The Total Diet Approach and Cancer Risk
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UnityPoint Health - John Stoddard Cancer Center

The Total Diet Approach and Cancer Risk

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Does what we eat and drink affect our risk of developing cancer? The short answer is yes but this answer comes with challenges. Research on diet and cancer risk has often taken a reductionist approach, focusing on specific, individual dietary components. But here is the problem with that approach; foods and beverages, as well as the nutrients and dietary constituents they contain, are consumed together, never in isolation of one another and for long periods of time, years and decades, not weeks or months. In the past we have made the assumption that a specific food or nutrient can induce a specific biologic effect that can lead to the formation and growth of cancer cells. This approach has not served us well and has led to some unanticipated and at times paradoxical findings. Dramatically increasing or decreasing consumption of a specific food or nutrient may have unintended or even adverse effects.


The total dietary approach now recognizes that healthy eating and cancer risk reduction is about a more holistic approach, looking at overall dietary and nutrient patterns across the lifespan and not just individual foods over a few months. This approach also takes into consideration meal timing, circadian rhythms, ethnic variations, food preparation and our attitude toward food as medicine. 

The total dietary approach encourages choosing a wide variety of foods from multiple different food groups over the lifespan. These food groups include vegetables, whole fruit, nuts, seeds and legumes (beans) with modest amounts of dairy, whole grains, fish and meats, eggs and chocolate. Limiting ultra processed foods (think breads, bakery goods, crackers, chips, snack foods and fast foods) and limiting beverages with sugar and artificial sweeteners. The total dietary approach also takes into account how and when we eat, taking into consideration our circadian rhythm. Meal timing over a lifetime can have significant health consequences. Our bodies appear to assimilate nutrients best when we follow an eating pattern coherent with our sleep/wake cycle. Eating late in the evening just before bed or midnight snacking has many known deleterious metabolic effects. How we eat our food can also influence the absorption of vital nutrients. Eating slowly and purposely and chewing your food well (until your food is liquid) improves digestion and increase the absorption of essential vitamins and minerals. Slow down and enjoy all the tastes food has to offer. Based on the teachings of Ayurvedic Medicine principles (a traditional system of healing originating in India) how food is prepared can have a significant influence on health. Food prepared with love and kindness toward the earth is healing whereas food prepared without thought or kindness will have adverse consequences. 

For decades the western vision of food is that it is a source of calories to keep the body fueled and that it really made no difference where the calories came from. This could not be farther from the truth. We need to think of food as medicine. When people think this way they then begin to realize that each food choice can be healing. We need to think of food as a medicine supplying us with all the necessary nutrients for health and vitality. This fundamental premise then allows you to consider everything you eat as supportive of health.  

The total diet is a new world way of thinking about food. It is about the sum and not the parts. The sum of a diverse, whole foods, unprocessed diet over the lifespan has greater health benefits and potential cancer risk reduction than any one component. 

As Michael says: “eat food, not too much, mostly plants.” If you do this over a lifetime the current science says you can reduce your risk of cancer. 

REFERENCES: 

1) Position of the Academy of Nutrition and Dietetics: A Total Approach to Healthy Eating. J Acad Nutr Diet. 2013;113:3-7-317 

2) https://www.cancer.gov/news-events/cancer-currents-blog/2018/cancer-risk-total-diet