Healthy living is the new catch phrase of western societies. The media is filled with stories and pictures of people working out in gyms, eating health foods, living the good life. At the same time many of the messages coming through are overstated in the extreme. People are told to mega dose on vitamins, to eat fad diets and to imbibe new wonder pills (claimed to give the person new vigour and vitality).

What is the truth in 2007 Taking a rational look at the world medical literature to date, strongly suggests that living a so-called 'healthy lifestyle' is indeed beneficial to one's health. So, what are the facts and what is fantasy?

What is good for you?

• Eating a low saturated fat, low salt, high fibre diet (see below)

• Taking in an adequate supply of vitamins

• Regular aerobic exercise (half hour on alternate days is the minimum)

• No smoking

• Alcohol restricted to two measures per day

• Avoid stress

What is bad for you?

• Taking mega doses of some vitamins (particularly vitamin A)

• Taking mega doses of some minerals (particularly iron, zinc, selenium)

• Passive smoking (even if you do not smoke yourself, sitting in a room with other smokers is damaging to your health)

• Ustening to the rantings and glib promises of unbelievable vitality, if you take this "new nature remedy" and so on (in other words, beware of the "gurus")

• Not going to your doctor when you notice that something is wrong (see next page)

Before I expand on these points, let me explain something. You may be wondering what all this has to do with breast disease. Well, the following points should be noted.

i) There is a close correlation between dietary fat intake and breast cancer incidence in populations. Although this does not prove that a high saturated fat diet will significantly increase the risk of breast cancer, it is very suggestive.

Closely associated with this, is the observation that obesity has been show to double the breast cancer risk in postmenopausal women. So if you are fat and over fifty years, your risk of getting carcinoma of the breast is twice that of a thin fifty year old female. It must be emphasised that no such association (between obesity and breast cancer) has ever been demonstrated in premenopausal females (women still having their 'periods'). But even if this risk of a high fat diet causing breast cancer is not that strong, it is nevertheless there. In any event, there are so many other advantages to eating a low fat, high fibre diet that it seems strange to watch people engorging food literally dripping with FAT.

They obviously don't want to live out the lifespan destined for them in their genes.

ii) There is a strong correlation between high alcohol consumption and breast cancer. Women who drink more than two measures of alcohol per day (three or more tots of spirits or three or more glasses of wine) may have a higher risk of getting breast cancer. The reason for this is not known, but one may speculate that it could be through the 'promoting' effect of oestrogen. The hormone oestrogen is metabolised in the liver and it is well known that alcohol is a liver poison (toxin). With liver damage from high daily alcohol intake, the oestrogen is not broken down adequately, giving raised oestrogen levels, which in turn predispose to breast cancer. It must be noted that small daily doses of alcohol are actually good for you. If a woman limits herself to two measures of alcohol per day, she does not increase her risk of breast cancer, but she will certainly reduce her risk of heart disease. This is because alcohol raises the good cholesterol (HDL cholesterol), which decreases the chance of coronary artery disease.

Good foods for breast health

• Green tea or green tea extract. University of Purdue researchers recently concluded that a compound in green tea inhibits the growth of cancer cells. The secret of green tea lies in the fact that it is rich in catechin polyphenols, particularly epigallocatechin gallate (EGCG). EGCG is a powerful anti-oxidant: besides inhibiting the growth of cancer cells, it kills cancer cells without harming healthy tissue.

• Cruciferous vegetables of the brassica genus, for example, broccoli, brussel sprouts, cabbage, cauliflower. These vegetables contain indole-3-carbinol and researchers suspect that this component is one of several found in vegetables that may protect against cancer. Diets high in fruit and vegetables are associated with a decreased risk of cancer. Indole-3-carbinol is one of the major anticancer substances found in cruciferous (cabbage family) vegetables. It is a member of the class of sulfur-containing chemicals called glucosinolates. It is formed from parent compounds whenever cruciferous vegetables are crushed or cooked. Indole-3-carbinol and other glucosinolates (e.g. other indoles and isothiocyanates such as sultoraphane) are anti-oxidants and potent stimulators of natural detoxifying enzymes in the body. Indole-3-carbinol and other glucosinolates are believed to be responsible for the lowered risk of cancer in humans that is associated with the consumption of broccoli and other cruciferous vegetables like cauliflower, cabbage and kale. Preliminary studies have also shown indole-3-carbinol has significantly increased the conversion of estrogen from cancer-producing forms to nontoxic breakdown products.

• Root vegetables such as turnips also contain indole-3-carbinol.

• Rooibos tea contains 37 anti-oxidant compounds which destroy free radicals in the body thus protecting the cells against attack.

• Evening primrose oil (avoid during pregnancy). The therapeutic use of evening primrose oil (EPO) was long considered as "alternative medicine' but today European and American physicians commonly prescribe it as the drug of choice to treat mastalgia i.e. tender and lumpy breasts with symptoms of pain and dull heaviness. Mastalgia often occurs in connection with PMS for which EPO also is an effective, relatively cheap and safe therapy. The response to EPO therapy is usually slow, often requiring over 6 months for full efficacy. The effective ingredient of EPa is gammalinolenic acid (GLA), which in the body turns into prostaglandin PGE1. It seems to correct the disturbed fatty acid metabolism often prevalent in mastalgia and PMS.

• Grape seed extract. The antioxidants in grape seed extract work at helping to control cellular damage, routinely hunting down and neutralizing mutations within the genetic material of cells that could lead to tumour formation. The development and progression of cancers of the lung, breast, stomach, prostate, colon, skin and other body parts may be stalled as a result.

• Folic acid. A team of American and Chinese researchers has discovered that folic acid (folate) is highly effective in preventing breast cancer in both pre- and postmenopausal women. Their investigation involved 1321 women with breast cancer and 1382 healthy controls. The women were between the ages of 25 and 64 years when they enrolled in the Shanghai Breast Cancer Study during 1996-98. The researchers found a clear correlation between dietary intake of folic acid and the risk of breast cancer. Women with a daily intake of 345 micrograms or higher had a 38 per cent lower risk than did women with an intake of less than 195 micrograms - after adjustment for total vegetable, fruit and animal food intake. The protective effect of folic acid was even more pronounced in women who also had a high dietary intake of vitamin 86, vitamin 812 and methionine. Women with a daily intake equal to or higher than 345 micrograms of folic acid, 8.47micrograms of vitamin 812, 2 mg of vitamin 86, and 1.9 grams of methionine had a 53 per cent lower risk of breast cancer than did women with daily intakes at or below 195 micrograms of folic acid, 1.32 micrograms of vitamin 812, 1.35 mg of vitamin 86, and 1.27 grams of methionine. Researchers believe that folic acid exerts its protective effect by preventing errors in DNA replication and by helping to regenerate methionine, a vital component in DNA synthesis. They also point out that both vitamin 812 and vitamin 86 are vital cofactors required for folic acid to 'do its job'. NOTE: Most multivitamins have levels of folic acid, vitamin 86 and vitamin 812 well above the levels found to be beneficial in the Shanghai study. Shrubso/e, Martha J., et a/. Dietary folate intake and breast cancer risk: results from the Shanghai Breast Cancer Study. Cancer Research Vol 61 October 1, 2001 pp. 7136-41.

• Vitamin B6. Improve symptoms of PMS (premenstrual syndrome) and fibrocystic breast changes. Some women find that taking vitamin 86 supplements eases PMS symptoms. This is particularly true for women who suffer from severe breast pain (fibrocystic breasts), specifically around the time that PMS symptoms occur. The nutrient appears to help by assisting the liver in its effort to wash excess estrogen from the body. In addition, 86 raises levels of the hormone progesterone and assists in the manufacture of serotonin, a neurotransmitter that enhances mood.

Some useful dietary and lifestyle tips:

• Enjoy more fruits and vegetables. They contribute powerful antioxidants, phytochemicals, and fibre

• Work a carotenoid-rich food into your day (mango, butternut, chili peppers, pumpkin, spinach, sweet potato, tomato, carrot).

• Eat more fibre, especially from whole grains. Phytochemicals found in whole grains have been found to reduce risk of breast and colon cancers in animal studies.

• Keep fat, saturated fat, and animal fat moderate. Researchers are still trying to figure out if and how the amount of fat (as well as the types of fat) in our food changes our risk for breast cancer. Results from animal studies have suggested the possibility that the amount and type of fat we eat could encourage or discourage certain breast tumours.

• Switch to monounsaturated fats. Research has been showing that monounsaturated oils, such as olive and canola oil, do not have many cancer-promoting effects (Journal of the American Dietetic Association 97: 16 1997).

• Drink little or no alcohol. At least 50 studies show that too much alcohol may play a role in breast cancer risk.

• Emphasize variety in food choices. Eating various foods will give many different nutrients and helpful phytochemicals.

• Try to keep extra weight off as you age. A Harvard University study showed that women who gained 44 to 55 pounds after age 18 had almost double the risk of developing breast cancer following menopause, compared with women who had gained only a few pounds.

• Oil used in frying that is heated to high temperatures, or re-heated is a known carcinogen. Beware of too much take-out food. Discard 011 after it has been used.

• Get bitten by the fitness bug! Try to exercise at least half an hour on alternate days, even if it is just walking. Some studies have found a reduced risk of breast cancer among women who exercise regularly or who were athletic as adolescents.

What should one do and what to avoid

Nothing seems to be easy and simple any more. There are conflicting reports on many aspects of healthy living. Nevertheless, the following recommendations are widely accepted today.

1. Low saturated fat diet

Can one cut this fat from the diet? As saturated fat is present in a whole spectrum of foods, it is virtually impossible to eliminate it completely. Saturated fat is present in the following foods in high quantities:

• meat, pies, boerewors, sausage

• cream, butter, cheese, full cream milk, ice cream, chocolate

• biscuits, pastry, cakes

So these are the foods that must be drastically reduced in the diet. Eating saturated fats ultimately results in increased levels of the bad cholesterol in the blood (LDL cholesterol). This is the cholesterol that causes blockage of arteries with consequent heart attacks, strokes, gangrene, etc

2. Try to replace saturated fat with "good fats"

These so-called good fats are unsaturated. The chemistry of this is not relevant to this book, but for those interested, reference to the sister book 'Know Your Blood Vessels' will explain fat metabolism in detail. The two main varieties of unsaturated fat that concern health are poly and mono unsaturated fatty acids (PUFA and MUFA). PUFA are derived from vegetable oils such as sunflower, safflower, corn and soya bean oils. The important component of these oils is the omega 6 fatty acid, linoleic acid. MUFA are found in olive oil, avocados and rapeseed oil (canola oil). MUFA are stable and do not become rancid like PUFA. When PUFA becomes oxidized or rancid, it actually damages your health (leaving oil open and standing in the kitchen, re-using oil, and excess heating of oil). In fact rancid PUFA may be as bad as saturated fats. So, in summary, MUFA and fresh PUFA (non rancid) appear to be good for you and should replace the saturated fat in your diet.

The other good fat is fish oil fat. The chemicals in fish oil are eicosapentanoic acid and docosahexanoic acid, which are beneficial to the body. They are also PUFA, and they prevent clotting in the arteries. Fish oils tend to lower the triglyceride fats in the body. Fish oils contain omega 3 fatty acids. They are found in high concentration in cold seawater fish (mackerel, salmon).

3. Use tub margarine

Tub margarine should replace butter. Butter is rich in saturated fat. The correct margarine (like canola) will contain PUFA and MUFA. Do not think that brick margarine is also good for you. It is not Brick margarine, where the PUFA has been re-hydrogenated, is as bad as butter.

4. Eat fresh fruit and vegetables

These should form a large component of any diet. Besides being a source of fiber (roughage), these foods contain the antioxidant vitamins (vitamins E, C and A). Antioxidants are free radical scavengers in the body. They mop up the toxic free radicals that may play a part in cancer, heart disease, aging and so on.

5. Eat high fibre foods

What exactly is fibre?

Biological tissues are made up of millions of tiny cells and fibre refers to the supporting structure of these cells in the plant kingdom i.e. the cell walls. Fibre is mostly undigested in the human gut.

There are two types:

• Water soluble fibre such as oats, legumes, etc.

• Water insoluble fibre such as whole Wheat, other grains, fruit, vegetables, etc.

Fibre increases stool bulk, makes the stool soften and it decreases gut transit time.

How much to we need?

We should eat about 30 grams of fibre per day. In South Africa, rural people tend to eat more fibre and easily reach 30 grams per day. Westenised people tend to eat half of this or less. This is unsatisfactory and a high fibre diet should be encouraged.

What fibre should we be eating?

• One of the best ways to boost fibre intake if the diet is in any way deficient in fibre, is to supplement your daily fibre intake with high quality fibre such as FYBOGELII. By simply boosting your diet with 3 to 6 grams of FYBOGELII per day (1 to 2 sachets), you can get the fibre you need easily and efficiently. YBOGELII is a perfectly natural fibre that cannot possibly do you any harm.

It is not a drug.

• Fibre cereals.

• Brown bread particularly the 'health breads', which are filled with roughage.

• Fresh vegetables and fruit. What does fibre do for you?

• improve the quality of your bowel habits (prevents constipation).

• decreases the tendency to obesity.

• tends to lower blood cholesterol; particularly oat bran.

• tends to lower the blood sugar; particularly oat bran.

• fill up your stomach so you do not crave all the harmful foods.

Fibre is recommended to help prevent many illnesses including:

• constipation (infrequent passage of hard stool)

• arterial disease (atheroma / atherosclerosis causing heart disease, stroke, gangrene, etc.)

• colon cancer (malignant colon disease)

• diabetes (particularly non insulin dependent diabetes mellitus NIDDM).

• obesity (overweight)

• diverticulosis coli (benign colon disease).

A recently completed large study (over 40 000 people over a period of ten years in the USA) found an inverse relationship between fibre intake and myocardial infarction (heart attack).

6. Exercise Studies throughout the world have repeatedly demonstrated that people who avoid exercise have a 33% greater risk of developing cardiovascular disease. Aerobic exercise is associated with a lowering of both the systolic (upper) and the diastolic (lower) blood pressure. But, perhaps even more exciting, aerobic exercise tends to elevate the HDL. This is the good cholesterol that leaches fat out of arteries. Exercise lowers the cancer rate by 37%.

What is aerobic exercise?

Any exercise that increases oxygen consumption. Activities recommended are:

• jogging / running

• swimming

• cycling

• climbing stairs repeatedly

• dancing (often called 'aerobics')

• skipping

• sport such as tennis, soccer, rugby, golf, squash, racket ball

• light and rapid weight lifting

• brisk walking.

Note that heavy weight lifting may raise the blood pressure and could be counterproductive. These exercises should be performed for at least a half hour four times per week. The intensity should induce sweating after about fifteen minutes, but should still be comfortable enough to allow for a conversation with a companion. In other words, aerobic exercise should not leave one so breathless that speech becomes a burden.

What does exercise do for you?

• Increase HDL cholesterol (which is protective against heart disease; it literally sucks the cholesterol out of the artery).

• Diminishes blood pressure.

• Helps you to lose weight.

• Makes smoking more distasteful and disagreeable (it may actually make you an intolerant anti-smoker).

7. Alcohol Two measures per day is good for you. More is not! Alcohol also increases the HDL (good) cholesterol. High intake of alcohol may increase the risk of breast cancer.

8. Stop smoking

Not next week, not tomorrow, not today, but now. Each cigarette you smoke harms your health. Smoking is the scourge of this century. It is a killer! Passive smoke (from someone else smoking) is also a killer.

Cigarette smoke, amongst other things, causes:

• blocked arteries (heart attack, stroke, gangrene)

• cancer (lung, bladder, oral)

• obstructive lung disease (emphysema, chronic bronchitis, worsens asthma)

• slows the growth of the embryo (foetus).

Nevertheless, no correlation between smoking and breast cancer has ever been demonstrated. So smoking does not cause breast cancer.

How does smoking cast its evil spell? It does the damage to the body by increasing free radicals. These damage the lining of the blood vessels - atheroma; cause mutations to the cells lining the lungs - lung cancer, and so on.

9. Low salt diet High salt results in the body retaining fluid, which may eventually cause high blood pressure.

10. Avoid stress You cannot avoid stress these days; this is especially true in Johannesburg. But it has repeatedly been demonstrated that stress can damage your health. Adrenal hormones increase in stress situations (adrenalin, cortisol). These hormones suppress the immune system with all its attendant disadvantages including the increased risk of getting cancer.

How do you control stress?

Well, some good ways to do so are:

• exercise

• relaxation techniques

• beautiful music

• beautiful scenery

• alternative medicine (aromatherapy, reflexology).