Currently, within the United States, cancer is ranked as one of the leading causes of mortality immediately following coronary heart disease. Cancer is an all-inclusive illness, capable of manifesting itself in different areas across the human body. It is the disease that has accounted for nearly six-hundred thousand deaths in the past year – responsible for nearly 21.7 percent of all deaths in the United States, according to a recent CDC (2017) report. Research has proven that there is indeed a genetic aspect or predisposition towards expressing cancerous cell mutations, those exhibiting particular DNA mutations developing corresponding malignant neoplasms, however, the vast majority of newly diagnosed cases are a resultant of a particular lifestyle (Rahner and Steinke, 2008). This lifestyle is such that factors including “unhealthy” dieting, a lack of physical activity, and engaging in high-risk behaviors such as smoking are far more influential determinants in the development of cancer as compared to a genetic disposition. Looking towards the future, a larger emphasis must be placed on addressing these lifestyle factors as supposed to searching for a solution that lies within our genes.
One major factor capable of influencing the development of malignant carcinomas, coined “cancer”, is likely obesity. Regarded as a body mass index exceeding 30 kg/m^2, obesity has been directly linked to a list of major chronic diseases including diabetes, high blood pressure, and osteoarthritis in addition to cancer. Proposing obesity as a possible contributing factor, the comparative rates of obesity and newly diagnosed instances of cancer must be analyzed. Examining trends within past half-century, childhood and adult obesity within the United States have consistently trended upwards. Among adolescents, two to nineteen years of age, the rate of obesity has increased from 5 to 16.2 percent between the years 1971 and 2014 respectively (NHANES, 2008). Among adults aged 20 to 74 years of age, the rate of obesity has increased dramatically from a mere 15% in 1970 to 34% in present time (NCHS, 2014). The staggering rates of obesity within the United States may have a large contribution to the stifled progress our healthcare system has seen in its attempt at diagnosing and treating cancer. Early methods of intervention and screening have had seemingly little effect on the number of new cases developing annually. According to the United States Cancer Statistics, an organization funded by the CDC, an estimated 417 Americans out of 100,000 Americans will continue to present new instances of cancer every year and 159 of previously diagnosed individuals will consequently die. Over the past two decades, despite innovative medical intervention, there has been a minimal decrease in these numbers leading researchers to question whether or not these methods have been effective; it raises the question of whether or not the annual allocation of billions of dollars towards genetically centered research is the proper approach towards combating cancer (NIH, 2018).
An alternative method towards combating cancer must begin with the examination of epidemiologically upstream factors contributing to obesity. The main component to which we should divert our attention: diet – namely the transition our society has made which has increased one’s chances of developing cancer. Viewing one’s diet holistically centers our attention around three categories of interest: carbohydrates, proteins, and fats. Firstly, our culture has evolved such that the consumption of grains has facilitated a transition from the traditional whole grain to a more refined homogenous white grain. By consuming strictly refined grain products, consumers rob themselves of the benefits accompanying a whole grain diet. The latter has been shown to exhibit anti-inflammatory traits by reducing the overall energy intake without altering our gut physiology – a significant factor in reducing gastric cancer outcomes. Additionally, as compared to whole grains, refined grains characteristically have higher glycemic indices resulting in spikes in blood plasma insulin levels. This subsequently elevates levels of Insulin-like growth factor I – a protein shown to stimulate the growth of malignant tumors (Xu et al., 2018). These statistics must not be ignored as our society transitions into an era where whole grains are evidently obsolete. A study conducted to assess the trends associated with whole grain intake, across adolescents from both high and low-income households, found that the majority failed to consume even one-third of the minimum daily recommended serving. In addition, researchers cited that 1 in 4 adolescents aged 13-18 did not consume any whole grains throughout their day (Tester et al., 2017). These findings are indeed substantial because it demonstrates our society’s increase in susceptibility to chronic inflammation, to obesity, and to the early development of cancer among youth into adulthood.
The second area of dietary concern for many individuals is the consumption of red meat. Red meat consumption has risen to extraordinarily high levels over time. It now accounts for nearly 58% of all meat consumption within the United States. The average American is estimated to consume 128 grams of protein per day. This dietary trend is extremely problematic as the heme irons found in red meat have shown to be carcinogenic. Scientists have hinted at two main pathways through which this constituent of red meat has been particularly harmful. In digestion, iron heme reacts as a catalyst in the formation of NOC compounds – a nitrate-based compounds linked in the formation of esophageal carcinoma. A meta-analysis linking red meat consumption and gastrointestinal-related carcinomas found a positive correlation between the intake of iron from red meat and an increased risk of developing esophageal and stomach cancer (Ward et al., 2012). Though a direct link has not yet been made, linking red meat and cancer, research has pointed towards the conclusion that the increased consumption of red meat within the United States has been a contributing factor in the prevalence of newly diagnosed cancer.
In addition to diet, physical activity – rather physical inactivity – plays an instrumental role in cancer prevention as well as cancer treatment. Routine physical activity is proven to substantially reduce obesity among all demographics. By emphasizing routine physical activity and further reducing the average Body Mass Index among Americans, the number of annually diagnosed cancer cases should be reduced. Aside from reducing overall Body Mass Index, longitudinal studies suggest that reinforced physical activity from a young age has seen the development of healthier eating habits in post-adolescent years (Maier and Barry, 2015). This may have notable effects through the incorporation of foods rich in antioxidants. Similar to the effects of eating whole grain products – foods containing selenium and similar antioxidant are shown to be integral in the reduction of pancreatic carcinogenesis (Han et al., 2014). This is achieved by eliminating free radicals and reactive oxygen species synthesized during periods of heavy oxidative stress.
Lastly, the major contributor to carcinogenesis that will be discussed is smoking and the dangers associated with this high-risk behavior. Due to recent anti-smoking campaigns, it is no secret that smoking is a practice that linked with numerous negative health outcomes. The inflammatory nature of tobacco smoke is connected with the growth of both small and non-small epithelial carcinoma as well as the development of bronchus and lung cancer. The added respiratory stress of smoking additionally decreases the probability of attaining the proper amount of physical activity, a tendency towards being overweight (Heydari et al., 2016).
The aforementioned factors influencing carcinogenesis in Americans share one commonality. They are factors directly affected by the lifestyle choices our society makes. However, often times the choices we make are influenced by social constraints that are not so easily changed. For example, the limited income and systemic location of particularly low-income neighborhoods may limit access to healthier foods such as whole grains and fresh fruit. A lack of safety and cleanliness of one’s living conditions can initiate poor lifestyle habits, as safety concerts inhibit exercise and psychosocial factors encourage practices such as smoking (Childs and de Wit, 2010). To combat these issues, programs such as the Veggie Van Program in Albany New York should become interests of federal and state funding. Providing access to fresh fruits and vegetables to areas of low socioeconomic status has shown to increase the daily consumption of healthier and less carcinogenic foods (Leon et al., 2016). Reallocating funds towards programs with initiatives geared towards encouraging healthier lifestyles such as this may, in effect, reduce the number of obese individuals and newly diagnosed cancer cases within the United States.
Works Cited
National Center for Health Statistics. (2017). Retrieved from https://www.cdc.gov/nchs/data/hus/2017/019.pdf
Rahner, N., & Steinke, V. (2008). Hereditary cancer syndromes. Deutsches Arzteblatt international, 105(41), 706-14.
National Health and Nutrition Examination Survey (2008) Retrieved from https://www.cdc.gov/nchs/data/hestat/obesity_adult_07_08/obesity_adult_07_08.pdf
National Center for Health and Statistics , Examination Surveys II Retrieved from https://www.cdc.gov/nchs/data/hestat/obesity_child_13_14/obesity_child_13_14.htm
National Center for Health and Statistics , Examination Surveys II Retrieved from https://www.cdc.gov/nchs/data/hestat/obesity_child_13_14/obesity_child_13_14.htm
National Institute of Health, Reports of Cancer Funding Retrieved from https://www.cancer.gov/about-nci/budget/fact-book/data/research-funding
Tester, J. M., Leung, C. W., Leak, T. M., & Laraia, B. A. (2017). Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012. Preventing chronic disease, 14, E55. doi:10.5888/pcd14.160540
Xu, Y., Yang, J., Du, L., Li, K., & Zhou, Y. (2018). Association of whole grain, refined grain, and cereal consumption with gastric cancer risk: A meta-analysis of observational studies. Food science & nutrition, 7(1), 256-265. doi:10.1002/fsn3.878
Ward, M. H., Cross, A. J., Abnet, C. C., Sinha, R., Markin, R. S., & Weisenburger, D. D. (2012). Heme iron from meat and risk of adenocarcinoma of the esophagus and stomach. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP), 21(2), 134-8.
Maier, J. H., & Barry, R. (2015). Associations among Physical Activity, Diet, and Obesity Measures Change during Adolescence. Journal of nutrition and metabolism, 2015, 805065.
Han, X., Li, J., Brasky, T. M., Xun, P., Stevens, J., White, E., Gammon, M. D., … He, K. (2012). Antioxidant intake and pancreatic cancer risk: the Vitamins and Lifestyle (VITAL) Study. Cancer, 119(7), 1314-20.
Heydari, G., Hosseini, M., Yousefifard, M., Asady, H., Baikpour, M., & Barat, A. (2015). Smoking and Physical Activity in Healthy Adults: A Cross-Sectional Study in Tehran. Tanaffos, 14(4), 238-45.
Childs, E., & de Wit, H. (2010). Effects of acute psychosocial stress on cigarette craving and smoking. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 12(4), 449-53.
Leone, L. A., Haynes-Maslow, L., & Ammerman, A. S. (2016). Veggie Van Pilot Study: Impact of a Mobile Produce Market for Underserved Communities on Fruit and Vegetable Access and Intake. Journal of hunger & environmental nutrition, 12(1), 89-100.
