It’s been common knowledge for some time that what we eat affects our risk of cancer. It has, however, been far more difficult to try to ascertain whether specific foods affect our odds of getting cancer. Our diet contains so many different foods and nutrients that it can be extremely difficult to isolate any effects due to a single food.
The odds of eating certain foods and nutrients tend to be linked, e.g. people who eat large amounts of fruit & vegetables also tend to eat lots of fibre. By looking at these dietary patterns, scientists can try to work out how a person’s diet as a whole affects their risk of cancer.
The Mediterranean diet is associated with a reduced incidence of cancer, Heart Disease and Parkinson’s and Alzheimer’s Diseases.
The EPIC Study
A study published in the British Journal of Cancer provides strong evidence that cancer is less common amongst people who eat ‘Mediterranean’ diets.
The European Prospective Investigation into Cancer and Nutrition (EPIC) study is one of the largest cohort studies in the world, with more than half a million (521 000) participants recruited across 10 European countries and followed for almost 15 years.
EPIC was designed to investigate the relationships between diet, nutritional status, lifestyle and environmental factors, and the incidence of cancer and other chronic diseases.
Researchers graded participants in the study on a scale of 0-9 according to how closely their diet matched the typical Mediterranean pattern, including:
- Drinking moderate amounts of alcohol
- Eating comparatively more monounsaturated fats than saturated fat
- Eating less red or processed meat and dairy products
- Eating lots of fruit, vegetables, legumes, nuts, cereals and fish
They found an increase of 2 points on this scale led to a reduction in the overall risk of cancer by 12 per cent. This could be achieved by combinations of different dietary choices, like eating substantially more vegetables and less red meat, or eating more legumes and substituting butter for olive oil in cooking.
Ecological evidence in the 1960s suggested that the traditional Mediterranean diet could have beneficial health effects, mostly on cardiovascular diseases. EPIC investigators operationalized adherence to the Mediterranean diet through a simple scoring system and have documented, in a series of papers, that closer adherence to this diet is associated with reduced overall mortality as well as incidence of and mortality from cardiovascular diseases and cancer.
In a paper studying more than 70 000 elderly men and women from nine European countries, it was shown that adherence to the Mediterranean diet can improve survival in this vulnerable group. 1
The EPIC study shows that typical Mediterranean eating habits can act as a rough guide for a cancer-preventing diet, but there are probably going to be ways of tweaking it to reduce your risk even further. The general Mediterranean pattern is very much in keeping with Cancer Research UK’s advice of eating a healthy, balanced diet.
What is a Mediterranean Diet?
- Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
- Replacing butter with healthy fats such as olive oil and canola oil
- Using herbs and spices instead of salt to flavor foods
- Limiting red meat to no more than a few times a month
- Eating fish and poultry at least twice a week
- Enjoying meals with family and friends
- Drinking red wine in moderation (optional)
- Getting plenty of exercise
Fruits, Vegetables, Nuts & Grains
The Mediterranean diet traditionally includes fruits, vegetables, pasta and rice. Residents of Greece eat minimal red meat and average nine servings of antioxidant-rich fruits and vegetables daily.
Grains in the Mediterranean region are typically whole grain, and generally contain very few unhealthy trans fats; bread is also an important part of the diet there. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil, not eaten with butter or margarine, which contain saturated or trans fats.
Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat (approximately 80% of their calories come from fat), but most of the fat is not saturated. Because nuts are high in calories, they should not be eaten in large amounts — generally no more than a handful a day. Avoid candied or honey-roasted and heavily salted nuts.
The focus of the Mediterranean diet isn’t on limiting total fat consumption, but rather to make wise choices about the types of fat you eat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.
The Mediterranean diet features olive oil as the primary source of fat. Olive oil provides monounsaturated fat — a type of fat that can help reduce LDL cholesterol levels when used in place of saturated or trans fats.
“Extra-virgin” and “virgin” olive oils — the least processed forms — also contain the highest levels of the protective plant compounds that provide antioxidant effects.
Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain the beneficial linolenic acid (a type of omega-3 fatty acid). Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure.
Fatty fish — such as mackerel, lake trout, herring, sardines, albacore tuna and salmon — are rich sources of omega-3 fatty acids. Fish is eaten on a regular basis in the Mediterranean diet.
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking.
However, alcohol — in moderation — has been associated with a reduced risk of heart disease in some research studies.
The Mediterranean diet typically includes a moderate amount of wine. This means no more than 5 ounces (148 ml) of wine daily for women (or men over age 65), and no more than 10 ounces (296 ml) of wine daily for men under age 65.
If you’re unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol.
Putting it All Together
The Mediterranean diet is a delicious and healthy way to eat. Many people who switch to this style of eating say they’ll never eat any other way. Here are some specific steps to get you started:
- Eat your Veggies & Fruits — and switch to whole grains. An abundance and variety of plant foods should make up the majority of your meals. Strive for seven to 10 servings a day of veggies and fruits. Switch to whole-grain bread and cereal, and begin to eat more whole-grain rice and pasta products.
- Go Nuts. Keep almonds, cashews, pistachios and walnuts on hand for a quick snack. Choose natural peanut butter, rather than the kind with hydrogenated fat added. Try tahini (blended sesame seeds) as a dip or spread for bread.
- Pass on the Butter. Try olive or canola oil as a healthy replacement for butter or margarine. Use it in cooking. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter. Or try tahini as a dip or spread.
- Spice it up. Herbs and spices make food tasty and are also rich in health-promoting substances. Season your meals with herbs and spices rather than salt.
- Go Fish. Eat fish once or twice a week. Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it’s sautéed in a small amount of canola oil.
- Rein in the Red Meat. Substitute fish and poultry for red meat. When eaten, make sure it’s lean and keep portions small (about the size of a deck of cards). Also avoid sausage, bacon and other high-fat meats.
- Choose Low-fat Dairy. Limit higher fat dairy products such as whole or 2 percent milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.
- Raise a Glass to Healthy Eating. If it’s OK with your doctor, have a glass of wine at dinner. If you don’t drink alcohol, you don’t need to start. Drinking purple grape juice may be an alternative to wine.