In the news

A deadly trend

          There have been several articles in the past couple of months about the rise in colon and rectal (colorectal) cancer among younger persons, even those in their thirties, actually doubling since the 90s. As a result of this trend, some medical authorities now recommend that screening for colorectal cancer should begin at the age of 45, or even earlier.

            The gold standard for the identification of colon cancer is a colonoscopy, not a trivial procedure but hardly a painful or risky one. Even the so-called “bowel prep”, which sometimes requires long sessions sitting on the commode, has become less onerous. New methods of non-invasive screening that identify blood and abnormal DNA in a stool sample are convenient and cost a fraction of that for a colonoscopy.

            I have read several media articles describing this worrisome trend, and those writers who point to diet blame junk or highly processed food. This is probably one cause but more important, I believe, is what is not in the diet: plant food. Everyone is aware that the fiber in fruits and vegetables promotes bowel activity but few understand why that matters. Simply put, when fecal material that may contain cancer-causing substances (carcinogens) stays in prolonged contact with the lining of the colon it may initiate DNA damage that leads to cancer. But there is another factor. Plant foods contain salicylates, one form of which is aspirin. The inflammation-reducing effect of aspirin/salicylates is obvious; we have used it for centuries to reduce the inflammation of infection and injury. Such inflammation promotes cancer, and it may explain why vegans are at lower risk of colorectal cancer than consumers of the Standard American Diet (SAD).

            Young persons are notoriously lax in their intake of fruits and vegetables. The average teenager eats less than one serving per day – a documented 0.9 servings – instead of the recommended ten, thus losing out on the myriad of nutrients such as vitamins, minerals and phytonutrients that our bodies have evolved to require.

            We can seriously slow down this cancer surge by making some simple dietary changes, educating people about the nature of the disease and promoting early screening. Is that asking too much?

Lifestyle

Pizza – the good, the bad and the ugly

            Would it surprise you to learn that I consider pizza a health food? With caveats, of course.

            First – the good. The toppings make all the difference. The crust, usually made of refined flour, is not a great source of nutrients but the (usually) most common topping is tomato sauce, sometimes with chunks of tomato as well. Cooking tomato enhances the absorption of lycopene, a carotene, and some studies have shown that it reduces the risk of cardiovascular disease and prostate cancer.

            Other nutritious toppings include bell pepper, which is rich in antioxidants, and onions, which are also rich in antioxidants and may be helpful in preventing cancer. Mushrooms are a good source of vitamin D and are known to improve immune function, possibly because of the vitamin D content and numerous phytonutrients. Olives are a Mediterranean staple for a good reason. They are rich in monounsaturated fats and vitamin E; the latter is associated with a documented reduced risk of osteoporosis. Eggplant, very much underappreciated, is rich in vitamins and antioxidants. Pineapple is a newcomer to the pizza world but it is rich in fiber. And of course, there is garlic, whose cardiovascular and anticancer benefits have been studied for decades.

            The bad: cheese (Sorry!) The amount of cheese on a single slice of American pizza would be enough for a Mediterranean family of four for a couple of days, because they use it only as a garnish, not as a main meal ingredient. You’ll find a standard serving of cheese in only two slices, with plenty of saturated fat. And if you’ve wondered why you’re so thirsty after eating pizza it’s because of the salt. A single slice of pizza contains more than 500 milligrams of sodium, so two slices (without the sausage or pepperoni) will provide you with nearly half of the recommended dietary allowance. Is it any wonder why more than half of Americans have high blood pressure?

            Pizza without cheese?? No way! But if you ask for half the usual amount of cheese, you’ll still enjoy the full flavor of America’s favorite comfort food, and if you ask for a “no cheese pizza” you’ll certainly confuse your server but you’ll still enjoy it if you add all those other veggie toppings.

            The ugly: sausage and pepperoni. These processed meat products have been classified by the World Health Organization as a Group 1 carcinogen, and strongly associated with cancer of the stomach and colon. Their high concentration of nitrites and nitrates has the European Union pushing for their reduction in food products.

            Putting pizza in perspective. As mentioned above, the toppings make all the difference. Ask for lots of the good, less of the bad, and none of the ugly.

            And here’s a bonus for readers in San Diego’s North County: Jay’s Gourmet Restaurant in Carlsbad (at the intersection of Carlsbad Village Drive and Carlsbad Boulevard), has the best pizza in town: seafood pizza loaded with fish, scallops, mussels, calamari and clams. All excellent sources of lean protein and omga-3 fatty acids. You’ll never again miss the pepperoni.