Date: Jul 01, 2014
July 2014: The Doctor Tells All-Link Between Cancer & Nutrition

The scourge of cancer is a menace we all want defeated.  As producers of fresh fruits, vegetables and tree nuts, farmers are helping to do that by preventing obesity and providing good nutrition and roughage in people’s diets.  I had the pleasure to speak with one of the top physicians in cancer research and prevention, Dr. Otis Brawley, chief medical officer for the American Cancer Society (ACS).  Here’s what he had to say about the kinds of food our farmers grow and how diets that include fresh fruits, vegetables and tree nuts help prevent and fight cancer and other chronic diseases.


How does obesity contribute to cancer risk?

There have been a number of epidemiological studies that show a correlation between cancer and obesity.  Obesity is linked to a dozen different cancers from prostate, colon, kidney and pancreatic cancer to breast and uterine cancer. But cancer isn’t the only disease it is linked to and obesity isn’t the only factor.  Lack of physical activity and high caloric intake contribute.  It’s like a three-legged stool.  Studies, both population-based and animal-based, have shown this.

How do we arrive at this causation?  At the molecular level, we still struggle with verifiable causation and don’t know exact causes, but we are looking at several theories and hypotheses.  It is known that people who are overweight and don’t exercise have high amounts of circulating insulin.  This is very common in someone with Type 2 diabetes.  For example, a diabetic who is six-feet tall and weighs 200 pounds has more circulating insulin than someone the same size who is not diabetic.

Type 2 diabetes is a disease of insulin resistance and while an increased amount of insulin helps overcome that resistance, it may also stimulate the growth of cancer tumors.  Insulin doesn’t cause cancer, but without stimulation from insulin, cancer cells might very well just die on their own and no one would ever know a patient ever had cancer.  Another fact is that fat produces estrogen and estrogen plays a role in the growth of breast and uterine tissue.  This may be the reason why overweight people who have high caloric intake and little physical activity, have increased risk of breast, uterine and prostate cancer.


Good nutrition is important in fighting disease.  How does the consumption of fresh produce contribute to health?

For some time now, the USDA, American Cancer Society and the National Cancer Institute have recommended people try to consume five to nine servings of fruits and vegetables a day.  There are many reasons for this.  People who eat this many servings decrease the amount of hunger they have and decrease the number of carbohydrates and animal fats they consume.  We used to think eating fruits and vegetables was all about the vitamins and minerals they have, but that actually has little to do with the benefits.  Eating five to nine servings is a way to have a lower calorie diet.

The roughage in vegetables, fruits and nuts helps with digestion.  It is thought that this decreases the risk of colorectal cancer.  Roughage increases stool transit time which decreases the exposure in the colon to carcinogens.


Our members grow both organic and conventional fresh produce.  A recent British study concluded there was little or no decrease in the incidence of cancer associated with consumption of organic food.  What is your opinion?

I tend to look at a number of different studies and articles.  Of the majority out there, there is not an advantage to organic food nor is there a disadvantage to non-organic produce except for price as long as it (fresh produce) is adequately cleaned and washed.  I am aware of a number of studies that have looked at the question, “Is organic food safer?”  I have never been able to find convincing evidence that organic is safer and there are concerns of bacterial infection among organic produce.


The 2014 California Cancer Facts book states that only 29 percent of California adults reported eating the recommend amount of fruits and vegetables each day.  What do you have to say about that?

There are certain states, especially in the southern U.S., where the average consumption of fruits and vegetables for the entire population is less than one serving per day.  Many of those folks think French fries are a vegetable.  We have gone from 4 percent of kids aged 6 to 11 being obese in 1970 to 20 percent in 2010; and from 15 percent of American adults in 1970 to 36 percent of adults in 2010.  In certain locations 50 percent of black adult women are obese; and 45 percent of Hispanic women are obese.  We desperately need to focus on both diet and exercise.

We are approaching a tsunami of chronic disease, like cardiovascular disease, diabetes, cancer and orthopedic injury due to being overweight (hip and knee replacements, arthritis).  Increasing health care costs are part of the tsunami of chronic disease.


Is the Affordable Care Act an answer to improving the health care system in the U.S.?  What more could be done to improve the law?

ACA is by no means perfect — but it is better that the system we had.  When fully implemented, it will allow more people to have good healthcare.  I suspect it will be tweaked and changed just as other sweeping laws were like Social Security and Medicare.  The ACA is better than the system we had before especially in its emphasize of disease prevention.  The ACA is not the solution to all disparities of the health care system, but it is a dramatic improvement.


Dr. Brawley, we ask everyone we interview for our magazine about his or her own preferences for healthy foods.  What are some of your own favorite fruits and vegetables and tree nuts?

It’s sometimes a struggle for me to eat five to nine servings a day, I admit, but I do love melons: cantaloupe, honeydew, and watermelon.  I also like asparagus and broccoli.  I once told that to President George H.W. Bush and he looked at me like I was a total fool.  He hates broccoli and will tell anybody that.  I love it, and if you cook Brussels sprouts the right way — with a bunch of garlic — they’re delicious.


What else would you like our members to know?

I do a lot of international and global work in underdeveloped countries.  When I go to Africa and Asia, it’s about people not being able to get enough calories.  Then in the U.S., it’s about people getting many calories, but not the right kind of calories.  There is a different kind of malnutrition here.  Quality calories should have variety and diversity.  Fruits, vegetables and nuts (a great source of protein and a good between-meal snack), are part of that diversity.  I think the fruit, vegetable and nut growers of America are doing an incredible service for the American consumer.

Many people in this country are not very sophisticated about fruits and vegetables and don’t appreciate them.  There is a tremendous amount of education in having gardens in schools.  People that do the kind of work I do, have to start learning biology at some point and school gardens are an interesting way to start to learn the biology.  It’s a non-boring way — because you actually get to eat the end products!  It also helps kids appreciate different food.  I’ve spent time in inner-city schools and have been amazed that kids don’t know what lima beans or broccoli are or have never seen asparagus.  I think growing them are a fun way to learn about them.




Otis W. Brawley, M.D., F.A.C.P., chief medical officer for the American Cancer Society, is responsible for promoting the goals of cancer prevention, early detection, and quality treatment through cancer research and education.  He currently serves as professor of hematology, oncology, medicine and epidemiology at Emory University.  From April of 2001 to November of 2007, he was medical director of the Georgia Cancer Center for Excellence at Grady Memorial Hospital in Atlanta.  He is listed by Castle Connelly as one of America’s top doctors for cancer.  A graduate of University of Chicago, Pritzker School of Medicine, Dr. Brawley completed his internship at University Hospitals of Cleveland, Case-Western Reserve University, his residency at University Hospital of Cleveland, and his fellowship at the National Cancer Institute.

For more information about nutrition and exercise go to the ACS website:

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