WOMEN S HEALTH GU DE

Transcription

1 WOMEN S HEALTH GU DE

2 Dear reader, Thank you for picking up this copy of World Cancer Research Fund s booklet, Women s Health Guide. Today s busy lifestyles mean that our own health rarely features at the top of our list of priorities. Women especially are renowned for putting their families first. And when it comes to cancer, it is easy to see why as it often isn t seen as a concern for right now. But by taking steps today, you could start to see benefits to your health straight away as well as making cancer less likely in your future. World Cancer Research Fund looks at the most up-to-date science from around the world, and translates the findings into simple Recommendations to help you reduce your cancer risk. Simply put, our advice is to: eat well, move more and be a healthy weight (see page 31 for a complete list of our Cancer Prevention Recommendations). If you want to make changes for the good of your health, you ve already made an important first step by opening this booklet. It is written with you and me in mind, and gives support and advice that is more likely to fit with our lives. Once you ve read this booklet, please help to spread our cancer prevention messages by sharing it with your family and friends. Kind regards Dr Rachel Thompson Dietitian and Head of Research Interpretation World Cancer Research Fund

3 Contents Common cancers in women Take control of your risk Be a healthy weight Not all foods are equal Reshape your plate 5 A DAY Perfect your portions Cut down on red meat Think about what you drink Dietary supplements If you can, breastfeed Move your baby more Move more Smart goals for a healthier you Cancer Prevention Recommendations

4 Common cancers in women In the UK, 172,500 new cases of cancer are diagnosed in women every year and 76,000 women die from the disease. The really positive message is that, by knowing how you can reduce your risk and spot the early signs of cancer, we can bring these numbers down. 1 Breast cancer About 53,350 new cases in UK women a year Possible symptoms: lump or thickened area of tissue; discharge from either of the nipples; change to the size or shape of the breast or nipple; dimpling on the skin of the breast. Lifestyle risk factors: drinking alcohol; not breastfeeding after having a baby; being inactive; being overweight; taking hormone replacement therapy (HRT). Screening: the NHS Breast Screening Programme provides free screening for all women aged 50 and over: cancerscreening.nhs.uk/breastscreen Lung cancer About 21,000 new cases in UK women a year Possible symptoms: a cough that lasts for more than three weeks; coughing up blood; unexplained weight loss; shortness of breath; chest pain. Lifestyle risk factors: smoking causes almost 90 per cent of lung cancers, so the most important thing you can do to reduce your risk is to not smoke or to give up smoking. 4

5 3 Bowel cancer About 18,850 new cases in UK women a year Possible symptoms: blood in poo; abdominal pain; change in bowel habits; a lump in the abdomen. Lifestyle risk factors: a diet high in red meat; drinking alcohol (especially harmful if you also smoke); eating processed meats; being overweight; smoking; being inactive; a diet low in fibre (found in wholegrain foods, vegetables and fruit). Screening: the NHS Bowel Cancer Screening Programme provides free screening for those aged 60 and over (50 in Scotland): cancerscreening.nhs.uk/bowel 4 Womb cancer About 8,800 new cases in UK women a year Possible symptoms: abnormal vaginal bleeding including vaginal bleeding post-menopause, unusually heavy bleeding and bleeding between periods; vaginal discharge. Lifestyle risk factors: being overweight; being inactive; taking oestrogen-only hormone replacement therapy (HRT). 5 Ovarian cancer About 7,050 new cases in UK women a year Possible symptoms: irregular periods; bloating; lower abdominal pain; back pain; passing urine more frequently than usual; constipation; pain during sex. Lifestyle risk factors: being overweight; smoking. Malignant melanoma About 7,350 new cases in UK women a year Possible symptoms: a mole that has increased in size, changed shape (especially with an irregular edge), become darker in colour, itchy, inflamed or started bleeding; the development of a new mole; or other changes to the skin. Lifestyle risk factors: ultraviolet light from excess sun exposure or sunbed use. Early detection: get any changes to your skin or moles checked out by your doctor. If you want to read about different types of cancer, visit our website: Please note: having any of these symptoms doesn t mean that you have cancer, but it s best to visit your doctor and get checked out. It s also a good idea to find out if any types of cancer run in your family, and to speak to your doctor if you are concerned. 5

6 Take control of your risk Almost all of us are affected in one way or another by cancer, and the current statistic is that one in two people in the UK will develop cancer during their lifetime. But we are not powerless. Most of us know that smoking and too much sun exposure increase our risk of cancer, but there are other lifestyle factors that affect our cancer risk. About a third of the most common cancers could be prevented that s about 80,000 cases every year in the UK if we all: Kept a healthy weight Drank less sugary drinks, like cola and sweetened coffee Drank little, if any, alcohol Ate less salt and salty foods, like canned soup Ate more wholegrains, veg, fruit and beans, rather than relying on supplements Limited red meat and avoided processed meat, like bacon and ham Ate less high-calorie foods, like chocolate, biscuits, pastries, crisps and fried foods Moved more, like walked, went swimming, cycling or to an exercise class, or gardened regularly No doubt you will already be doing some of these things. For others, making small adjustments to your lifestyle could make a big difference to your health and your cancer risk. Take the quiz on the next page to see how healthy your lifestyle is right now. Then keep reading to work out what changes you could make to help you towards a healthier, cancer-free future. 6

7 How healthy are you now? 1 How often are you active for 30 minutes or more a day? Any activity that raises your heart rate and makes you breathe deeper counts, and the 30 minutes don t have to be done in one go. a) 5 or more days a week b) 3 4 days a week c) Less than 3 days a week 2 How many portions of vegetables and fruit (80g, or a large handful) do you eat a day? a) 5 or more b) 3 4 c) 2 or less 3 How often do you eat red meat (beef, pork, lamb)? a) 2 3 times a week or less b) 4 5 times a week c) Every day 4 When you have bread, pasta or rice, what do you tend to eat? a) Mostly brown or wholegrain b) Vary between brown and white c) Mostly white 5 When you re thirsty, what do you tend to drink? a) Water or unsweetened tea or coffee b) Vary between a) and c) c) Sugary soft drinks like cola; fruit juice; or tea or coffee (with sugar) 6 How much alcohol do you drink? One drink equals a small glass (125ml) of wine, half a pint of beer, or a single measure of spirits. a) I don t drink alcohol; or only 1 or 2 drinks on special occasions b) Up to 7 drinks a week c) 8 or more drinks a week 7 Do you smoke? a) No b) Yes, but I am trying to give up c) Yes 8 Do you know if your weight is healthy? a) I am a healthy weight b) I need to lose weight c) I don t know How did you score? Mostly As Well done, you seem to be living a healthy lifestyle already. Keep reading for extra tips to help you maintain your health. Mostly Bs You re on the right track, but there s room for improvement. Keep reading to see what else you can do to be healthier and reduce your cancer risk. Mostly Cs Your lifestyle needs improvement. Even small changes could make a big difference to your health and your risk of cancer. Keep reading to see how easy it can be. 7

8 Start making positive changes today

9 Be a healthy weight Did you know that being a healthy weight is the most important way you can reduce your risk of cancer, after choosing not to smoke? Nearly 60 per cent of women in the UK are overweight or obese, and a higher proportion of women than men are obese or morbidly obese, so, as a nation, we are doing a lot of potential harm to our health. There is strong evidence that being overweight or obese increases the risk of 10 types of cancer in women, including cancer of the: breast (in postmenopausal women), bowel, womb, ovaries, oesophagus, stomach, liver, pancreas, gallbladder and kidney. If all women in the UK were a healthy weight, about 16,000 cases of weight-related cancers could be prevented every year. Balancing your weight Your weight is a balancing act between the energy you put in (calories from foods and drinks) and the energy you use (for normal functions, such as your heart beating, and by being active). If you eat or drink more than your body needs, you will put on weight. In fact, eating just 100 calories a day more than you need can lead to weight gain of around 5kg (11lbs) in a year. The reverse is also true: if you regularly use more energy than you take in, you will start to lose weight. The average adult woman needs about 2,000 calories a day Here are some examples of how much physical activity it takes to burn off calories* Bar of chocolate (45g) contains 240kcal You need to swim for 35 minutes Fruit and seed flapjack contains 225kcal You need to jog for 27 minutes * Based on an average UK woman, weighing 70.7kg (11st 2lbs) 9

10 Are you a healthy weight? Measuring your BMI Body Mass Index (BMI) is a simple way to find out whether you re a healthy weight for your height. 1. Measure your height, in metres (1ft = 0.3m). 2. Weigh yourself, in kilograms (1 stone = 6.35kg). 3. Divide your weight by your height. Press equals. Then divide your answer by your height again to work out your BMI. BMI Less than 18.5 Underweight Healthy weight Overweight 30 or more Obese Your BMI: Weight (kg) Height (m) x Height (m) = BMI of... Example calculation: Weight: 70kg Height²: (1.7m x 1.7m) = BMI of 24.2 Or put your details into our online calculator: bmi-calculator If you are elderly, less than 1.5m/5ft tall, pregnant, or an athlete, BMI may be less reliable, but for most adults it s a good way of checking whether you re a healthy weight. Target health If you re already within the healthy range, that s a great start for your health. It is worth remembering that the more body fat you have, the higher your cancer risk. This means that gaining weight even when you are in the healthy BMI range can increase your cancer risk. That s why, unless you are underweight, it is important to keep those pounds from sneaking on. The tips in this booklet can benefit your health and can be used to help keep your weight healthy in the future. 10

11 Measuring your waist Carrying too much fat around the waist is linked to a greater risk of cancer, heart disease and Type 2 diabetes, so measuring your waist is a good way of checking if you are a healthy shape. 1. Place the tape measure around your waist, at the halfway point between your lowest rib and the top of your hip bone. If you have trouble finding this point, then lean to one side and see where the skin folds. This is the point where you can measure your waist. 2. Make sure it s level and a snug fit, but not digging into your skin. 3. Breathe normally, and measure after you have breathed out. As a guide, a healthy waist measurement is: Less than 80cm/31.5inches for women Healthy way to lose weight If your BMI or waist measurement is over the healthy range, you're likely to reduce your cancer risk by losing some weight. You may also lower your risk of heart disease and Type 2 diabetes. Even if you re at the top of the healthy range, trimming down further could be good for you. If you set yourself the goal of losing weight, try to eat healthily rather than following a fad diet. Although you can lose weight on some of these diets, because they are too low in calories or cut out vital food groups, they can t be healthily followed for a long amount of time and, when you return to your normal diet, the weight easily returns too. Instead, aim to gradually lose weight by using this booklet to make healthy changes to your diet and add more activity into your routine: shedding kg (0.5 2lbs) a week is a realistic goal and one that you can achieve in a healthy way. Once you've achieved your goal, it s important to continue eating healthily and being active to keep the weight off. 11

12 Not all foods are equal If you re trying to lose weight, or even stop the pounds from creeping on, the solution may seem to be to eat less, but this can leave you feeling hungry, and make snacking harder to resist. A better way can be to focus more on changing what you eat rather than the amount. Calories in foods The amount of calories (energy) that different foods and drinks contain can vary greatly. For example, there are 41 calories in 100g of carrot, but 530 calories in 100g of milk chocolate that s 13 times more! The best way to keep your calories in check is to choose lower calorie foods, like vegetables and fruit, which contain a large amount of water that adds bulk but not calories. They also contain fibre, which helps keep us fuller for longer. High-calorie foods, like chocolate, crisps, biscuits and fried foods, tend to be high in fat and/or sugar, and offer little in the way of vitamins, minerals and fibre. Regularly eating these foods can contribute to weight gain, because even small amounts contain a lot of calories. Some high-calorie foods, like oily fish, avocado, nuts and seeds contain good fats and nutrients, meaning they can be consumed in moderation as part of a healthy diet. A guide to calories: 12 HIGH-CALORIE MEDIUM-CALORIE LOW-CALORIE Foods containing more than about 225 calories (kcal) per 100g. Examples: snack foods, like chocolate, crisps and biscuits; and foods that are high in fat like burgers, pastries, chips and other fried foods. Foods containing about kcal per 100g. Examples: cooked brown rice and wholemeal pasta; wholemeal bread; lean meat; poultry; and fish. Foods containing up to about 100 kcal per 100g. Examples: vegetables; fruit; and cooked pulses, like lentils and beans.

13 Reshape your plate Looking at what is on your plate at mealtimes is a simple way to start checking if what you eat could be healthier. 3/4 (or more) wholegrains, vegetables, fruit and pulses Reshaping your plate to include at least three-quarters of wholegrains, vegetables, fruit and pulses will help to provide your body with the nutrients it needs for good health. It can also help to lower the calories in every meal and increase the fibre content. This means your meals will keep you feeling fuller for longer on fewer calories, which can help you maintain a healthy weight. 1/4 (or less) meat, fish and other protein foods Vegetables and plant foods Meat and other protein foods Vegetables and fruit fresh, Red meat eating no more than frozen, dried and canned in water or natural juices all count towards your 5 A DAY Pulses eg. lentils, peas and beans count towards your 5 A DAY Grains and cereals eg. rice, oats, pasta, bread, cous cous and unsweetened breakfast cereals. Opt for wholegrain varieties, and limit highly processed foods, such as cakes and pastries Starchy vegetables eg. potatoes. Try to not add fat, like butter or cream, and opt for boiled or steamed rather than roasted or fried in oil 500g (cooked weight) a week and little, if any, processed meat will reduce your cancer risk Poultry eg. skinless chicken and turkey Non-oily fish eg. cod and canned tuna (in spring water) Oily fish eg. salmon, fresh tuna, trout, sardines and mackerel Eggs, dairy and dairy alternatives eg. milk, yoghurt, cheese. Opt for reduced-fat, unsweetened varieties Nuts eg. Brazil nuts and hazelnuts Meat-substitutes eg. tofu, Quorn and pulses 13

14 5 A DAY An important first step when reshaping your plate is to aim for at least five portions of vegetables, fruit and pulses a day. As fruit can be quite high in sugar, it is best to focus on vegetables. The 5 A DAY recommendation is based on the World Health Organization s advice to eat at least 400g of vegetables and fruit a day to lower the risk of serious health problems, such as heart disease, stroke and some cancers. One 5 A DAY portion weighs 80g which is about a handful so five portions weigh 400g. See the next page for examples of what counts as a portion. Switch to wholegrain Another important step when reshaping your plate is to opt for wholegrain varieties of foods like bread, rice, pasta and breakfast cereals. Although they don t count towards your 5 A DAY, they do contain fibre and are a good source of healthy nutrients many of which are removed in the more processed varieties of these foods, such as white pasta. How a plant-based diet can reduce your cancer risk: Eating a diet rich in wholegrains, vegetables, fruit and pulses can help you stay a healthy weight, which has now been linked with a reduced risk of 10 cancers in women. Vegetables and fruit provide vitamins, minerals and other substances known as phytochemicals, which help protect cells in the body from damage that may lead to cancer. Different types of vegetables and fruit contain different phytochemicals, so it is best to eat a variety every day. A top tip is to choose a range of different coloured vegetables and fruit. Diets rich in fibre (found in wholegrain foods, vegetables and fruit) have been shown to decrease the risk of bowel cancer. This may be because fibre helps to move food more quickly through the bowel. 14

15 What is a 5 A DAY portion? Here are some examples of what counts as a 5 A DAY portion for an adult. One portion weighs roughly 80g, equivalent to: GREEN VEGETABLES 3 heaped tablespoons eg. shredded cabbage ROOT VEGETABLES 3 heaped tablespoons eg. diced carrots SALAD LEAVES 1 cereal bowl eg. mixed salad MEDIUM-SIZED VEGETABLES 1 whole vegetable eg. a pepper SMALL VEGETABLES 3 handfuls eg. sliced mushrooms LARGE FRUITS 1 slice eg. melon MEDIUM-SIZED FRUITS 1 whole fruit eg. a banana SMALL FRUITS 2 whole fruits eg. kiwi fruits BERRIES 1 2 handfuls eg. raspberries UNSWEETENED FRUIT OR VEGETABLE JUICE 1 glass (150ml) (only counts once per day) eg. orange juice PULSES (peas, beans & lentils) 3 4 heaped tablespoons (only counts once per day) eg. cooked mixed beans DRIED FRUITS 1 heaped tablespoon (30g) (only counts once per day) eg. raisins 15

16 Perfect your portions As well as getting the balance of food right, it is important to eat healthy portion sizes. This has become more difficult as, over the last 20 years, the serving size of many foods, especially convenience foods, have become much larger, and bigger portions encourage us to eat more. What is a healthy portion size? What we mean by healthy portion size depends on the type of food. For example, as talked about on the previous pages, a portion of vegetables or fruit weighs 80g. However, as they are low in calories and rich in fibre, eating more than 80g, especially of vegetables, will help fill you up on fewer calories, which can help you stay a healthy weight. However, eating more than a healthy portion of higher calorie foods can contribute to weight gain and is unlikely to provide added nutritional benefit. The next page shows what a healthy portion size is for an average adult for some common foods. Top tips for keeping your portion sizes healthy Use a smaller plate or bowl at mealtimes to reduce the amount you eat. Alternatively, try filling most of your plate with salad or steamed vegetables. Weigh out a portion of the foods you eat regularly, like breakfast cereals, pasta and rice, to see what the suggested portion size actually looks like. Read labels of prepacked foods to find out how many servings are included it might be more than you think. Rather than automatically going back for seconds, wait a few minutes before deciding if you are still hungry. Leftovers don t need to go to waste most foods can be chilled and kept for the next day. 16

17 What does a healthy portion look like? Here are some examples of healthy portion sizes for an average adult. * STARCHY FOODS: Eat 2 portions at each main meal. Choose wholegrain varieties. RICE & PASTA 2 3 tablespoons (cooked) POTATO 2 egg-sized potatoes BREAD 1 medium slice BREAKFAST CEREAL 2 3 tablespoons (unsweetened) DAIRY FOODS: Eat 2 3 portions a day. Choose lower fat, unsweetened varieties when possible. CHEESE 30g the size of a small matchbox YOGHURT & FROMAGE FRAIS 1 small pot eg. low-fat plain yoghurt MILK 1 glass eg. skimmed milk MEAT & ALTERNATIVES: Eat 2 3 portions a day. Eat more pulses and fish. Choose lean meat and aim for less than 500g of red meat (cooked weight) a week. Avoid processed meat. MEAT & POULTRY 80g (cooked weight) the size of a pack of cards WHITE & OILY FISH 140g (cooked weight) the size of a slim glasses case SOYA, TOFU & QUORN 120g the size of a snooker ball PULSES (peas, beans & lentils) 3 4 heaped tablespoons eg. cooked mixed beans EGGS 2 eggs FATTY & SUGARY FOODS Try to avoid high-calorie processed foods. eg. crisps, chips, sweets, cakes, biscuits, pastries * The number of portions you should have may vary depending on your age, gender and how active you are. 17

18 Cut down on red meat Meat, especially red meat, is often seen as the star of a meal but, by reshaping your plate, you can reduce the amount you eat without going hungry. Not only can this lower the calories on your plate, but it can benefit your purse and reduce your cancer risk too. What is red meat? Red meat is beef, pork, lamb and goat. As red meat is a good source of nutrients, it can form part of a healthy, balanced diet, but we don t need to eat it every day. Aim for less than 500g (cooked weight, which is about g raw weight) a week. Regularly eating more than this can increase your risk of bowel cancer. What is processed meat? Processed meat includes bacon, salami, chorizo, corned beef, pepperoni, pastrami, hot dogs and all types of ham. Meat is considered to be processed if it has been smoked, cured or had salt or chemical preservatives added to it rather than having just been cooked or reformed (like some sausages and burgers). Red meat how much a week? Here s an example of how you could have four meals a week containing medium-sized portions of red meat and still stick to less than 500g (cooked weight): Spaghetti Bolognese with minced beef = 140g (about 200g raw weight) Small pork or lamb chop = 75g (about 110g raw weight) Medium steak = 145g (about 210g raw weight) Roast beef, pork or lamb (3 thin slices) = 90g (about 130g raw weight) 18 We recommend avoiding processed meat because there is strong evidence that it is a cause of bowel and stomach cancer. It also tends to contain added salt, be higher in fat and provide fewer nutrients than unprocessed red meat, making unprocessed red meat the better choice if you do eat red meat.

19 Top tips for making healthier choices Read food labels Food labels include lots of useful information to help us make healthier choices. Use the front-of-pack traffic light label to see, at a glance, if a food is high, medium or low in fat, sugar and salt. You can also use food labels to compare calorie content and see how many servings are in a pack. A pinch less salt The average woman in England consumes 6.8g of salt a day, that s above the recommended maximum of 6g a day. Although the evidence linking added salt to stomach cancer has become less clear partly because of the difficulty in measuring salt consumption we cannot rule out the link, and eating too much salt is still a health concern. Therefore we recommend consuming no more than 6g of salt a day that s about one teaspoon. As well as not adding salt when you are cooking or at the table, it is a good idea to check food labels as foods like biscuits, soups and breakfast cereals may contain more salt than you expect. Make realistic changes It is important to make changes that you can stick to. Take small steps to achieve your goals, such as: Eating half a chocolate bar with a piece of fruit if you d normally eat a whole bar. Sharing your treats. Order one dessert or a side of chips to share. Choose wholegrain varieties of breads, pasta, rice and unsweetened breakfast cereals. They are higher in fibre so will help you feel fuller for longer. Trim the fat Fat is high in calories. To cut down, try to: Choose lower fat dairy, like reduced-fat cheese, skimmed milk and low-fat natural yoghurt. Swap butter for reduced-fat spread. Avoid pastry. Opt for lower fat mayonnaise and salad dressings. Measure oil into a teaspoon, or use an oil spray. Use healthy cooking methods that use little or no fat or oil, such as baking or grilling.

20 Think about what you drink Whether it s a glass of wine with a meal, or a gin and tonic at the end of a busy day, for many of us, drinking alcohol can become a normal part of day-to-day life. And, while the immediate effects of drinking alcohol are obvious, we often don't think about the longer-term impact on our health. There is strong scientific evidence that all drinks containing alcohol can increase your risk of mouth and throat, oesophageal, breast, bowel, stomach and liver cancer. For some cancer types, alcohol is particularly harmful if you also smoke. To reduce your cancer risk as much as possible, we recommend not drinking alcohol at all. If you do choose to drink alcohol, follow national guidelines. In the UK the guideline is to drink no more than 14 units a week, which is roughly equal to seven drinks, spread over at least three days. Alcohol and weight gain Alcohol can be surprisingly high in calories and offers few of the healthy nutrients your body needs. What is a drink? A drink contains about grams of alcohol, so one drink is the same as: Half a pint of normal strength beer, lager or cider (3 5% ABV*) One 25ml measure of spirits such as vodka or whisky (40% ABV*) A pint of beer or lager contains about 170 calories similar to 3 chocolate chip cookies. A large (250ml) glass of wine contains about 190 calories similar to a butter croissant. One small (125ml) glass of wine (12 13% ABV*) Cutting down on alcohol could help you to maintain a healthy weight, further reducing your cancer risk. * Alcohol by volume the strength or amount of alcohol a drink contains 20

21 Swap soft drinks It is easy to forget that soft drinks contain calories too. Evidence has shown that sugary drinks such as cola, lemonade, flavoured milks and coffees, cordials and squashes like blackcurrant juice drink can contribute to weight gain if consumed regularly or in large amounts. It is easy to drink a lot, as they don t fill you up despite being quite high in calories. Natural fruit juice is a source of healthy nutrients but also contains a lot of sugar and has lost most of the fibre you d get by eating the whole fruit so it is best not to drink more than one small glass (150ml) a day. Similarly, milk provides vital nutrients like calcium, but also contains calories, so opt for skimmed or semi-skimmed versions. Swapping sugary drinks for lower calorie alternatives like water, low-calorie soft drinks, or unsweetened tea and coffee with a small amount of milk can help you to keep a healthy weight. Top tips for savvy drinking: Opt for the smallest serving size. Avoid double measures of spirits. If you drink alcohol at home, pour small measures. Alternate between alcohol and water or low-calorie soft drinks. Dilute alcoholic drinks ideally with a low-calorie mixer. For example, opt for a small wine spritzer with soda water rather than a large glass of wine. Swap sugary soft drinks for lowcalorie versions, or better still, sparkling mineral water with a slice of lemon, lime or cucumber. Instead of a large glass of fruit juice, pour a small portion and dilute the juice with sparkling mineral water. Instead of sweet, frozen coffee drinks, try an iced Americano with a splash of milk. Swap chai tea lattes for a black tea with fresh mint leaves you ll be surprised how sweet it tastes. Rather than regular lattes, opt for skinny versions of less milky coffees like Americanos or cappuccinos (without chocolate) to cut the calories and sugar. 21

22 Dietary supplements Despite the promises made by some manufacturers, we advise against taking supplements to reduce your cancer risk. Instead, aim to meet your nutritional needs by eating a varied, healthy, balanced diet. Whole foods provide more than just vitamins and minerals. For example they contain fibre, which is important for bowel health. For this reason supplements shouldn't be used as an alternative to eating well. What are supplements? Supplements contain: vitamins; minerals; other components of foods such as lycopene, found in tomatoes; herbs; and plant materials such as ginseng, garlic and green tea, sometimes in high doses. Supplements can be in pill, capsule, powder or liquid form. Supplements and cancer Evidence to date is inconsistent. Some studies suggest that high-dose supplements can actually be harmful. As the effect of supplements on cancer risk is unclear, it is best not to use them to protect against cancer. Who may benefit? Most people can meet their nutritional needs by eating a healthy, balanced diet. However, some groups may benefit from taking supplements, such as people who restrict their diet due to allergy or through choice; frail, older people with a poor appetite; women of childbearing age and new mothers; children under the age of five; people with darker skin; and those who are not exposed to much sun, such as housebound people or people who cover their skin. People with bowel diseases, those who are being treated for cancer or who have survived cancer may not be able to absorb enough nutrients from their diet or to eat a normal diet, so may also benefit. In such cases, a doctor, dietitian or specialist nurse will be able to provide advice. 22

23 If you can, breastfeed your baby Breastfeeding is a personal choice but, if you are a new mum or have a baby in the future, choosing to breastfeed can have many benefits for you and your baby. If you are able to, it is best to only give your baby breast milk for the first six months of life. After that, your baby will benefit if you continue to breastfeed alongside introducing other foods and water. Even if you can t do this, any breastfeeding is beneficial for you and your baby, and the longer you breastfeed for, the longer the protection and benefits last. What are the benefits for your baby? Breast milk is the best start for your baby as it contains all the nutrients your baby needs for healthy growth and development. It helps protect your baby from infection and disease, and can also help you and your baby to bond. Breastfed babies are also less likely to become overweight or obese later in life compared to babies fed on infant formula. Helping your baby to be a healthy weight throughout their life means you are reducing their risk of developing cancer in the future. What are the benefits for you? As well as being good for your baby, breastfeeding can also reduce your risk of breast cancer by: Helping you to lose any excess baby weight more quickly. Lowering the levels of some cancer-related hormones in your body. Getting rid of any cells in your breasts that may have DNA damage. 23

24 Move more Life can often get in the way of staying active, but making time for physical activity is important for your health. Doing at least 30 minutes of moderate to high intensity physical activity every day can reduce your risk of cancer as well as help you maintain a healthy weight and feel great. Whatever your age or level of fitness, it is never too late to start. Why being active can reduce your cancer risk u There is strong evidence that being physically active helps protect against cancer of the colon (part of the large bowel), breast (in postmenopausal women) and womb. u Studies show that regular activity can help to keep hormone levels healthy. This is important as having high levels of some hormones can increase cancer risk. u Being active can lower insulin resistance (a condition where the hormone insulin becomes less effective at lowering blood sugar levels), which has been shown to have a role in cancer development. u Activity helps move food through the digestive system more quickly, reducing the amount of time that any cancer-causing substances are in contact with the lining of the bowel. u Being overweight or obese is linked to many types of cancer. As physical activity uses calories, it can help in maintaining a healthy weight. Other benefits of being active: u Reduces risk of heart disease, stroke and Type 2 diabetes u Eases symptoms of arthritis u Reduces risk of depression and anxiety u Reduces risk of cognitive decline and dementia u Improves balance u Helps lower blood pressure u Improves blood cholesterol levels Despite the wide range of benefits that can be gained from physical activity, only 1 in 2 women are active for at least 30 minutes on 5 days each week (England, 2012). 24

25 Practical tips for getting active Active transport Rather than using public transport or driving to work, try cycling, jogging or even power walking for part or all of your journey. Lunch break If you work in an office, use your lunch break to get active. Maybe you have a gym nearby where you can go for a swim or attend a class, or simply stick on your trainers and go for a jog or brisk walk. Bringing in your lunch makes this even easier. Be proactive Make small adjustments to your normal routine like taking the stairs, walking up the escalator, or getting up to talk to a colleague. Keep it fun An activity you enjoy is much easier to stick at. Inviting a friend, family member or colleague for a game of tennis, or to join you for a jog can make it more fun for you and help make them healthier too. Sit less As well as moving more, it is important not to sit or lie down more than necessary, when not sleeping. Limiting your sedentary time can help you maintain a healthy weight. If you work in an office or spend a lot of time sitting down, try to take regular standing breaks. See how many calories some popular activities burn: 25

26 Mix up your movement Being active doesn t just mean going for a run. There are three basic types of physical activity: aerobic activity, strengthening (also called toning or resistance) and stretching. Each one helps your body in a different way so aim to include all three in your routine. Aerobic activities Activities that raise your heart rate and make you breathe deeper for a period of time. u Frequency: Fit in some aerobic activity five or more days a week. u Intensity: Aim for moderate (where you are still able to talk) to vigorous (where talking becomes difficult and you might be out of breath). u Duration: Aim for at least 30 minutes. This can be all in one go or spread throughout the day. u Type: Includes brisk walking, jogging, playing tennis, cycling and swimming. Strengthening Activities that work your muscles against weight or resistance to increase strength. Women often don t consider this type of exercise as important as they aren t aiming to build big muscles. However, from the age of 30, our muscle strength starts to decrease and strengthening exercises can help to combat this and keep us toned. That s why strengthening exercises are important for everyone. u Frequency: Two or more days a week. u Intensity: You should be able to complete 8 12 repetitions of each exercise. u Duration: Three sets of 8 12 repetitions of each exercise with a 30 second rest between sets. u Type: Includes using hand weights, resistance bands, weight machines or exercises that use your own body weight, such as squats. Try to work all the major muscle groups across the week (abdomen, arms, back, chest, gluteal muscles, legs and shoulders). 26

27 Stretching Stretching is important for improved flexibility and balance. Aim to include exercises that work your joints through their full range of motion as part of your exercise routine. These exercises tend to be gentle so they don t count towards your recommended 30 minutes of daily activity. First, warm up It s important to warm up before doing any exercise. Gentle aerobic exercise warms up the muscles and joints so there s a lower risk of injury, particularly from strength exercises and stretching. How many calories you can burn Here are some examples of activities you can build into your day, and a guide to how many calories you can burn in 30 minutes.* CYCLING PLAYING SQUASH JOGGING 265 calories 260 calories 250 calories SWIMMING WEIGHT TRAINING GARDENING 210 calories 175 calories 135 calories * This shows the approximate calories burnt by a 70.7kg (11st 2lb) woman of average build. 27

28 Smart goals for a healthier you Now you ve read through this booklet, you can start to think about how your health could benefit by making changes to your diet and lifestyle. Changing a habit can be difficult, even if you know it is for the good of your health. For most people, trying to change too much at once will not be successful. Instead, make small, gradual changes that you are much more likely to stick to. Set SMART goals SPECIFIC: A defined action rather than a vague statement. For example, instead of I m going to walk more, say I m going to go for a 15-minute walk each evening before dinner. MEASURABLE: Can you say with certainty that you have achieved your goal each day or week? For example, say I ll add a piece of fruit to my breakfast each morning, rather than I will eat more fruit. ATTAINABLE: Can you do it? For example, if your goal is to walk to the shops, are the shops within a distance you are able to walk? REALISTIC: Does it fit into your routine? For example, can you make the time to do it? Or if your goal is to walk to the shops, can you get your shopping home without the car? TIMELY: Decide on a date when you can start, and set target dates to reward yourself for keeping on track. Make a record of your goals and how you are going to achieve them: GOAL 1 GOAL 2 GOAL 3 If you aren t sure about what goals would work for you, ask your doctor, dietitian or a nurse for advice. 28 To help support your goals, start filling in the diet and physical activity diaries on the next two pages. These will show you how well you are doing and help you to spot areas where you could make changes to improve your health.

29 Diet diary Use this meal planner for the week ahead to keep your diet balanced. Breakfast Lunch Dinner Portions of fruit & veg Monday Tuesday Wednesday Thursday Friday Saturday Sunday 29

30 Physical activity diary Use this diary to record any activity (eg. walking, jogging, vigorous housework) you did this week and for how many minutes. Today I achieved: Types of activity Time being active Monday Tuesday Wednesday Thursday Friday Saturday Sunday To download more copies of these diaries, visit: 30

31 Cancer Prevention Recommendations 1 Be a healthy weight. Keep your weight as low as you can within the healthy range. 2 Move more. Be physically active for at least 30 minutes every day, and sit less. 3 Avoid high-calorie foods and sugary drinks. Limit high-calorie foods (particularly processed foods high in fat or added sugar, or low in fibre) and avoid sugary drinks. 4 Enjoy more grains, veg, fruit and beans. Eat a wide variety of wholegrains, vegetables, fruit and pulses, such as beans. 5 Limit red meat and avoid processed meat. Eat no more than 500g (cooked weight) a week of red meat, such as beef, pork and lamb. Eat little, if any, processed meat, such as ham and bacon. 6 For cancer prevention, don t drink alcohol. For cancer prevention, it s best not to drink alcohol. If you do, limit alcoholic drinks and follow national guidelines. 7 Eat less salt. Limit your salt intake to less than 6g (2.4g sodium) a day by adding less salt and eating less food processed with salt. 8 For cancer prevention, don t rely on supplements. Eat a healthy diet rather than relying on supplements to protect against cancer. Special Populations: 9 I f you can, breastfeed your baby. If you can, breastfeed your baby for six months before adding other liquids and foods. 10 Cancer survivors should follow our Recommendations. After cancer treatment, the best advice is to follow the Cancer Prevention Recommendations. Check with your health professional. And, always remember do not smoke or chew tobacco. 31

32 About World Cancer Research Fund We are the leading UK charity dedicated to the prevention of cancer. Our mission is to champion the latest and most authoritative scientific research from around the world on cancer prevention and survival through diet, weight and physical activity so that we can help people make informed lifestyle choices to reduce their cancer risk. Cancer currently affects one in two people in the UK but about a third of the most common cancers could be prevented by following our Cancer Prevention Recommendations. That s around 80,000 cancer-free lives every year. The cornerstone of our research programme is our Continuous Update Project (CUP). It s the world s largest source of scientific research on cancer prevention and survival through diet, weight and physical activity. The CUP reviews new research findings to ensure our advice is always up-to-date. Find out more: For the references used in this booklet or for tips and advice to reduce your cancer risk, please contact us on the details below. World Cancer Research Fund 22 Bedford Square, London WC1B 3HH Tel: wcrf@wcrf.org twitter.com/wcrf_uk facebook.com/wcrfuk Blog cancer-prevention.org Registered in London, England No: Registered with the Charity Commission in England and Wales (Registered Charity No: ). Registered Office: 22 Bedford Square, London WC1B 3HH. All information correct at time of print World Cancer Research Fund WEA8WHG Next review date August 2019