Let's separate fact from fiction! In this conversation on cancer, Dr. Mridul Malhotra, Medical Oncologist, and Dr. Vaishali Verma, ...

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Cancer Podcast | Dr. Mridul Malhotra and Dr. Vaishali Verma | Manipal Hospital Delhi

[Music] hello everyone I am dietitian stutti in our social system in today's world there are a lot of myths and misconceptions regarding cancer and most of these myths and con misconceptions are related to food or our eating habits so it is very important that we get correct information on these doubts on the occasion of world cancer day we are here to clarify those doubts with the help of research based evidence and with the help of our esteemed experts so I would like to welcome our experts Dr mul motra senior consultant Department of medical oncology manipal hospitals dwarka and we also have with us dietician vishali VMA head of nutrition and dietetics manipal Hospital dka thank you so as we go forward my first question is to Dr motra and I would like to ask that sir that why particularly This research paper was chosen and what do you think is the significance of This research yes uh so let me put some light uh we have taken this uh research paper it is a recent publication in uh nature Communications which is easily a available to everyone and uh in this research paper basically they have looked into around um 5 lak 52,000 uh females who are originally from uh you United Kingdom and in that it was prospectively studied for over a period of 16 years and then in this they saw that the incidence of the colon cancer was around 14,250 in this paper they have correlated this incidence of colon cancer with 97 dietary factors so it is a huge research there are certain uh things that we already know that will be subsequently discussing but a lot of good insights have come out of this paper and usually we are not discussing about these things because these are primary preventive factors which will help us that the cancer will never occur in our body so it becomes very important that we disseminate this knowledge and let people be aware of this okay and dition Vali what is your uh points on this why this research was chosen uh yes as a doctor said uh so we can take an idea from this paper because there is a lot of misconception regarding the milk or regarding the fiber sometime the people say broccoli there is a lot of misconception towards diet so in this paper only they had taken the 96 food item and in terms of uh vitamin minerals riboflavin calcium phosphorus whole green cereals there is a lot of factor which they explain very well and that is a with the HED time of period which was a 16 years so yes it's a good paper to discuss on that okay so we know that there are a lot of pro promoting factors uh basically that we are discussing on coloral cancer and there are a lot of promoting factors so I would like to discuss on those promoting factors so uh Dr motra what do you think how does alcohol consumption leads to risk of colorectal cancer this is very important question alcohol per se it has been labeled as a class one carcinogen by various International agencies that are doing the research on the cancer so class one carcin carcinogen it is clearly proven alcohol consumption cancer now how does it ca basically there are several mechanisms d m which in turn leads to cancer second important thing Al hor horon and horon third important thing retive oy species these reactive oxygen species they again react with the stable compounds like DNA RNA and all those things again DNA damage and then eventually it leads to mutations and promotes cancer so preliminary cons smoking consumtion alcohol per acts as a solvent alcohol and by virtue of that Effect 1 + 1 2 this is exp so these are four M important factors alcohol leads to production of cancer in the body okay thank you so much because as we know that basically the trend of alcohol consumption is particularly rising and it's majorly seen in the Young Generation that we are call as genzi or all these things so it is good that they'll also get some knowledge apart from that we also know there are other promoting factors and I don't know whether it is a myth or a fact but we have also heard about red meat being a promoting factor in uh colon cancer so Di V what is your uh point on that it's a completely this paper is showing the result if you are including the red meat uh in daily routine so we are going to increase the uh colog cancer uh in India also because uh nowadays red meat culture also has been increased in India and how I will say it's it is going to cause so when we are consuming red meat so there is a compound nitrate and nitrites when the if that is that red meat is going to digest so n nitroso compounds which is known as the carcinogen the factor is nowadays it has trend has been increased for the processed meat if you heard even so you also know about that processed food uh processed meat that culture has been increased that contains a high amount of preservative and the because of the high salt contents that damage the lining of the intestine so if that that is going to is there is a inflammation cause and even that everyone talk about the hiron okay if there is a HB on the lower side then we should consume animal protein because it's rich in hiron so that paper is saying can heem iron if we are taking above from the moderation limit that is also the patient will fall in the um colorectal cancer so we should not consume the red meat yes that's right but as as dietitians also and as doctors also are suggesting we also suggest to our patients that if you are having anemia or if you want to increase the protein intake especially after some injuries or trauma so doctors are advising dietitians are also advising animal protein to increase uh the the hemoglobin levels and to promote recovery so is there any set level for that or see uh yes I got your question so basically we can include the white chicken because if we see the amount in a mg so white chicken contains 0.2 G per 100 gam and their red meat contains 1.2 to 1.5 G per 100 G that is also not good which this study state so in a one go if we are controlling on the amount we can increase because there is a lot of option in a white chicken also which we can consume for the uh to increase the hemoglobin okay so now that we know what are the promoting factors uh in this research it has also been discussed about the preventative factors of colal cancer and Dr motra I would like you to elaborate on the significance of calcium in particularly reducing the risk of colorectal cancer definitely so that was the highlight of this paper where uh they have shown uh that uh supplemental calcium uh it reduces the risk of colal cancer supplemental calcium they said the calcium quantity to be around 300 Mig is protective and it reduces the risk of cancer colal cancer by 17% in addition to that when they evaluated the diary products and uh its association with the calcium they said that basically this calcium effect if it comes through the dairy products uh predominantly and the quantifi quantity that they have given is they have given 200 Mig of dairy products per day say reduction of cancer that is the tune of 40% so important point that daily product consumption and micro so that actually the calcium and the phosphorus in the dairy products that helps to reduce uh the risk of cancer significantly uh specific with respect to theal cancer  cancer so basically calcium it binds to the B and the free fatty acids in the colonic Lumin so when it binds to that that it nullifies the car carcinogenic effect of these two things and especially when calcium is available along with phosphorus maybe this is the reason that milk per se reduces the risk of colal cancer much more than calcium supplements alone so this is one mechanism just say when we eat more of the calcium especially with the dairy it reduces the risk of colal cancer uh even though sir addition to that uh milk contains the lacto ferin also so lactoferrin have that antioxidants property which is going to clean the free retical so as we talked about alcohol being a promoting factor in in in coloral cancer but still as we know alcohol is a major part of our social system it is being used by youngsters I think over 18 all age groups are being using alcohol at some point so do you recommend this is there any safe dosage for alcohol consumption or as people say that wine is considered to be a healthier option than other types of alcohol like beer or uh whiskey so is what would you like to put some light on this topic well it's a very relevant question in today's eram so interestingly there is another paper that was recently published and it was in news all around the world this paper was published in uh US Surgeon Journal which is a very reputed uh Journal all around the world so this was an epidem ological stud Al canc interesting findings number one was that uh uh the people in us around 90% of them are consuming the alcohol but only 45% of the people are aware that alcohol can cause cancer so we need to inre improve the awareness level for everyone number two coming to your question ke uh about the dosage there is no no safe level of consumption of alcohol even people who consume less than one uh drink per week the risk of acquiring cancer is 177% in females and 10% in males so no level of alcohol is safe coming on to the when we increase the dose of alcohol when we consume more amount of alcohol so as we increase the dose from less than one drink per week to two drinks per day the there is additional risk of additional five women to acquire cancer and additional three men to acquire cancer so additional people will be at risk they also looked as the at at the dose of alcohol and relationship with the breast cancer and they saw as the dose increases from less than one drink per week to two drink per day there are additional four women who are at risk of breast cancer okay this is about the dosage coming out to the type of alcohol so uh people say some people would say that wine is healthy wine is good for heart but any uh drink it contains certain amount of alcohol if wine has lesser amount of alcohol when compared to the whiskey but if you consume wine at a greater uh amounts probably the exposure of the alcohol is same in the body so there is no drink that that contain alcohol is safe there is no particular type that is safe for the body so the end product is going to be as we have discussed it is going to be ATI exactly exactly okay fine so this paper has also shown that alcohol increases the risk of seven types of cancer those seven types of cancer are cancer of the oral cavity cancer of the throat cancer of the voice box cancer of the food pipe cancer of the liver cancer of the breast and cancer of the colon in the rectum as we discussing so these are the seven cancers that Callum that alcohol increases the risk and because of this Surgeon General has advised that there should be warning labels on alcoh alcohol containing beverages the way these labels are there on the tobacco containing products they are now promoting that these labels should come on the Alcohol containing beverages we don't know how much it will be implemented but it is a big news and it is a big wakeup call for everyone that watch for your alcohol consumption and curb it as early as possible so sir as you talked about calcium and its intake related to uh the risk reducing the risk of coloral cancer so we have seen in the new generation there is a new trend emerging known as the vegan diet so what do you think that the people who are on vegan diet on a long term do they have a higher risk of getting chal cancer so it's a very relevant question in today's uh era um I would say this paper has clearly shown if your calcium is coming from the milk products it has reduced the risk of colal cancer by 40% if your calcium is coming in the form of calcium supplements which is probably not related to the dairy products then uh the risk of reduction of the colal Calin is still there but it is to the tune of 177% so it is totally up to people uh whether they want a greater reduction in the risk of potin cancer or they want to avoid the dairy products I would say if you are vgan by choice I think you should try the milk products because it definitely has a better impact in reducing the risk thank you sir that was really informative because it's a great message to our Young Generation who are blindly following the vegan diet even if it is required or not so Vali my next question is for you that as we know calcium is good and it is reducing the risk of colored cancer how do we incorporate in that in our diet so that we are also meeting our daily requirements and plus we are also not exceeding the requirements and causing toxicity in the body see so as uh if you as the paper research paper is saying 200 mL milk is sufficient because uh see they are talking about they has taken the example as a 200 mL they introduced a 200 mL milk to see that result so if you are including Dair products 200 to 500 mL which we suggest to our patient as per BMI as per the lipid profile reports that is totally different scenario but 200 mL milk can be consumed in any situation until or unless patient is not a lactose intolerance if I talk about the RDA so 1,000 mg per day calcium required so if if we are not focusing on to protect the col rectal cancer or any kind of cancer at least if we are focusing for the Rd which is the recommended dietary allowances so we should uh include the dairy products the curd these thing in our daily routine and yes this paper state that we cannot include cheese and ice cream because the next question from The Young Generation even the children okay I if I don't consume the milk I consume the cheese and the ice cream so I can get that calcium so in this paper that is clearly said you have to include the C yogurt milk these kind of thing apart from that see that uh 25% although in a daily routine Diet also so we when we are deciding the calcium so we include 25% from the dairy products only rest is the cereal seeds like cesame seeds it's a very rich in calcium so to complete the RDA there is a complete plan which we add in for the calcium sources but yes here I for this uh concept I will say 200 mL to 250 ml milk is sufficient if you are not eating direct milk you can use that milk to prepare the dough I will say for the chapati okay so I believe the essence of incorporating any vitamin which is considered might be considered a superfood is it should always be in a balanced amount exactly yes right okay fine so we have also heard sir that fiber is a good good for colon or the intestines so what do you think that how does whole grain consumption is reduced related to reduction in the risk of coloral cancer this is very AP question and this has also been addressed in this paper so uh what fiber does is fiber is inre fiber increases the bulk of the uh our luminal contents so when we eat fiber it basically dilutes the effect of the all the carcinogens the cancer causing things which are bile acids and fatty acids so it dilutes its effect and it also reduces the transit time that for the for the the luminal contents will be Avail available uh to cause the inflammation for a shorter period of time so it reduces the transit time eventually all the toxins they are diluted and they are flushed out of the system so that is the way where the whole grains and the fiber containing products they are asked to add to the diet and they reduce the risk of coral cancer okay thank you sir so uh again same question when we get to know that this thing is good we always need an opinion from the dietician that how do we incorporate this we know we have to eat this so what do you think that whole grain and the new trend or we can say actually it is good that millets are on a rising Trend so so how does whole grain fiber all these things can be incorporated into the diet again so that it does not increases the tox so the uh this question today we are discussing but if you see the Indian diet pattern which we we were following before 10 to 15 years that was completely rich in the whole grain cereals I will say and that was rich in the fiber but again this study is also based in the UK and there were there is a trend to increase or include in their diet just only the refined products they eat only bread biscuits or pasta pizza or these kind of trend we are adapting from there only so if we are not going to adapt those things so we will uh we are preventing to ourself from cancer and all because uh sir will say about that uh colal cancer if you get the patients so I think the maximum number of that belongs to the those countri right right so basically if you look at the incidence and the prevalence of the colal cancer it is third third most common cancer worldwide and majority of it comes from the Western World from the United States from the Europe from the Australia New Zealand all all these places that is because of the dietary Department one important thing that was also noticed that uh people who have uh the who have migrated to new places you know the incidence of colon it uh changes to that place to which the people have migrated over a period of 10 years so if you have a change dietary pattern over period of 10 years your uh risk of acquiring the colal cancer becomes similar to that place from where the person has migrated which tells us that there is an extrinsic factors that are playing role in causing C Ral cancer and diet being the most important of them so basically uh the diet which I will back to your question to incorporate the whole grain cereal now we need to learn the whole grain cereal because we are totally adapting the foreign culture and being a dietitian it's request to my audience please eat low local and seasonal associated with your root and that is the balanced diet kindly follow that if we talk about the whole grain cereal your Dalia your millets as you were talking about even your whole wheat flour rooty nowadays there is a trend uh then we need to add the brand in wheat flowers or in Chila and all because there is a in a wheat flour also that is a kindly refined flour so because there is no husk so uh there should be a balance in a whole grain cereal yes salads which I basically if you see your breakfast so nowadays there is a use of vili pasta suji based preparation so if you are going to grind the suji that is again the MAA that is just one uh I will say 1 to 2% best from your refined flour but again this is a refined thing only so try to incorporate the whole grain cereals in the form of your jaw or gunia or you can include put the more of vegetables in it in it if you are making any preparation of the suji and try to incorporate some sprouts and all so you will get the cooked form of fiber and whenever you are having your lunch or dinner or you are if you are making the vegetable moong Dal or Chila kind of you can include the vegetable RA in a Dal you can add like palak Dal thank you so much so now we know that how to incorporate these things in our diet and it is also very important to consider that all the things that we hear on the Internet or the emerging Trends or The Fad diets that are coming it is always important to take the expert advice so that we never go wrong and we always having a healthy and healthy body because Healthy Mind healthy body everything is going to be basically increase your longevity so I thank you both Dr mul motra and dietician vishali Verma for their esteemed advice and I believe that on the occasion of this cancer day we are learning something new and and we are helping those people who are in need of our help so that this information reaches to them thank you thank you thank you [Music] [Music]

Dr.

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