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Cancers of the Breast and Colon by How We Choose to Live Each Day”, which was held in association with the Scottish Cancer Foundation and supported by the Cruden Foundation, Byers focused on the ‘driver factors’, considering how our behaviour and choices, both individually and as a society, can lead to cancer. In Scotland, more than a quarter, 28 per


cent, of all cancers in women are breast cancers, he said. Risk factors for breast cancer include a woman’s age, menstrual history, pregnancy history and hormone pill use. However, nutritional factors –obesity, physical activity, alcohol and height – account for around 40 per cent of all breast cancers. While evidence indicates that taller


women are at higher risk of breast cancer than shorter women, he said that is not something we can do much about, adding: “I don’t think amputation reduces breast cancer and I don’t think we should do a trial on that.” However, the other risk factors can be


addressed. Tere is a clear relationship between


alcohol consumption and breast cancer risk, he said, with even small amounts increasing risk. However, this is not often talked about, he said. “Te reason why I think we don’t talk


more about alcohol and breast cancer is because of this reality that for alcohol this is the one nutritional factor where there is a trade off between heart disease and cancer. Everything else is consistent – obesity, physical activity, fruits and vegetables. Alcohol is the one inconsistency.”


Beyond the headlines Dental hygiene


It was not our proudest moment, as headlines declared last week that Scots have the worst dental hygiene in the UK. A survey by the British Dental Health Foundation of 1000 people across the UK found that nearly one in five adults regularly skips brushing their teeth in the morning; while at the other end of the day, nearly half of the population regularly skip brushing their teeth at bedtime. Perhaps the most stomach churning of the statistics, however, was the 20 per cent who admitting to having gone without brushing their teeth for more than two days in the past. Although only a small study, the results hint at some of the secrets behind our smiles, as children in Scotland have substantially higher levels of recorded decay compared with other European countries.


“Anyone who regularly skips brushing their teeth - morning or night-time - is storing up oral health problems for the future such as tooth decay and gum disease - the biggest cause of tooth loss often resulting in the need for bridges, dentures or implants,” warned Chief Executive of the British Dental Health Foundation, Dr Nigel Carter. He stressed that good oral health can’t be maintained by simply brushing once a day. “Brushing first thing in the morning coats the tooth’s enamel with fluoride to strengthen and protect the tooth surface against acid attacks throughout the day,” he


With other studies suggesting a lower


risk of coronary heart disease from moderate alcohol intake to be taken into account, this is a choice individuals should think carefully about, he advised. “What I advise people is if you are at


average risk for breast cancer and heart disease, one or two drinks per day is fine because the net benefit is going to be positive. If you are at high risk of breast cancer, however, and, say, average or low risk for heart disease, then one or two drinks a day may be a bad choice for you. So I think this is one of those dietary


“Nutritional factors –obesity, physical activity, alcohol and height – account for around 40 per cent of all breast cancers ”


factors where there does need to be some tailored decision making.” Other choices are clearer, however.


Obesity may be one of the most important of all the nutritional factors for cancer, Byers said, pointing out that it affects risk in many sites including: breasts; the colon; oesophagus; liver; pancreas; kidney; and uterus, with obesity causing “probably about half of uterine cancer,” he added. Tere is also an overlapping relationship between obesity and physical activity, he said, highlighting that the World Health


Organisation estimates that one in five cancers in developed countries is caused by obesity and lack of physical activity. And yet, obesity is “preventable and it is modifiable,” he stressed. “I think we often get a fatalistic attitude about obesity because of our own experience and our own difficulties controlling our own weights, as well as those of us in clinical practice’s own frustration at our abilities to help our patients lose weight. But we do know it is preventable and it is modifiable.” Further, he said it is “encouraging” to


note that an individual doesn’t have to lose all the extra weight they are carrying to substantially reduce their risk. “Tat is true of diabetes, we know that


is true of heart disease and I think we are going to find it is true for cancer as well. If somebody is carrying 80lb extra, he or she doesn’t have to have lost 80lb to substantially reduce cancer risk - stopping weight gain is an important first step and modest weight loss may have a positive effect.” Tese positive effects can also have


a “fairly immediate” effect, he said. Referring to a Swedish study comparing men and women who were assisted to achieve weight loss with gastric surgery and medical management – with some in the former group losing as much as 30 per cent of their body weight – it found that there was about a 40 per cent lower risk of cancer in women. “Tis drop in risk for women included


breast cancer but also included several other cancers as well. Te encouraging


explained. “Brushing last thing at night removes the deposits which have built up from eating and drinking during the day, as well as removing plaque - the cause of gum disease. “The last brush of the day also coats the teeth with fluoride, which is not washed away through eating and drinking, and continues to protect the tooth’s surface further during sleep.” The foundation hopes during National Smile Month to remind people of the three golden rules for oral health:


1. Brush for two minutes twice a day using a fluoride toothpaste


2. Cut down on how often you eat and drink sugary foods and drinks


3. Visit your dentist regularly.


The results show Scots need to brush up on their brushing habits – and sticking to these three simple rules would be a good start.


13 June 2011 Holyrood 49


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