Ask the Expert

We brought your questions to nutrition experts and research scientists about inflammation and its link to cancer, increasing your calorie intake during cancer treatment and the dangers of prolonged sitting.

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Q: I keep hearing about inflammation and how that relates to cancer. I’m assuming that means more than having swollen joints or limbs? What’s the relation?

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Dr. Nigel Brockton, a research scientist in molecular cancer epidemiology, says the link between cancer and inflammation goes way back to the 1800s when it was first proposed by Rudolf Virchow but it was largely ignored until the late 20th century!

“We now know that cancer often arises at sites of chronic inflammation, and chronic inflammatory conditions dramatically increase a person’s risk of cancer,” he says, adding that, “Inflammation is a natural reaction to a wound, irritation or infection, but chronic inflammation can damage DNA, provide a powerful stimulus for cell growth, may increase the number of cells that can become cancerous and may help cancer spread from its primary site.”

He explains that the most common cancers occur in epithelial cells that line organs such as the colon, lungs, prostate and breast. “These cells typically divide more quickly than other cell types, and chronic inflammation can damage the controls that normally limit their growth and division,” he says. “It is particularly inflammation that affects epithelial tissues that is associated with an increased cancer risk. However, lifestyle factors such as obesity, smoking and an unhealthy diet increase systemic (whole body) inflammation that can worsen local inflammation and increase a person’s risk of cancer.”

Does that mean it’s worth controlling inflammation with medication to reduce the risk? Not necessarily, says Brockton. “Anti-inflammatory drugs can reduce the risks of certain cancers but the potential risks associated with those medications are not currently justified by the reduced risk of cancer.” So can anything be done about inflammation? “Making healthy choices such as avoiding obesity, tobacco use and an unhealthy diet, all of which can increase systemic (whole body) inflammation, can reduce inflammation and a person’s risk of cancer,” he says.

Q: I’ve been told I should increase my calorie and protein intake during cancer treatment. Do you have any tips on how I can do this?

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Katherine Younker, manager of Education Resources at Alberta Health Services, says that even a little more protein and calories every day can help you to maintain or gain weight and strength during treatment. She provides the following suggestions:

  • Try to eat every 2 to 3 hours, even when you don’t feel hungry.
  • When you feel well, make larger amounts and freeze meals in single portions. Or, try frozen TV dinners or meal services.
  • Most fluids, especially clear broth, coffee and tea are low in calories. Drink fluids between meals or at the end of your meal.
  • Limit foods and drinks that are labelled “light,” “low fat,” “fat-free,” “low calorie” or “sugar-free.”

In addition, here are some foods she suggests that are higher in calories and protein:

  • Meat, fish, and poultry are good sources of ­protein. So are dried, cooked beans, peas, lentils, tofu, and eggs. Have these foods with your meals and snacks.
  • Choose higher fat milks like 3.25% (homogenized) or 2%, or flavoured milks like chocolate or strawberry.
  • Try adding skim milk powder or evaporated milk to soups, puddings, milkshakes, and casseroles.
  • Add Greek-style yogurt to fruit and vegetables, dressings, soups, or smoothies.
  • Choose egg dishes like soufflés, quiches, and omelettes. Add eggs to dishes like casseroles, hot cereal, fried rice, or stir-fries.
  • Snack on nuts, seeds, hemp hearts, or trail mix.

“If you try these tips and are still worried about your appetite or your weight, ask your health-care provider to refer you to a registered dietitian,” says Younker.

Q: Recently I’ve heard that sitting all day at work is bad for me even if I’m getting regular exercise. Is this true and what can I do about it?

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Dr. Christine Friedenreich, scientific leader of Cancer Epidemiology and Prevention Research and adjunct professor at the University of Calgary, confirms that there is now increasing scientific evidence that prolonged sitting is associated with an increased risk of developing several chronic diseases. These include different types of cancer, cardiovascular disease and diabetes.

“Research has demonstrated that the average person has the opportunity to sit for 15.5 hours per day even if they are incorporating 30 minutes of exercise into their daily routine,” she says. As a result, several agencies including the American Institute for Cancer Research/World Cancer Research Fund now recommend that, in addition to aiming for 150 minutes per week of moderate or 75 minutes per week of vigorous intensity activity, prolonged sitting should be avoided to reduce the risk of developing these diseases.

“Everyone should aim to avoid sitting all day whether at work, home or wherever they are,” says Friedenreich, who provides several options for breaking up sitting time that can be implemented in workplaces, homes and everyday life: “These include using a sit-stand desk at work, having standing or walking meetings, breaking up time while watching television or other screen-based activities, using stairs instead of elevators and trying to incorporate as much non-sitting time into everyday activities. Even a few minutes of standing to interrupt prolonged sitting is beneficial.”

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