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Showing posts with label Contents. Show all posts
Showing posts with label Contents. Show all posts

The Blue Zones

The Okinawa Centenarian, National Geographic Magazine

They are called blue zones – places in the world where people live longer and healthier than anywhere else on earth. Several of these blue zones exist, and in each of these places people living to 90 or even 100 years is common. And they aren’t just living long either – these people are living healthy – without medication or disability (see video later in this post).

Five blue zones have so far been identified and thoroughly researched by journalist Dan Buettner in a partnership with National Geographic during more than five years of on-site investigation. So what is the secret to longevity and health underlying these fascinating communities? Do they possess modern technology, do they take massive amounts of supplements, do they run on treadmills, do they have special genes? As you may have guessed, the answer is none of these.

The five blue zones are as follows:
* The Italian island of Sardinia
* Okinawa, Japan
* Loma Linda, California
* Costa Rica’s isolated Nicoya Peninsula
* Ikaria, an isolated Greek island

Power 9® are lessons that emphasize making changes to your environment that will influence your habits. Creating the right surroundings and following specific lifestyle habits shared by the world’s longest-lived people is the secret to living longer.

Move Naturally

1. Just Move
The world’s longest-lived people don’t pump iron, run marathons or join gyms. Instead, they live in environments that constantly nudge them into moving without thinking about it.  They live in places where they can walk to the store, to their friends house or places of worship, their houses have stairs, they have gardens in their yards.

Consider making things a little inconvenient.  Make that extra trip up or down the stairs instead of loading things at the top or bottom to take up later, walk to your airport gate instead of taking the moving walkway, park far from the entrance, walk a dog, do your own yard and house work, get rid of some the time saving electronics and power equipment that have "simplified" your life.

Right Outlook

2. Purpose Now
Knowing your sense of purpose is worth up to seven years of extra life expectancy. The Okinawans call it "ikigai" and the Nicoyans call it "plan de vida" for both it translates to “why I wake up in the morning.”  Do an internal inventory. Be able to articulate your values, passions, gifts and talents.  What are the things you like to do and the things you don’t? Then incorporate ways to put your skills into action.

3. Down Shift
Even people in the Blue Zones experience stress. Stress leads to chronic inflammation which is associated with every major age-related disease.  What the world’s longest-lived people have that we don’t are routines to shed that stress. Okinawans take a few moments each day to remember their ancestors, Adventists pray, Ikarians take a nap and Sardinians do happy hour. Find a stress shedding strategy that works for you and make it routine.

Eat Wisely

4. 80% Rule
Marketers tell us we can eat our way to health.  America has been eating its way well beyond health.  Our strategy focuses on taking things out — instead of putting more things in — our diet.   "Hara hachi bu" – the Okianawan, 2500-year old Confucian mantra said before meals reminds them to stop eating when their stomach is 80 percent full.  The 20% gap between not being hungry and feeling full could be the difference between losing weight or gaining it.  Serve food at the counter, store leftovers, then sit down to enjoy the meal. Replace your big dishes with 10" plates. Remove TV’s from the kitchen.  People in the Blue Zones eat their smallest meal in the late afternoon or early evening and then they don’t eat any more the rest of the day.

5. Plant Slant
Go ahead and eat meat if you want.  But consider it a condiment and try the leanest, finest meat you can afford. Try to limit it to a portion the size of a deck of cards and only twice per week.  Beans, including fava, black and soy and lentils are the cornerstone of most centenarian diets.  Snacking on nuts–about a handful a day has been associated with and extra 2-3 years of life expectancy.

6. Wine @ 5
Moderate drinkers outlive non-drinkers.  The trick is to drink 1-2 drinks per day (preferably Sardinian Cannonau wine), with friends and/or with food.  And no, you can’t save up all weekend and have 14 drinks on Saturday.

Connect 

7. Belong
All but five of the 263 centenarians we interviewed belonged to some faith-based community.  It doesn’t matter if you’re Christian, Buddhist, Muslim, Jewish or some other religion that meets as a community.  Research shows that attending faith-based services four times per month will add 4-14 years of life expectancy.

8. Loved Ones First
Successful centenarians in the Blue Zones put their families first. This means keeping your aging parents and grandparents near by or in your home. (It lowers disease and mortality rates of children in the home too.) Work on being in a positive, committed relationship (which can add up to 3 years of life expectancy)  and invest in your children with time and love. (They’ll be more likely to care for you when the time comes.)

9. Right Tribe
The world’s longest lived people chose–or were born into–social circles that supported healthy behaviors,   Okinawans created "moais"–groups of five friends that committed to each other for life.  Research from the Framingham Studies show that smoking, obesity, happiness, and  even loneliness is contagious. Assessing who you hang out with, and then proactively surrounding yourself with the right friends, will do more to add years to your life than just about anything else.

Dan Buettner: How to live to be 100+
To find the path to long life and health, Dan Buettner and team study the world's "Blue Zones," communities whose elders live with vim and vigor to record-setting age. At TEDxTC, he shares the 9 common diet and lifestyle habits that keep them spry past age 100.

References:
  • Dan Buettner (Biography): National Geographic writer and explorer Dan Buettner studies the world's longest-lived peoples, distilling their secrets into a single plan for health and long life.

Resources:
  • www.bluezones.com
  • Dan Buettner: TEDMED 2011,
    Uploaded by tedmed on Dec 9, 2011 [YouTube]
    Buettner talks about universal lifestyle behaviors that promote longevity, why they're so hard to adopt in the U.S., and how one town undertook its own Blue Zone experiment, to great effect.
  • Dan Buettner: TEDMED 2011 - Q&A,
    Uploaded by tedmed on Dec 9, 2011 [YouTube]
    Author Dan Buettner answers questions about how to make more longevity-promoting Blue Zones in the U.S.
Books:
   

Healthy Bowel Movements

Photo: Constipation by flickr/Alexander Ekman
Photo: Constipation by flickr/Alexander Ekman

The form, frequency, and transit time of bowel movements may play an important role in colon health. Larger bowel movements rid the body of excess estrogen. A minimum of 200 grams of fecal output (about a half pound) per day is the goal for cancer prevention. Fiber from whole foods can prevent diverticulosis and constipation, while eating meat and processed foods may increase one’s risk for conditions such as diverticulosis. Foods high in antioxidants may also help increase stool size, whereas fat blocking drugs and certain fish can cause anal leakage.

Bowel Movement Frequency

Comparing the regularity of omnivores, vegetarians, and vegans.

The fiber in flax seeds and other whole plant foods is more than just about reducing our risk for the heart disease and cancer. More than just the discomfort constipation can increase risk for hiatal hernia, varicose veins, hemorrhoids and painful conditions with names like anal fissure.

The biggest study on bowel movement frequency in history was recently published comparing the bowel habits of 15,000 meat eaters to 5000 vegetarians and a thousand vegans. Being vegetarian and especially vegan is strongly associated with a higher frequency of bowel movements. Moreover, having a high intake of dietary fibre and fluids and a high BMI are associated with an increase in frequency of bowel movements(BM).Vegans for example were about 3 times more likely to have daily BMs.

Bristol Stool Chart

Bristol Stool Scale or Bristol Stool Chart is a medical aid designed to classify the form of human faeces into seven categories. Sometimes referred to in the UK as the "Meyers Scale", it was developed by Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997).

Seven different classifications:
Type 1: Looks like rabbit droppings. Separate hard lumps, like nuts, hard to pass.
Type 2: Looks like a, bunch grapes. Sausage-shaped, but lumpy.
Type 3: Looks like corn on the cob.
Type 4: Like a sausage or snake, smooth and soft.
Type 5: Looks like chicken nuggets.
Type 6: looks like porridge, and
Type 7: Looks like gravy.

Meat-eaters, on average, poop out corn cob(Type 3) stools, while vegetarian and vegan on average, type 4, like sausage, smooth and soft. Vegans actually ended up beating vegetarians, because none of the vegans had the hard rabbit-turd stools, whereas a few of the vegetarians, like a bunch of the meat-eaters, struggled to pass type 1’s.

bristol-stool-chart
Photo: Bristol Stool Scale by Wikipedia

Stool Size Matters

Larger bowel movements are associated with lower risk of appendicitis, colon cancer, constipation, and diverticulitis.

The bigger our bowel movements, the healthier we may be. The risk of low stool weight includes bowel cancer, diverticular disease, appendicitis, various anal diseases - even perhaps, the healthfulness of breast tissue.

Chart: Mean daily stool weight and colon cancer incidence
Chart: Mean daily stool weight and colon cancer incidence

From a study of 23 populations across dozen countries, a graph, of average daily stool weight versus colon cancer incidence. As you can see, once you get down around 200 grams, colon cancer rates really seem to skyrocket. That's about half a pound. And once people start dropping quarter pounds or 25 grams, though, colon cancer incidence doubles.

The link between stool size and colon cancer may be related to transit time, the number of hours it takes for food to go from your mouth to anus. The larger your stool, the quicker the transit time, the easier it is for your intestines to move things along.

People don’t realize, though, you can have daily bowl movements and still be effectively constipated. You can be regular, but five days late.

What you’re seeing today you may have eaten last week. If you want to test it for yourself, you can eat a big bowl of beets and see when things turns pretty in pink.

Food Mass Transit

Most women experience a four-day intestine transit time, likely too long to meet the target 200 gram (half pound) minimum fecal output for cancer prevention.

How long food takes to get from one end to the other depends on gender and eating style. If you’re a vegetarian male it should just be a day or two, though if you eat meat it could end up being 5 days. Female vegetarians also mostly 1 or 2 days but those who eat meat are most likely looking at 4 days.


Chart: Bowel transit time (h)
Chart: Bowel transit time (h)

If it’s just 24, 36 hours your daily stool weight, which is what's flushing out all that excess estrogen and cholesterol, is probably going to hit that half pound target, though if it’s a couple days you may be hurting.

Or, if you have a really good bathroom scale, you can just measure stool weight directly, to see if you hit that half pound minimum.. by of course weighing yourself before and after, not, you know, messing up your scale.

Kiwi fruit for Irritable Bowel Syndrome with constipation

Photo: Kiwi Fruit by flickr/justusbluemer
Photo: Kiwi Fruit by flickr/justusbluemer
A kiwi fruit intervention was found to improve bowel function in those suffering from irritable bowel syndrome with constipation. Two kiwis a day for a month in this study funded by, of course, the world’s largest marketer of kiwis. They did find such a kiwi intervention “shortens colon transit time, increases defecation frequency, and improves bowel function”

This was accomplished without side-effects such as heart attacks and stroke associated with the primary drug prescribed to treat the condition, tegaserod, the most frequently prescribed drug for irritable bowel.

When to see a doctor

If you've made lifestyle changes that can contribute to having more frequent bowel movements, and you have no other signs or symptoms, you're probably in good health. Make an appointment with your doctor, however, if you're experiencing:

Changes in the consistency, volume or appearance of your bowel movements, such as repeatedly passing narrow, ribbon-like stools or loose, watery stools, abdominal pain, blood, mucus in your feces

Source:
Bowel Movement Frequency, NutritionFacts.Org, Dr Michael Greger
Link: http://nutritionfacts.org/video/bowel-movement-frequency/ (Accessed: 2013 Mar)

Stool Size Matters, NutritionFacts.Org, Dr Michael Greger
Link: http://nutritionfacts.org/video/stool-size-matters/ (Accessed: 2013 Mar)

Food Mass Transit, NutritionFacts.Org, Dr Michael Greger
Link: http://nutritionfacts.org/video/food-mass-transit/ (Accessed: 2013 Mar)

Bowels of the Earth, NutritionFacts.Org, Dr Michael Greger
Link: http://nutritionfacts.org/video/bowels-of-the-earth/ (Accessed: 2013 Mar)

Bowel movements: the scoop on poop, NutritionFacts.Org, Dr Michael Greger
Link: http://nutritionfacts.org/2011/09/29/bowel-movements-the-scoop-on-poop/ (Accessed: 2013 Mar)

Nutrition and lifestyle in relation to bowel movement frequency: a cross-sectional study of 20630 men and women in EPIC-Oxford. Sanjoaquin MA, Appleby PN, Spencer EA, Key TJ. Public Health Nutr. 2004 Feb;7(1):77-83.

Pilot evaluation of flaxseed for the management of hot flashes. Pruthi S, Thompson SL, Novotny PJ, Barton DL, Kottschade LA, Tan AD, Sloan JA, Loprinzi CL. J Soc Integr Oncol. 2007 Summer;5(3):106-12.


Bowel function measurements of individuals with different eating patterns. G.J. Davies, M. Crowder, B. Reid, & J.W. Dickerson. Gut, 27(2):164-169, 1986.


Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber). Cummings JH, Bingham SA, Heaton KW, Eastwood MA. Gastroenterology. 1992 Dec;103(6):1783-9.

Bowel transit, stool weight, and diverticular disease. Watts GT. Lancet. 1977 Sep 10;2(8037):564.

Haemorrhoids-postulated pathogenesis and proposed prevention. Burkitt DP, Graham-Stewart CW. Postgrad Med J. 1975 Sep;51(599):631-6.


Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Burkitt DP, Walker AR, Painter NS. Lancet. 1972 Dec 30;2(7792):1408-12.

Fibre and bowel transit times. Gear JS, Brodribb AJ, Ware A, Mann JI. Br J Nutr. 1981 Jan;45(1):77-82.

Stool form scale as a useful guide to intestinal transit time. Lewis SJ, Heaton KW. Scand J Gastroenterol. 1997 Sep;32(9):920-4.


Kiwi fruit improves bowel function in patients with irritable bowel syndrome with constipation. Chang CC, Lin YT, Lu YT, Liu YS, Liu JF. Asia Pac J Clin Nutr. 2010; 19(4):451-7.

Updates on treatment of irritable bowel syndrome. Hammerle CW, Surawicz CM. World J Gastroenterol. 2008 May 7; 14(17):2639-49.

Ensure sufficient sleep and rest

During our sleep, our body cells go into process of eliminating toxic substances (detoxify) and at the same time repair damaged cell (heal). It is especially important at this time to listen to our body. If we overexert ourselves, it can undermine the healing process. It is important to have sufficient sleep and rest.
Photo: Sleep by flickr/rabble

In fact, research suggests that sleep is necessary for optimal health and well-being. Sleep does more for you than just help you to feel rested the next day. Lack of sleep not only increases the risk of health problems – including obesity, diabetes, cardiovascular disease, and hypertension – it can also lead to impaired judgment, risky decision making, and even decrease your attractiveness. Aiming for 7-8 hours of sleep each night is ideal to optimize your health and longevity[1].

Photo: Sleep by flickr/peasap

Bedroom Checklist

KNOW YOUR SNORE SCORE
How to do it: Determine your snore score by taking the short assessment at American Sleep Apnea Association - Test Yourself. If you answer “yes” to any of the questions, discuss your symptoms with a medical provider.

Why do it? The Snore Score was developed by the American Sleep Apnea Association to help individuals assess their risk of sleep apnea, which is a medical condition that can impair sleep and cause health problems. It is important to identify whether sleep problems are due to a medical condition so it can be treated early and appropriately.


COMFORTABLE MATTRESS AND COMFORTABLE PILLOWS
How to do it: Mattresses should be replaced every 8-10 years. Make sure that your mattress is not sagging and is supporting you comfortably during sleep. When choosing a mattress, spend at least 10 minutes testing it out before buying. Choose pillows that support your head and neck and are comfortable to you.

Why do it? Having a comfortable mattress and comfortable pillows are important to getting a good night sleep[2]. Getting a good night sleep improves productivity, physical and emotional health, and longevity[3].


DIM THE LIGHTS AN HOUR BEFORE BED
How to do it: Dim the lights in your home an hour before you go to sleep.

Why do it? Practicing good sleep hygiene is the first step to getting the optimal 7-8 hours of sleep each night. Dimming the lights before bedtime prepares your body for sleep, allowing you to fall asleep faster and stay asleep longer.


REMOVE OR TURN THE DIGITAL ALARM CLOCK SO IT IS FACING AWAY FROM THE BEDSIDE
How to do it: Remove digital alarm clocks from your bedroom or turn your clock away from your bedside so the time is not visible to you. DO NOT wear a watch during bed time.

Why do it? The LED light from digital alarm clocks can disrupt sleep. In addition, hiding your clock from your line of sight will help you avoid clock watching during the night.


USE THE BEDROOM ONLY FOR SLEEP AND SEX
How to do it: Avoid doing work, watching TV, using the computer, or doing anything else that might agitate you in your bedroom.

Why do it? Your bedroom environment should be a comfortable and relaxing place that promotes sleep. Avoiding activities that may lead to stress is one way to ensure the bedroom is a place associated with calm and sleep. In addition, artificial light from screens including digital clocks and cell-phones can disrupt sleep[3].

PUT A LAVENDER PLANT NEXT TO THE BED
How to do it: Purchase a lavender plant from your local florist, or sprinkle a little lavender essential oils on your sheets.

Why do it? The smell of lavender is calming, soothing, and helps induce sleep[6].


HANG LIGHT-BLOCKING WINDOW SHADES IN THE BEDROOM
How to do it: Hang dark shades and heavy drapery or curtain that can block out all outside light when drawn.

Why do it? Light can be disruptive to sleep, even light from a clock or a computer[4]. Make your room as dark as possible for the best sleep.


SET THE TEMPERATURE OF YOUR BEDROOM TO 18°C / 65°F
How to do it: Set your thermostat to 18°C / 65°F at bedtime. If you have a programmable thermostat, program it to automatically adjust to 18°C / 65°F during sleeping hours.

Why do it? Temperatures below 12°C / 54°F or above 24°C / 75°F can actually wake you up at night. The ideal temperature for sleep is around 18°C /65°F. If it feels a little colder than you’d like, grab a couple of extra blankets.


INSTALL DOUBLE-PANED WINDOWS IN THE BEDROOM
How to do it: Install double paned windows in your bedroom.

Why do it? Double-paned windows help block out noise, which can be disruptive to sleep[7]. Another way to block out unwanted sounds is to use earplugs or 'white noise' such as a fan, air cleaner, or sound conditioner.

Source:

    • Mortality Associated With Sleep; Duration and Insomnia. Arch Gen Psychiatry; 59:131-136. Kripke D, Garfinkel L, Wingard D, Klauber M and M Marler. (2002).
    • Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. Sleep. 2009 Mar;32(3):295-301. Ikehara S, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, Inaba Y, Tamakoshi A; JACC Study Group.
  1. America National Sleep Foundation’s 2012 Bedroom Poll http://www.sleepfoundation.org/sites/default/files/bedroom2012.pdf  (Accessed 2012/08/01). 
  2. Institute of Medicine Report. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Released: March 21, 2006. http://www.iom.edu/Reports/2006/Sleep-Disorders-and-Sleep-Deprivation-An-Unmet-Public-Health-Problem.aspx  (Accessed 2012/08/01).
  3. Lockley SW; Evans EE; Scheer FAJL et al. Short-wavelength sensitivity for the direct effects of light on alertness, vigilance, and the waking electroencephalogram in humans. SLEEP 2006;29(2): 161-168.
  4. Goel N, Kim H and R Lao. (2005). An olfactory stimulus modifies nighttime sleep in young men and women. Chronobiology International; 22 (5): 889-904.
  5. Ulrich R, Quan X, Zimring C, Joseph A, and R Choudhary. (2004). The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity. Report to The Center for Health Design for the Designing the 21st Century Hospital Project.  http://www.rwjf.org/files/publications/other/RoleofthePhysicalEnvironment.pdf   (Accessed 2012/08/01)

Resources:

  • American Sleep Apnea Association - Test Yourself,(Accessed 2012/08/01)

Conventional medicine

Choose for alternative medicine or at least change your diet before steps in the conventional medicine:
  1. Cut (Surgery)
  2. Poison (Chemotherapy)
  3. Burn (Radiation Therapy)

Cut Poison Burn in conventional medicine
Cut Poison Burn is a controversial, eye opening, and sometimes heartbreaking documentary that puts the business of cancer treatment under the microscope. Follow the frustrating journeys of critically ill cancer patients as they try to navigate the confusing and dangerous maze of treatment and encounter formidable obstacles in the "cancer industrial complex."


Source:

http://cutpoisonburn.com/
Collection of Videos:

Cut Poison Burn from Dr. Paul Ling Tai on Vimeo.


Mind

Photo: Left bran vs right brain by Mercedes-Benz

Improve our brain health can protect us from:
  • Dementia
  • Increase our memory
  • Sharpen concentration

1. Nuerobic exercises
  • Getting dressed or showering in the dark
  • Switching what you normally wear on one side to the other like putting your watch on the opposite side of the wrist
  • Using your opposite hand to brush your teeth or open the doors
  • Cooking ethnic foods that you've never prepared before

2. Try Something New
  • "A lifetime of good mental habits payoff," says University of Alberta researcher Dr. Dennis Foth
  • People who are curious at young age are more likely to be mentally active and stay active as they age

3. Sleep to boost memory
  • Your brain requires huge amounts of energy to function properly; sleep boost memory and allows your brain to process information
  • Sleep little, if at all during day because naps rob you of sleep at night
  • To improve you overall brain health, get up and go bed at set times
  • To improve your memory, enjoy healthy food eat light meals at night and avoid caffeine

4. Socialize with People
  • Talking can increase memory and cognitive skills
  • ..

5. Strive For Variety
  • Don't rely on a particular practice, supplement, or food to improve your brain health. Instead incorporate different activities into your life
  • The more you challenge you brain and body the healthier and stronger they become. To improve your memory, enjoy healthy food, eat light meals at night, and avoid caffeine

6. Reduce Exposure to Neurotoxins
  • Harmful chemicals, food additives, and chemically altered ingredients can harm your brain and health
  • Pure product, organic produce natural fragrances, whole foods and fresh air will improve brain health and sharpen concentration
Just like we exercise our body, our brain also needs a workout to stay healthy and maintain peak performance. scientifically designed brain games are a great option because you can have fun and improve the health of your brain at the same time.

Resources:

  • Improve brain health and performance. www.lumosity.com

Anti-cancer Vegetables

Vegetables is the healthier choice among beans, fruits, nuts/seeds and whole grains.

A scientific study on 34 common vegetables against 8 types of human cancer cells shown vegetables have very different inhibitory activities towards cancer cells and that the inclusion of cruciferous and Allium vegetables in the diet is essential for effective dietary-based chemo preventive strategies.

Photo: Garlic by flickr-foxypar4


Top anti-cancer vegetables (chemopreventive potential):
  1. Garlic
  2. Leek
  3. Green onion
  4. Brussels sprouts
  5. Green cabbage
  6. Curly cabbage
  7. Kale
  8. Spinach
  9. Cauliflower
  10. Broccoli
  11. Radish
  12. Yellow onion
  13. Rutabaga
  14. Green bean
  15. Red cabbage
  16. Asparagus
  17. Fiddlehead ferns
  18. Beetroot
  19. Celery
  20. Eggplant
An inhibitory effect less than 50% on cancer cells:
  1. Acorn squash
  2. Bok choi
  3. Boston lettuce
  4. Carrot
  5. Endive
  6. Cucumber
  7. Fennel
  8. Jalapeno
  9. Orange bell pepper
  10. Potato
  11. Radicchio
  12. Romaine lettuce
  13. Tomato
Note: Above bold type covered all eight cancer diseases.

Charts below shown inhibition of tumour cell proliferation by vegetable extracts:
(The further down right the better it is to slowing down the cancer cell)

Breast cancer

Glioblastoma is a cancer of the brain

Kidney disease cancer

Lung cancer

Medulloblastoma is a cancer of the brain

Pancreatic carcinoma is cancer of the pancreas

Prostate Cancer

Stomach Cancer

Source:

D. Boivin, S. Lamy, S. Lord-Dufour, J. Jackson, E. Beaulieu, M. Cote, A. Moghrabi, S. Barrette, D. Gingras, and R. Beliveau. Antiproliferative and antioxidant activities of common vegetables: A comparative study. Food Chemistry, 112(2):374-380, 2009.

Anticancer vegetables, December 30, 2010. Dr Michael Greger, Nutrition Facts. http://nutritionfacts.org/video/1-anticancer-vegetable/

Veggies vs. Cancer, December 29, 2010. Dr Michael Greger, Nutrition Facts. http://nutritionfacts.org/video/veggies-vs-cancer/

Reversal of Coronary Heart Disease

Eating for Health, Not Weight

By DEAN ORNISH

ALMOST half of Americans are on a diet — not surprising, since two-thirds are overweight or obese, a frightening statistic that inspired Mayor Michael R. Bloomberg to push through a ban on large soft drinks in New York City. The country is preoccupied with calories. McDonald’s, for instance, is now posting them. But our widespread hope for weight loss makes us vulnerable to all kinds of promises, even ones that aren’t true, when it comes to food. 

Perhaps the biggest misconception is that as long as you lose weight, it doesn’t matter what you eat. But it does. Yet being thin and being healthy are not at all the same thing. Being overweight is not necessarily linked with disease or premature death. What you eat affects which diseases you may develop, regardless of whether you’re thin or fat. Some diets that may help you lose weight may be harmful to your health over time. 

A widely publicized study earlier this year showed that a low-carb Atkins-type diet might be a faster way to lose weight. That may have given many people the idea that eating meat and butter is the route to thinness and thus health. 

In 35 years of medical research, conducted at the nonprofit Preventive Medicine Research Institute, which I founded, we have seen that patients who ate mostly plant-based meals, with dishes like black bean vegetarian chili and whole wheat penne pasta with roasted vegetables, achieved reversal of even severe coronary artery disease. They also engaged in moderate exercise and stress-management techniques, and participated in a support group. The program also led to improved blood flow and significantly less inflammation which matters because chronic inflammation is an underlying cause of heart disease and many forms of cancer. We found that this program may also slow, stop or reverse the progression of early stage prostate cancer, as well as reverse the progression of Type 2 diabetes

Also, we found that it changed gene expression in over 500 genes in just three months, “turning on” genes that protect against disease and “turning off” genes that promote breast cancer, prostate cancer, inflammation and oxidative stress. 

The program, too, has been associated with increased telomerase, which increases telomere length, the ends of our chromosomes that are thought to control how long we live (studies done in collaboration with Dr. Elizabeth Blackburn, who shared the Nobel Prize in 2009 with Carol Greider and Jack Szostak for discovering telomerase). As our telomeres get longer, our lives may get longer.

In a randomized controlled trial, patients on this lifestyle program lost an average of 24 pounds after one year and maintained a 12-pound weight loss after five years. The more closely the patients followed this program, the more improvement we measured in each category — at any age.

It’s not low carb or low fat. An optimal diet is low in unhealthful carbs (both sugar and other refined carbohydrates) and low in fat (especially saturated fats and trans fats) as well as in red meat and processed foods. 

WHAT you eat is as important as what you exclude — your diet needs to be high in healthful carbs like fruits, vegetables, whole grains, legumes, soy products in natural, unrefined forms and some fish, like salmon. There are hundreds of thousands of health-enhancing substances in these foods. And what’s good for you is good for the planet.

Calories do count — fat is much denser in calories, so when you eat less fat, you consume fewer calories, without consuming less food. Also, it’s easy to eat too many calories from sugar and other refined carbs because they are so low in fiber that you can consume large amounts without getting full. Sugar is absorbed so quickly that you get repeated insulin surges, which promote Type 2 diabetes and accelerate the conversion of calories into body fat.

But never underestimate the power of telling people what they want to hear — like cheeseburgers and bacon are good for you. People are drawn to Atkins-type diets in part because, as the study showed, they produce a higher metabolic rate. But a low-carb diet increases metabolic rate because it’s stressful to your body. Just because something increases your metabolic rate doesn’t mean it’s good for you. Amphetamines will also increase your metabolism and burn calories faster, which is why they are used to help people lose weight, at least temporarily. But they stress your body and may mortgage your health in the progress.

Patients on an Atkins diet in this study showed more than double the level of CRP (C-reactive protein), which is a measure of chronic inflammation and also significantly higher levels of cortisol, a key stress hormone. Both of these increase the risk of heart disease and other chronic diseases. A major research article published recently in the British Medical Journal studied 43,396 Swedish women over 16 years. It concluded that “low carbohydrate-high protein diets ... are associated with increased risk of cardiovascular diseases.” An important article in The New England Journal of Medicine examined data from a study showing that high-protein, low-carb diets promote coronary artery disease even if they don’t increase traditional cardiac risk factors like blood pressure or cholesterol levels. A diet low in fat and high in unrefined carbohydrates caused the least amount of coronary artery blockages, whereas an Atkins-type diet caused the most.

Outcomes from more than 37,000 men from the Harvard-sponsored Health Professionals Follow-Up Study and more than 83,000 women from the Nurses’ Health Study who were followed for many years showed that consumption of both processed and unprocessed red meat, a mainstay of an Atkins diet, is associated with an increased risk of premature death as well as greater incidence of cardiovascular disease, cancer and Type 2 diabetes.

About 75 percent of the $2.8 trillion in annual health care costs in the United States is from chronic diseases that can often be reversed or prevented altogether by a healthy lifestyle. If we put money and effort into helping people make better food and exercise choices, we could improve our health and reduce the cost of health care. For example, Medicare is now covering this program for reversing heart disease. In an increasingly polarized political landscape, this approach provides an alternative to some Republicans who want to privatize or dismantle Medicare and some Democrats who want to simply raise taxes or increase the deficit without addressing the diet and lifestyle choices that account for so much health spending.

This way of living helps you lose weight and keep it off while enhancing rather than harming your health. 

A clinical professor of medicine at the University of California, San Francisco, and the founder of the Preventive Medicine Research Institute.

Source:
  • Eating for Health, Not Weight, The New York Times, September 22, 2012

Reference

Intensive Lifestyle Changes for Reversal of Coronary Heart Disease, December 16, 1998
Dean Ornish, MD; Larry W. Scherwitz, PhD; James H. Billings, PhD, MPH; K. Lance Gould, MD; Terri A. Merritt, MS; Stephen Sparler, MA; William T. Armstrong, MD; Thomas A. Ports, MD; Richard L. Kirkeeide, PhD; Charissa Hogeboom, PhD; Richard J. Brand, PhD
JAMA. 1998;280(23):2001-2007. doi:10.1001/jama.280.23.2001
http://jama.jamanetwork.com/article.aspx?articleid=188274

Effects of stress management training and dietary changes in treating ischemic heart disease.
Ornish D, Scherwitz LW, Doody RS, Kesten D, McLanahan SM, Brown SE, DePuey E, Sonnemaker R, Haynes C, Lester J, McAllister GK, Hall RJ, Burdine JA, Gotto AM Jr.
JAMA. 1983 Jan 7;249(1):54-9.
http://www.ncbi.nlm.nih.gov/pubmed/6336794

Intensive lifestyle changes may affect the progression of prostate cancer.
Ornish D, Weidner G, Fair WR, Marlin R, Pettengill EB, Raisin CJ, Dunn-Emke S, Crutchfield L, Jacobs FN, Barnard RJ, Aronson WJ, McCormac P, McKnight DJ, Fein JD, Dnistrian AM, Weinstein J, Ngo TH, Mendell NR, Carroll PR.
J Urol. 2005 Sep;174(3):1065-9; discussion 1069-70.

The effectiveness and efficacy of an intensive cardiac rehabilitation program in 24 sites.
Silberman A, Banthia R, Estay IS, Kemp C, Studley J, Hareras D, Ornish D.
Am J Health Promot. 2010 Mar-Apr;24(4):260-6.
http://www.ncbi.nlm.nih.gov/pubmed/20232608

Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Ornish D, Lin J, Daubenmier J, Weidner G, Epel E, Kemp C, Magbanua MJ, Marlin R, Yglecias L, Carroll PR, Blackburn EH.
Lancet Oncol. 2008 Nov;9(11):1048-57. Epub 2008 Sep 15.
http://www.ncbi.nlm.nih.gov/pubmed/18799354

Plant-Based Diet


Alternative Medicine

Below is a list of alternative medicine. The most effective and the cheapest option is Plant-based diet:
  • Plant-based diet
  • Naturopathy, or Naturopathic Medicine
  • Traditional Chinese Medicine (TCM), or
    Acupuncture and Chinese Medicine
  • Urine Therapy - Shivambu Shastra


The Last Heart Attack



Bill Clinton heart attack:


View in YouTube

Fight Alzheimer's Disease With Coconut Oil

CBN News Medical Reporter Lorie Johnson shares new hope in the battle against Alzheimer’s Disease on  5 January 2012

Five million people have Alzheimer's disease and that number is expected to increase exponentially as baby boomers enter their golden years. If you have a loved one with this dreaded disease you should know that, in some people, coconut oil slows the progression of Alzheimer's and may also prevent it. One of those people is Steve Newport. His Alzheimer's has slowed considerably. Some of his symptoms even reversed, thanks to the unlikely treatment prescribed by his wife, Dr. Mary Newport, a physician who runs a neonatology ward at a Tampa, Florida, hospital.

Dr. Mary Newport became determined to help her husband after the severity of his disease was revealed upon taking an Alzheimer's test in which the person being tested is asked to draw the face of a clock. "He drew circles and several numbers just in a very random pattern, didn't really look anything like a clock," she said. "And the doctor pulled me over to the side and said, ‘You know, he's actually on the verge of severe Alzheimer's at this point, he's beyond moderate.’ So that was very, very devastating news."

WHAT IS ALZHEIMER’S DISEASE?

Dr. Newport began learning everything she could about her husband's disease. "It appears to be a type of diabetes of the brain and it's a process that starts happening at least 10 or 20 years before you start having symptoms and it's very similar to type 1 or type 2 diabetes in that you develop a problem with insulin." In this case, insulin problems prevent brain cells from accepting glucose, their primary fuel. Without it, they eventually die. But there is an alternative fuel: ketones, which cells easily accept. Ketones are metabolized in the liver after you eat medium-chain triglycerides, like those found in coconut oil.

So Dr. Newport added coconut oil to the diet of her husband, Steve. Just two weeks later, he took the clock test again and demonstrated stunning improvement. Newport said, "I thought at the time, was it just good luck? Was it a lot of prayer? Was it the coconut oil? And I thought, well, we're going to keep the coconut oil going," she said.

Three weeks later Steve took the clock test a third time and continued to perform better on it. And it wasn't just intellectually, he also improved emotionally and physically. "He was not able to run; he was able to run again," she recalled. "He could not read for about a year and a half, but after two or three months, he was able to read. Instead of being very sluggish, not talking very much in the morning, he would come out in the morning with energy, talkative and joking, and he could find his water and his utensils." Steve's success is documented in a book called:

Click image to buy.
Alzheimer's Disease: What If There Was a Cure?
The Story of Ketones by Mary T. Newport, MD
(Copyright © 2011; Published by Basic Health Publications, October 7, 2011).


ANOTHER KETONE SOURCE?

And while coconut oil is encouraging in the battle against Alzheimer's disease, there's something even more powerful available—but at a price. A team of biochemists led by Professor Kieran Clarke at England's Oxford University have developed a ketone ester that packs a punch ten times greater than coconut oil. "It reaches quite considerably higher levels," said Clarke, "and you can get whatever levels you want depending on how much you drink." The problem is, they need millions of dollars to mass-produce it. "It's very expensive. And so we can't make very much of it ourselves," said Clarke. "And what we would like is funding so we could actually scale up and make it. But of course there's no real profit in manufacturing stuff like that, and so people really don't want to fund that sort of thing."

So until a high-potency ketone ester is available to the general public, coconut oil is still a good ketone source. Just make sure it's pure, in other words, non-hydrogenated. Avoid any hydrogenated oil, including hydrogenated coconut oil, because hydrogenated oils are the same thing as dangerous trans fats. Look on the list of ingredients for the word "hydrogenated."

INCREASE YOUR GOOD CHOLESTEROL WITH COCONUT OIL

Some people are afraid to eat coconut oil because they think it's bad for your heart. But it's actually very healthy. Dr. Beverly Teter, lipid biochemist, is a researcher at the University of Maryland who specializes in the area of dietary fat. She says years ago coconut oil was criticized for raising cholesterol. But scientists have since learned there are two kinds of cholesterol: LDL, the bad kind, and HDL, which is very good for you, and is the kind coconut oil raises. "So they put out the message that it increased serum cholesterol," explained Dr. Teter, "but the truth of the matter is, it was helping the profile of the serum cholesterol. That never has been corrected in the public press, and I think that's the reason people have misconceptions about it."

BEYOND ALZHEIMER'S DISEASE

Not only does coconut oil improve cholesterol levels, but Dr. Teter says the way it helps the brains of some Alzheimer's patients can be extended to people with Parkinson's disease, ALS (Lou Gehrig's disease), epilepsy, dementia, and even schizophrenia and autism.

COCONUT OIL—A NATURAL ANTIBIOTIC

Coconut oil is a natural antibiotic but without the negative side effects. Dr. Teter says because of that, it can also help defend against viruses like HIV and herpes viruses. "The coconut oil tends to keep the bacteria down so that if you're assaulted with a virus your immune system can concentrate on the virus. It doesn't have to concentrate on 27 other bacteria that day," she explained.

HAVE OTHERS EXPERIENCED IMPROVEMENTS?

Since the St. Petersburg Times published Dr. Newport’s article "What If There Was a Cure for Alzheimer's Disease and No One Knew?" on October 29, 2008, she has received many reports from caregivers about their loved ones, and has also read on various forums and online message boards about people who have had dramatic improvements like Steve. They include such improvements as: better social interaction, better recognition of loved ones, improved conversation, resumption of activities, better appetite, better sleep, having more energy and being more talkative. Many others experience more subtle improvement or very gradual improvement that turns into very significant improvement over several months. Others feel they see no change, but their loved one has at least stabilized and not worsened. Several people have e- mailed Dr. Newport telling her that until they stopped taking the coconut oil, they did not realize how much the oil was helping them. Dr. Newport recommends that caretakers keep a journal, so that they can decide months down the road if there has been improvement.

She has also heard from some people with diseases other than Alzheimer’s who believe they have seen some improvements, including other forms of dementia (FTD, CBD), Parkinson’s, ALS (Lou Gehrig’s), Huntington’s, MS, bipolar disease, even glaucoma and macular degeneration (which affect neurons).

STEVE'S DIET

Dr. Newport has received many thank-you letters from people whose loved ones with Alzheimer’s were helped after they followed Steve's diet. Dr. Newport explained the overall eating plan she and her husband follow in addition to adding coconut and MCT oils to their daily diet: “We adhere to a ‘whole food’ diet, and avoid processed foods, and reduce carbohydrate intake overall. We eat fish several times a week; poultry, occasional beef, fresh, or fresh frozen, fruits and vegetables; whole grain bread, rice or pasta (relatively small amounts); eggs, whole dairy, goat milk/cheese, coconut oil and coconut milk. For lunch meats we eat ‘all natural’ brands that have no artificial color or preservatives. We buy organic, cage-free, or free-range whenever possible. We do have the occasional treat but overall we stick with this program.” Dr. Newport adds, “Using coconut oil capsules is not an efficient way to give the oil since the capsules are relatively expensive and contain only 1 gram of oil per capsule, whereas the oil is 14 grams per tablespoon.”

STEVE’S OTHER SUPPLEMENTS

In addition to taking coconut/MCT oil, Steve also takes a combination of fish oil and cod liver oil (rich in vitamins A and D). It’s been shown that people with Alzheimer’s disease as a group are deficient in DHA (an omega-3 fatty acid) and DHA is a large component of the brain and crucial to its normal functioning. Dr. Newport referred to a study that showed that people with Alzheimer’s may be deficient in an enzyme in the liver that converts the shorter vegetable form of omega-3 fatty acids found in soybean and flax oils to the DHA and EPA forms of omega-3 fatty acids needed by the brain and other organs. Therefore she believes that it is important to include a marine source of omega-3 fatty acids in the diet. She recommends an algae form marketed to pregnant women, available in pharmacies, to those who have a problem taking fish oil. Coconut oil contains some omega-6, but no omega-3 fatty acids.

INCORPORATING COCONUT OIL INTO YOUR DIET

According to Dr. Newport, coconut oil can be substituted for any solid or liquid oil, lard, butter or margarine in baking or cooking on the stove, and can be mixed directly into foods already prepared. Some people take it straight with a spoon, but for most people it may be hard to swallow this way and more pleasant to take with food. When cooking on the stove, coconut oil smokes if heated to greater than 350 degrees F. or medium heat. You can avoid this problem by adding a little olive or peanut oil. Coconut oil can be used at any temperature in the oven when mixed in foods.

Coconut milk is a combination of the oil and the water from the coconut and most of the calories are from the oil. Look for brands with 10 to 13 grams of fat in 2 ounces. Look in the grocery store’s Asian section. Some brands are less expensive but are diluted with water. Coconut cream is mostly coconut milk and sometimes has added sugar. Flaked or grated coconut can be purchased unsweetened or sweetened and is a very good source of coconut oil and fiber and has about 15 grams oil and 3 grams fiber in ¼ cup. Frozen or canned coconut meat usually has a lot of added sugar and not much oil per serving. A fresh coconut can be cut up into pieces and eaten raw. A 2” x 2” piece has about 160 calories with 15 grams of oil and 4 grams of fiber. MCT Oil (medium-chain triglycerides) are part of the coconut oil and can also be purchased in some health food stores or online. This may be useful for people who are on the go and do not have much time to cook. Also, MCT oil is used as energy and not stored as fat, so it may be useful for someone who wants to lose weight, if substituted for some of the other fats in the diet. Coconut water does not usually contain coconut oil, but has other health benefits. The electrolyte composition is similar to human plasma and is useful to prevent or treat dehydration.

The above nutrition and research information along with support information for caretakers, recipes, and so much more are available at Dr. Newport’s website www.coconutketones.com.

Sources of information used in the creation of this edition of A Closer Look include the book Alzheimer's disease: What If There Was a Cure? The Story of Ketones by Mary T. Newport, MD (Copyright © 2011; Published by Basic Health Publications, October 7, 2011), Dr. Mary Newport’s blog: Coconut Oil and Ketones, and the CBN News story "Coconut Oil" by medical reporter Lorie Johnson that first aired on January 5, 2012.

Resources:

A Case Study by Dr. Mary Newport, 2008 July 22, "What If There Was a Cure for Alzheimer's Disease... and No One Knew?", http://www.coconutketones.com/whatifcure.pdf (Accessed 2012/08/01)

Bibliography

Books

The Blue Zone: Lessons for Living Longer From the People Who've Lived The Longest, by Dan Buettner

Eat This Not That! for Kids!: Be the Leanest, Fittest Family on the Block! (Paperback) by David Zinczenko

Beating Cancer with Nutrition, book with CD by Patrick Quillin (May 20, 2005)


Arcticles/Reports

The Influence of Food Cooking on the Blood Formula of Man by Paul Kouchakoff (Suisse), M.D. of the Institute of Clinical Chemistry, Lausanne, Switzerland. Proceedings: First International Congress of Microbiology, Paris 1930.

Cancer Update From Johns Hopkins - Email Hoax by The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System at www.hopkinsmedicine.org (Accessed 2012/08/01)

Oxygen Therapy, American Cancer Society, www.cancer.org


Organizations

American Cancer Society
RSShttp://www.cancer.org/rss/index

The Blue Zones
RSS: http://www.bluezones.com/feed/

Take Control of Your Health by Dr Joseph Mercola, www.mercola.com
RSS: http://articles.mercola.com/sites/articles/rss.aspx

Natural News Network, www.naturalnews.com
RSS: http://www.naturalnews.com/Index-Feeds.html

Agricultural Research Service, United States Department of Agriculture
RSS: http://www.ars.usda.gov/News/docs.htm?docid=6697

United States Department of Agriculture, US National Nutrient Database,
http://ndb.nal.usda.gov/ndb/foods/list

T. Colin Campbell Foundation, health benefits of a whole food, plant-based diethttp://www.tcolincampbell.org

Singapore

Food Safety, Agri-Food and Veterinary Authority (AVA) ensures the safety of all food from production to just before retail.  http://www.ava.gov.sg/

Consumer Alerts, Consumers Association of Singapore
http://www.case.org.sg/consumer_alerts.html (Accessed 2012/08/01) 


Web-based Health Information

Consumer Lab: www.consumerlab.com. Provides independent test results on hundreds of vitamins, herbs and natural products to help consumers and doctors eveluate their nutritional content

Singapore

http://www.nutrition.com.sg
Fast Food Facts - http://www.nutrition.com.sg/do/dofastfood.asp
Local Foods - http://www.nutrition.com.sg/do/dolocal.asp

Recommended Dietary Allowances (RDA)

  • Singapore Health Promotion Board,  http://www.hpb.gov.sg/HOPPortal/article?id=2652 (Accessed 2012/08/01)
  • Nutrient Reference Values for Australia and New Zealand,  http://www.health.govt.nz/publication/nutrient-reference-values-australia-and-new-zealand  (Accessed 2012/08/01)
  • Indian RDAs -
  • Thailand RDAs - 
  • ...

Online Pharmacy

  • National Healthcare Group, Online Pharmacy, www.pharmacy.nhg.com.sg

Conventional Medicine

  • Angiogenesis Foundation, http://www.angio.org
    Southeast Asia: http://www.clinicaltrials.gov/ct2/results/map/click?map.x=621&map.y=252&term=Angiogenesis
     
  • Eat to Defeat Cancer, Anti-angiogenesis from nutritions, http://www.eattodefeat.org

      GLOSSARY

      Terms here are defined in the context of this Site. Some terms may have other meanings in other contexts.
      Absorption
      The movement of nutrients and other food constituents from the gut into the blood.
      Acid-base balance
      The appropriate acidity of the blood and tissues. Abnormal acid-base balance may indicate a change in respiratory or metabolic status.
      Adduct (see DNA adduct)
      Adenocarcinoma
      Cancer of glandular epithelial cells.
      Adenosine triphosphate (ATP)
      The principal molecule used for storage and transfer of energy in metabolic processes.
      Adipose tissue
      Body fat. Tissue comprising mainly cells (adipocytes) containing triglyceride. It acts as an energy reserve, provides insulation and protection, and secretes metabolically active hormones.
      Adiposity rebound
      The age at which body mass index (BMI) increases after reaching a nadir at around 4–6 years of age. Earlier age of adiposity rebound has been linked to later development of obesity.
      Adjustment
      A statistical tool for taking into account the effect of known confounders (see reference 3.1).
      Adrenarche
      The period, typically between age 6 and 10 years, characterised by an increase in secretion of androgens from the adrenal cortex. Aerobic metabolism The normal process of producing ATP as a source of energy using oxygen. Aflatoxins Naturally-occurring mycotoxins that are produced by many species of Aspergillus, afungus, most notably Aspergillus flavus and Aspergillus parasiticus. Aflatoxins are toxic and carcinogenic to animals, including humans (see reference 4.1.4).
      Age-adjusted incidence
      The number of events in a population, usually expressed per 100,000 people, over a defined period of time, adjusted for the varying proportion of people in each age group between populations and over time. It allows for comparisons between countries with different age structures (see reference 7.1.1).
      Alpha-linolenic acid
      An essential n-3 polyunsaturated fatty acid (C18:3 n3).
      Amenorrhoea
      The absence of menstruation.
      Amino acid
      An organic compound containing an amino group and a carreferenceylic acid group. The basic building blocks of proteins such as enzymes.
      Anaerobic metabolism
      The process of producing ATP as a source of energy without oxygen, resulting in lactic acid accumulation.
      Androgen
      Any masculinising sex hormone, such as testosterone.
      Angiogenesis
      The process of generating new blood vessels.
      Antioxidants
      Any substance that inhibits oxidation or traps or quenches reactive oxygen species generated during metabolism. Anthropometric measures Measures of body dimensions. ATP (see adenosine triphosphate)Basal energy expenditure (see basal metabolic rate)
      Basal metabolic rate (BMR)
      The amount of energy required to maintain the essential body functions in resting and fasting conditions, expressed as megajoules, kilojoules, or kilocalories per minute, hour, or day.
      Begg’s test
      A statistical test for small study effects such as publication bias.
      Beta-glucans
      Non-starch polysaccharides composed of glucose subunits linked in such a way as to render them indigestible by pancreatic amylase. A major component of the cell wall polysaccharides of oats (see non-starch polysaccharides and dietary fibre).
      Bias
      In epidemiology, deviation of an observed result from the true value in a particular direction (systematic error) due to factors pertaining to the observer or to study design or analysis. See also selection bias.
      Bile
      A greenish-yellow fluid secreted by the liver and stored in the gallbladder. Bile plays an important role in the intestinal absorption of fats. Bile contains cholesterol, bile salts, and waste products such as bilirubin.
      Biliary tract
      The biliary tract includes the bile ducts within the liver, the common bile duct, which connects the liver and gallbladder to the small intestine, and the cystic duct, which connects the gallbladder to the common bile duct.
      Bioavailability
      The degree to which a nutrient (or other substance) can be absorbed and used by the body.
      BMI (see body mass index)
      BMR (see basal metabolic rate)
      Body mass index (BMI)
      Body weight expressed in kilograms divided by the square of height expressed in metres (BMI = kg/m2). It provides an indirect measure of body fatness. Also called Quetelet’s Index.
      Caffeine
      An alkaloid found in coffee, tea, kola nuts, chocolate, and other foods that acts as a stimulant and a diuretic.
      Cancer survivor
      Any person who has received a diagnosis of cancer
      Cantonese-style salted fish
      Fish that has been treated with varying amounts of salt and dried in natural conditions outdoors. It is characterised by treatment with less salt than typically used and is also subject to fermentation duringthe drying process due to relatively high outdoor temperature and moisture levels (see reference 4.3.5).
      Carcinogen
      Any substance or agent capable of causing cancer.
      Carcinoma
      Malignant tumour derived from epithelial cells, usually with the ability to spread into the surrounding tissue (invasion) and produce secondary tumours (metastases).
      Carcinoma in situ
      The first stage of carcinoma in which the malignant tumour has not spread beyond the epithelium.
      Cardiovascular disease
      A group of diseases that involve the heart and/or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system, it is usually used to refer to those related to atherosclerosis.
      Case-control study
      An epidemiological study in which the participants are chosen based on their disease or condition (cases) or lack of it (controls) to test whether past or recent history of an exposure such as smoking, genetic profile, alcohol consumption, or dietary intake is associated with the risk of disease (see reference 3.4).
      CE
      Common Era — the period of measured time beginning with the year one on the Gregorian calendar. The notations CE and BCE (Before Common Era) are alternative notations for AD and BC, respectively.
      Cell cycle
      The sequence of stages that a cell passes through between one cell division and the next.
      Cell signalling
      Mechanisms whereby cells send messages to, or respond to external stimuli from, other cells.
      Cerebrovascular disease
      A group of diseases of the brain due to damage to the blood vessels, in which an area of the brain is transiently or permanently affected by ischaemia or bleeding.
      Cholesterol
      The principal sterol in animal tissues, synthesised in the body; an essential component of cell membranes and the precursor of the steroid hormones and vitamin D.
      Chromatin
      Mass of genetic material in the nucleus of a cell, composed of DNA and proteins that condense to form chromosomes.
      Chronic disease
      A disease that develops or persists over a long period of time. Includes noncommunicable diseases such as cancer, cardiovascular disease, and diabetes, and some infectious diseases such as tuberculosis.
      CI (see confidence interval)
      Coeliac disease
      Intolerance to the gliadin fraction of the protein gluten from wheat, rye, and barley. The villi of the small intestine atrophy and nutrient absorption from food is poor. Stools are often bulky and contain a large amount of unabsorbed fat.
      Cohort study
      A study of a (usually large) group of people whose characteristics are recorded at recruitment (and sometimes later), followed up for a period of time during which outcomes of interest are noted. Differences inthe frequency of outcomes (such as disease) within the cohort are calculated in relation to different levels of exposure to factors of interest, for example smoking, alcohol consumption, diet, and exercise. Differencesin the likelihood of a particular outcome are presented as the relative risk comparing one level of exposure to another (see reference 3.4).
      Compliance
      The extent to which people such as study participants follow an allocated treatment programme.
      Computed tomography (CT)
      A form of X-ray that produces cross-sectional or other images of the body.
      Confidence interval (CI)
      A measure of the uncertainty in an estimate, usually reported as 95% confidence interval (CI), which is the range of values within which there is a 95% chance that the true value lies. For example the effect of smoking on the relative risk of lung cancer in one study may be expressed as 10 (95% CI 5–15). This means that in this particular analysis, the estimate of the relative risk was calculated as 10, and that there is a 95% chance that the true value lies between 5 and 15.
      Confounder
      A variable, within a specific epidemiological study, that is associated with an exposure, is also a risk factor for the disease, and is not in the causal pathway from the exposure to the disease. If not adjusted for, this factor may distort the apparent exposure–disease relationship. An example is that smoking is related both to coffee drinking and to risk of lung cancer and thus, unless accounted for (controlled) in studies, might make coffee drinking appear falsely as a possible cause of lung cancer (see reference 3.1).
      Confounding factor (see confounder)
      Confounding variable (see confounder)
      Cretinism
      Underactivity of the thyroid gland (hypothyroidism) in infancy, resulting in poor growth, severe mental retardation, and deafness.
      CT (see computed tomography)
      Curing
      Various preservation and flavouring processes, especially of meat or fish, by the addition of a combination of salt, sugar, and either nitrate or nitrite. Curing processes often involve smoking. The addition of saltpetre (sodium nitrate) gives a pinkish colour to meat. Bacteria convert the nitrates in cured meats to nitrites and nitrosamines, which are potentially carcinogenic to humans (see reference 4.3.2).
      Cytotoxic
      Poisonous to living cells.
      Deoxyribonucleic acid (DNA)
      The double-stranded, helical molecular chain found within the nucleus of each cell that carries the genetic information.
      DEXA (see dual energy X-ray absorptiometry)
      Diabetes mellitus
      A metabolic disorder involving impairedmetabolism of glucose due either to failure ofsecretion of the hormone insulin (type 1diabetes) or to impaired responses of tissues toinsulin (type 2 diabetes), which results incomplications including kidney failure,blindness, and increased risk ofcardiovascular disease.
      Dietary fibre
      Constituents of plant cell walls that are notdigested in the small intestine. Severalmethods of analysis are used, which identifydifferent components. The many constituentsthat are variously included in the definitionshave different chemical and physiologicalfeatures that are not easily defined under asingle term. The different analytical methodsdo not generally characterise the physiologicalimpact of foods or diets. Non-starchpolysaccharides are a consistent feature andare fermented by colonic bacteria to produceenergy and short chain fatty acids includingbutyrate. The term dietary fibre is increasinglyseen as a concept describing a particular aspectof some dietary patterns (see reference 4.1.2).
      Dietary supplement
      A substance, often in tablet or capsule form,which is consumed in addition to the usualdiet. Dietary supplements typically refer tovitamins or minerals, thoughphytochemicals or other substances may beincluded.
      Differentiation
      The process of development of cells to take onthe structural and functional characteristicsspecific to a particular tissue. Also, the degreeto which tumour cells have the structure orfunction of the organ from which the tumourarose. Tumours can be described as well,moderately, or poorly differentiated: welldifferentiatedtumours appear similar to thecells of the organ in which they arose; poorlydifferentiated tumours do not. The degree ofdifferentiation is often of prognosticsignificance.
      Disaccharide
      A carbohydrate composed of twomonosaccharides.
      Diverticular disease
      The presence of pouch-like hernias(diverticula) through the muscle layer of thecolon, associated with a low intake of dietaryfibre and high intestinal pressure due tostraining. Faecal matter may be trapped inthese diverticula, causing them to becomeinflamed, causing pain and diarrhoea(diverticulitis).
      DNA (see deoxyribonucleic acid)
      DNA adducts
      DNA adducts are compounds formed by thereaction of a chemical with DNA, which maydamage the DNA. If repaired, some adductscan be excreted and measured in the urine as amarker of DNA damage. If not repaired, DNAmay function abnormally and may thereforebe a stage in carcinogenesis.
      Docosahexaenoic acid (DHA)
      A long-chain n-3 polyunsaturated fatty acid (C22:6 n3).
      Dose response
      A term derived from pharmacology thatdescribes the degree to which an effectchanges with the level of an exposure, forinstance the intake of a drug or food (see reference3.2).
      Double bond
      A covalent bond between two carbon atomseach with one hydrogen atom, for instance infatty acids.
      Dual energy X-ray absorptiometry (DEXA)
      A means of measuring the density of differentbody tissues such as bone or fat, using two Xraybeams with differing energy levels.
      Dyslipidaemia
      Any disorder of lipoprotein metabolismresulting in abnormal plasma concentrationsor forms of lipoprotein, such as high total orlow-density lipoprotein (LDL) cholesterolor triglyceride, and low high-densitylipoprotein (HDL) cholesterol concentrations.
      Dysplasia
      Abnormal development of the cells of a tissue.
      Ecological study
      A study in which differences in patterns of exposure, for instance in consumption of a particular nutrient or food, are compared at aggregate level, with populations (rather than individuals) as the unit of analysis (see reference 3.4).
      Egger’s test
      A statistical test for small study effects such as publication bias.
      Eicosapentaenoic acid (EPA)
      A long-chain n-3 polyunsaturated fatty acid(C20:5 n3).
      Effect modifier/effect modification
      Effect modification (or effect-measure modification) occurs when a measure of effectfor an exposure changes over levels of another variable (the modifier) (see reference 3.6).

      Emulsifier
      A substance that promotes the formation of astable mixture, or emulsion, of two substancesthat do not normally mix well (for example oiland water).
      Endocrine
      Referring to organs or glands that secretehormones into the blood.
      Energy
      Energy, measured as calories or joules, isrequired for all metabolic processes. Fats,carbohydrates, proteins, and alcohol fromfoods and drinks release energy when they aremetabolised in the body.
      Energy adjustment
      The use of statistical methods to ‘adjust’intakes of a dietary factor under study for total energy intake (see reference 3.7).
      Energy balance
      The state in which the total energy absorbed from foods and drinks equals total energy expended. Also the degree to which intake exceeds expenditure (positive energy balance)or expenditure exceeds intake (negative energy balance).
      Enzyme
      A protein that acts as a catalyst in living organisms, promoting chemical reactions andregulating the rate at which they proceed.
      Epidemic
      A widespread or rapidly spreading disease that affects many individuals in a population at thesame time, markedly in excess of the number normally expected.
      Epigenetic
      Relating to the control of gene expression through mechanisms that do not depend onchanges in the nucleotide sequence of DNA,for example through methylation of DNA oracetylation of histone.
      Epithelial (see epithelium)
      Epithelial-mesenchymal transition (EMT)
      A disorder of cell differentiation where cellsassume a mesenchymal rather than anepithelial phenotype. Cancer cells may have phenotypic similarities to EMT.
      Epithelium
      The layer of cells covering internal andexternal surfaces of the body, including theskin and mucous membranes lining body cavities such as the lung, gut, and urinary tract.
      Essential amino acid
      An amino acid that is required for normal cellular structure and metabolic function but which humans cannot synthesise and so mustobtain from food.
      Evidence
      Information that helps to determine whethera proposal or belief is true or valid, or false orinvalid.
      Exercise
      A type of physical activity, often deliberatesuch as sport, which improves fitness or health.
      Exposure
      A factor to which an individual may beexposed to varying degrees, such as intake ofa food, level or type of physical activity, oraspect of body composition.
      Extracellular fluid
      All body fluid not contained within cells.Includes the fluid in blood vessels (plasma) and between cells (interstitial fluid).
      Factor analysis
      A statistical technique used to examine thestructure underlying the interactions betweenseveral variables.
      Fat-free mass
      The mass of all body tissue excluding the lipidcomponents.
      Fatty acid
      A carreferenceylic acid with a carbon chain ofvarying length, which may be either saturated(no double bonds) or unsaturated (one ormore double bonds). Three fatty acid sattached to a glycerol backbone make up atriglyceride, the usual form of fat in foods and adipose tissue.
      Fermentation
      The anaerobic metabolic breakdown ofmolecules such as glucose. Fermentation yieldsenergy in the form of lactate, acetate,ethanol, or other simple product.Fetal programming (see programming)
      Food systems
      The interconnected agricultural, ecological,economic, social, cultural, and technologicalsystems involved in food production,distribution, and consumption.
      Forest plot
      A simple visual representation of the amountof variation between the results of theindividual studies in a meta-analysis. Theirconstruction begins with plotting the observed exposure effect of each individualstudy, which is represented as the centre of a square. Horizontal lines run through this toshow the 95% confidence interval. Different sized squares may be plotted for each of theindividual studies, the size of the referenceincreasing with the size of the study and theweight that it takes in the analysis. The overallsummary estimate of effect and its confidenceinterval can also be added to the bottom ofthis plot, if appropriate, and this isrepresented as a diamond. The centre of thediamond is the pooled summary estimate andthe horizontal tips are the confidence intervals(see reference 3.3).
      Fortification
      The deliberate addition of nutrients to foodsor drinks as a means of increasing the level ofintake in a population (see reference 4.10.1).
      Functional food
      Any food, similar in appearance toconventional food, claiming to have specific physiological effects that benefit healthand/or reduce the risk of disease. Products aresometimes sold in medicinal forms (see reference4.10.2).
      Gene expression
      The active production of the RNA and proteinthat are coded for by a particular gene. In any cell, not all genes are expressed (seeepigenetic).
      Genetic modification
      The manipulation of a living organism’sgenetic material by eliminating, modifying, oradding copies of specific genes, often fromother organisms. Also known as ‘geneticengineering’.
      Germ cell (see germ line)
      Germ line
      Eggs and sperm and the cells that develop intothem, through which genetic information ispassed from generation to generation.
      Genotype
      The genetic makeup of a cell or organism.
      GH (see growth hormone)
      Gleason score
      A quantitative measure of the degree ofdifferentiation of prostate cancers. HighGleason scores, representing aggressivedisease, are associated with poor prognoses.Whitemore and Jewett scales are used toassess prostate cancer stage.
      Glycaemic index
      A system for ranking foods containingcarbohydrates according to the effect of astandard amount on blood glucose levels.Foods that raise the blood sugar the mosthave the highest glycaemic index (see reference4.1.3).
      Glycaemic load
      The glycaemic index of a food multiplied bythe number of grams of carbohydrate in theserving of food (see reference 4.1.3).
      Glycerol
      A three-carbon molecule that forms thebackbone of triglyceride in fats (see fattyacid).
      Goitre
      Enlargement of the thyroid gland, seen as aswelling in the neck; may be hypothyroid, withlow production of thyroid hormone,euthyroid (normal levels), or hyperthyroid(excessive production). Deficiency of iodine isone cause.
      Gross domestic product
      The total market value of all the goods andservices produced within a nation in a givenyear.
      Growth hormone (GH)
      Also known as somatotropin, a hormonesecreted by the pituitary gland that stimulatessecretion of growth factors from the liver andso also protein synthesis and growth of thelong bones in the legs and arms. It alsopromotes the breakdown and use of fattyacids, rather than glucose, as an energysource.
      Haem
      The part of the organic molecule haemoglobinin red blood cells containing iron to whichoxygen binds for transport around the body.
      Herbicide
      A pesticide used to kill or control the growthof unwanted plants. Selective herbicides killcertain targets while leaving a desired croprelatively unharmed. Non-selective herbicideskill every plant with which they come intocontact.
      Heterocyclic amines
      A family of compounds formed from proteinand sugars in meat, chicken, and fish cookedat very high temperatures by grilling (broiling)or frying that have potential carcinogeniceffects (see reference 4.3.4).
      Heterogeneity
      A measure of difference between the resultsof different studies addressing a similarquestion. In meta-analysis, the degree ofheterogeneity may be calculated statisticallyusing the I2 test.
      High fructose corn syrup (HFCS)
      A form of corn syrup that has undergoneenzymatic processing in order to increase itsfructose content. Used to sweeten soft drinks,juices, ice cream, and many other processedfoods, especially in the USA (see reference 4.6.1).
      High-income countries
      Countries with a gross average annualnational product of more than an agreedfigure per head (in 2006 this was more than$US 10 726). This term is less judgemental andmore descriptive than ‘economicallydeveloped’ countries.
      Homeostasis
      The maintenance of biological conditions in astable state.
      Hormone
      A substance secreted by specialised cells thataffects the structure and/or function of othercells or tissues in another part of the body.
      Hydrogenation
      The process by which unsaturated fatty acidsin vegetable oils are made more saturated bythe addition of hydrogen. This makes liquidoils more solid at room temperature and moreresistant to oxidation, for instance in themanufacture of margarines. Incompletehydrogenation can lead to the formation oftrans-fatty acids (see reference 4.5.1).
      Hyperkeratosis
      Excessive thickening of the outer horny layerof the skin, affecting the palms and soles.
      Hyperplasia
      An increase in the number of cells in a tissue.
      Hypertension
      High blood pressure; a risk factor forcardiovascular and kidney disease.
      Hypoxia
      Abnormally low levels of oxygen in blood ortissues.
      IARC
      International Agency for Research on Cancer(www.iarc.fr).
      IGF binding proteins
      Proteins that bind to insulin-like growthfactors (which are implicated in the cancerprocess, see Chapter 2) in the bloodstream.
      Immune response
      The production of antibodies or specialisedcells in response to foreign proteins or othersubstances.
      Incidence rates
      The number of new cases of a conditionappearing during a specified period of timeexpressed relative to the size of thepopulation, for example 60 new cases ofbreast cancer per 100 000 women per year.
      Inflammation
      The immunologic response of tissues to injuryor infection. Inflammation is characterised byaccumulation of white blood cells thatproduce several bioactive chemicals, causingredness, pain, and swelling.
      Inflammatory bowel disease
      A term used to describe Crohn’s disease andulcerative colitis: both are characterised bychronic inflammation of the gut.
      Insulin
      A protein hormone secreted by the pancreasthat promotes the uptake and utilisation ofglucose, particularly in the liver and muscles.Inadequate secretion of, or tissue response to,insulin leads to diabetes mellitus.
      Intrinsic sugars
      Sugars naturally integrated into the cellularstructure of foods, for example those presentin unprocessed fruits and vegetables.
      Intra-abdominal fat
      Also known as visceral fat. Fat stored withinthe abdomen surrounding the internal organs(see adipose tissue).
      In utero
      In the uterus; refers to events that occurbefore birth.
      Invasive cancer
      Tumours that spread into surrounding healthytissue.
      Iron-deficiency anaemia
      A low blood concentration of haemoglobindue to a deficiency of iron, due either tounusually high demands or low intake orimpaired absorption.
      Irradiation
      Exposure to ionising radiation. Foodirradiation is used to disinfest, sterilise, orpreserve food.
      Jewett scale (see Whitemore and Jewett scales)
      K-ras
      One of a class of genes (proto-oncogenes)which when mutated can malfunction tobecome an oncogene, promoting thetransformation of normal cells into cancer cells(see reference 2.2).
      Lactation
      The production and secretion of milk by themammary glands.
      Lacto-ovo-vegetarian diet
      A vegetarian diet characterised by theinclusion of eggs and dairy products, but noother animal products.
      Latency
      The period of time between the onset of adisease process and its detection or clinicalappearance.
      Lean body mass
      The mass of those parts of the body that arenot adipose tissue. Lean body mass includessome lipid and is not synonymous with fatfreemass.
      Lesion
      A general term for any abnormality of cells ortissues, including those due to cancerouschange.
      Linoleic acid
      An essential n-6 polyunsaturated fatty acid(C18:2 n6).
      Lipids
      Naturally occurring organic molecules that areinsoluble in water, including triglycerides;fatty acids; phospholipids; lipoproteins;carotenoids; cholesterol, which is aprecursor of steroid hormones and vitaminD; and the other fat-soluble vitamins A, E, andK. Lipids are an essential component of cellmembranes and many metabolic processes.
      Low-density lipoprotein (LDL) cholesterol
      A class of lipoproteins that is the major carrierof cholesterol in the blood in humans. A highblood LDL cholesterol concentration is a causeof coronary artery disease.
      Low-income countries
      Countries with a gross average annualnational product of less than an agreedfigure per head (in 2006 this was $US 875).This term is less judgemental and moredescriptive than ‘economically developing’countries.
      Lymphocyte
      Several types of white blood cell, part of theimmune system, found in the blood and lymphglands.
      Macronutrient
      Those nutrient components of the diet thatprovide energy: carbohydrate, fat, andprotein; ethanol also provides energy but isnot a nutrient.
      Magnetic resonance imaging (MRI)
      A technique that produces images of parts ofthe body using analysis of the behaviour ofwater molecules within body tissues whenplaced in a strong magnetic field.
      Malignant
      A tumour with the capacity to spread tosurrounding tissue or to other sites in thebody.
      Melanoma
      Malignant tumour of the skin derived fromthe pigment-producing cells (melanocytes).Membrane potentialThe difference in electrical charge across thecell membrane.
      Menarche
      The beginning of menstruation (see referencees 6.1and 6.2).
      MET (see metabolic equivalent)
      Meta-analysis
      The process of using statistical methods tocombine the results of different studies.
      Metabolic equivalent (MET)
      One MET equals the resting metabolic rate,measured as the rate of oxygen consumption,which is approximately 3.5 millilitres of oxygenper kilogram body weight per minute.Equivalent to physical activity ratio (see reference5.1).
      Metabolic syndrome
      A common cluster of a variety of several riskfactors for cardiovascular disease includinginsulin resistance, abdominal obesity, highblood pressure, and abnormal blood lipids.
      Metastasis
      The spread of malignant cancer cells todistant locations around the body from theoriginal site.
      Micronutrients
      Vitamins and minerals present in foods andrequired in the diet for normal body functionin small quantities, conventionally of less than1 g/day (see reference 4.2.3).
      Migrant study
      A study of people who migrate from onecountry to other countries with differentenvironments and cultural backgrounds. Theexperience, such as mortality or diseaseincidence, of the migrant group is comparedwith that of people in their current country ofresidence and in their country of origin.
      Mineral
      An inorganic compound in food required bythe body for normal function, such as calcium,magnesium, and iron.
      Monosaccharide
      Simple sugar consisting of a single sugarmolecule, such as glucose, fructose, andgalactose. They form the basis ofdisaccharides such as sucrose, and ofoligosaccharides, starch, and non-starchpolysaccharides.
      MRI (see magnetic resonance imaging)
      Mucosal
      Relating to mucous membranes.
      Mutagens
      Chemical compounds or physical agentscapable of inducing genetic mutations.
      Mycotoxins
      Toxins produced by fungi (moulds), especiallyAspergillus flavus under tropical conditionsand Penicillium and Fusarium species undertemperate conditions (see reference 4.1.4).
      Neoplasm
      A benign or malignant tumour.
      Nested case-control study
      A case-control study in which cases andcontrols are drawn from the population of acohort study; often used for studies ofprospectively collected information orbiological samples.
      Neurotransmitter
      A chemical secreted by one nerve cell thatstimulates a response in a neighbouring nervecell.
      Night blindness
      A condition in which a person has impairedvision in the dark, characteristic of vitamin Adeficiency.
      Nitrate
      A salt containing the nitrate ion, whichcontains nitrogen and oxygen in proportion1:3 (NO3). Derived from decomposing organicmaterial such as manure, plants, and humanwaste, and a component of chemical fertilisers(see reference 4.3.2).
      Nitrite
      A salt containing the nitrite ion, whichcontains nitrogen and oxygen in proportion1:2 (NO2). Sodium nitrite is added to manyprocessed meats. Nitrites are also formed inthe body from nitrates in plant foods that areeaten. When consumed, nitrites can lead tothe generation of N-nitroso compounds,some of which are known carcinogens (seereference 4.3.2).
      Nitrosamines
      A group of chemicals formed by the reactionof nitrites with amines; some nitrosaminesare carcinogens (see reference 4.3.2).N-nitroso compound (see nitrosamines)
      Non-caloric sweetener
      A food additive that replicates the sweetnessof sugar but with negligible food energy (seereference 4.6.2).
      Non-exercise activity thermogenesis (NEAT)
      The energy used in non-conscious orspontaneous physical activity, such asfidgeting and posture maintenance.
      Non-milk extrinsic sugars
      Sugars not present within the cellularstructure of foods, apart from those in milk ormilk products. For example those added tofoods or in juices, syrups, or honey.
      Non-starch polysaccharide
      A carbohydrate comprising at least 10 simplesugar molecules; a major component of plantcell walls and the principal analytic fractioncharacterising dietary fibre (see reference 4.1.2).
      Nucleic acid
      The four building blocks of DNA – guanine,thymine, cytosine, and adenine.
      Nutrient
      A substance present in food and required bythe body for maintenance of normal structureand function, and for growth anddevelopment. Nutrients includemacronutrients (fat, protein, andcarbohydrate), which provide energy as wellas performing metabolic and structuralfunctions, and micronutrients (vitamins andminerals), which do not provide energy butare necessary for normal metabolic function.
      Obesity
      Excess body fat to a degree that increases therisk of various diseases. Conventionallydefined as a BMI of 30 kg/m2 or more.Different cut-off points have been proposedfor specific populations.
      Odds ratio
      A measure of the risk of an outcome such ascancer, associated with an exposure ofinterest, used in case-control studies;approximately equivalent to the relative risk.
      Oligosaccharide
      A compound comprising between 2 and 10simple sugar molecules (monosaccharides).
      Oncogene
      A gene whose protein product contributes tothe transformation of normal cells into cancercells. Oncogenes result from the mutation ofnormal genes called proto-oncogenes (see reference2.2).
      Organic compounds
      Any member of a large class of chemicalcompounds whose molecules contain carbon(and other elements), with exception ofcarbides, carbonates, and carbon oxides. Mostoccur naturally only in the bodies andproducts of living organisms.
      Organic farming
      Agricultural production system without orwith only limited use of pesticides, syntheticfertilisers, growth regulators, and livestockfeed additives (see reference 4.9.2).
      Osteomalacia
      A disease due to vitamin D deficiencycharacterised by inadequate bonemineralisation, pain, and increased bonefragility.
      Osteoporosis
      Loss of the tissues of bone (bone cells, mineral,and protein) to an extent that increases therisk of fracture.
      Oxidative damage
      Damage to cells or structures in cells caused byoxidation, either by chemicals or by radiation.Some oxidants are generated in the normalcourse of metabolism. Oxidation of DNA isone cause of mutation.p53A protein central to regulation of cell growth.Mutations of the p53 gene are importantcauses of cancer (see oncogene and reference 2.2).
      Pasteurisation
      Partial sterilisation of foods at atemperature that destroys microorganismssuch as bacteria, viruses, moulds, yeast, andprotozoa without major changes in thechemistry of the food.
      Pathogenesis
      The origin and development of disease. Themechanisms by which causal factors increasethe risk of disease.
      Pedometer
      An instrument that records the number ofsteps taken.
      Peer review
      The scrutiny of scientific papers by one ormore suitably qualified scientists.
      Pentosan
      A polysaccharide composed of pentosesugars (with a ring comprising 5 carbonatoms), for example arabans or xylans.
      Phenotype
      The characteristics displayed by an organism;this depends on both the genotype andenvironmental factors.
      Phosphorylation
      Addition of phosphate groups to hydroxylgroups on proteins, catalysed by a proteinkinase with ATP as phosphate donor. A keyprocess in cell signalling and energytransfer.
      Physical activity
      Any movement using skeletal muscles.
      Physical activity level (PAL)
      Energy expenditure per day as a multiple ofbasal metabolic rate (BMR) (see reference 5.2).
      Physical activity ratio (PAR)
      The energy cost of an activity per minutedivided by the energy cost of basalmetabolic rate per minute. Thus, the energycost of sitting at rest is about 1.2; for walkingat a normal pace, 4; and for jogging, 7.
      Phytochemicals
      Compounds found in plants not required fornormal structure or function, which maymodify physiological functions and influencehealth (see reference 4.2.1).
      Point estimate
      An estimate that is reported as a single value.The precision of a point estimate is indicatedby the width of the confidence interval thatsurrounds it.
      Point mutation
      Mutation of a single DNA base in a gene oftenleading to a single peptide change in aprotein, which can influence its function.
      Polycyclic aromatic hydrocarbons
      A family of chemical compounds, includingseveral known carcinogens, formed byincomplete combustion of organic substancessuch as wood, coal, diesel, fat, or tobacco (seereference 4.3.4).
      Polymorphisms
      Common variations (more than 1 per cent ofthe population) in the DNA sequence of agene.
      Polyphenol
      Any of a group of chemical substances foundin plants that have more than one phenolgroup per molecule; includes tannins, lignins,and flavonoids.
      Polysaccharide
      A polymer composed of multiple subunits ofmonosaccharides (simple sugars) linkedtogether.
      Polyunsaturated fatty acids
      Fatty acids containing two or more doublebonds.
      Pooled analysis (see pooling)
      Pooling
      In epidemiology, a type of study whereoriginal individual-level data from two ormore original studies are obtained, combined,and re-analysed.Positive energy balance (see energybalance)
      Prebiotic
      Dietary carbohydrate that reaches the colon,where it promotes growth of beneficialbacterial flora (see reference 4.10.2).
      Precursor
      A chemical compound from which anothercompound is formed.
      Processed meat
      Meat (usually red meat) preserved bysmoking, curing, or salting, or by theaddition of preservatives. Definitions varybetween countries and studies as to whatprecisely is included (see reference 4.3.1).
      Programming
      The process whereby events happening duringfetal life (fetal programming), such as growthrestriction, or in infancy can permanentlyaffect the structure and function of particularorgans, and so also metabolic processes.Combined with other factors, this can in turnalter the response to environmentalexposures and so susceptibility to disease.
      Promoter region
      The region of DNA in a gene which initiatesthe transcription of DNA to RNA when theenzyme RNA polymerase binds to it.
      Prostaglandins
      A range of hormones derived from essentialfatty acids. Among many other processes,they influence blood pressure andinflammation.
      Publication bias
      A bias in the overall balance of evidence inthe published literature due to selectivepublication. Not all studies carried out arepublished, and those that are may differ fromthose that are not. Publication bias can betested for with either Begg’s or Egger’stests.
      Randomised controlled trial (RCT)
      A study in which a comparison is madebetween one intervention (often a treatmentor prevention strategy) and another (control).Sometimes the control group receives aninactive agent (a placebo). Groups arerandomised to one intervention or the other,so that any difference in outcome between thetwo groups can be ascribed with confidence tothe intervention. Neither investigators norsubjects usually know to which condition theyhave been randomised; this is called ‘doubleblinding’(see reference 3.4).
      RCT (see randomised controlled trial)
      Reactive oxygen species
      Oxygen-containing radical or reactive ion thatoxidises DNA (removes electrons); can behydroxyl radical (OH-), hydrogen peroxide(H2O2) or superoxide radical (O2-).
      Red meat
      Meat from domesticated cattle, pigs, sheep,and goats; not poultry and fish or meat fromwild animals.
      Refined sugars
      Sugars obtained by purification from plantswhich contain it, principally sugar cane orbeet.
      Relative risk (RR)
      The ratio of the rate of disease or deathamong people exposed to a factor, comparedto the rate among the unexposed, usually usedin cohort studies (see odds ratio).
      Resting metabolic rate
      Metabolic rate in a fasting subject sittingquietly (also see basal metabolic rate).
      Reverse causation
      The situation when an abnormal level of anexposure is caused by the cancer or itstreatment, rather than the other way round.For example if cancer causes weight loss, thenthe finding that low BMI is associated withincreased risk may reflect weight loss due tocancer rather than low weight causing cancer.
      Ribonucleic acid (RNA)
      The molecule created by RNA polymerase fromDNA (transcription) which carries the geneticmessage to ribosomes (translation), whereproteins are made.
      Rickets
      Malformation of the bones in growingchildren due to deficiency of vitamin D. Inadults the equivalent is osteomalacia.
      RNA (see ribonucleic acid)
      Salt iodisation
      The practice of fortifying salt with iodide as ameans of ensuring adequate iodine intake.
      Satiation
      The development of fullness during eatingthat limits the size of a meal consumed (seesatiety).
      Satiety
      The suppression of appetite after eating thatinhibits the starting of eating (see satiation).Saturated fatty acidsFatty acids that do not contain any doublebonds.
      Selection bias
      Bias arising from the procedures used to selectstudy participants and from factors influencingparticipation.
      Single bond
      A covalent bond between two carbon atoms,each with two hydrogen atoms, for instance insaturated fatty acids.
      Single nucleotide polymorphism (SNP)
      DNA sequence variation where a singlenucleotide in the DNA is altered. SNPs accountfor 90% of all human genetic variation (seepolymorphism and point mutation).SLR (see systematic literature review)
      Smoking (foods)
      Smoking is the process of curing, cooking, orseasoning food by exposing it for long periodsof time to the smoke from a wood fire. ‘Hotsmoking’ is a process that can be used to fullycook raw meats or fish, while ‘cold smoking’ isan hours- or days-long process that is generallyused to preserve or flavour foods (usuallymeats or fish, but sometimes cheeses,vegetables, fruits).
      SNP (see single nucleotide polymorphism)
      Socioeconomic status
      A combined product of social and economicstatus reflecting education level, personalwealth, class, and associated factors.
      Solvent
      Substances (usually liquid) capable ofdissolving or dispersing one or more othersubstances.Spontaneous physical activity (see nonexerciseactivity thermogenesis)
      Squamous cell carcinoma
      A malignant cancer derived from squamousepithelial cells.
      Stabiliser
      One of a number of food additives, such asagar or pectin (used in jam, for example), thatgive foods a firmer texture. While they are nottrue emulsifiers, they help to stabiliseemulsions.
      Statistical significance
      The probability that any observed result mightnot have occurred by chance. In mostepidemiologic work, a study result whoseprobability is less than 5% (p < 0.05) isconsidered sufficiently unlikely to haveoccurred by chance to justify the designation‘statistically significant’ (see confidenceinterval).
      Stem cell
      A cell that can self-renew or give rise to alineage of more differentiated cells.
      Sterilisation
      The destruction of bacteria or othermicroorganisms by heat, radiation, orchemical means.
      Steroid hormone
      One of several hormones derived fromcholesterol and having a central effect ongrowth and metabolism.Supplement (see dietary supplement)
      Systematic literature review (SLR)
      A means of compiling and assessing publishedevidence that addresses a scientific questionwith a predefined protocol and transparentmethods (see reference 3.5).
      Testosterone
      An androgenic steroid hormone and the principal male sex hormone.
      Thermodynamics
      The branch of physics concerned with the study of energy and its conversion between different forms.
      Thermogenesis
      The process of heat production. In adults, arising from the metabolic processes during the digestion and assimilation of food and during shivering.
      Tocotrienol
      A form of vitamin E.
      Total energy expenditure
      The energy expended in a 24-hour period by an individual or a group of individuals. It reflects the average amount of energy spent in a typical day, but may not be the exact amount of energy spent each and every day.
      Transcription
      Synthesis of RNA from DNA by the enzyme RNA polymerase.
      Transition cultures
      Countries in the process of changing from one predominant social/cultural structure to another, for instance moving from lowerincome to higher-income status with the accompanying changes that this implies.
      Translation
      The process by which RNA carries the genetic message from DNA to generate proteins in the ribosome.
      Tumour suppressor gene
      A gene whose protein product inhibits tumour formation (see also oncogene and reference 2.2).
      UICC
      International Union Against Cancer (www.uicc.org).
      Ulcerative colitis
      A disease causing chronic inflammation of the large intestine (colon). Together with another disease of inflammation of the intestines called Crohn’s disease, referred to as inflammatory bowel disease.
      Underwater weighing
      A method for estimating the proportions of body fat and lean mass. By comparing weight underwater with weight on land, and taking account of the different densities of fat and lean tissue, the proportions of fat and lean can be calculated.
      UVA/UVB
      Ultraviolet light of different wavelengths. UVA has relatively long wave lengths, UVB relatively short.
      Visceral fat (see intra-abdominal fat)
      Waist to hip circumference ratio (WHR)
      A measure of body shape indicating fat distribution.
      Weight cycling
      Repeated abnormal losses and regains of weight, often the result of repeated diet regimes.
      Whitemore and Jewett scales
      A scale used to describe the stage of prostate cancer.
      WHO
      World Health Organization (www.who.int).
      Wholegrain
      Cereal grain that retains the bran and germ as well as the endosperm, in contrast to refined grains that retain only the endosperm. All components of the grain are retained in their usual proportions, though the term‘wholegrain’ may apply to products that include other constituents, so that the complete product comprises less than 100% wholegrain (see reference 4.1.1).
      WHR (see waist to hip circumference ratio)