14 February 2011

Ian Gawler blog: Body weight and cancer

After last weeks recipes, lets go “Out on a Limb” again and tackle a vexed issue – body weight and cancer. What is the effect of too much or too little weight?

The context is the rising epidemic of a new form of disability called obesity. Today, around 34% of Americans are obese while a further 30% are overweight. Australia has similar statistics and along with the USA and Britain is among the countries with the fastest growing obesity rates.

Obesity means being roughly 30lbs or 13.5 kgs over a healthy weight. It is a significant risk factor for cancer, as well as heart disease, diabetes, MS and other diseases.

Treating obesity, according to mainstream medicine requires a multipronged approach including strong policy measures, lifestyle counselling and individual management. Disturbingly, lap band surgery (which shrinks the size of the stomach) is becoming one of the most common treatments for obesity.

But that is just the context. We all know about it. Lets tackle the other end of the spectrum – weight loss associated with cancer.

One of the most common questions I am asked about food is “will this diet cause me to lose weight?”

Here is the simple answer. A healthy, well balanced diet, whether intended for maintaining good health or to facilitate healing, must by definition lead to a healthy, well balanced body. As such, a good diet must support healthy weight.

I suggest that the diet put forward in “You Can Conquer Cancer” (YCCC) is a healthy, well balanced diet. After nearly 30 yrs of experience I can say that people who follow these suggestions consistently tend towards a healthy body weight, commonly a little on the lean side. It is well known being lean has huge health benefits when compared to the risks associated with being overweight or obese.

On this diet, those who are underweight tend to put it on; those overweight tend to lose it. When you consider around 60% of the population are overweight or obese, most initially do lose weight on this diet – and that is a good thing!

The recurring problem I find among people with cancer is the fear of weight loss. This fear seems to be fed (pun intended) by many doctors and other health professionals, including dieticians. Why?

Maybe it is because weight is easy to measure and is taken fairly reasonably to be a good measure of overall health. Put on a few pounds when you have cancer – that’s good. Lose a few pounds – that’s bad. And this despite the 60% who will benefit from losing some weight.

But there is another crucial issue – cachexia. Cachexia is the medical term for weight loss (specifically muscle mass) resulting from disease, in this case, the cancer itself. Cachexia is recognised as having multifactorial causality and is actually one of the most common and problematic signs of advancing cancer. However, in my experience, further difficulties often come from the way blame is assigned for it.

Over the years I have observed numerous people with advanced cancer and cachexia who were on what I considered to be a sound diet (following YCCC). They were losing weight because of their illness, yet some health professionals blame the diet for the weight loss, not the disease. Further, these same professionals often recommend patients to eat lots of high protein, high fat, high caloric foods, frequently encouraging them to consume junk food. While it can be helpful to modestly increase protein intake, care is required. High protein, high fat and high caloric intake are all risk factors for cancer. There cannot be many diseases where the risk factors are recommended for those working on recovering from that disease.

Prof Dan Nixon was a mainstream Oncologist before he researched the treatment of cachexia. In a landmark study he force fed (willing) people with advanced cancer and was shocked to find they died much quicker than those on standard diets. The rational that explains this outcome is strong if somewhat complex. It is to do with glucose metabolism and the impact of insulin on immune function and healing.
Dan Nixon went on to become a world authority on cancer nutrition.

So what to do?

1. Consider this: body weight is a function of several things including:

. Intake – what we eat.

. Digestion – which can vary amongst individuals and be diminished by old age and disease.

. Metabolic factors – some have racey, inefficient metabolisms (and lose weight easily); some slow and efficient (and gain weight easily). Cancer can affect metabolism.

2. The 3 factors above inform what to do:

. Intake – ensure adequate amounts of good quality food. If appetite is low, graze. Often when not well, a large meal can be off putting, but you can consume a lot by nibbling throughout the day. Consider adding more juices and smoothies. Make sure protein levels are adequate but not excessive.

. Digestion – consider supporting it by:

- chewing well so that all you swallow is like well mashed ripe bananas. Physical digestion starts in the mouth.

- boosting stomach acid with fresh ginger.

- aiding bowel flora with yoghurt or supplements

- if necessary, eat more easily digestible foods such as soups, juices and even white rice rather than brown.

- eat with gratitude and calm; breath, relax and smile.

. Output – paradoxically perhaps, exercise aids healthy metabolism and body weight – again, mostly through the insulin axis. Even when not so well, regular exercise (3-4 or more days per week) that is within manageable limits is highly recommended and supported by good research.

. Metabolic factors – for those with cachexia, it still makes sense to eat well. Remember that being on the lean side makes reasonable sense, but certainly if someone is really underweight it makes just as good sense, and in fact it is imperative to get good professional advice. The recommendations here are very general and intended to stimulate thought and discussion rather than being for specific advise.

But to be blunt – there is more chance of recovering on a good diet than a crappy one. As well, if I thought I actually was close to dying, I would be even more attentive to what I was eating (and I eat pretty well anyway!) as my experience is that a good, healthy diet minimises side effects and makes the process physically easier.

The fact is that when I was close to dying of cancer 35 yrs ago, I was very particular about what I ate and I was fortunate to recover. In my mind there is no doubt the diet was an important part of that recovery.

Good luck and enjoy your food.


Books: You Can Conquer Cancer: Ian Gawler
             Taking Control of MS: George Jelinek
             The Cancer Recovery Eating Plan: Dan Nixon
              Life over Cancer: Keith Block

CDs:      Eating Well, Being Well: Ian Gawler
              Eating for Recovery: Ian Gawler

Related Blogs: Good food prepared quickly
               Big Mac or a salad?
               Eating for recovery
               What food goes into your tank?

Programs: The Gawler Foundation.


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  2. It is alarming to see Australia being one of the top countries with a high percentage of obese people. People should look into various weight loss programs to help with this problem.