Women consuming too much red meat may have a higher risk of stroke than women eating less, says a new study. Red meat is high in saturated fat and cholesterol; both are risk factors for cardiovascular disease, heart attack, and stroke. The United States Centers for Disease Control and Prevention suggests lowering saturated fat intake and eating more fresh fruits and vegetables to help reduce your risk of stroke. Writing in the journal Stroke, researchers examined nearly 35,000 Swedish women, ages 39 to 73. None of the women had heart disease prior to the start of the study in 1997.
After ten years, results showed 4% of the study participants, 1,680 women, had a stroke. Those consuming the most red meat had the highest risk of stroke. Women in the top tenth of red meat intake, consuming at least 3.6 ounces each day, were 42% more likely to have a stroke, compared to women who ate just under one ounce of red meat daily.
Eating processed meat also increased stroke risk. Women eating 1.5 ounces of processed meat each day were 24% more likely to suffer a cerebral infarction, compared to woman consuming less than half an ounce of processed meat each day. Processed meat was not linked to any other form of stroke. Cerebral infarction is a type of stroke caused by a disturbance in the blood vessels supplying blood to the brain. Other types of stroke involve a rupturing of a blood vessel, called hemorrhagic strokes.
The scientists blame red meat and processed meat’s effect on raising blood pressure for the increased stroke risk. According to the World Health Organization (WHO), every year an estimated 17 million people die due to cardiovascular diseases, most notably stroke and heart attack. The WHO lists physical inactivity and unhealthy diet as the main risk factors for heart disease and major cardiac events.
The study was carried out by researchers from University of Otago Medical School, New Zealand. Funding was provided by Genesis Oncology Trust, the Dean’s Bequest Funds of the Dunedin School of Medicine, the Gisborne East Coast Cancer Research Trust and the Director’s Cancer Research Trust. The research was published in the peer-reviewed American Journal of Epidemiology. This was a case-control study in New Zealand that compared a group of adults with bowel cancer, and a group without bowel cancer, and looked at whether they drank milk at school. School milk was freely available in most schools in New Zealand until 1967 when the government programme was stopped. Many schools in the Southland region stopped free milk as long ago as 1950.
Case-control studies are appropriate for looking at whether people with and without a disease have had a particular exposure (milk in this case). The difficulty is in accounting for all potential confounding factors, particularly other health and lifestyle factors, which could be related to both diet and bowel cancer risk, for example regular childhood milk consumption could be a reflection of a ‘healthy’ diet and other healthy lifestyle behaviours that may reduce risk of cancer. In addition, when examining such a specific dietary factor – ie milk consumed in school – it is difficult to account for all possible milk or other dairy products consumed outside of school.
In this case-control study, 562 adults (aged 30 to 69) with newly diagnosed bowel cancer were identified from the New Zealand Cancer Registry in 2007. For a control group, 571 age-matched adults without cancer were randomly selected from the electoral register. All participants were mailed a questionnaire that asked about any previous illness, use of aspirin or dietary supplements in childhood, participation in school milk programmes, other childhood milk consumption, childhood diet (including other milk and dairy), smoking, alcohol consumption prior to 25 years of age, screening tests for bowel cancer, family history of cancer, education and sociodemographic characteristics. Childhood weight and height were not questioned. For school milk consumption they were specifically asked:
- Whether they drank school milk
- How many half-pint bottles they drank a week
- What age they first drank school milk
- When they stopped drinking school milk
Statistical risk associations between school milk participation and cancer were calculated. The calculations took into account several risk factors for bowel cancer risk including age, sex, ethnicity and family history.
What were the basic results?
Data on school milk consumption was available for 552 cases and 569 controls. As expected, people who started school before 1967 were more likely to have had free school milk than those who began school after 1968. Seventy-eight percent of cases participated in the school milk programme compared with 82% of controls. School milk consumption was associated with a 30% reduced risk of developing bowel cancer (odds ratio 0.70, 95% confidence interval 0.51 to 0.96).
When looking at the effect of number of bottles consumed per week they found that compared with no bottles, five bottles per week was associated with 32% significantly decreased risk, and 10 or more bottles with 61% significantly decreased risk. However, there was no significant association with one to four bottles or six to nine bottles. The researchers found a similar trend when the total school consumption of milk was compared with no consumption: 1,200-1,599 bottles was associated with 38% significantly decreased risk; 1,600-1,799 with 43% decreased risk; and 1,800 or more bottles associated with 38% significantly decreased risk. There was no significant association with fewer than 1,200 bottles. The researchers calculated that for every 100 half-pint bottles consumed at school there was a 2.1% reduction in the risk of bowel cancer. Outside of school, there was a significantly reduced risk of bowel cancer with more than 20 dairy products a week compared with none to nine dairy products a week.
The researchers conclude that their national case-control study ‘provides evidence that school milk consumption was associated with a reduction in the risk of adult colorectal cancer in New Zealand. Furthermore, a dose-dependent relation was evident’. This study has strengths in its relatively large size, its reliable and nationally representative identification of cases and controls, and its thorough data collection. However, the conclusion that school milk consumption is associated with a reduced risk of bowel cancer in adulthood must be interpreted in light of a number of considerations:
The analysis took into account established risk factors for bowel cancer including age, sex, ethnicity and family history. However, many other potential confounders were not considered, including diet, physical activity, overweight and obesity, smoking or alcohol consumption. Diet in particular has been implicated in bowel cancer risk, with diets high in saturated fat, red meat and processed foods and low in fibre, fruit and vegetables thought to increase risk. Potentially, any of these lifestyle behaviours could be confounding the relationship between school milk consumption and bowel cancer and regular childhood milk consumption could be a reflection of a ‘healthy’ diet and other healthy lifestyle behaviours that reduce risk of cancer. When looking at the effect of number of bottles consumed per week, the researchers found that, compared with no bottles, five bottles were associated with 32% significantly decreased risk and 10 or more bottles with 61% significantly decreased risk. However, there was no significant association with one to four bottles or six to nine bottles. Therefore, the trend here is not very clear. Particularly as only 16 cases and 31 controls drank 10 or more bottles a week, statistical comparison between such small numbers should be viewed with caution. With many food questionnaires there is the potential for recall bias. For example, adults may have difficulty remembering how many bottles of school milk they drank many years before. When estimating their average weekly amount, it is highly possible that this could be inaccurate or that their consumption varied slightly from week to week and year to year. Particularly when researchers were using this response and combining it with the number of weeks in the school year and their total years at school to give a total number of bottles consumed at school (figures in 100s or 1,000s), there is the possibility of being incorrectly categorised. Hence, there may be less reliability when calculating risk according to the category of total milk bottles consumed. Cancer prevalence, and particularly environmental and lifestyle risk factors for cancer, can vary between countries. These findings in New Zealand may not be represented elsewhere. Of note, the researchers acknowledge that a cohort study in the UK found the opposite: increased childhood dairy consumption was associated with increased risk of bowel cancer. Case-control studies are most appropriate for looking at rare diseases, where you would expect there to be only a small number of cases developing among a large number of people. In the case of bowel cancer, which is common, the slightly more reliable cohort design could have also been used, where children who drank milk at school and those who didn’t were followed over time to see if they developed cancer. However, such a cohort would consequently need extensive long-term follow-up.
The possible association between milk/dairy consumption, or calcium intake, in childhood, or in later years, is worthy of further study. However, from this study alone, it cannot be concluded that school milk prevents bowel cancer later in life.
To test their hypothesis that environmental influences experienced by the father can be passed down to the next generation in the form of changed epigenetic information, Rando and colleagues fed different diets to two groups of male mice. The first group received a standard diet, while the second received a low-protein diet. To control for maternal influences, all females were fed the same, standard diet. Rando and colleagues observed that offspring of the mice fed the low-protein diet exhibited a marked increase in the genes responsible for lipid and cholesterol synthesis in comparison to offspring of the control group fed the standard diet.
These observations are consistent with epidemiological data from two well-known human studies suggesting that parental diet has an effect on the health of offspring. One of these studies, called the Överkalix Cohort Study, conducted among residents of an isolated community in the far northeast of Sweden, found that poor diet during the paternal grandfather’s adolescence increased the risk of diabetes, obesity and cardiovascular disease in second-generation offspring. However, because these studies are retrospective and involve dynamic populations, they are unable to completely account for all social and economic variables. “Our study begins to rule out the possibility that social and economic factors, or differences in the DNA sequence, may be contributing to what we’re seeing,” said Rando. “It strongly implicates epigenetic inheritance as a contributing factor to changes in gene function.”
The results also have implications for our understanding of evolutionary processes, says Hans A. Hofmann, PhD, associate professor of integrative biology at the University of Texas at Austin and a co-author of the study. “It has increasingly become clear in recent years that mothers can endow their offspring with information about the environment, for instance via early experience and maternal factors, and thus make them possibly better adapted to environmental change. Our results show that offspring can inherit such acquired characters even from a parent they have never directly interacted with, which provides a novel mechanism through which natural selection could act in the course of evolution.” Such a process was first proposed by the early evolutionist Jean-Baptiste Lamarck, but then dismissed by 20th century biologists when genetic evidence seemed to provide a sufficient explanation.
Taken together, these studies suggest that a better understanding of the environment experienced by our parents, such as diet, may be a useful clinical tool for assessing disease risk for illnesses, such as diabetes or heart disease. “We often look at a patient’s behavior and their genes to assess risk,” said Rando. “If the patient smokes, they are going to be at an increased risk for cancer. If the family has a long history of heart disease, they might carry a gene that makes them more susceptible to heart disease. But we’re more than just our genes and our behavior. Knowing what environmental factors your parents experienced is also important.”
The next step for Rando and colleagues is to explore how and why this genetic reprogramming is being transmitted from generation to generation. “We don’t know why these genes are being reprogrammed or how, precisely, that information is being passed down to the next generation,” said Rando. “It’s consistent with the idea that when parents go hungry, it’s best for offspring to hoard calories, however, it’s not clear if these changes are advantageous in the context of a low-protein diet.”
The link between obesity and cardiac disease is not merely anecdotal, there is proof for that. Now, there is further proof that even overweight causes a clustering of risk factors for cardio vascular abnormalities. A recent publication in Heart Asia, a British Medical Journal, has showed that there is not much difference between the cardio vascular risk factors in obese and overweight people. “The clutch of risk factors – glucose intolerance, hyper tension, high cholesterol – are all significantly higher among overweight and obese subjects than among normal subjects,” Vijay Viswanathan, MV Hospital for Diabetes and Prof. M.Viswanthan Diabetes Research Center said. He co-authored the article with Shabana Tharkar, also from the Indian hospital.
The study, conducted among two groups – 2021 subjects aged over 20 years, and 1289 subjects aged 8-19 years – indicated that even among overweight, 'non-obese' people, the presence of major cardiovascular risk factors was not significantly different. While the total diabetes prevalence among the obese population is 28.4 per cent, among the overweight population is 25 per cent. Again, with hypertension, the value for the obese group is 34.2 per cent, while for the overweight population it is 27.6 per cent. In contrast, the corresponding values are 16.2 per cent (diabetes) and 20.2 (hypertension).
Similarly, the study showed higher values for triglycerides and high HDL cholesterol for both these groups.
Overweight was defined as a Body Mass Index, equal to, or in excess of 25 kg/m2 and obesity, a BMI of 30 kg/m2 or above. Further worrisome is the increasing rate of overweight and obesity among both men and women from 1995 to 2008, across all age groups. Dr. Viswanathan added that this is the result of rapid urbanisation. “Obesity has already hit the Western world and it is time for Indians to wake up to the alarm bells,” according to the article. Results from previous studies show a lower risk of developing diabetes with just a five per cent initial reduction in weight, Dr. Viswanathan said.
The findings highlight the urgent need for framing direct and indirect strategies to control the rising levels of obesity in the population, in order to substantially reduce the country's non communicable diseases burden, he added. Regulating the diet, reducing intake of fast foods and high-calorie meals, and upping physical activity and exercise on a regular basis would go a long way in keeping weight under control, diabetologists advise.
What did the research involve?
The researchers needed to obtain several sets of data to fill their model. Data for UK deaths from coronary heart disease, stroke and cancer were obtained from the Office for National Statistics, the General Register Office for Scotland and the Northern Ireland Statistics and Research Agency. Information on the population's intake of foods and nutrients was obtained from two sources: the average intake of fatty acids, fibre, and fruit and vegetables for 2005–7 was derived from the Expenditure and Food Survey, while estimates of salt intake came from the National Diet and Nutrition Survey, 2006.
The modelling also incorporated several meta-analyses of individual studies looking at diet and disease risk factors. The researchers looked at reviews that had pooled data from randomised trials, cohort studies or case-control studies, giving priority to meta-analyses of randomised trials. These different studies were combined in the model to calculate the change in risk of disease for an individual who changes his or her diet. To estimate the change in health outcomes with a change in diet at a population level, the model used the difference between current average consumption levels and recommended levels of different foods in the UK.
What were the basic results?
In a general summary of the main findings, the researchers calculated that:
About 33,000 deaths a year would be avoided if UK dietary recommendations were met. There would be a reduction in deaths from coronary heart disease of 20,800 (95% credible interval 17,845 to 24,069), a reduction of 5,876 for deaths from stroke (3,856 to 7,364) and a reduction of 6,481 for deaths from cancer (4,487 to 8,353). About 12,500 of these avoided deaths would be in people aged 75 or under. About 18,000 of the avoided deaths would be men and 15,000 would be women. More than 15,000 of the avoided deaths (nearly half the total figure) would be due to increased consumption of fruit and vegetables. Reducing average salt intake to 6g a day would avoid 7,500 deaths annually. The greatest number of deaths avoided would be in Northern Ireland and Scotland, whose populations are furthest from achieving dietary recommendations.
How did the researchers interpret the results?
The researchers say their study suggests that increasing average consumption of fruits and vegetables to five portions a day is the target likely to offer most benefit in terms of deaths avoided. They also say that reducing recommended salt levels to 3g daily and saturated fat to 3% of total energy would achieve a similar reduction in mortality.
They conclude that their calculations based on the Dietron model are robust, pointing out that their estimate of deaths avoided is lower than a previous government survey which calculated that 70,000 deaths a year could be avoided if government dietary recommendations were met. The estimates could be used in calculating the allocation of resources for interventions aimed at reducing chronic disease.
This well-conducted modelling study used various data sources to link consumption of different dietary components with disease risk factors (for example blood pressure, cholesterol and obesity) and subsequent mortality from coronary heart disease, stroke and cancer. The study supports previous research showing that diet plays a crucial role in health and that a diet with plenty of fruit and vegetables, fibre and low fat and salt levels can reduce the risk of chronic disease, in particular coronary heart disease. However, its predictions are made at the population level. A model such as this cannot predict individual risk, which will depend on many factors, including family history, smoking and other lifestyle habits.
It is important to note that the figures are based on the estimates and assumptions made when using a mathematical model, and not on reality. As the authors themselves note, the modelling technique they used may have led to “some degree of double counting” and that, therefore, their estimate of reduced mortalities if dietary recommendations were met is likely to be an overestimate. Also, the accuracy of the model depends to some extent on the quality of the meta-analyses that were included, and the quality of the individual studies that were pooled within these reviews in order to establish associations between diet and particular disease risk factors.
Overall, this study supports current dietary recommendations and even though it cannot predict how diet influences risk for individuals, it does indicate that keeping to dietary recommendations reduces the risk of disease.
Dietary recommendations include eating five portions of fruit and vegetables a day (about 440g) and 18g of fibre (provided by wholegrain foods and some fruit and vegetables). It is recommended that salt intake is limited to a maximum of 6g a day and that a third of total energy is provided by fats, with saturated fat comprising 10%. The researchers point out that in 2007, according to the estimated average intakes in the sources they used, none of the UK countries met these recommendations.
Here is another reason to make the tasty almonds a part of your daily diet. The humble tidbit nuts that combine tons of essential nutrients in one delicious package are an effective weapon in fighting type 2 diabetes and cardiovascular diseases, claims a new study. According to researchers, almonds added to the diet have a favorable effect on blood cholesterol levels and insulin sensitivity, two vital risk factors that can trigger diabetes and heart problems.
Lead author of the study, Dr. Michelle Wien, Assistant Research Professor in Nutrition at Loma Linda University’s School of Public Health stated, “We have made great strides in chronic disease research from evidence of effective treatment to evidence of effective prevention. “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.”
In a bid to assess the impact of almond enriched diet as a prescription for physical wellness, the researchers conducted a study. The focus of the study was to analyze the effect of the humble nut on the progression of type 2 diabetes and cardiovascular disease. The investigators enrolled a group of 65 adults comprising 48 women and 17 men with pre-diabetes in their mid-50s. The study subjects were split into two groups. As a part of the study, one group was assigned to almonds while the second formed the control group. The control group followed a diet recommended by the American Diabetes Association (ADA).The group assigned to almonds conformed to a similar diet but also added 20 percent calories from almonds. All the participants were asked to consume the same amount of calories from carbohydrate-containing foods, such as pasta, bread, and rice. However, those consuming the almond-enriched diet reported a lower intake of carbohydrate-containing food items.
After a period of 16 weeks, the investigators compared the insulin and cholesterol levels of both the groups. It was noticed that people consuming almond-enriched diet exhibited marked improvement in their insulin sensitivity and a dramatic reduction in LDL cholesterol as opposed to those eating the nut-free regular diet.
The study was conducted at the University of Medicine and Dentistry of New Jersey. The findings of the research are published in the ‘Journal of the American College of Nutrition
Having psoriasis appears to double the risk that a person will also have a dangerous clustering of risk factors for heart disease and diabetes known as metabolic syndrome, a new study shows. Previous research has found patients with psoriasis to be at higher risk for getting diabetes and high blood pressure, but the new study, which is in the Archives of Dermatology, is one of the first to document the broader complement of cardiovascular risks associated with the disease.
“It is more than skin deep,” says Abrar Qureshi, MD, MPH, co-author of the paper and vice chairman of the department of dermatology at Brigham and Women's Hospital in Boston. “We like to tell patients that psoriasis is a systemic disease. The risk for metabolic syndrome is high.”
Psoriasis is an autoimmune disease in which the body overproduces skin cells, causing a thick, scaly, red rash to appear on the palms, soles of the feet, elbows, scalp, or lower back. It is thought to be one manifestation of chronic, body-wide inflammation. Metabolic syndrome is defined as having at least three of the following risk factors for heart disease and diabetes: high blood pressure, too much belly fat, high fasting blood sugar, low levels of HDL “good” cholesterol, and high levels of bad blood fats called triglycerides. Studies have shown that having metabolic syndrome dramatically increases the risk of heart attacks, strokes, peripheral vascular disease, and type 2 diabetes.
Researchers say it's difficult to know which of the two might be driving the other. “There's evidence on both sides of the fence,” says lead study author Thorvardur Jon Löve, MD, of Landspitali University Hospital in Reykjavik, Iceland. “There's evidence that obesity drives the development of psoriasis. There's also evidence that inflammation drives some components of insulin resistance. It's a real chicken and egg problem at this point.”
Metabolic Syndrome and Psoriasis
The new study used blood test results from nearly 2,500 people who participated in the government-sponsored National Health and Nutrition Examination Survey between 2003 and 2006. None had previously been diagnosed with diabetes. Among study participants who said that a doctor had diagnosed them with psoriasis, 40% had metabolic syndrome, compared to just 23% of those who did not have psoriasis.
The association was particularly strong in women. Nearly half of women with psoriasis had metabolic syndrome, compared to just one in 5 women without psoriasis. In contrast, psoriasis appeared to raise a man's risk of having metabolic syndrome by only about 4%. “When you get this constellation of factors together, the risk is higher than the sum of the individual factors,” Löve says. “Visit your primary care physician and bring this up.”
Smoking accounts for more than a third of cases of the most severe and common form of rheumatoid arthritis, indicates research published online in the Annals of the Rheumatic Diseases. And it accounts for more than half of cases in people who are genetically susceptible to development of the disease, finds the study.
The researchers base their findings on more than 1,200 people with rheumatoid arthritis and 871 people matched for age and sex, but free of the disease. The patients came from 19 health clinics in south and central Sweden, while their healthy peers were randomly selected from the population register. All the participants were aged between 18 and 70. They were quizzed about their smoking habits and grouped into three categories, depending on how long they had smoked. Blood samples were taken to assess all the participants' genetic profile for susceptibility to rheumatoid arthritis and to gauge the severity of their disease, as indicated by their antibody levels.
More than half of those with rheumatoid arthritis (61%) had the most severe form of the disease, which is also the most common form, as judged by testing positive for anticitrullinated protein/peptide antibody (ACPA). Those who were the heaviest smokers – 20 cigarettes a day for at least 20 years – were more than 2.5 times as likely to test positive for ACPA. The risk fell for ex-smokers, the longer they had given up smoking. But among the heaviest smokers, the risk was still relatively high, even after 20 years of not having smoked.
Based on these figures, the researchers calculated that smoking accounted for 35% of ACPA positive cases, and one in five cases of rheumatoid arthritis, overall. Although this risk is not as high as for lung cancer, where smoking accounts for 90% of cases, it is similar to that for coronary artery heart disease, say the authors. Among those with genetic susceptibility to the disease, and who tested positive for ACPA, smoking accounted for more than half the cases (55%). Those who smoked the most had the highest risk.
The authors point out that several other environmental factors may contribute to an increased risk of rheumatoid arthritis, including air pollutants and hormonal factors. But they suggest that their findings are sufficient to prompt those with a family history of rheumatoid arthritis to be advised to give up smoking.
Many people snore. Many people have heart attacks. Researchers from the University of Pittsburgh say they have found a connection between the two conditions. “People often report in primary care offices that they or their spouse complains of loud snoring, that they have difficulty falling asleep or staying asleep. And we as sleep researchers were interested in how this broad array of sleep symptoms that are often reported might relate to later cardiovascular risk,” lead research author Wendy Troxel of the University of Pittsburgh School of Medicine said.
Previous research has looked at the link between heart disease and obstructive sleep apnea, a problem where excess tissue blocks the airway during sleep. But this study looked purely at snoring. “There are some people with loud snoring who don't have obstructive sleep apnea,” Troxel continued.
In Troxel's government-funded study, more that 800 relatively healthy people ages 45 to 78 were followed for three years. High blood sugar and low levels of good cholesterol, both risk factors for heart disease, were twice as likely to present in the participants who reported frequent, loud snoring.
In addition to snorers, participants who had trouble falling asleep and had unrefreshing sleep were also at increased risk for metabolic syndrome, when additional heart disease risk factors like obesity, high blood pressure, and high levels of triglyceride fats are present. “Sleep complaints aren't just benign annoyances but something that can really foretell important health consequences,” Troxel stressed, “and they should really be discussed with [medical] providers and referred for further treatment if necessary.”
The research conducted at Pitt was an observational study. Patients were not treated to see whether decreasing snoring could lower the risk of heart disease. Rather, the study shows that snorers should pay particular attention to their heart disease risk factors.
A new UK research has found that more than a third believe cancer is down to fate and there is nothing they can do to avoid it. Cancer Research UK stated that one in five men and women feared cancer ahead of debt, knife crime, Alzheimer's disease and losing their job whereas 34 percent believed the disease was down to fate, rising to 41 percent of those aged 55 to 64.
The findings come in the midst of growing evidence suggesting lifestyle factors such as losing weight, taking exercise, reducing alcohol consumption and quitting smoking can significantly reduce the risk of developing cancer.
The survey questioned more than 2,000 adults aged 16 and over. Those questioned were asked to choose what they feared most from a list including developing Alzheimer's, being in debt, old age, being the victim of knife crime, cancer, being in a plane crash, motor neurone disease, being in a car accident, having a heart attack, losing your job and losing your home.
More people (20 per cent) overall chose cancer than anything else, followed by 16 per cent who feared Alzheimer's disease the most. Among adults up to the age of 44, cancer was feared most by 25 per cent while 7.5 per cent feared Alzheimer's most. For those aged over 65, Alzheimer's was feared most by 30 per cent while 14 per cent feared cancer most.
John Fyall, Cancer Research UK's spokesman for Scotland, said: “It's absolutely vital for us to get the message out that people can do something to alleviate their emphatic fear of cancer. Cancer is no longer the death sentence people still seem to dread,” the Scotsman quoted, John Fyall, Cancer Research UK's spokesman for Scotland, as saying. “Spotting early signs and symptoms of what could be cancer – but probably isn't – and getting these checked out by a doctor means that the disease can be diagnosed more quickly,” he added.
Teresa Nightingale, general manager of the World Cancer Research Fund, said, “It is a concern that so many people think cancer is a matter of fate, because there is now strong scientific evidence that people can make relatively simple changes to reduce their risk.” “Scientists estimate about a third of the most common cancers in the UK could be prevented just by eating a healthy, plant-based diet, being regularly physically active and maintaining a healthy weight. This includes about 40 per cent of breast and bowel cancer cases,” she added. Nightingale further informed that, “The strong evidence that diet, activity and weight affect our risk, together with other well-known risk factors such as smoking and sunburn, means that cancer is actually a largely preventable disease.” (ANI)