A Disease-Prevention Plan for Men - Food for Thought - Harvard Commentaries

By Anne Chiavacci, M.S., M.A., R.D.
Brigham and Women's Hospital and Dana-Farber Cancer Institute

Men, do you know which diseases pose the biggest threats to your health? Heart disease and cancer — specifically lung, colon and prostate — are the top killers of men in the United States. Reducing your risk for these diseases is within your control. Don't wait for severe chest pain, high cholesterol, high blood sugar or an elevated PSA (prostate-specific antigen) level to get your attention. Here's a plan to tune up your diet in three easy steps and take that target off your back.

A diet rich in colorful fruits and vegetables contains natural sources of vitamins, minerals and fiber that help lower your risk for heart disease and certain cancers. They can also slow down the disease process. For example, men diagnosed with prostate cancer who added one serving of fish or tomato sauce daily had a 50% lower risk of their cancer progressing. Adding just two servings a week lowered the risk of progression by about 20%.

Two large Harvard-based studies of over 124,000 people showed that those who ate foods rich in carotenoids, such as carrots and tomato products reduced their risk of lung cancer by 32%. The link between red meat and heart disease is familiar to many. Now there's also a cancer connection:

In a large U.S. study, men who ate at least 1.2 ounces of processed meat a day over the long term were 50% more likely to develop colon cancer, compared with those who ate the lowest amounts.

Men who eat more than 6 ounces of red meat (beef, pork, lamb) a day have a 60% higher risk of metastatic prostate cancer than men who eat less than 2.5 ounces a day.

What can you do? Eat 5 to 10 (1/2 cup) servings of fruits and vegetables daily. Choose varieties of different colors — green romaine, orange sweet potatoes, black beans, yellow corn, purple grapes, red watermelon, or white onions — to get the full range of health benefits.

Highly processed carbohydrates and sugars are stripped of fiber, vitamins, minerals and phytonutrients. An excessive intake of these foods leads to high insulin levels in the blood. This condition appears to be a growth factor for cancer cells, particularly when combined with obesity and a sedentary lifestyle.

Choose grain products (breads, cereals, crackers) that list "100% whole grain" on the package label.
Try brown rice, whole wheat pasta, barley, millet, oatmeal and bulgur in place of white rice and pasta.
Aim for 25 to 35 grams of fiber daily.

Don't exceed 1,500 mg/day of calcium from foods and supplements. Men with calcium intakes above 1,500 mg/day have a 2- to 2.5 -fold increase in advanced and fatal prostate cancer, compared with men who consume only 500 to 750 mg/day.

Take a vitamin D supplement. A form called cholecalciferol is best: 600 to 800 IU daily. Low blood levels of vitamin D are associated with higher rates of several cancers including cancers of the:

Breast
Colon
Ovaries
Pancreas
Prostate

Avoid high-dose zinc supplements. Compared with nonusers, men who take more than 100 mg/day of supplemental zinc have more than double the risk of advanced prostate cancer. Zinc from food sources, however, is not associated with prostate cancer risk.

Increase your intake of omega 3-rich fish, such as salmon, sardines, herring, mackerel and bluefish. Omega-3 fatty acids found in oily fish, walnuts and flaxseed decrease inflammation, reduce risk of fatal heart disease and lower triglyceride levels. They also may help protect against arthritis, depression, and dementia. (Men should avoid flax oil supplements however, which are linked to increased risk of prostate cancer.) If you take a fish oil supplement, I recommend a dose of 500 to 1,000 mg EPA/DHA daily.

Get your antioxidants — vitamins C and E, selenium, beta carotene and other nutrients you won't find in a pill — from fruits, vegetables, nuts, whole grains. Overall, the collective results from 38 studies fail to show a benefit of vitamin C and E supplements in cancer prevention and treatment. Studies on vitamin E and prevention of heart disease have also shown scant evidence of a protective role. Beta-carotene supplements actually increase the risk of lung cancer and death in smokers. More research is in progress to test the effectiveness of vitamin E and selenium supplements in prostate cancer prevention.

Get moving. Moderate exercise lowers the risk of colon and prostate cancers and heart disease. It also helps prevent diabetes, obesity, stroke and hip fracture. Male doctors and dentists age 65 and older who exercised vigorously for at least three hours weekly had a 70% lower risk of advanced and fatal prostate cancer, according to one study. The American Cancer Society and other health organizations suggest at least 30 minutes of moderate intensity exercise, 5 days a week. There is growing evidence that physical activity may decrease the risk for recurrence among some cancers.

Weight control really matters! Obesity can shorten your life and put you at risk of developing heart disease and some types of cancer. Obesity is measured using a scale called a body mass index, or BMI, which is calculated using your weight and height. ( Calculate your BMI. ) As a man's BMI climbs above the normal range (19-25), his risk of dying of colon, esophageal, kidney, liver, leukemia, and several other cancers rises. And once an overweight man is diagnosed with prostate cancer, he's more likely to die or have advanced disease, compared with a normal-weight man. Furthermore, having a "beer belly" appears to be a strong predictor of colon cancer risk: A waist size of 40 inches or more doubles your risk of colon cancer. Add a sedentary lifestyle to that and your risk is 3 to 4 times higher.

Anne Chiavacci, M..S, M.,A., R.D. is a senior clinical nutritionist at Brigham and Women's Hospital and Dana-Farber Cancer Institute. She received her Bachelor of Science in nutrition from the University of Massachusetts at Amherst and her Master of Science in nutrition from Tufts University. She provides medical nutrition therapy and counseling services for oncology patients and their families.