Blood sugar, blood pressure and diet

Q: Once blood sugar or blood pressure goes up, can people really bring them back down with healthy habits, or is that something from research but not seen in real life?

A: Without lifestyle changes, blood pressure or blood sugar levels that are too high usually continue increasing to more and more harmful levels. However, if you make changes – and the sooner after you see blood sugar or blood pressure going up, the better – by adding healthy habits you can make a difference. Programs for diabetes prevention and blood pressure control have shown benefits not only in tightly controlled research settings, but also in actual community settings. In fact, a few studies following people after participation in programs aimed at making health changes show that these health benefits last even 10 years afterward. Weight loss seems to be a key factor in these positive changes for people who are overweight. In some cases, obese participants who lost seven to 14 pounds and walked regularly reduced fasting blood sugar by about four percent and blood pressure by about five to 15 percent. These results may sound small, but they are enough to make a difference in health risk. Consider these small but important improvements as motivators as these changes can continue and bring more and more impact. For some people, once changes in blood sugar and blood pressure begin, they may not be able to get back to normal levels, but weight loss, daily physical activity and healthier food choices can still provide health benefits, such as decreased inflammation and other risk factors for heart disease and cancer. So if your check-up shows unhealthy elevations, don’t delay in finding options available in your community to learn new lifestyle habits that you can fit in your life.

Exercise and Cancer Risk

Q: Does exercise still help reduce cancer risk even if you don’t lose weight?

A: Studies presented at the most recent research conference of the American Institute for Cancer Research identified physical activity as a potentially major step we can take to reduce cancer risk. Evidence is strongest regarding physical activity’s ability to reduce colon, breast and endometrial cancer by 20 to 35 percent. Along with potential reductions in ovarian, prostate and lung cancer, the latest research suggests that meeting recommendations for daily physical activity could prevent more than 173,000 cases of these six cancers every year. For people who are overweight, weight loss – especially involving waistline fat – does seem to be one part of the way activity works. However, even outside of weight control, regular physical activity helps keep insulin and other hormones at a healthy level, and seems to decrease inflammation and improve immune function. The role of physical activity in reducing cancer risk is a huge area of research right now and we sti ll have much to learn. Whether or not you are overweight, including physical activity in your daily life – whether as a “work out,” playing sports, daily walks or transportation to work or errands – is now seen as an important part of a strategy to reduce cancer risk.

Pomegranates and Prostate Cancer

Q: Is it true that pomegranates help prevent prostate cancer? If so, what are some ways to eat them?

A: The research showing strongest anti-cancer effects of pomegranates and pomegranate juice involves prostate cancer, but bear in mind that results are still tentative. Pomegranates rank high among fruits for antioxidant and anti-inflammatory effects because of their vitamin C and phytochemical compounds. The laboratory evidence shows that substances, called urolithins, that our body produces from pomegranates’ compounds can decrease prostate cancer cell growth and ability to spread. Some human studies show that pomegranate juice or extract raises levels of antioxidant compounds in the blood, but we have only a handful of relatively small human studies directly related to cancer. There is research suggesting that individuals may vary in how well they absorb these compounds, so it’s possible that some will benefit more than others from pomegranate consumption. One small intervention trial of men previously treated for prostate cancer who had rising PSA levels (an indicator of prostate growth or inflammation) reported that consumption of eight ounces of pomegranate juice significantly slowed signs of prostate cancer progression. We need more research before recommending pomegranates for cancer prevention and we also need to know if there are differences between the juice and eating the pomegranate arils (the little sacks that hold the seeds and juicy pulp). In the meantime enjoy these fruits for great nutrition and taste. For an easy, neat way to get those juicy arils, simply place pomegranate quarters in a large bowl of water and roll the arils out with your fingers. Remove the membranes that float to the top, and then empty the bowl into a strainer to capture the juicy arils. Enjoy them mixed in salads, cereal, yogurt, rice and many other foods.

Red Grapefruit or White?

Q: Is it true that red grapefruit is higher in antioxidants than white grapefruit?

A: Not necessarily. All grapefruit is an excellent source of vitamin C, which acts as an antioxidant. All types also supply compounds called flavonoids, including naringinin. In animal and cell studies, naringinin decreases growth and increases self-destruction of colon, mouth, skin, lung, breast and stomach cancers. It decreases inflammation and increases enzymes that deactivate carcinogens. In some research, white grapefruit has higher levels of naringinin than red grapefruit, but content varies among individual fruits. The amount of naringinin may depend more on how much of the white material surrounding grapefruit sections is consumed than on the color of the grapefruit. Red and pink grapefruit do provide beta-carotene and a compound called lycopene not found in white grapefruit. Lycopene is a carotenoid – a pigment that’s a “cousin” to beta-carotene. It cannot form vitamin A like beta-carotene can, but it is actually a much stronger antioxidant. Especially for those who don’t eat tomatoes frequently, choosing red or pink grapefruit makes good sense; the darker the red, the higher the lycopene content. Still, all types of grapefruit are healthy choices that provide a variety of compounds that promote health, both as antioxidants and through other mechanisms.

Soup and Weight Loss

Q: Does soup really help you lose weight?

A: Some research suggests that starting a meal with soup may help fill you up and reduce the calories you consume at the rest of the meal. For this to work, the soup needs to be broth- or vegetable-based, not a high-calorie cheesy or creamy soup. You are more likely to be successful with this strategy if foods you eat following the soup are served in smaller portions, because studies have clearly established that for many of us, overeating is not necessarily due to more hunger, but a response to seeing more food. Another way you can use soup to help with weight loss is to make your soup a complete meal using plenty of lower calorie vegetables. Be sure to include beans, chicken, fish or other lean protein in addition to a bevy of vegetables, and perhaps a whole grain like brown rice or whole-wheat pasta. For overall good health, keep in mind that if you include soup frequently in your meals, prepared commercial soup can be very high in sodium. Regular commercial soup often co ntains from 750 to 1000 milligrams (mg) per one-cup serving (if you start with condensed soup, that means less than half of a ten-ounce can). That’s a hefty portion of the suggested maximum of 1500 to 2300 mg of sodium a day. Reduced-sodium versions often contain 400 to 850 mg per cup, which is better, but definitely not truly low-sodium. You can dilute reduced-sodium soups with an equal amount of sodium-free bouillon for a further cut, adding onion, garlic and herbs for plenty of flavor. Or make your own soup starting with low-sodium broth or no added salt tomatoes as a base.

Coffee and Cancer Risk

Q: Does coffee affect cancer risk?

A: Although previously there was concern that coffee might increase risk of some cancers, recent larger, better-controlled studies show that for most cancers, up to six cups of coffee per day do not increase risk. Now research is underway evaluating whether coffee might help reduce cancer risk, either as a major source of antioxidants or by affecting specific steps in the process of cancer development. Coffee contains several natural compounds that in laboratory studies can reduce inflammation, inactivate carcinogens and help regulate cell growth. In some population studies, people who drink moderate or high amounts of coffee daily show modestly reduced risk of a wide range of cancers, such as endometrial cancer in one recent study. Yet despite promising laboratory evidence, the large NIH-AARP population study did not find any link between coffee of any type and breast cancer risk, and other population studies show mixed results about any potential link between coffee and lower risk of cancer, such as pancreatic and prostate cancers. Bottom line: unless advised otherwise for medical reasons, enjoy moderate amounts of coffee without fear of cancer risk if you like, but make it part of an overall healthy diet and weight control, which have stronger research support as effective ways to reduce cancer risk.

Karen Collins, is a registered dietitian and nutrition adviser for the American Institute for Cancer Research. She served as an expert reviewer for the landmark international report, Diet, Nutrition, Physical Activity and the Prevention of Cancer Prevention: a Global Perspective. Karen holds a BS in dietetics and an MS in nutrition.