Interview with Richard Béliveau, PhD
A passionate scientist and educator, Richard Béliveau wants to convey the message to as many people as possible that many cancers can be prevented. It’s a matter of lifestyle, moderation, balance and self-awareness. Rather than focusing on individual foods as a cure-all, he wants people to look at the big picture… to eat for health as well as pleasure, follow some basic principles and develop an attitude of responsibility and respect for their bodies.
Richard Béliveau writes regular health columns, co-hosts a French-language television show called Kampaï! (To your health), and is a frequent speaker at meetings addressing a wide range of audiences including doctors, cancer associations, schoolchildren, politicians, even Supreme Court judges. With Denis Gingras, PhD (a fellow researcher at UQAM), he has written three bestselling books on nutrition and health.
Our Voice interviewed Richard Béliveau at his office at UQAM. While his approach is grounded in hard science, much of his advice about cancer prevention is fairly simple and based on tradition and common sense. Put into practice, the recommendations can have astounding results.
OV: Please tell us a bit about your research on foods and cancer, and your objectives as an educator.
RB: My criteria for selecting certain types of foods that help fight cancer are based on molecular, animal and population studies. In the lab, we isolate molecules that show certain types of pharmacologic action. I’m a biochemist; I need molecular evidence to develop drugs such as chemotherapy, etc. We also need population studies that show a relationship to cancer risk reduction in humans. And third, we need animal studies to demonstrate that when we inject compounds, we can prevent cancer development. These three levels of evidence are necessary and complementary.
What we find in the laboratory today will be applied in five to 10 years, so my aim is to bring this knowledge to the public as early as possible, to educate people that cancer is a chronic disease that can be prevented, and to help them bring about changes in their lifestyle. This central point represents a major shift in attitude. Cancer is generally seen as a hereditary disease. When we published our first book in 2005, most people were unaware that they could do something to prevent cancer besides quit smoking.
People’s attitudes are changing, and they want information. Their biggest question is what they can do to prevent cancer. People have stopped me on the street to say they’ve read our books from cover to cover. Parents have written telling me their kids have read the books. Our new Kampaï! show is reaching 700,000 people every week — this shows the level of interest.
OV: How does cancer grow and develop?
RB: Generally, cancer develops through a long, slow process before it becomes clinically detectable. Normal cells undergo a gradual series of transformations (mutations), linked to heredity or lifestyle, or randomly appearing through cell division, that modify their genetic material. This can take years — for example, it may take 20 years for precancerous lesions to appear in the prostate (prostatic intraepithelial neoplasia or PIN), and another 10 to 15 years for these lesions to develop into a mature cancer. A long latency period is due to resistance of the cellular environment. If the balance of the environment is altered, normal defense mechanisms are removed and cancer cells can achieve their full potential.
Cancer is a chronic inflammatory disease. Chronic inflammation can be promoted by certain lifestyle factors (smoking, obesity, excess of calories, lack of omega-3 fatty acids). If precancerous cells are present in the environment, they can use growth factors secreted by inflammatory cells and the new blood vessel network to grow into a mature tumour. So reducing inflammation plays a key role in cancer prevention.
OV: To what degree is cancer related to lifestyle, and what are the other contributing factors?
RB: Almost two-thirds of all cancer cases are directly linked to lifestyle — smoking accounts for 30% and health practices such as diet, obesity, lack of physical activity are responsible for 35%. Of the remaining 35%, heredity accounts for 15%, infections 10% and other factors such as exposure to UV rays, pollution etc, 10%.
OV: What is the role of heredity in prostate cancer?
RB: Heredity is a seed, a predisposition, and it depends on a certain environment for growth. The heredity factor is modulated by lifestyle — this is a very important concept. The proof is that the rate of cancer changes according to people’s migration patterns. For example, the incidence of prostate cancer is more than 25 times higher in the US than in countries like Japan, India and China. These differences aren’t solely due to genetic predispositions, since Asians who migrate to America become susceptible to the same high cancer rates as natives of their adopted country.
OV: What health issue are you most passionate about?
RB: Obesity, caused by a complex range of genetic, environmental and cultural factors, has become the major health issue. It dramatically increases the risk of many serious chronic diseases: diabetes, heart disease, cancer, and some neurodegenerative diseases.
The junk food or “transformed” food industry, based on huge quantities of sugar, refined flour and salt, is largely to blame. It costs nothing to produce these foods, so the margin of profit is huge. Billions of dollars are then put into aggressive marketing campaigns aimed mainly at kids. We’re presently creating a civilization of obesity, in which 70% of kids will remain obese as adults. Obesity is the worst possible metabolic condition, because it creates an inflammatory environment, promotes angiogenesis (formation of new blood vessels, especially those that supply oxygen and nutrients to cancerous tissues), and overcharges the heart.
Junk food has two major impacts on health. The first negative aspect is the phytochemical deficiency aspect: The lack of fruits and vegetables associated with junk food consumption creates a favourable environment for microtumour development. Second is the excess factor: an excess of calories leading to obesity.
Success in medicine through vaccination, antibiotics, etc. has helped in the war against respiratory and infectious diseases, but at the same time, the rate of chronic diseases has gone up. This is because we have become sedentary and started to eat large amounts of empty, high-calorie foods that have no vitamins, fibre or phytochemicals. This has upset the equilibrium between our caloric intake and output, and is creating the metabolic disarray we call obesity.
We need to make many changes, not only through education but also through legislation. It took 50 years of fighting by doctors and scientists to ban smoking in public places, and some people still oppose it. The fight against junk food will be even tougher.
OV: What are the benefits of phytochemicals?
RB: Whereas animals run away from danger (fight or flight), plants produce a cocktail of millions of phytochemicals, which were developed through evolution to protect them against bacteria, viruses, plant-eating animals, etc. A huge number of these phytochemicals have anticancer properties. This is not a new concept — 50% of the drugs we use to treat cancer are plant-derived. The discovery we’ve made in the last 10 years is that nature has put some of these chemicals in edible products.
OV: What is the evidence that certain foods or food groups are better than others at fighting cancer?
RB: Instead of recommending particular foods (for example, saying “Eat tomatoes to fight prostate cancer”), we approach the problem globally from the point of view of population studies. We get inspiration from regions where chronic diseases are generally lower. With prostate cancer, we look at countries where the incidence is lower, such as Asia or Southern Mediterranean countries like Italy. Then we study how men in these countries live and eat. These countries have specific signatures in terms of foods, for example: India for its herbs and spices, large amounts of legumes; Southern Mediterranean for olive oil, tomatoes, lots of garlic and onions, red wine; North Africa and the Middle East for herbs and spices, fruits, vegetables; China for abundant ginger, dark green vegetables; Japan for seaweed, soy, green tea, mushrooms.
OV: What about alcohol and its effect on health/cancer?
RB: Excess consumption of alcohol is certainly not healthy, but we also have to distinguish between wine and other alcohol. Red wine is a unique alcoholic beverage that possesses powerful antioxidant and anti-inflammatory properties due to its high concentration of resveratrol (a phytochemical compound also found in grape juice, but in much lower amounts). In addition, taking a glass of red wine a day in the context of a healthy diet allows you to eat more slowly, increase your pleasure at the table, and enjoy more diversity of plant-containing foods. Wine is not a drink that goes well with junk food! Remember that countries (e.g. in the Mediterranean) where wine has been associated with lower cancer mortality rates have diets rich in a variety of fruits, vegetables, legumes and nuts. People in those countries also eat less meat and use olive oil as the main source of fats.
Generally, my position is: If you don’t drink, don’t take it up in order to protect against cancer, but red wine in moderation can provide benefits.
OV: What are the barriers to changing diet/lifestyle?
RB: People have high self-esteem when it comes to their diets… that’s a problem. If you ask, they all think they live and eat well, but it’s not true. Two-thirds of Canadians don’t eat the recommended daily amounts of fruits and vegetables, 20% still smoke and 65% are overweight!
Also, people sometimes have the attitude (fueled by the media and advertising) that they can take medications to counteract the bad effects of their unhealthy eating habits.
OV: Should people take supplements to prevent cancer?
RB: Except for vitamin D (1000 units per day), people shouldn’t take multivitamins or supplements for cancer prevention. They just don’t work!
We shouldn’t medicalize prevention. Don’t eat junk food and then take vitamins to make up for it. Prevention is at the heart of all traditional medicine, which provides treatment after trying everything to avoid the occurrence of disease. But often, we do the opposite; we do everything to provoke the illness, then ask research to develop new drugs to treat things we could have prevented.
OV: Is it ever too late to change your eating habits and lifestyle?
RB: It’s never too late. For example, recent colorectal cancer studies show a 60% increase in survival in patients who adopt good eating patterns. Balanced diet and lifestyle habits are part of a global approach to promoting health. Disease is an opportunistic event that is created by a rupture of physiological homeostasis (physical equilibrium). Basically, what we want is to strengthen our immune system, to build up a very tight fence to protect our health so disease cannot penetrate — in other words, to create a very nasty environment for cancer.
OV: What advice do you have for cancer patients and survivors?
RB: Don’t stress yourself out trying to make all kinds of changes to your diet during your treatment. Focus on treatment, and follow your doctor’s recommendations. Afterwards, cancer survivors should follow the same guidelines for primary prevention as everyone else. Listen to the big public health agencies: Health Canada, Canadian Cancer Society, World Cancer Research Fund International, etc. Overall, by applying five golden rules — watch your body weight (body mass index under 25), don’t smoke, stay away from junk food, get 30 minutes of exercise a day, follow Canada’s Food Guide and eat seven to 10 portions of fruits and vegetables daily — you can reduce diabetes by 90%, heart disease by 82%, stroke and cancer by 70%. Those are pretty good odds!
We should all be more zen — be aware of what we are and have respect for our bodies. We’d do well to follow our mothers’ and grandmothers’ advice, “Take good care of your health, and eat your vegetables!”
Richard Béliveau, PhD, holds the Chair in Cancer Prevention and Treatment at the Université du Québec à Montréal (UQAM). He is also Director of the Molecular Medicine Laboratory at UQAM, holds the Claude Bertrand Chair of Neurosurgery at the Centre hospitalier de l’Université de Montréal (CHUM) and is Associate Professor in the Departments of Surgery and Physiology (Faculty of Medicine) at the Université de Montréal.
