancer risk, there is no evidence that specific foods can cause or cure cancer.

Food and some common cancers
Some common cancers (and how they are affected by what we eat) include:

• Lung cancer – this is the leading cause of death from cancer in the world and smoking is mostly responsible. There is convincing evidence that diets high in vegetables and fruits are protective against lung cancer. It is thought that compounds called carotenoids (present in significant amounts in fruits and vegetables), as well as vitamin E, are probably responsible for some of this effect. However, the use of antioxidant supplements, such as beta-carotene and vitamin E, has not been proven to be effective in either prevention or treatment of lung cancer and may, in fact, increase the risk of developing cancer in those who smoke. While fruits and vegetables may offer some degree of protection, not smoking in the first place is by far the best prevention.

• Breast cancer – this is the most common type of cancer in women in the world. There is an increased risk of breast cancer with factors such as rapid early growth, greater adult height and weight gain in adulthood. Much of the risk of developing breast cancer involves factors that influence oestrogen levels during a woman’s reproductive life, such as age of menarche (first period), number of pregnancies and breastfeeding practices. Post menopausal women who are carrying too much weight, especially around their middle, have more than twice the average risk of breast cancer. Diets high in mono-unsaturated fat and high in vegetables and fruits may reduce the risk, while alcohol consumption increases the risk.

• Prostate cancer – a quarter of all new cancers diagnosed in men in UK is prostate cancer. Vegetables, soy in particular may decrease the risk, while a high fat diet that comprises mostly animal fat sources (such as dairy products, fatty meats and takeaway foods) may increase the risk. Lycopene is a potent antioxidant found in tomatoes, tomato-based products, watermelon and strawberries. It may also help lower the risk of prostate cancer.

• Bowel cancer – this is the fourth most common cancer in the world. Up to 70 per cent of cases can be prevented by following a healthy lifestyle. Keeping a healthy weight, being physically active and a diet high in vegetables and fibre are protective, while consuming a large amount of red meat (especially processed meat) and alcohol may increase the risk.

Foods to ‘eat less’
Foods to limit in your diet or eat less of include:

• Fatty processed red meats

• Highly processed foods that are low in fibre

• Heavily salted and pickled foods.

Foods to ‘eat more’
The strongest protective anti-cancer effect has been shown with:

• Vegetables, especially raw vegetables or salads

• Leafy green vegetables

• Carrots

• Tomatoes

• Citrus fruits

• Cruciferous vegetables like broccoli, cabbage, brussels sprouts, bok choy and other Asian greens.

Include more of these vegetables and fruits in your diet along with other varieties.

Seven a day
Eating seven or more serves daily of a variety of grains, grain products, legumes, roots and tubers will also provide protective benefits against cancer. The less processed the grains, the better. Diets high in refined starch and refined sugar may increase the risk of stomach cancer and bowel cancer.

Meat and bowel cancer
There is now convincing scientific evidence that eating processed meat increases bowel cancer risk. The World Cancer Research Fund (WCRF) has recently recommended that people avoid eating processed meat. Processed meats are any meat that has been preserved by curing, salting or smoking, or by adding chemical preservatives. These meats include hot dogs, ham, bacon and some sausages and burgers.

It is recommended that children are not given processed meats at all. This is because many of the habits we develop as children last into adulthood. Substitutes for processed meats that are recommended for children include poultry or fish, low fat cheese or small amounts of lean meat.

The WCRF also recommends limiting the amount of fresh red meat we eat to 500g (cooked weight) a week. This is because there is convincing evidence that red meat also increases a person’s risk of bowel cancer.

Some research suggests that eating burnt or charred meat may increase cancer risk, but the evidence is unclear.

Fats and cancer
There has been a great deal of interest in the possible association between fat and cancer. Current evidence does not indicate a direct link between fat intake and particular types of cancer (with the possible exception of prostate cancer). However, a high fat diet may lead to obesity, which is a risk factor for several cancers including cancer of the colon, breast, kidney, oesophagus, gallbladder and endometrium.

Supplements are not the answer
Results of studies that show a protective effect of foods containing certain nutrients should not be taken to mean that these nutrients, when isolated and taken as supplements, will provide the same benefits for cancer prevention. In some cases, there has been an increased risk of cancer in those people who take nutrient supplements at doses higher than the amount of that nutrient normally eaten in foods.

Suspect foods examined
While a high energy, low fibre diet may increase a person’s risk of developing cancer, some individual foods have also been singled out as potentially causing cancer (carcinogenic). These include:

• Artificial sweeteners – such as aspartame, saccharin and cyclamate. Laboratory rats can develop bladder cancer if fed huge amounts of saccharin or cyclamate, although this is at levels thousands of times greater than a normal diet. International studies agree that humans aren’t affected in the same way. Artificial sweeteners are considered safe to eat.

• Cured, pickled or salty foods – there is no conclusive evidence that red meat causes cancer. However, bacon and other cured or pickled meats contain a substance called nitrate, which has the potential to cause cancer in laboratory animals when eaten in huge doses. How this research relates to humans isn’t clear. To be on the safe side, it is best to limit the amount of cured meats in the diet because they are generally high in fat and salt. Salt has also been associated with an increased risk of stomach cancer and should be consumed in limited amounts.

• Burnt or barbecued foods – a group of carcinogenic substances called polycyclic aromatic hydrocarbons (PAHs) can be produced if foods are overheated or burnt. Although charred or smoked foods could contain traces of PAHs, experts agree that the amount in the average UK diet is too low to be considered a significant cancer risk. However, when cooking, it’s best to use relatively low temperature methods wherever possible. These include steaming, boiling, poaching, stewing, casseroling, braising, baking, stir-frying, microwaving or roasting. Avoiding char-grilled meats and foods would also be smart.

• Peanuts – some laboratory animals can develop cancer after eating peanuts that are contaminated with toxin-producing moulds. However, peanuts sold in the UK are generally uncontaminated and contamination is routinely screened for.

• Alcohol – consuming alcohol increases the risk of cancers of the mouth, pharynx, larynx, oesophagus, breast and liver. The risk is even greater in those people who smoke. Alcohol has also been associated with colon, breast and rectal cancers. Men should drink less than two standard drinks a day and women less than one standard drink a day.

Treating cancer with food
While food plays an important role in preventing some cancers, the therapeutic value of food in treating existing cancer is less clear. It is true that a person with cancer needs excellent nutrition in order to better cope with the physical demands of the illness and the rigours of medical treatment. However, claims that particular foods, vitamins or micro nutrients can kill cancer cells should be viewed with scepticism To date, there is little scientific proof that a particular food or supplement can cure cancer or destroy cancer cells.

Recently some Japanese studies have found that green tea may delay the development and spread of certain cancers. Other studies have suggested that soy may also have a similar effect. Although this work is preliminary, it may suggest a more important role for food in the treatment of cancer in the future.

Nutrition for the person with cancer is important for many reasons, including:

• The immune system needs bolstering to fight at full strength.

• The diet may be adjusted to cope with various symptoms, such as constipation, diarrhoea or nausea.

• Loss of appetite or an increased metabolism means that high energy foods may need to be included in the daily diet.

• Extra protein may be needed to help prevent loss of muscle from weight loss.

Things to remember

• High fat, low fibre diets may increase the risk of many cancers, including bowel, lung, prostate and uterine cancers.

• You can reduce your risk of developing cancer by eating more fresh fruits, leafy green vegetables and wholegrain foods.

• Even though diet can influence your risk of developing cancer, there is little evidence that special foods can be used to cure existing cancers.

Osteoporosis means ‘bones with holes’. Bones lose their strength and density, become fragile and break (fracture) more easily because of calcium loss. Breaks are most common in the spine, hip and wrist and often occur after only a minor fall or knock. Osteoporosis particularly affects women in their middle and later years, although some men are also affected.

Most people show no signs of developing osteoporosis until a fracture occurs. Both men and women can take steps from a young age to avoid developing the condition in later life. Reduce your risk of fractures by taking steps to prevent and treat osteoporosis (or brittle bones) and avoid falls wherever possible. Activity and a healthy diet rich in calcium and vitamin D are both important.

Osteoporosis and bone growth
Bone is formed by specialised cells. Like the rest of the body, bone is constantly being broken down and renewed. It is living tissue that needs exercise to gain strength, just like muscle. In the early years of life, more bone is made than is broken down, resulting in bone growth. By the end of your teens, bone growth has been completed and ‘peak bone mass’ is achieved.

Sex hormones, such as oestrogen and testosterone, have a fundamental role in maintaining bone strength in men and women. The fall in oestrogen blood levels that occurs during menopause results in accelerated bone loss. During the first five years after menopause, the average woman loses up to 10 per cent of her total body bone.

Fractures of the spine caused by osteoporosis can lead to loss of height, pain and changes in posture such as the ‘Dowager’s hump’. This hump is caused when spinal fractures are compressed due to the force of gravity, resulting in an abnormal bending of the spine (kyphosis).

Symptoms
Osteoporosis causes no specific pain or symptoms. However, it does increase the risk of serious or debilitating fractures. If you think you may be at risk of developing osteoporosis, see your doctor.

Risk factors for osteoporosis
Several factors can place a person at risk of osteoporosis. Risk factors include:

• Family history of osteoporosis (mother, sister or grandmother)

• Inadequate amounts of dietary calcium

• Low vitamin D levels

• Cigarette smoking

• Alcohol intake of more than two standard drinks per day

• Caffeine intake of more than three cups of tea, coffee or equivalent per day

• Lack of physical activity

• Early menopause before the age of 45

• Loss of menstrual period if it is associated with reduced production of oestrogen, which is vital for healthy bones (the menstrual cycle can cease following excessive dieting and exercise)

• Long-term use of medications such as corticosteroids for rheumatoid arthritis and asthma.

Some conditions place people at a higher risk of osteoporosis. These conditions include:

• Thyroid disease or an over active thyroid gland

• Rheumatoid arthritis

• Chronic liver and kidney disease

• Conditions that affect the body’s ability to absorb nutrients, such as Crown’s disease, coeliac disease and other inflammatory bowel conditions.

Preventing osteoporosis
Both men and women can take steps from a young age to prevent osteoporosis by making sure that they:

• Have a healthy and varied diet with plenty of fresh fruit, vegetables and whole grains

• Eat calcium rich foods

• Absorb enough Vitamin D

• Avoid smoking

• Limit alcohol consumption

• Limit caffeine

• Do regular weight bearing and strength training activities.

A varied and calcium rich diet is the key
We need calcium to build and maintain strong and healthy bones, help our muscles work and support our nervous system. Good sources of calcium include:

• Dairy foods – low fat varieties are available to reduce the risk of weight gain or raised cholesterol levels

• Canned fish with edible bones – for example, sardines.

The minimum recommended daily intake of dietary calcium is:

• Infants (under 12 months) – 210–270mg calcium per day

• Children (over four years) – 700–1,000mg calcium per day

• Adolescents – 1,300mg calcium per day

• Women under 50 and men under 70 – 1,000mg calcium per day

• Post menopausal women and men over 70 – 1,300mg calcium per day.

Adequate vitamin D
Vitamin D levels are increased with sun exposure. People who are housebound or who dress with most of their body covered are at risk of vitamin D deficiency. The majority of women have inadequate levels of vitamin D during winter months. All that is needed is 10–20 minutes of sun exposure to the arms and face daily, without sunscreen and not through glass. Sun exposure is safest before 11am or after 3pm.

Avoid smoking
Evidence has shown that smokers have a lower bone density. Nicotine is known to be toxic to bone cells.

Limit alcohol intake
Excessive alcohol consumption is associated with the development of osteoporosis. Restrict your alcohol intake to no more than two standard drinks on any one day for both men and women to reduce your risk. Everyone should have at least two alcohol-free days each week.

Reduce caffeine intake
A large amount of caffeine (more than two to three cups per day of cola, tea or coffee) has also been associated with an increased risk of osteoporosis.

Do regular weight bearing and strength training activities
You should exercise at least 30 minutes three to four times a week to maintain healthy bones. Recommended activities are:

• Walking

• Jogging

• Tennis

• Dancing

• Using weights.

This helps maintain bone strength and balance so falls are reduced.

Diagnosis
The most reliable way to diagnose osteoporosis is to measure bone density using a DEXA scan. This is done with x-ray technology that involves minimal radiation, is accurate and can be used to follow up treatment.

Ultrasound tests are available at many pharmacies and involve an ultrasound measurement of the heel. These tests are not as accurate in assessing for osteoporosis as a DEXA study and are not recommended by doctors.

It’s never too late for treatment
If you have osteoporosis, it is never too late to seek treatment. Treatment can halt bone loss and significantly reduce the risk of fractures. It is important that your doctor excludes other medical conditions that can cause osteoporosis, including vitamin D deficiency.

Medications and treatments are available to strengthen bones and prevent fractures by slowing down bone loss. They may improve bone density in women with osteoporosis after the menopause.

Available medical treatments include:

• Bisphosphonates – such as alendronate, risedronate and zolindrinic acid, which can be combined with vitamin D and calcium

• Strontium ranelate – also called Protelos

• Selective oestrogen receptor modulators (SERMs) – in the form of raloxifene

• Vitamin D derivatives and calcium supplements

• Hormone replacement therapy (HRT) – short-term use of oestrogen and progestogen at menopause.

Other potential therapies that may be used as treatment include parathyroid hormone.

Hormone replacement therapy
All treatments for osteoporosis aim to prevent fractures. Oestrogen replacement at menopause prevents bone loss and fractures, but the effect lasts only as long as oestrogen is used.

Oestrogen can be is used to prevent fractures mainly for younger women with premature menopause. This is because most fractures do not occur until after the age of 65 and long-term oestrogen use is not recommended.

Falls are a risk for people with osteoporosis
For people with osteoporosis, even minor trauma – such as coughing, knocks on the limbs and simple falls – can lead to fractures. Falls are a particular problem in the elderly as they are often more likely to result in fractures, particularly of the hip. Any fracture occurring from minimal trauma should be investigated as it may indicate underlying osteoporosis.

There are several ways to reduce your risk of falls. It may be necessary to see a physiotherapist and/or occupational therapist to provide assistance with walking aides and ensure your home environment is safe. Talk with your doctor or contact your community health centre to find the services you need.

Things to remember

• Osteoporosis occurs when bones lose their density and strength.

• A healthy lifestyle throughout life (adequate dietary calcium and regular physical activity) can help prevent osteoporosis.

• Oestrogen replacement helps maintain bone density in women with premature menopause.

No special diet or ‘miracle food’ can cure arthritis, but some conditions may be helped by avoiding or including certain foods or supplements. Arthritis is a general term describing over 100 different conditions that cause pain, stiffness and (often) inflammation in one or more joints. Everyone with arthritis can benefit from eating a healthy, well-balanced diet to maintain general good health.

Some conditions may be helped by dietary changes. For example, people with inflammatory conditions such as rheumatoid arthritis seem to benefit from an increased intake of omega-3 fats, found in oily fish such as sardines and salmon, while gout sufferers may benefit from avoiding foods high in purines, including offal, shellfish and beer and drinking plenty of water.
Always seek the advice of your doctor or dietitian before changing your diet. You may be restricting your food intake unnecessarily or taking too much of products (such as mineral supplements) that may have no impact on your condition at all. Some supplements can also interact with other medications.

General recommendations
General dietary recommendations for a person with arthritis include:

• Eat a well-balanced diet. This will help to maintain general good health, and a healthy weight.

• Avoid crash dieting or fasting.

• Increase dietary calcium to reduce the risk of osteoporosis in later life.

• Drink plenty of non-alcoholic fluids.

• Keep your weight within the normal range. Excess bodyweight increases the stress on joints, especially weight-bearing joints such as the knee and hips.

Dietary modification for gout
Uric acid is a waste product that is normally excreted from the body in urine. Gout is a type of arthritis characterised by the build-up of uric acid in the joints (such as the big toe), which causes inflammation and pain.
It is believed that lowering uric acid levels through small changes in your diet may help reduce the chance of future gout attacks. These changes include:

• Restrict or avoid alcohol.

• Avoid binge drinking.

• Restrict or avoid offal meats, such as liver, kidneys and brains.

• Restrict or avoid shellfish, such as prawns and scallops.

• Restrict or avoid some sea foods including sardines, herrings, mackerel and anchovies.

• Restrict or avoid products containing yeast, such as beer and Vegemite.

• Drink plenty of non-alcoholic fluids.

• Avoid fasting or ‘crash’dieting

• Make sure you don’t overeat on a regular basis.

• Take your time when eating.

Omega-3 fats and Inflammation
Foods that contain omega-3 fats have been found to help reduce the inflammation associated with some forms of arthritis, such as rheumatoid arthritis. These effects are modest compared with medications, however they do not have side effects, and may also have other health benefits, such as reduced heart disease.

Foods rich in omega-3 fats include:

• Fish – oily fish such as salmon and sardines, have greater amounts of omega-3 fats

• Linseeds and linseed (flaxseed) oil

• Canola (rapeseed) oil

• Walnuts

• Foods fortified with omega-3, such as margarines and eggs

• Some fish oil supplements.

It is important not to confuse fish oils with fish liver oils (such as cod liver oil and halibut liver oil). Fish liver oils also contain vitamin A. Large amounts of vitamin A can cause serious side effects. Ask your doctor before taking any supplements, to ensure the correct dosage.

Other supplements
The supplements glucosamine and chondroitin are popular – yet evidence about their success in treating arthritis is limited.

Studies show that glucosamine and chondroitin, taken either separately or in combination, may relieve pain for people with osteoarthritis where there has been a breakdown of cartilage. There is no evidence that these supplements are effective for any other forms of arthritis.

Glucosamine and chondroitin may interact with other medications, including warfarin, and should only be taken after consultation with your doctor.

Obesity may worsen arthritis symptoms
If you are overweight or obese, the extra load on your joints may be exacerbating your arthritis symptoms, especially if your affected joints include those of the hip, knee or spine. There is also a clear link between being overweight and an increased risk of developing osteoarthritis.

To lose excess weight you must be active, but this can be difficult for people with arthritis due to pain or stiffness. See your doctor, dietitian or health professional for information and advice.

Current evidence for dietary cures is sparse
Gout can be helped by avoiding some foods. However, there is no substantial scientific evidence that other forms of arthritis can be helped by avoiding particular foods, unless that person has specifically shown intolerance to them.
There is no evidence that acidic foods such as lemons, tomatoes, potatoes and eggplants or dairy foods trigger arthritis symptoms. These foods all contain important nutrients and avoiding them may be a health risk.

Tips for managing arthritis and diet
If you think a particular food may aggravate your arthritis, it can help to keep a diary of your food intake and symptoms. After a month, you may have some idea about which food could be provoking symptoms. Discuss these results with your doctor or a dietitian.
Don’t cut whole food groups from your diet – for example, all dairy products – without talking to your doctor, as you may miss out on important vitamins and minerals.

Remember that remission may be coincidental
The symptoms of arthritis, particularly the inflammatory types, can change for no apparent reason. Don’t assume any improvement in your symptoms is due to what you eat or avoid. Be guided by your health professional.

Things to remember

• Arthritis is a general term describing over 100 different conditions that cause pain, stiffness and (often) inflammation in one or more joints.

• No special diet or ‘miracle food’ can cure arthritis, but some conditions may be helped by dietary changes.

• Fish oil can ease the symptoms of inflammatory types of arthritis, such as rheumatoid arthritis.

• The symptoms of gout can be eased by avoiding alcohol and offal meats, and by drinking plenty of water.

First off, this type of headache, prompted by exercise, is called an "exertional headache" or "exercise headache."  Running is known to cause exertional headaches, and lifting weights is another common cause.  Generally, exercise headaches cause pain (lasting from 5 minutes - 2 days) on both sides of the head.  They may even cause nausea.

What might be contributing factors?
-Hot weather
-High altitude
-Caffeine
-Alcohol
-Dehydration

How serious is this?
-You should know that, while they can be very irritating, these headaches are not medically serious. -However, these headaches still should be properly diagnosed, as they could possibly be a sign of something serious (potentially bleeding in the brain).  In fact, over 10% of people with exercise headaches may have a serious underlying condition, so you should talk to your doctor...especially if you've never had a headache like this before.
-It is probably nothing serious if the headache leaves within a few hours and there are no other neurological symptoms
-A doctor might recommend a MRI exam if your headaches do last longer than a few hours, if they begin very suddenly, if you are older than 40, and if you have accompanying symptoms (including nausea).  This MRI will help the doctor to verify that there is no serious underlying issue.

How can I treat this?
-Normally, these headaches leave on their own.
-If treatment is necessary, the medication "indomethacin" may be helpful.
-Aspirin and ibuprofen may also be effective.
-Actually exercising regularly can help to prevent exercise headaches (funny as that sounds!), although it may be best to avoid the specific circumstances in which your headaches tend to arise.

Many people do not realise that alcohol can be viewed as a nutrient, just like protein, carbs and fat. Would you ever have thought of it that way?. When consuming alcohol the following is to be remembered:

• Alcohol contains kilojoules and therefore adds extra kilojoules to your daily intake, which can jeopardise your weight management programme
• The human body prefers to use alcohol as an energy source rather than fat. Consuming too much alcohol will therefore diminish fat loss which is counter productive if your'e wanting to reduce weight
• It is better to have an alcoholic drink with a meal or a snack as alcohol is absorbed directly from the stomach and may cause hyperglycaemia if taken on an empty stomach
• Consuming too much alcohol late at night may lead to high blood glucose levels in the morning, especially if you have diabetes. Always take alcohol in moderation and with food.
• Give preference to the following drinks, as they are lower in kilojoules and/or alcohol:
  • Dry or "lite" white wine
  • Dry red wine
  • Wine "spritzer" - wine mixed with soda water
  • Dry sherry
  • "Lite" Beer
  • Spirits such as whisky, brandy, vodka (have asingle tota and top it up again and again with soda water)
• If you are trying to maintain weight, do not consume more than 1-2 units of alcohol for female and 2-3 units for males. This is also a good guide for general health as over consumption predisposes high blood pressure, high cholestrol levels, many types of cancer and osteoporosis amongst others.
• Remember that 1 unit of alcohol is equal to:
  • 125 ml wine or champagne
  • 60 ml sherry
  • 340 ml can or bottle "lite" beer
  • 170 ml regular beer
  • 25 ml of spirits
  • 250 ml "spritzer" at least half should be soda water or ice
  • 170 ml apple cider
  • 80 ml spirit coolers such as Smirnoff Ice