Malcolm Scerri-Ferrante questions why cancer is on the rise and how to prevent it. He talks to Emily Biever, an American senior clinical dietician – the main speaker at a recent cancer nutrition conference at the UAE Cancer Congress held in Dubai.

Cancer is arguably the most hated six-letter word in the English language. Bring it up over a meal with friends or family and the topic will more often than not be put to bed swiftly. As a friend once put it: “Let’s change subject. I don’t want to ‘call’ it.” So ignorance becomes bliss and supposedly we are safeguarded that way.

Meanwhile, we continue to hear of friends or their friends contracting this killing disease. As a result, we console each other and the avid religious ones will even say a prayer or two. But seldom do we ask: “Why is cancer on the rise and what is causing it?”

It is convenient to blame a gene disposition or environmental pollution. While experts agree these factors play a role in causing cancer, the consensus appears to be that cancer is caused mainly by the way we live, our lifestyle. And yet, most do nothing about it, as if it’s all solely the fault of government or society or simply God’s will.

Schools fail to provide enough nutritional education and the popular saying ‘You are what you eat’ is still foreign to many Maltese. One local cancer support group recently wrote in its guidelines how red meat should be taken into the ward, rather than caution about its moderation and processing. This despite the World Health Organisation (WHO) warning in 2015 against processed meat.

Another supporter thinks providing ice cream to children with cancer is just fine. It will not kill them after one meal, but these kind gestures epitomise our disregard to the relationship between nutrition and illnesses, and our lack of knowledge about carcinogens.

Emily Biever, senior clinical dietician at Boston’s Dana-Farber Cancer Institute, believes a bad diet plays a big part in cancer and its role is very much underplayed across the globe. She favours a plant-based diet over meat and laughs at claims that protein can only be obtained from meat.

“It’s not true at all. That’s what people who love meat say when they are afraid of giving it up. They also don’t know that eating plant-based proteins can actually be very satisfying. They are afraid that they have to eat salads all along and are not going to get that satisfied feeling,” she says.

“When we look at how the brain responds to processed foods, sugary or refined foods, it lights up our brain, it excites our dopamine receptors.”

She explains that 12 to 14 new food exposures are required until one’s taste buds adjust to a new diet. That’s how much time it takes for a new flavour to be understood or appreciated. Ms Biever believes unhealthy eating can be called an addiction, just like coffee, smoking and shopping addictions.

She is reluctant to say that nutrition alone can cure cancer and does not think it is a miracle pill on its own. She is, however, convinced that good nutrition can substantially help prevent cancer, especially if other factors are improved, such as the stress in our lives and the air we breathe.

She claims that bad stress management in our lives is a significant determining factor for causing cancer and other illnesses and feels technology is not helping us move our bodies enough; we are also living in a very stressed culture.  “We are moving so quickly. We are spread so thin, leading to inflammation in our bodies,” she says. Ms Biever believes quality time for families is nowadays sparse. Sustaining a family can be difficult and people are often forced to work hard.

And the busier we become, the more processed foods we tend to eat, because it’s easier to store and prepare them. However, Ms Biever doesn’t think food labelling is very honest and lots of catchy words are used to mislead consumers.

Emily’s interesting stress argument is supported by Charlene Mercieca, a Maltese cancer survivor and blogger who believes that reducing stress in her life played no small part in her fight against her advanced cancer.

Bad stress management in our lives is a significant determining factor for causing cancer and other illnesses

Organic food is becoming popular but a common argument is it’s too expensive or difficult to find. While recommending organic if we had the choice, Emily says she would much rather people consume plant foods if they cannot afford organic. The phytochemicals and phytonutrients in these foods are more potent and more important than the potential risk of consuming pesticides. By washing we can remove some of these.

She feels people are more at risk by eating processed foods than eating phytonutrient, rich wholefoods that are not organic.

“What people are putting into their bodies before, during and after cancer treatment is important.” As to supplements, Ms Biever believes that for the most part these are not necessary if we are promoting a wholefood diet. Depending on how restricted one’s diet is, if one is a vegan, she cautions against a B12 deficiency, adding that vitamin D can be deficient in the body if one is getting limited sun exposure.

She recommends varying protein sources as much as possible, sanctioning unsweetened and natural dairy products, describing processed foods as a continuum and recommending we choose the least processed. She recommends a plain dairy yoghurt that has nutrients over a drinkable yoghurt that has 10 teaspoons of sugar and much less protein.

“Choose a better quality dairy if you are going to eat it” she sums up.

She explains that a wholefood is a food that can be identified when you are eating it. For example, very few people can say what is in an apple-flavoured energy bar. Instead, she recommends we chop up an apple with oats, cinnamon and honey.

Her advice to busy people unable to change their busy lifestyles is: “Know what you’re putting in your mouth. See how you can incorporate more foods that you can identify. If you don’t have time and your fruits and vegetables are going stale, remember you can go for frozen. You can keep vegetables in the freezer and they remain just as nutritious. Eggs, beans and nut butters are all inexpensive ways to move towards lean protein. Little changes can make a big deal.”

I bring up the topic of patients with very advanced cancer attending alternative clinics to consume a full plant-based diet with oil extracts from the cannabis plant. Ms Biever thinks there is some really interesting research and connections between CBD oil and reducing cancer. She thinks we should stay tuned, as this may become a more attractive option.

She feels strongly about high-sugar foods, processed and really refined foods.

“People who drink multiple sodas over the course of the day will suffer huge negative impacts on their health.”

When healthy patients tell her they will die one day, so why can’t they eat what they want? Ms Biever reminds them it’s all about balance, enjoying the foods you love and being responsible by finding what foods are healthy and delicious.

“If you’re eating a very processed or unhealthy diet and if you indulge all the time, there is a likelihood that you will develop a chronic disease. Not only will this be harmful to you and your body but also to your family and the healthcare system. Not only are you responsible for taking care of yourself for yourself but also for your family, culture and society.”

Emily Biever is a senior clinical dietician at the Dana-Farber Cancer Institute in Boston, US. Besides working with cancer patients she specialises in weight management and exercise nutrition. She speaks regularly on CBS, Fox and other media.

A video of the interview is available at this link:

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