Category Archives: WCPP Blog

Eating Well for Cancer Prevention

slide_004Christina Chiu, MS, RD, CSO, LDN, CNSC

Did you know that about one-third of cancers in this country are related to things people do (or don’t do) every day? Cancer has many causes, and some, like age and genetics, are not factors you can control. Others, such as weight, diet, and physical activity, are factors you can change.

Why does weight matter?
There is strong evidence that excess weight, especially around the mid-section of your body, is the most harmful and is linked with increased risk for certain cancers, including colon and postmenopausal breast cancer. One of the ways to figure out whether you are at a healthy weight is by knowing your body mass index (BMI). Although not it’s not a perfect tool in all cases, your BMI is a great starting point for figuring out whether you need to gain or lose weight, or keep your weight about the same. Think about asking your primary care doctor about your weight at your next annual physical.

What’s the right thing to eat?
Certain eating patterns are associated with lower cancer risk. The most important foods to focus on are whole, minimally-processed plant-based foods. This means it is important to eat a wide variety of colorful fruits, vegetables, whole grains, and legumes such as beans. These plant-based foods should be about two-thirds or more of your overall food intake. While it isn’t clear from research that any particular fruit or vegetable can decrease cancer risk, we do know from laboratory studies that plant nutrients, known as phytonutrients or phytochemicals, can influence cancer development and cell growth. Eating many different types of fruits and vegetables and other plant-based foods ensures that we get a wide range of nutrients that protect our health. Most plant-based foods contain fiber and are also low in calories. By choosing foods that are filling and satisfying without overeating calories can help us attain or achieve a healthy weight.

Is there anything I shouldn’t eat?
Alcohol drinking is clearly linked with several types of cancer, including head and neck, esophageal, liver, breast, and colorectal cancer. People who use both alcohol and tobacco have an even greater risk of developing cancer. In general, if you do drink, limit yourself to no more than one drink per day (for women) and no more than two drinks per day (for men). If you do not drink, there is no reason to start. In one study in the United Kingdom, every 10 grams of alcohol consumed per day (there’s 14 grams in a 12-ounce beer) was associated with a 12% increase in the risk of breast cancer.
According to the American Institute of Cancer Research, limiting red meat and avoiding processed meat reduces the risk of certain types of cancer, especially colorectal cancer. Red meat includes beef, lamb, and pork, while processed meats are meats that have been smoked, salted, or cured either by salt or other preservatives. Processed meats include deli meats, bacon, hot dogs, and lox. Try to keep your intake of red meat to less than 18 (cooked) ounces per week.
Dietary supplements, such as vitamins and extracts of herbs or foods, have not been shown to reduce cancer risk. In some people, taking high doses of certain vitamins can even have the opposite effect. In most cases, it is better to choose the actual whole food than the supplement (for example, including blueberries or orange slices at breakfast rather than taking a vitamin C supplement pill).

What do I do with all this information? Where do I start?
We all experience roadblocks when it comes to eating healthfully. You might now know what you should be eating, but you might not be so sure what eating healthfully looks like in your own life. You may have particular preferences about food, other health conditions that restrict what you can or cannot eat, or simply have no idea how to start. If that’s the case, it might be a good idea to ask your doctor for a referral to see a Registered Dietitian/Nutritionist (RD or RDN). RDs are trained specifically to make science-backed, personalized food recommendations that take into consideration your personal preferences, health conditions, and other specific needs. If you are a cancer survivor, it might be a good idea to meet with an RD who is a board-certified specialist in oncology nutrition (CSO). In any case, here are a few questions for you to ask yourself when you evaluate yourself and what you are eating:
 Am I eating fruits and vegetables every day?
 Am I eating a colorful mix of different fruit and vegetables?
 Are my meals at least half vegetables/fruits?
 Am I hydrating regularly throughout the day?
 How many calories am I getting from beverages?
 Can I choose water or other non-diet and non-caloric beverages more often?
 How many alcoholic beverages am I drinking each day/week?
 Am I eating because I am hungry or am I eating out of habit, emotions, or other reasons?
 How can I be more physically active throughout the day?

Christina Chiu, MS, RD, CSO, LDN, CNSC is a registered dietitian in the Vernon Cancer Center at Newton-Wellesley Hospital, where she has worked since 2008. A graduate of Cornell University and Boston University, Christina is a board-certified specialist in oncology nutrition and a board-certified nutrition support clinician. She applies her nutrition counseling expertise to help patients eat well throughout and after cancer treatment. She is particularly interested in helping patients realize that eating well for health can be realistic, achievable, and delicious all that the same time.

The ABCDEs of Getting to Know Your Moles

You may feel healthier with a bit of a tan, but the sunlight that warms our bones and make flowers grow contains ultraviolet (UV) radiation that can damage the skin. Exposure to UV radiation from sunlight can lead to sunburn, which causes premature wrinkling and changes in skin pigmentation, and can lead to skin cancer. Skin cancer is the most diagnosed type of cancer in the U.S. The good news is that skin cancer can be prevented, and it can almost always be cured when it’s found and treated early.

The most common types of skin cancer are basal cell or squamous cell carcinoma, which tend to result from years of prolonged exposure to the sun. Melanoma is a rare, but more dangerous form of skin cancer and it is more likely to spread to other parts of the body.

Knowing your Risk

Anyone can get skin cancer. The risk is highest for people with:

  • White or light-colored skin with freckles
  • Blond or red hair
  • Blue or green eyes

You are at higher risk for melanoma if you have:

  • Unusual moles
  • A large number of moles (more than 50)
  • A family history of melanoma

Get to Know the ABCDEs of Your Moles

To detect skin cancer early, examine your skin all over your body and watch for changes over time. By checking your skin regularly, you’ll discover what is normal for you.

The best time to check your skin is after a shower or bath. Use a full-length mirror and a hand-held mirror in a room with plenty of light. Check yourself from head to toe and learn where your moles are and their usual look and feel.

Malignant moles can vary in appearance. Keep in mind the ABCDE’s when checking your moles:

  • Asymmetrical Shape: Look for moles with irregular shapes
  • Border: Look for moles with uneven, ragged or blurred borders
  • Color Changes:  Look for growths that have many colors (brown, black, tan and sometimes patches of red, blue or white) and an uneven distribution of color
  • Diameter:  Look for growths larger than ¼ inch (the size of a pencil eraser)
  • Elevation: Look for moles raised from the skin

“Also, pay attention to growths that ooze, itch, bleed, cause pain, get scaly or crusty, become hard or lumpy or spread their pigment into surrounding skin,” says Paul G. Rolincik M.D., Chief of Dermatology at Norwood Hospital and Dermatologic Surgeon at Dermatology Associates, P.C. with offices located in Norwood, Foxboro and Franklin. “These can also be signs of a possible skin cancer.”

Protect Your Skin from the Sun

Most skin cancer appears after age 50, but skin damage from the sun can start during childhood. The best way to prevent skin cancer is to protect your skin from the sun and other sources of UV rays, such as tanning beds or sun lamps.

Follow these steps to protect your skin:

  • Stay in the shade as much as possible between 10 a.m. and 4 p.m.
  • Use a broad-spectrum sunscreen. You need one that blocks UVA and UVB rays, with a SPF of 30 or higher.
  • Wear a broad-brimmed hat.
  • Wear long sleeves and long pants when possible.
  • Protect your ears, nose, cheeks, and hands. Since the majority of skin cancers occur on these areas, consider them top priority.
  • Don’t skip the lips. Look for a waterproof or water-resistant, lip-specific product with a high SPF. Plan on reapplying often as lips are moist and lip balms have a tendency to wear off easily.
  • Wear sunglasses. Choose sunglasses with UV protection. This will also protect the delicate skin around the eyes.

If you have any question about your risk for skin cancer or find anything unusual during a skin exam, talk to your doctor. If you need help scheduling a dermatology appointment, visit www.dermatology-pc.com or call 781-762-5858.

 

*Source: American Cancer Society, www.cancer.org

*Source: National Cancer Institute, www.cancer.gov/types/skin/self-exam

 

Shinrin-yoku: Landscaping for Personal, Public and Planetary health

Sarah Little, Ph.D.

Some people claim that a nice looking lawn adds $10,000 to the value of your home. In fact, your outdoor real estate has a value to you far above this miserly amount. “Health is wealth” and your yard, in addition to looking beautiful, can contribute to the health of yourself, your family, your neighbors, your town, even your planet. To understand how this is done, it helps to look at your yard in a very different way than you are used to. The land, water, air, plants, animals and soil under your care actually comprise an entire living ecosystem. This ecosystem is composed of plants, mammals, amphibians, birds, but also trillions of bacteria, fungi, protozoa, and a myriad of tiny soil creatures like pill bugs, nematodes and springtails. All these living organisms are linked together in both fierce competition and fantastic cooperation through the complex cycling and recycling of nutrients, waste and energy.

Biodiversity is the variety and spice of life; it is also its bank account and health insurance. It is a measure of how many different interacting species are in an ecosystem. Generally speaking, the more the better. Systems with high biodiversity are more able to withstand outside invaders and environmental insults like drought, flood, and pollution. It is not just rare species that are valuable, every living thing in an ecosystem counts.

Ecological landscapers use the concept of diverse, healthy ecosystems adapted to local climate and soil to manage properties as a whole, giving us the most stable, attractive and useful landscapes with the least amount of maintenance effort, cost, water use and material input. This is an incredibly powerful concept. It differs significantly from the way most Wellesley landscapes are currently managed, where the focus is on large inputs of fertilizer, pesticides and water to grow a single species (turfgrass), and on continually treating the same individual pests and diseases year after year.

When we cultivate a healthy, biodiverse ecosystem suited to Wellesley’s local soil and climate, the depth and breadth of services our yard can provide us are truly astonishing. The physical processes alone are invaluable, including carbon sequestration, aquifer replenishment, water purifying, air purifying, nutrient recycling, composting, soil building, and residential home cooling in summer. Even our neighbors and town can benefit from our yard, through cleaner air and water. The value of these services alone far out-weighs the cost a taxpayer would have to fork out for the DPW to do the same. Just ask NYC, who found it cost-effective to protect natural land in their watershed rather than build expensive water filtration infrastructure. How about keeping pets? Our little biological friends we enjoy so much, the birds, butterflies, dragonflies, rabbits, chipmunks, squirrels, bats and pollinator species, now live happily in the shelter that our plants have created, eating the food our ecosystem is generating, managing many of the insect pests we hate, and being cleaned up after by our tiny composting organisms. All this enjoyment you get for free, compared to the roughly $3,000 annual cost of owning a dog in Wellesley.

Most importantly perhaps, we ourselves now have an outdoor sanctuary where we can rest, relax, play and experience nature. The Japanese have a word for this, shinrin-yoku, the simple practice of enhancing health by going outside to visualize, touch, listen to, and quite literally inhale nature. It means to bathe in biodiversity. Studies show this to be good for our health in ways we don’t even understand yet. In fact, our yard full of green plants, trees, and grass can help reduce not only our, but our neighbors’ mortality from cancer. A recent national study found that women whose lives are surrounded by greenness from plants, within 250 m of a home, have a 12% reduction in cancer mortality compared to those who live surrounded by man-made structures.

There’s more. Did you know that you are an ecosystem yourself? Your gut is inhabited by hundreds of species of bacteria, your skin by thousands of species. These bacteria are most often in a highly beneficial mutual relationship with us, or are at least living a non-harmful coexistence. Science is just beginning to understand how these microbiota influence our health. As Michael Pollan put it, “the implications of what has already been learned, for our sense of self, for our definition of health and for our attitude toward bacteria in general — are difficult to overstate. Human health should now be thought of… as a function of the community, not the individual.”

This might be hard to take in, but, you are a part of your yard’s ecosystem, and it is part of yours. The microbial life in your soil is related to the microbial life on your skin, the same for your gut. Remarkably, this is an exceptionally good thing; this is how humans evolved to live so successfully in this complex ecosystem we call the world. These tiny cells help protect us from infections, digest our food, influence our appetites and help our immune systems. In fact, new studies have linked higher environmental biodiversity in the surroundings of people’s homes to fewer skin allergies. Your beautiful, biodiverse yard really can make you and your family healthier.

On the dark side, because there always is a dark side, since we are all connected to your yard, it means that the chemicals and synthetic fertilizers you put on your lawn are also in your body, in your family, in your neighbors, and in the town’s air and water. These chemicals don’t just affect the grubs, or the dandelions, or the crab grass, they affect every single one of the trillion organisms that make up your yard’s ecosystem, including you. In humans, these chemicals are carcinogens (EPA lists 70 carcinogenic pesticides, including herbicides, fungicides, pre-emergents and insecticides available to purchase in the U.S.), and reproductive, neural, and developmental toxins. In your yard’s ecosystem, they are a disaster, decimating the microbial, fungal and beneficial insect populations, killing all plants except grass, and disrupting normal soil processes that support plant health. This lifeless yard now needs constant inputs of pesticides, fertilizers and water in order to support the single species you have left, turfgrass. Instead of having a yard that supports your health and sense of well-being you now have a yard that increases your risk of chronic disease.

Ecological and organic properties come in all styles, from Paul Newman’s exquisitely managed weed-free organic estate in Connecticut to my inexpensive, stress-free, beautiful little organic freedom lawn in Wellesley. What they have in common is summarized in the “Checklist for an Eco-Friendly Property” below.

And of course, each yard makes a difference to the planet. In the U.S. alone, lawns make up 49,000 sq mi, making it the nation’s largest irrigated crop. What we do with our own yards matters a lot. By creating a biodiverse property, or simply helping it to create itself, your ecologically managed yard will make us all healthier. Experience your own shinrin-yoku – step outside onto your lush, green, organic lawn; see the monarch butterfly alight on your milkweed; hear the sparrows chirping in the rhododendron, take a breath of pure, fresh air; savor a deep sense of satisfaction about your thoughtful care of this piece of land under your feet; feel the sun, feel the connection.

Checklist for an eco-friendly property

  • Keep pesticides off your lawn and gardens. Using only non-toxic materials on your property reduces the health risk to yourself, your family, your neighbors and your local environment.
  • Use non-synthetic fertilizers from natural sources. Synthetic fertilizers are made in a chemical process that uses fossil fuel and contributes to global warming. Use of synthetic nitrogen fertilizer greatly increase the amount of nitrogen entering the global nitrogen cycle which has a serious negative impact on the organization and functioning of the world’s ecosystems, including accelerating the loss of biological diversity and decline of coastal marine ecosystems and fisheries. The use of synthetic phosphorus fertilizers has its own set of problems, in particular its contribution to the growth of pondweeds in fresh water lakes and ponds, and the limited global supply of phosphate rock.
  • Reduce water use. In many cities in the Northeast, 50% of the drinking water goes to lawns and landscapes, including in Wellesley. Over 75% of Massachusetts’ rivers are flow stressed during the summer because of water withdrawals for these residential uses.
  • Increase biodiversity. Biodiversity is the key to a healthy ecosystem on any scale, from backyard to global. Biodiversity increases the stability of ecosystems, reduces the need for intervention, and makes them, from an aesthetic viewpoint, much more interesting. The earth is currently losing species at a rate that rivals mass extinctions in our geologic record.
  • Care properly for your lawn… Mow high, 3”-4”; leave grass clippings on lawn; water infrequently, if at all; encourage a bit of white clover; fertilize lightly with compost; and seed bares spots in fall and early spring. Rake your lawn, but not your woods: let leaves, nature’s own mulch, stay in the woods and compost in place.
  • Grow food. For taste and nutrition, nothing beats organically raised fruits and vegetables, grown close to home. There are many ways to incorporate food plants and vegetable gardens into your annual or perennial landscape. Blueberry bushes are native, decorative and delicious. Many fancy lettuces are as pretty as annuals.
  • Make and use compost. Locally made compost has many advantages as a soil amendment and it is much less likely to cause pollution of the local and regional environment than fertilizers, even organic ones. Incorporating compost improves turf, shrub and shade tree performance in marginal or poor soils. Good quality compost improves soil structure, reduces runoff and compaction, enhances biodiversity, increases water and nutrient retention, increases microbial activity, supplies nutrients, helps suppress and prevent plant diseases, detoxifies certain pesticides, and inactivates and kills potential human pathogens.
  • Remove invasive plants. Invasive plants grow quickly and spread easily and often reduce the biodiversity of whole ecosystems. Learn about invasive plants, how to avoid spreading them, and how to remove them from your own property.
  • Garden with native plants. Native plants are site adapted and usually require little to no watering, fertilizing or pesticides. Stunning gardens can be made from entirely native plants. Since native plants are, well, native, it’s best to find a local conservation group who works with natives.
  • Test your soil. If you want your property to look its best, to save money, and to protect the environment even more, do an easy soil test before you apply anything at all. A soil testing lab will help you figure out how much of which fertilizers and nutrients to apply for optimum results.

References:

http://www.nyc.gov/html/dep/html/watershed_protection/land_acquisition.shtml NYC

http://www.akc.org/learn/akc-training/cost-to-raise-dog/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712592/   Shinrin-yoku

https://www.sciencedaily.com/releases/2016/04/160414170015.htm Greenness

http://www.nytimes.com/2013/05/19/magazine/say-hello-to-the-100-trillion-bacteria-that-make-up-your-microbiome.html Michael Pollan

https://www.sciencedaily.com/releases/2016/04/160413151108.htm Gut microbiota and inflammation

http://www.pnas.org/content/109/21/8334.abstract Skin microbiota and allergy

http://www.organiclandcare.net/sites/default/files/upload/2011_nofa_booklet_online_final.pdf Introduction to Organic Lawns and Yards plus a Checklist for an Ecoo-Friendly Property

BIO

Sarah Little has lived in Wellesley for 20 years. She has a Ph.D. in Geophysics from MIT. She spent 5 years as the Town of Wellesley’s Pesticide Awareness Coordinator and 10 years working with a regional non-profit that trains professional landscapers in organic land management techniques. She was the project manager for their “Standards for Organic Land Care,” and “Organic Lawn and Turf Handbook” and wrote “An Introduction to Organic Lawns and Yards.”

As Pesticide Awareness Coordinator she worked with the Health Dept., the Natural Resources Commission, the DPW and the Schools to create our Town’s IPM plan that uses organic land management techniques and prohibits synthetic chemicals on all NRC and School fields, parks, and water bodies except in health or environmental emergencies.