Field Notes

Do Popular Diets Prevent Cancer?

Not all diet plans help reduce a person’s chances of developing cancer, according to experts at the University of Texas M. D. Anderson Cancer Center. Nutrition experts from Anderson separate the good from the bad among popular diets.

“Losing weight can help lower your chances for cancer if you’re overweight or obese,” says Daxaben Amin, a senior clinical dietitian in the department of clinical nutrition. “But beware [because] not just any weight-loss plan will give your body the nutrients it needs to fight off diseases like cancer.

“Diets that make our ‘good list’ encourage long-term change,” Amin continues. “They also give you a variety of options from all food groups.”

The Mediterranean-style diet makes the good list because it encourages people to make a lifelong commitment to better nutrition.

It also meets many of the dietary guidelines used for preventing cancer and heart disease, such as making fruits, vegetables, nuts, and other plant-based foods a big part of every meal; choosing healthful fats, including olive and canola oils, instead of butter; flavoring foods with herbs and spices instead of salt; limiting red meat and alcohol intake; and eating fish and poultry at least twice per week.

The whole-body approach type of diet focuses on eating six to seven small meals each day instead of the standard three large meals. It makes the good list because it offers these cancer prevention benefits: adds fruits, vegetables, and whole grains into at least one half of daily meals; encourages eating lean protein; limits foods high in fat; and includes daily physical activity.

On the other hand, “Diet plans that encourage short-term change usually don’t provide the nutrients your body needs on a daily basis,” Amin says. “These diets make our ‘bad’ list.”

Gluten-free diets are becoming a popular trend. But unless someone has celiac disease or gluten sensitivity, he or she shouldn’t go gluten free because whole grains are rich in fiber, vitamins, and minerals and protect cells from damage that may lead to cancer.

“Don’t follow diet plans that tell you to completely ‘cut the carbs,’” Amin says.

People should limit their carbohydrates to maintain a healthy weight. But completely cutting out carbohydrates also cuts out the body’s primary energy source.

Even worse is that people deprive their bodies of some important cancer-fighting carbohydrates: vegetables, fruits, whole grains, and beans.

“Instead of going carb free, choose your carbohydrates wisely,” Amin says. “Pick whole grains rather than cakes, cookies, and other foods made with processed or refined grains and sugars.”

Maintaining a healthy weight requires a lifelong commitment, and the secret to long-term success is moderation.

“Keep your pantry stocked with a variety of cancer-fighting foods found in M. D. Anderson’s cancer prevention grocery list at www.mdanderson.org/focused,” Amin says.

— Source: University of Texas M. D. Anderson Cancer Center

 

New Diabetes Education Program Yields Improved Blood Sugar Control

An intensive program that taught low-income, poorly educated people with diabetes to better manage their disease resulted in significantly improved long-term blood sugar control, according to Johns Hopkins researchers who designed and implemented the program.

The findings, published online in the Journal of General Internal Medicine, offer clinicians a proven new tool to help those with poorly controlled diabetes make lifestyle changes to improve their health, the researchers say. They noted that many educational programs for people with diabetes typically have little impact, and the benefits wear off after the programs end.

“We know that people need information to manage their disease, but having knowledge of the facts is not enough for behavioral change,” says Felicia Hill-Briggs, PhD, an associate professor in the division of general internal medicine at the Johns Hopkins University School of Medicine and the study’s lead author. “With this novel approach, we have found a way to give people the skills to solve problems in all areas of their lives so that they can take diabetes off the back burner and start caring for their health.”

In the small study, 56 participants were randomized into one of two groups. One received the intensive, nine-session, problem-solving course that covered not only standard diabetes self-management and care but taught problem solving as a skill to help manage the financial, social, resource, and interpersonal issues that often stand in the way of managing diabetes. The other group received a condensed two-session version of the program.

Three months after the end of the program, participants in the intensive group saw their hemoglobin A1C levels fall by an average of 0.7 compared with their levels before the start of the program. After completing the program, one participant no longer needed insulin, Hill-Briggs says. The participants in the condensed program saw no improvement in their A1C levels.

Many who took part in the intensive program saw high cholesterol and high blood pressure drop as well. What struck Hill-Briggs most about her research was that A1C levels improved three months after the program was over. This is in contrast to many diabetes interventions, particularly with lower socioeconomic groups.

“When the program stops and support is taken away, the behavior stops and the benefits stop,” she says.

Hill-Briggs says she believes one reason for the sustained improvement in her study is that if problem solving as a life skill has been taught successfully, people see those skills improve as they use them more.

Hill-Briggs says the intensive program, like many other diabetes education programs, first focused on how to better manage the disease and prevent further dangerous complications. Facilitators explained the importance of a healthful diet, exercise, adherence to medication, and self-monitoring using materials designed for a fifth-grade reading level to better reach this group, in which one in three participants had very low literacy skills.

The program also explored why participants were having difficulty making lifestyle changes and adhering to care. Some said they didn’t have access to healthful foods near their homes. Others said eating healthfully was too expensive. Some said they didn’t take their medications because they couldn’t afford them. Many had family challenges, caretaking demands, and even neighborhood violence that affected their ability to care for their diabetes.

In response, the program taught participants problem solving as a way to manage these challenges. Participants applied their problem-solving skills in individual ways to address their own unique life situations. Some, for example, began to see their budgets in terms of must-haves and wants. Often, she says, participants saw rent and electricity as must-haves and not diabetes medication, because their chronic disease didn’t bother them enough to be considered an urgent need. With an understanding of the role of their medicines, participants described moving them to the must-have list and taking off something else that was a want.

For those who thought medication did not work, possible solutions they came up with included taking it consistently as prescribed for a week and then testing blood sugar to see what had happened. When results were good, subjects were encouraged, and the results reinforced the need for consistent self-care.

Participants were also taught about making the best choices when foods such as fresh fruits and vegetables were not available. Often, only canned products are available in neighborhoods with little access to large grocery stores. Two participants, on their own, convinced their small local grocers to stock the low-sodium varieties of vegetables, enabling them to make healthier choices.

“We helped people integrate diabetes care into everything else that was going on in their lives and in the context of how those things affected their health,” Hill-Briggs says. “The struggle is these other things seem more immediate, because if today they’re having a crisis, that is the focus. The diabetes is always there. We helped them understand that their diabetes can be a priority, and problem solving lets us meet them where they are. We help them improve their diabetes self-care by using a reliable skill to tackle the problems that come up every day that used to throw them off their game plan.”

— Source: Johns Hopkins Medicine