Read Trevor's essay from the book reproduced below:
Introduction
I first met Anne 10 years ago when she
discovered a breast lump. After preliminary tests, I had the
difficult job of explaining to her that this was a breast cancer
and then discussing treatment options with her. Anne went through
her treatment successfully, and since then I have seen her
regularly for follow-up appointments. She remains well and has
retained her zest for life. As I have got to know her and
discovered her passion for food and cooking, I have realised that
her style of food preparation encompasses many of the principles
that are now considered to be essential for healthy eating. I
suspect that this has played a part in her recovery from breast
cancer.
Healthy eating does not have to be onerous or boring. In fact,
discovering and enjoying new foods can add excitement and interest
to cooking for the whole family. Fewer people these days are
preparing their own meals and consequently most of us no longer
understand much about what goes into our food. Importantly from my
perspective as a surgeon, research shows that healthy eating can
reduce the risk of getting cancer and can also help in preventing
recurrence of the disease in the future This book demonstrates how
some simple guidelines and ideas can be used in preparing meals
that are great to eat, but also healthy. Anne has used her vast
knowledge of New Zealand ingredients to create meals that highlight
tasty healthy cooking with a distinctive New Zealand flavour.
A little bit of theory to set the scene: Cancer rates vary
dramatically across the world. The highest rates occur in Western,
industrialised countries suggesting that lifestyle factors are an
important consideration. The chart below shows rates of breast
cancer in various countries. You will notice that USA tops the list
with New Zealand uncomfortably close behind. Asian counties have
dramatically lower rates.
Interestingly, when women migrate from a low risk country to a
high-risk country they pick up the increased risk within a few
years. The World Cancer Research Fund is a large and
well-established organization. They have systematically reviewed
the available data from across the world on risk factors for all
types of cancer. They published their findings in November 2007.
This quote is from the introduction to their detailed report.
"The estimate of the previous WCRF/AICR Report was that cancer
is 30 to 40 per cent preventable over time, by appropriate food and
nutrition, regular physical activity, and avoidance of obesity. On
a global scale this represents over 3 to 4 million cases of cancer
that can be prevented in these ways, every year. In many of its
forms, cancer is a disease that can cause great suffering and
claims many lives. The overall commitment of scientists and other
professionals committed to disease prevention, as exemplified by
this Report, is to reduce the rates not just of cancer, but of all
diseases, so that more people enjoy good health until they
eventually die in old age."
Here are some of their recommendations for cancer
prevention.
I think that these provide an excellent and practical basis for
healthy lifestyle changes.
Be as lean as possible without being
underweight.
Be physically active for at least 30 minutes a
day.
Avoid sugary drinks. Limit consumption of
energy-dense foods (particularly processed foods high in added
sugar, or low in fibre, or high in fat.)
Eat more of a variety of vegetables, fruits,
whole-grains and pulses such as beans.
Limit consumption of red meats (such as beef,
pork and lamb) and avoid processed meats.
If consumed at all, limit alcoholic drinks to two for
men and one for women a day.
Limit consumption of salty foods and food
processed with salt (sodium)
Don't use supplements to protect against
cancer. Research shows that high-dose nutrient supplements
can adversely affect our risk of cancer, so it is best to opt for a
balanced diet rather than relying on supplements. (Note: some
supplements may be appropriate for specific groups of people.)
Do not smoke or chew tobacco.
Special population recommendations:
It's best for mothers to breast-feed exclusively for up
to six months and then add other liquids and foods.
After treatment, cancer survivors should follow the
recommendations for cancer prevention.
All of these simple measures can be implemented with immediate
effect. You can visit their website (www.wcrf.org) for more detailed
analysis of specific issues and for tips on how to make these
changes.
It should come as no surprise that dietary recommendations form
a key part of this strategy.
The first practical observation is that most of us simply eat
too much relative to our level of physical activity. The body is
very efficient at storing any unused calories as fat. Obesity is
now a major health problem affecting many children as well as
adults. Apart from the well-known risks of diabetes and heart
disease, obesity also increases the risk of a number of cancers.
Reducing the size of a helping and combining this with regular
vigorous exercise would be an excellent starting point for tackling
this problem. We need to reduce our consumption of energy dense,
processed foods, which contain high levels of sugar, fat and salt.
Processed foods also contain many preservatives, some of which can
also increase cancer risk.
There has been a lot of research looking at the chemicals in
natural foods that can limit cancer changes and actually interfere
with the growth of tumours. Phyto-chemicals are naturally occurring
substances that defend plants from disease. Many of these
substances can reduce the risk of cancer and cardiovascular disease
in humans. Research in this area is still in its infancy, but it
seems sensible to me to try to include more of these foods in our
diet. The great news is that many of them are delicious. Free
radicals are chemical molecules that are produced in cells during
normal metabolism that can damage the cells' delicate genetic
material. Antioxidants are chemicals that can neutralise the
harmful effects of free radicals. Many of the
plants that have been shown to reduce cancer risk contain
substances that are powerful antioxidants. Examples are the
carotenoids, flavonoids and retinoids. Carotenoids are the
chemicals that give some fruit and vegetables their bright orange,
green, yellow and red colours. Berries contain powerful
antioxidants called anthocyanins that can protect cells from free
radicals. Tomatoes are rich in lycopene, a phyto-chemical with
several anti cancer effects including being a strong anti-oxidant.
It can reduce risk of prostate cancer.
Broccoli, cauliflower, brussel-sprouts, and cabbage, are all
members of a group known as cruciferous vegetables. They contain
phyto-chemicals called indoles. These increase liver enzyme
activity that helps to metabolise carcinogens. Some also contain
sulphorophane that produces liver enzymes that can block tumour
growth.
Garlic, onions and leeks are members of the Allium family. They
contain allyl sulphides and diallyl disulphides. These chemicals
can slow the growth of cancer cells and increase liver enzymes.
Ginger and Turmeric are both members of the Zingiberaceae
family. These plants come from South East Asia. Ginger contains
gingerol and turmeric contains curcumin. Both of these substances
have powerful anti-inflammatory effects that slow down development
of cancer. They can particularly play a role in preventing colon
cancer.
The quantity of vitamins and phyto-chemicals in plants
diminishes rapidly over time. Try to harvest and use produce that
is as fresh as possible. Eat more freshly prepared salads
containing a variety of brightly coloured fruits and vegetables.
The bright colours are often produced by valuable phyto-chemicals.
Vitamins and phyto-chemicals are best consumed in whole foods
rather than processed into tablets. There are a phenomenal number
of nutrients contained in whole fresh plants that cannot be
filtrated into a bottle. They work best when absorbed together from
fresh food. Most normal people can obtain all of their regular
daily nutritional requirements from a balanced healthy diet high in
fresh fruit and vegetables. It is completely wrong to think that
this can be substituted by a couple of vitamin pills
Modern farming practice involves the use of many chemicals. It
is important to wash fruit and vegetables thoroughly to remove any
chemical residue during food preparation. Better still, grow your
own. That way you know exactly what went onto, and into your food.
Anne buys much of her food from the Otara and Matakana markets
where she can source fresh, organic produce.
Cooking processes can destroy many of the healthy
vitamins and other phyto-chemicals in plants. Anne serves a lot of
fresh produce and uses light and gentle cooking methods to bring
out the flavours of the food. Overcooked steak and chops contain
heterocyclic compounds that can cause cancer. Avoid charred parts
of cooked foods. I love the fact that so much of Anne's food is
grilled or steamed. These are really healthy cooking
techniques.
High consumption of red meat is linked to increased rates of
bowel cancer. WCRF recommend consuming less than 500g of red meat
per week. Anne uses lots of seafood in her recipes. Fish such as
salmon are rich in healthy omega 3 fatty acids. She also uses olive
oils and serves these protein-based dishes with lots of green
salads.
Enjoying a glass of wine with a good meal and great company is
one of life's simple pleasures. From a cancer perspective, alcohol
is known to be carcinogenic and high consumption of alcohol is
linked to a number of cancers including breast cancer. WCRF
recommend that " if consumed at all, limit alcohol to one standard
unit per day for women and two for men. Have alcohol free days and
experiment with non-alcoholic beverages at mealtime. Some of Anne's
dishes have a few more calories than you would want to ingest at
every meal, but there have to be treats in life and at Pakiri, one
can always end the meal with a wonderful walk along the beach to
burn up those extra calories!
Meals should be a time of relaxation and communion, when we slow
down and make time for the simple things. Involving the children in
food gathering and preparation is the best way to set a good
example and to teach them about nutrition. It is also great family
bonding time. Food is about more than pushing in calories.
Gathering produce, preparing and sharing a meal can be an event to
be enjoyed with family and friends, and Anne's hospitable style,
which she shows at both Auckland and Pakiri is a great example of
that.