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Cancers of the Affluent are on the Rise

Cancers of the affluent – or those associated with “good living” - are on the increase across the United States.

Those cancers include breast, prostate, liver, colon and pancreatic - among the most commonly seen - and all are heavily influenced by dietary factors – or, to be more precise, by poor eating habits.

Those include the increased intake of processed foods, prime among them fats, carbohydrates and proteins.

Evidence of this trend is seen in certain immigrant groups, who upon their arrival in the United States often switch to a “Western” diet with unhealthy results.
Cancers of the Affluent are on the Rise
James E. Gervasoni Jr., PhD, MD
James E. Gervasoni Jr., PhD, MD, and chair of the Department of Surgery at Saint Peter’s University Hospital in New Brunswick, N.J., has seen a rise in these sorts of lifestyle cancers during his career as a surgical oncologist. Dr. Gervasoni also holds a PhD in microbiology/immunology.

For more information about Saint Peter’s Healthcare System

Bill Klaproth (Host): Cancers of the affluent are those associated with good living around the increase across the United States, and those cancers include breast, prostate, liver, colon and pancreatic among the most commonly seen and all are heavily influenced by poor eating habits and the intake of processed foods. And here to explain this is James E. Gervasoni Jr., PhD, MD, and chair of the Department of Surgery at Saint Peter's University Hospital in New Brunswick, New Jersey. Dr Gervasoni also holds a PhD in microbiology and immunology. Dr. Gervasoni, thanks so much for being out with us today. Cancers of the affluent – it sounds like it's a disease for rich people. Is that the case?

Dr James E. Gervasoni (Guest): No, it's not. Actually, early on, I mean, in the 50s, late 50s and early 60s, that was the case because people that were eating high-fat diets, a lot of meat and a lot of animal products were actually people who were able to afford it. And so, early on in this recognition of this process, it was individuals that were able to afford these kinds of food. Now of course, it's not the case. It's a really everyone, all of us are exposed to processed foods and really toxic compounds that are put in these foods that we are just recognizing now.

Bill: I suppose this also includes fast food as well since it's all around us, is that right?

Dr. Gervasoni: Absolutely, fast food, processed food or any food that we as humans alter, and there are different degrees of processing. You can have processed foods that are packaged greens; that's food that has been manipulated in just collection and put in a package. So, that's processed food. You can have food where things are added like increased sugars or other types of minerals or vitamins that are thought to help us but actually may not.

Bill: All the bad stuff is in there. All that stuff we don't want is in there.

Dr. Gervasoni: Exactly.

Bill: So, you know, this food is all around us though and we all lead such hectic busy lives. Sometimes it seems it’s just easier to go through the drive-through, you know, or pop that packaged meal in the microwave or eat something out of a box. How do we get around that?

Dr. Gervasoni: Well, I think that it's a process where the education and communication with people to know what they're actually eating is important. Now, when I was growing up, it was important that you ate your meat, it was thought that all meat was equal, and so fast food wasn't really considered detrimental because it included the meats that we needed and the food that we needed. Now, we're recognizing that any food that's really processed to the point where we are adding supplements and adding things and manipulating the food, that's turning out to be a big problem for us. In addition to that, unbalanced food intake is really the problem.

Bill: So, we're faced with all these food choices and you said we're eating foods, as I put it, with all the bad stuff in it. Is there a simple way to see through that and eat healthier and eat better without having to have a PhD and all of this chemistry to understand what's going on?

Dr. Gervasoni: Yeah. Actually, it's fairly simple and straightforward. Eat your fruits and vegetables. That's what we were told when we were kids but we weren't really fed fruits and vegetables. So, simple and stupid is eat unprocessed food, meaning food that's not been manipulated to the point where supplements had been added and that would mean that it would be really fruits and vegetables for the most part. But you can eat foods in moderation. In other words, a fast food once every couple of months is not going to be a problem. It's when you overindulge in these foods that it becomes an issue where you're over-stimulating your body to produce insulin basically. At an increased rate, that is a problem, so it's moderation that really is what we have to look at.

Bill: So it sounds like it's getting back to the basics, as you said, fruits and vegetables. So when you go to the store, I guess stay out in the middle of the store where you find all the boxed items and spend more time in that produce section. Is that an easy way to look at it?

Dr. Gervasoni: Exactly. And what you have to do is you have to say this is a process that's going to occur throughout my life; therefore, it's not something that you have to do immediately cold turkey where you have to stop eating all of the processed foods tomorrow. Although that would be something I would recommend to my patients, it's not realistic. So people have to look at this as a long-term plan for better health and they have to do it gradually. It's almost like quitting any addictive behavior – quitting smoking, quitting drinking. It's not something that you could do just cold turkey or at least most of us can. And so, it's a gradual process. First thing that you have to do is to educate your patients; educate people to let them know what's good, what's not good. And start telling them, “This is what you need to do: You need to start incorporating more fruits, vegetables. If you can read the package, there are things in your food that has been added that's probably not a good thing.” So, these are the kinds of mechanisms that we can start with – communicating with our patients and letting them know this is a gradual process that we will work with them in order to move them forward.

Bill: Right. So pay attention to things without labels, like a banana doesn't have a label in it. So that would be a good thing.

Dr. Gervasoni: Correct. That's right. Bananas are good and any kind of fruit and vegetables. When I walk in the food isles, most of what we see is processed – canned foods, boxed foods, foods that sugar’s been added. And really let's keep in mind that with all of our processed food items that we have, there are also a lot of unprocessed foods and there is a lot of variety in our supermarkets that we can look at and supplement our lives.

Bill: So, when you talked about unprocessed foods, are you talking about not necessarily a fruit or vegetable, but something that is manmade that is okay for you?

Dr. Gervasoni: Well, I like pasta. Pasta is high in sugar, okay? Again, what you have to look at is, this is an age phenomena. In other words, people will come to me and say, “You know, my son is 20 years old. He eats all of these garbage processed foods, pastas, and he doesn’t gain an ounce of weight, his health is very good.” Well, that individual is probably correct because it’s an age phenomena where that individual of age 20 is just finishing their growth spurt and now they have to start watching their diet more closely, and kids that are not processing these foods well need to watch it, obviously. But we’re looking at an age group between really the ages of 40 and 65 where absolutely you have to watch what you’re eating because you’re not going to process the food. The growth stage of your life has ended and now you have to really be careful what you’re taking in. So, even foods, to get back to the question, that seem to be processed may or may not be good for you. Again I was getting back to the pasta I ate. I was looking at ingredients of brown rice pasta which is basically no sugar and gluten-free which has no sugar. It’s good for diabetics but it’s also good for people who are having problems with their sugar or having issues in terms of weight. And so, there are some items that you can look at that are processed that may be better for you than others. Long explanation for…

Bill: Correct, got you. No problem. So the 20-year-old might be burning it off too. They may be exercising so they’re burning it off. I think the other problem is that as we mature and age and have jobs and responsibilities, we’re exercising less we’re sitting more, and we’re eating food with the bad stuff in it, and that’s why we’re becoming overweight as a population and obesity is on the rise in our country. I think you were starting to talk about metabolic syndrome, isn’t that correct?

Dr. Gervasoni: Correct.

Bill: And that has a linkage to cancer too. Can you just quickly explain metabolic syndrome to us?

Dr. Gervasoni: Sure. So metabolic syndrome is really a group of risk factors that raises your risk for heart disease, diabetes, stroke, and multiple types of cancers, some of which you’ve mentioned. So these risk factors, there are several, but in metabolic syndrome, the particular types of risk factors that physicians are looking for would be obesity and that would be a waist line that is, in males 40, inches or greater; in females a little bit smaller, maybe 37 inches at the girth of their abdomen. Also, their glucose is elevated above 100, their fasting glucose levels. Their triglycerides which are their fats, which are greater than a 150, your good cholesterol which is your HDLs, should be greater than 40, and your blood pressure, if it’s greater than 130 over 85, can be a problem. So, it’s really obesity, lipid dysfunction or fat, blood pressure, and sugar poorly metabolizing your sugar. So that puts you at risk not only for heart disease, diabetes and stroke but for these “cancers of affluence” as we call them.

Bill: Right. So it sounds like the 1, 2 combatant punches: one, getting back to the basics, fruits, vegetables, eating unprocessed foods, eating clean as they say, and the other one is exercise right? So, tell us, for that 40 to 60-year-old person you were talking about, what type of exercise should that person start incorporating into their daily routine?

Dr. Gervasoni: So, what I do with my patients is if you’re working with an individual who’s in a metabolic syndrome or pre-diabetic individual which is metabolic syndrome, normally these people are not working out on a regular basis. So again we have to educate your patients and say, “You know, you’re not going to be able to work out 30 to 60 minutes per day where you’re getting up your metabolism so that when you’re speaking to someone, you can barely speak to the person next to you as you’re working out. You can’t do that.” People are not going to be able to do 30-60 per minutes per day right from the beginning. So what I normally do is that I say, “You know, what you need to do is instead of sitting, you need to get up and walk. Walk a mile. That’s a half hour.” And do that for the first month. And then you start gradually bringing the person along so that it’s not a chore. Somebody is not working out and you tell them you have to work out 30 minutes per day every day. Probably your patient’s not going to be able to do that so again, you have to work with your patient to get them where you want them to be. To answer your question, where you want someone to be after they kind of get into the routine is about 30 minutes to 60 minutes per day of cardio vascular working out and you could do that anywhere from 4 to 5 days a week. And the other two days you have to concentrate on kind of strength training and that’s where it’s static lifting, weights or like a step climber or things like this. So, you have to incorporate both cardiovascular workout as well as resistance training. And that’s where you get your patients to be. You wanted to get them to be working out roughly 30 minutes 4 to 5 days a week and then strength training for about a half hour twice a week.

Bill: And like you said not making it a chore I think is key.

Dr. Gervasoni: It’s key, because you have to understand that most people are not going into this routine so you have to gradually bring them into the routine as you bring them into their dietary changes as well. And it’s essential we’re not going to reverse the strength.

Bill: Cancers of the affluent, very interesting. Dr. Gervasoni, thank you so much for spending some time with us today to talk about this. And for more information, please visit I'm Bill Klaproth and this is Saint Peter's Better Heath Update. Thanks for listening.