Smokers' Health Page

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Minimising the Health Risks of Smoking

Here you will find the information that medical and anti-smoking campaigners refuse to promote to the smoking community.

You can reduce your smoking risks by adopting an appropriate risk reduction lifestyle - so read on and take action.

Topics covered in this page are listed below and subject to ongoing development:


-----1. Introduction (including relative risk v. absolute risk)

-----2. Using this Information - YOU MUST READ THIS -

-----3. What you need to do to reduce risks.
--------3.1 Smoke less
--------3.2 Choose your parents carefully!
--------3.3 Four healthy behaviours
--------3.4 Beneficial Foods
-----------3.41 Fruit, vegetables and grains
-----------3.42 Dark chocolate
-----------3.43 Tea and antioxidants
-----------3.44 Coffee's protective effects
-----------3.45 Olive oil and fish oil
-----------3.46 Herbs and spices
--------3.5 Alcohol
--------3.6 Exercise
--------3.7 Aspirin for over-50s
--------3.8 Food combining for health
--------3.9 Organic food....under development
--------3.10 10 ways to avoid cancer....under development

-----4. Summary of key beneficial activities....under development

The items still "under development" will be completed as soon as possible.

(Please Note: There are a large number of links to references for the health issues raised, and these will open in one separate window, but it will be the same window used for all links - to avoid cluttering up your task bar.)


We all hear in the press from time to time reports about the latest fad for keeping you healthy, but very few stray into the area of smokers' health.

For the anti-smoking lobby it is a taboo subject, since it doesn't seem to want smokers or the general public to think that there is anything smokers can do to reduce the health risks of smoking - it just wants everyone to believe that death from a smoking related disease is the early and almost inevitable outcome.

That this is a cynical and callous position seems to pass by most of the public and press, with even the main medical establishments seeming to avoid giving pro-active health advice to committed smokers.

It proves, if proof is needed, that the anti-smoking campaign is as much about ideology as it is about health.

On this point, in Spring 2007, Gio Batta Gori of the Health Policy Centre USA says a policy proposed almost 40 years ago, to develop a cigarette which effectively reduced the level of harmful substances by 50%, was suppressed by the anti-smoking lobby. He says they therefore cynically condemned many smokers to a premature death over the next 40 years. Apparently the policy for a safer cigarette was again raised in 2001, but was once more smothered by the anti-smoking lobby.

Also, the House of Commons (1999-2000) Select Committee on Health Second Report shows (paras. 142/143) that Imperial tobacco had attempted to introduce a safer cigarette in 1977, but its failure the company put down to "the Government's refusal to reduce levies on NSM products in relation to conventional cigarettes; adverse effects as a result of Government sponsored campaigns; and the fact that cigarette smokers preferred conventional cigarettes". What the "Government sponsored campaigns" were are not defined in the report. However, the Select Committee itself seemed committed to the production of a safer cigarette to try and reduce the health problems for committed smokers, and actually supports the concept in their final recommendations. But this recommendation doesn't seem to have been taken up. Why?

If Gori's 2007 accusation is correct then this must be a serious indictment of the methods adopted by the anti-smoking lobby and further underlines the fact that ideology is clearly their driving force.

Nevertheless, even if a safer cigarette were to be available smoking would still clearly have the potential to damage your health, so it makes sense to consider ways you can reduce these risks as much as you can.

Health Risks or Health Benefits - Getting behind the published statistics
It is beyond the scope of this article to go into the details of statistical analysis and statistical presentation of results, and those who wish to can research the topic themselves on the web. All I have been able to do at this stage is to present the results of research as they have been reported. However, there is one point worth bearing in mind when reading the research results described below.

As a smoker you are at risk of developing a range of cancers - primarily lung cancer (smoking reputedly causes around 85% of cases of lung cancer - there are other causes e.g Mesothelioma where exposure rates of as little as a few months can cause this cancer many years later). Also smoking is "linked" to over a dozen other cancers including cancers of the mouth, larynx (voice box), oesophagus (food pipe), liver, pancreas, stomach, kidney, bladder and cervix, as well as some types of leukaemia.
In addition there are risks relating to heart, circulatory system, chronic lung diseases and stroke.

Also, of course, all smokers have a 100% risk of dying - and following the logic of some of the more extreme risk aversion groups prevalent in today's society, you might want to consider whether it was worth ever being born in the first place!

The above risks are also risks for non-smokers of course, but the risks are reported to be higher for smokers - but what does "higher" really mean when you come to weigh up what it means to you personally?.

Whenever you read about the risks of smoking, the risks are almost always referred to as relative risks such as "increased"risk, "higher risk", 50% higher risk, 10 times the risk, etc., and rarely as "absolute risks". The increased risk usually means an increased risk compared to someone who never smokes (but you need to look carefully at the definition to be clear). By absolute risks it means a statement which tells us, say, out of 100,000 smokers how many will die this year, or over the next five years, etc.? (and of course, the information is complicated by factors about intensity of smoking, age, sex, lifestyle etc). Relative risk doesn't really help you take an informed decision about smoking - information on absolute risk is much more useful.

Unfortunately it is very difficult to find definitive information on absolute risk. (If anyone knows of a web-site that has managed to abstract and collate scientifically valid absolute risks around various aspects of smoking, then please contact me and I will link this page to it).

Why is relative risk used more than absolute risk? - because it is easier to sensationalise relative risk, and sensationalism sells newspapers, sells research projects, brings in more funding for further research and generally makes it easier to manipulate public opinion.

Cigar lung cancer rates compared with cigarettes However, here is one graph showing absolute risks which helps put risks into perspective. Cigarette smoking is generally considered to be more risky than cigar smoking, although cigars can cause similar hazards if their smoke is inhaled. Cigarettes, cigar and pipe smoking cause comparable hazards for cancers of the oral cavity, pharynx, extrinsic larynx and oesophagus.

The graph alongside comes from a wide review of cigar smoking reported in 1998 by the National Cancer Institute (US). It compared all available data on the health risks associated with cigar smoking with risks associated with cigarette smoking.

The graph shown alongside relates to lung cancer specifically, and compares lung cancer death rates of cigarette and cigar smokers for various levels of cigar smoking and inhalation of the smoke. The upper solid line denotes a 20 cigarette a day smoker's death rate assuming commencement at age 18. By the age of 60 there are approx. 200 smoker deaths per 100,000 (or 2 per 1,000), whereas never-smokers have a lung cancer death rate of 12 per 100,000 at this age. Hence the 20 a day smokers have an increased risk of around 17 times those of never smokers. This would normally be reported in the press as "20-a-day- smokers at age 60 have nearly 20 times risk of dying from lung cancer than non-smokers", which sounds a lot more frightening than the absolute figures (2 per 1000) at age 60 - even after 42 years of smoking 20 a day.

This puts into perspective the lack of any practical impact that occasional exposure to second hand smoke must have on absolute risk of cancer for non-smokers.

The reduced lung cancer risks for cigar smokers can be seen in the various plots, with non-inhalers having the lowest risk at around 40 per 100,000 (0.4 per 1000) at age 60 , which equates to about 20% of the risk for typical 20-a-day cigarette smokers. So, if cigarette smokers adopted a "Social Smoking" philosophy, smoking quality, good flavoured cigarettes, obtaining the pleasure and satisfaction from circulating the flavour around mouth and nose as cigar smokers do and inhaling less, then it seems plausible that they would reduce their risks down towards the cigar smoking level.

As age increases so does the risk. At age 85 the risk for the 20-a-day cigarette smoker is around 1000 per 100,000 (1 per 100), with non-inhaling cigar smokers' risks also increasing to around 260 per 100,000. Bear in mind that these are for lung cancer only, and when the other smoking risks as listed above are added they will increase the overall risk of death for a smoker.

Also, while your own personal risk may not seem devastatingly high, when you multiply even these small rates by the numbers of people smoking, it does produce a very large number of smoking related deaths. It is this that so excites the medical establishment and safety conscious governments - and they use it in all manner of emotive ways to put pressure on you not to smoke. The more virulent anti-smokers and smoker-haters use these figures and methods in even more inflammatory ways, but of course they are not really worried about your health, they just don't like anyone smoking and will use (have used) all means at their disposal to force you to comply with their own lifestyle choice.

It is all quite a vexed question, as one has to die of something, although if your number comes up at age 40, say, this is obviously no comfort to family and friends left behind. However, we are all living longer, but it appears that we mostly don't have good health and sound minds in these twilight years. Research says that we have about the same length of good quality life, it's just that when we finally become ill we just take a lot longer to die - and mostly of senile dementia, altzeimers and the like - and I personally, having seen it first hand, wouldn't wish that on anyone.

There was a recent article in a British newspaper by a journalist who had just watched a friend die of cancer and, as he found it so distressing he was happy to forgo smokers' civil liberities and support the ban on smoking. Whilst one can feel for his loss, what about someone who loses a family member in a car accident. Should they ask to ban all cars? People do an unending list of dangerous things, go hang-gliding, climbing rock-faces, motor racing, motorcycling, jump out of aeroplanes, pot-holing, scuba-diving, skiing, etc. But that is their choice, and no-one resents them making that choice - and there aren't proposals to refuse them medical treatment if they succumb to the risks they have taken..... As I said, a vexed question...... could be a topic for another web-page - if I ever find the time!

There has been, and will continue to be valid debate about the methods used for attributing deaths to smoking, but even if these statistics are acknowledged as upper estimates, it now appears that the scientific community at least is beginning to accept that smokers' risks can be reduced by adopting various lifestyle changes.

In recent research (December 2007), Michele Forman, a professor of epidemiology at the University of Texas states that "Although this is a very preliminary analysis, it gives us some important clues about how everyone - smokers and non-smokers alike - might be able to reduce their risk of developing lung cancer"

This page, will highlight scientific articles or reports which suggest how to reduce the health risks of smoking, and will be updated as time allows.

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•••• PLEASE NOTE••••
The actions identified on this page do not constitute professional medical advice. For that you would need to investigate the original source of the information and obtain advice from your own Doctor before making up your own mind about whether to adopt any of them - particularly if you are currently taking any medication. Also, common sense comes into play - the research we all hear reported involves results covering a range of different people who may respond differently to the various factors involved, and results only give you the "average" type of response.

In all studies there will be many complicating factors which introduce uncertainty into trying to establish the cause of the results found. The World Cancer Research Fund and the American Institute for Cancer Research (see in more detail in Section 3.10 below) indicate in their "Second Expert Report (2007)" on avoiding cancer through diet and exercise that:
"No single study or study type can prove that any factor definitely is a cause of, or is protective against, any disease".
However they do believe reliable judgments of the likely causes of disease can be based on assessment of a variety of well-designed epidemiological and experimental studies.

Researchers in this field also indicate that a difficult area to resolve is the potential for synergistic (enhanced inter-related) effects of various factors both beneficial and harmful. Here the effects of certain nutrients, pollutants, etc., might be reasonably well understood when investigated by themselves, but when a number of these factors are present at the same time the overall effects might be greater than just the sum of the individual effects.

Hence, the medical evidence is rarely unanimous, there is always some doubt involved. If you already have medical problems of one sort or another then the actions suggested by the research may not be appropriate.

Use your common sense; and if you do adopt any of the strategies outlined below then whatever you do, do it gradually and in moderation while assessing whether it affects you adversely or not. Your body normally tells you how it is responding - if it feels good, then it is probably beneficial, if you feel bad after it, then it's probably not doing you any good. Get in tune with your body!

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The articles below provide information how to adopt a healthier lifestyle to reduce the risks associated with smoking :-

3.1 Smoke less.

It seems well accepted and general common sense that the fewer cigarettes you smoke, the lower the risk.

Try to adopt the "social smoking philosophy", control when you smoke, go for a better quality cigarette and only smoke if possible when you have time to savour it and get the most pleasure and relaxation out of it. Try to reduce the depth of inhalation of the smoke.

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3.2 Choose your parents wisely!

Very few cancers are genetically derived, it is the inheritance of mutated genes or genes that mutate during your lifetime that reduce your ability to fight cancers. Inherited genetic problems are not large however, and account for less than 10% of cancers .

If you have a family history of more than one or two family members dying of cancer, then it seems you may be at increased risk yourself. Hence you need to take a common sense view of your risks and consult your doctor for better advice.

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3.3 Four relatively simple, healthy behaviours

Apparently, for middle aged and older people:-
"The millions of people resolving to live a healthier life in 2008 can take heart. Four relatively simple healthy behaviours, may add 14 years to your life, say researchers. Even better, they help no matter how fat or unhealthy you are already". It was in the reduction of deaths attributed to cardiovascular disease where the findings were most pronounced, with those scoring zero five times more likely to succumb than those scoring four. But there was also a relationship between score and cancer deaths. While the main analysis excluded people with known disease, the researchers found that those with serious conditions fared better the higher they scored than those who scored lower. The full research paper is shown here.

Cumulative survival rates over 14 years for scores 0-4 The study covered 20,00 people in the Norfolk county of England over the period 1993-2006, ages ranging from 45 to 79 not, as far as they were aware at the time, having cancer or any heart problems.

A point was awarded for each of the following:

1. not currently smoking;
2. consuming between one and 14 units of alcohol per week (one unit of alcohol is approx. equivalent to half a pint of beer or one small glass of wine);
3. eating five servings of fruit/vegetables each day;
4. not being inactive.

This last category was defined as either having a sedentary (sit down most of day) occupation and taking half an hour of exercise a day, or simply having a non-sedentary job like a nurse or plumber. (The exercise criteria were based on reported hours of exercise per week, and the total divided by 7 to get an average daily amount.)

The message seems clear - and quite welcome! If you currently smoke, you can only get a maximum of 3 points if you do the others, i.e. exercise, eat a diet with lots of fruit and vegetables, and drink moderately. On the graph this implies that out of a 100 people who scored 3 points 92 are likely be alive after 14 years and 8 are likely to be dead.

If you don't smoke and also meet the other 3 requirements, you get the maximum of 4 points. This means that out of every 100 people scoring 4 points, 95 are likely to be alive after 14 years and 5 are likely to be dead.

If you scored zero points, then out of the 100, 75 are likely to be alive with 25 being dead within 14 years.

The other interesting point is that if you smoke, exercise and drink only moderately (but don't eat plenty of fruit and vegetables), you would be better off than someone who doesn't smoke but neither exercises, drinks, or eats the required fruit and vegetables.

An iteractive version of this research is available at a University of Cambridge site called Understanding Uncertainty. (Requires Flash Player).

The implications are that smoking as a risk in the relatively short term (14 years) is similar to the risks of not exercising, or not drinking at all, or drinking to excess, or rarely eating fruit and vegetables.

The message is simple - if you don't want to give up smoking, then modify your lifestyle to include doing points 2, 3, and 4 as specified. If you are a regular pub drinker, then 7 pints of beer (14 Units) a week might be a bit difficult to keep to, but at least you will now know what you should be aiming for!

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3.4 Beneficial Foods

3.4.1 Fruit, vegetables and whole grains - roughage and anti-oxidants

We have all heard the exhortation from the medical world that we should eat more fruit and vegetables - at least five portions per day is the current recommended advice to help reduce the risk of some cancers, heart disease and many other chronic conditions. Part of the reasoning is the body's need for roughage to function effectively.

It was thought that it was the fibre absorbing water and bulking out which stimulates movement and transports toxins more quickly through the gut which reduces contact time with the wall of the intestine, so reducing damage that could lead to cancer. However, recent research indicates that when fibrous foods, which cannot be fully digested, rub up against a cell in the lining of the intestine, they rupture the outer cover and cell-protecting mucus is released. The cells then act within seconds to repair the damage, producing more beneficial mucus in the process. It appears that this mucus could also provide a lining against carcinogens we take in which might cause bowel cancer.

Although this is not primarily applicable to smoking, it makes sense that if your body is functioning efficiently, and not labouring under the stress of trying to neutralise toxins in the gut, then it will have more potential to combat any toxins taken in while smoking.

Briefly, "Antioxidant" is a classification of a number of organic substances, including vitamins C and E, vitamin A , selenium (a mineral), carotenoids and others. Fruit, vegetables and whole grains (cereals) have high levels of these substances which are thought to be effective in helping to prevent heart disease, cancer, and stroke, although as ever there is some conflicting evidence.

At the molecular and cellular levels, antioxidants serve to neutralise certain particles called free radicals. In humans, free radicals tend to become oxidised, and this oxidation process can sometimes be carcinogenic. Free radicals are the natural by-products of many processes within and among cells. They are also created by exposure to various environmental factors such as air pollution, radiation, tobacco smoke, infection, and excessive sunlight for instance.

If not neutralised these free radicals can cause damage to cell walls, certain cell structures, and genetic material within the cells. In the worst case scenario and over a long time period, such damage can become irreversible and lead to disease (e.g. cancer). Antioxidants play the housekeeper's role, "mopping up" free radicals before they get a chance to do harm in your body. Researchers have postulated that antioxidants prevent the possible carcinogenic effects of oxidation.

For more information search the web for "antioxidant". This educational site is an example.

Fruit, vegetables and whole grains
Studies have consistently shown that regular consumption of fruits, vegetables, and whole grains is strongly associated with reduced risk of developing chronic diseases, such as cancer and cardiovascular disease.

In fact, the recent "Second Expert Report (2007)" by the World Cancer Research Fund and the American Institute for Cancer Research (see in more detail in Section 3.10 below) states that :-
  • Non-starchy vegetables probably protect against cancers of the mouth, pharynx (throat), and larynx (voicebox), and those of the oesophagus (food pipe) and stomach. There is limited evidence suggesting that they also protect against cancers of the nasopharynx, lung, colorectum, ovary, and endometrium (lining of the uterus).

  • Allium vegetables (e.g. onions, garlic, shallots, leeks, and chives) probably protect against stomach cancer, with garlic also probably protecting against colorectal cancer;

  • There is limited evidence suggesting that carrots protect against cervical cancer;

  • There is limited evidence suggesting that pulses (legumes - fruits or seeds of anything that comes in a pod such as green beans, butter beans, broad beans, all dried beans (soy beans, kidney, haricot)), including soya and soya products, protect against stomach and prostate cancers;

  • There is limited evidence suggesting that chilli is a cause of stomach cancer;

  • Fruits in general probably protect against cancers of the mouth, pharynx, and larynx, and those of the oesophagus, lung, and stomach. There is limited evidence suggesting that fruits also protect against cancers of the nasopharynx, pancreas, liver, and colorectum.

It is generally thought that this protection is attributed to the complex mixture of phytochemicals (non-nutritive plant chemicals that have protective or disease preventive properties) present in whole foods. Many thousands of phytochemicals have been identified but only a small proportion have as yet been investigated.

Phytochemicals include antioxidants and deliver additional benefits through hormonal actions, stimulation of enzymes, preventing multiplication of cancer cells, anti-bacterial actions and physical binding actions which prevent the adhesion of pathogens to human cell walls.

The numerous phytochemical extracts present in fruit and vegetables exhibit strong antioxidant and antiproliferative activities. These are thought to be enhanced by their additive and synergistic effects.

Whole grains are cereal grains that retain the bran and germ as well as the endosperm. Common whole-grain products include oatmeal, maize (corn), brown rice, whole-wheat flour, sprouted grains, and whole-wheat bread. Refined-grain products include refined white flour, white rice, white bread and pasta (although whole-grain varieties of pasta are available).

Whole grains are rich in many components, including dietary fibre, starch, fat, antioxidant nutrients, minerals, vitamins, lignans and phenolic compounds, all of which have been linked to reduced risk of cancer. Most of the components are found in the germ and bran which are reduced in the grain refining process. Dietary guidance recommends consumption of whole grains for the prevention of cancer especially gastrointestinal cancers such as gastric, colonic, and hormonally-dependent cancers including breast and prostate.

However, the comprehensive "Second Expert Report (2007)"by the World Cancer Research Fund and the American Institute for Cancer Research (see later in Section 3.10 below) concludes that the direct evidence that cereals (grains), roots, tubers, or plantains affect the risk of any cancer remains unimpressive, but nevertheless states :-

"However, foods containing dietary fibre probably protect against colorectal cancer; and there is limited evidence suggesting that such foods protect against oesophageal cancer. Dietary fibre is mostly found in cereals, roots and tubers, and also in vegetables, fruits, and pulses (legumes). All of these are highest in dietary fibre when in whole or minimally processed forms".

So, the evidence is clear - if you want to reduce the risks - and it is clear from the above that you can - you need to adopt a diet rich in fruits, vegetables and whole grains.

It may involve you in more effort planning and purchasing what you eat, but the evidence shows that it will help reduce your risks of getting cancer and/or heart and circulation problems. This next list of antioxidant levels in fruit and vegetables will help.......

Foods containing high levels of antioxidants
The US Department of Agriculture has developed a rating scale that measures the antioxidant content of various plant foods. The scale is called ORAC, which stands for Oxygen Radical Absorbance Capacity. They discovered that a small group of "super foods" have up to twenty times the antioxidant power of other foods. They recommend a daily intake of at least 3,000 units per day. The list below (courtesy USDA) gives the ratings for 100gm (~ 3.5 ounces) of each food.

A 100gms is about the weight of an average sized lemon.

Prunes = 5,770
Pomegranates = 3,307
Raisins = 2,830
Blueberries = 2,400
Blackberries = 2,036
Cranberries = 1,750
Strawberries = 1,540

Raspberries = 1,220
Plums = 949
Oranges = 750
Red Grapes = 739
Cherries = 670
Kiwi Fruit = 610
Grapefruit Pink = 483

White Grapes = 460
Banana = 210
Apple = 207
Tomato = 195
Apricot = 175
Peach = 170
Pear = 110
Watermelon = 100

Garlic = 1939
Kale = 1,770
Spinach = 1,260
Brussels Sprouts = 980
Alfalfa Sprouts = 930
Broccoli Florets = 890
Beets = 840
Red Bell Peppers = 710

Onion = 450
Corn = 400
Egg plant = 390
Cauliflower = 385
Frozen Peas = 375
Potato = 300
Sweet Potato = 295

Cabbage = 295
Leaf Lettuce = 265
Carrot = 200
String Beans = 200
Iceberg Lettuce = 105
Celery = 75
Cucumber = 60

And wait for it ....

Unprocessed Cocoa powder = 26,000
Dark Chocolate = 13,120
Milk Chocolate = 6,740

So, pack your daily diet with these natural foods (giving at least 3000 units per day). If you don't do your own shopping, then give this list to the person who does!

Using the above list you can plan how best to obtain your regular dose of anti-oxidants and the other protective ingredients in fruit and vegetables. The red/orange coloured fruits/vegetables seem (generally) to contain higher levels than other colours. You might want to go easy on the garlic though, no point living forever if you don't have any friends!!

Fruits and vegetables could also be used to systematically replace snacks between meals - a small handful of raisins and non-salted mixed nuts (brazil, walnut, almond, peanut, pecan, etc) would provide a substantial shot of antioxidants and fibre and stop the craving for unhealthy sugary snack bars. (Nuts have a high fat content so should be eaten sparingly if you need to be careful of calories).

Although apples are not particularly high on the above list, they have traditionally been linked to a reduced risk of chronic health problems such as lung cancer, heart disease, and stroke. Traditional advice on eating apple peel was based mainly on its fibre content, with peel packing about 75 percent of the dietary fibre in an apple.

More recently (May'07), however, research has shown that the peel also contains most of the beneficial phytochemicals believed to be responsible for the apple-a-day-keeps-the-doctor-away effect. They identified compounds in the peel which in tests had "potent" anti-cancer effects in laboratory cultures of human liver, breast, and colon cancer cells.

Cocoa and Chocolate
By far the highest concentrations of antioxidants occur in cocoa and chocolate, although chocolate is also high in fat content and neither, in the volumes sensibly consumed (!), have the benefit of substantial amounts of fibre.

So now, armed with the above information, you can better organise your intake of health promoting phytochemicals and fibre - with a few squares of dark chocolate per day looking like a persuasive treat.

Antioxidant Supplements in Tablet/Capsule Form
You might think that a quick and easier way to deal with this is to take lots of high dose supplement (tablets/capsules)


It appears important that, unless they are fulfilling a special need prescribed by your doctor, antioxidants, etc., should be consumed in their natural state rather than as a supplement in a highly concentrated tablet/capsule form.

Overall, the large number of clinical trials carried out on antioxidant supplements suggest that either these products have little effect on health, or that in some cases they cause a small increase in mortality in elderly or vulnerable populations.

In fact, in the comprehensive "Second Expert Report (2007)" by the World Cancer Research Fund and the American Institute for Cancer Research (see later in Section 3.10 below) there is a recommendation that one should:

"avoid Dietary supplements" - except in special cases such as folic acid during pregnancy (or for any other specific need advised by your doctor).

This follows increasingly mixed evidence regarding the affects of supplements, where very high doses of some antioxidants may have harmful long-term effects. One study of lung cancer patients in Finland found that male smokers given supplements containing high doses of beta-carotene and vitamin A had increased rates of lung cancer. A subsequent study confirmed these adverse effects.

Hence, take note that vitamin and mineral supplements should not normally be used as substitutes for a healthy, well balanced diet!

Over the years an enormous amount of research has been carried out in trying to determine how diet affects the incidence of disease. The majority of studies show a beneficial effect for consuming high quantities of fruit, vegetables and whole grains, although in some studies this effect is absent.

Nevertheless, overall general medical opinion is that these substances in their natural form are particularly beneficial to health and should be promoted.

For greatest benefits, consume in their natural state!

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3.4.2 The benefits of dark chocolate

Research (Aug'03) into the absorption of an antioxidant found in chocolate has shown that dark chocolate by itself increases an antioxidant (epicatechin) in the blood up to 20%, and that the effect persisted for up to four hours after ingestion. However, milk chocolate did not produce the same increase, and neither did dark chocolate if eaten with a milk drink. This raised the possibility that the milk proteins are binding with the antioxidant, and that milk may also bind with antioxidants in other foods as well - such as fruit and green vegetables.

Other research concluded that cocoa powder dissolved in milk (as one of the most common ways of cocoa powder consumption) apparently seems to reduce the absorption of polyphenols. However, analyses have shown that milk does not impair the underlying bioavailability of the protective polyphenols .

So, take your choice! To be on the safe side and ensure you maximise the uptake of antioxidants, perhaps one could generally try to avoid taking milk at the same time as your fruit and vegetables (and tea), and go for dark chocolate rather than milk chocolate.

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3.4.3 Tea and antioxidants

Tea has long been consumed for its health giving properties which arise from the high levels of polyphenol antioxidants.

Green tea, black tea, oolong tea - they all come from the same tea plant, Camellia sinensis; the leaves are simply processed differently, explains Weisburger.

Green tea leaves are not fermented; they are withered and steamed. Black tea and oolong tea leaves undergo crushing and fermenting processes. All teas from the Camellia tea plant are rich in polyphenols, which are antioxidants -- meaning they scavenge for cell-damaging free radicals and detoxify them.

Says Weisburger, "In my lab, we found that green and black tea had identical amounts of polyphenols. We found that both types of tea blocked DNA damage associated with tobacco and other toxic chemicals. In animal studies, tea-drinking rats have less cancer. While herbal teas may also contain antioxidants, less is known about them.

However, be careful about doctoring-up your tea, one study found that adding too much milk to can greatly reduce tea's health benefits".

However, other research (May'05) on the effect of milk in tea on antioxidant levels suggested that although milk reduced the perceived levels of the antioxidant the actual beneficial effects of the antioxidants in black tea were not completely negated.

So, if you normally take your tea with milk, it might be wise to try leaving out the milk, go for green tea for a change, adding a slice of lemon and initially making a weaker brew until you get used to it. It is much milder than the black tea the British normally drink and you will find it is very refreshing and soon grow to love it. Try different teas - there are many available from health food shops. That doesn't mean you need to give up your normal tea and milk drink, you can just look upon your lemon tea as a different refreshing drink, and if it replaces sugary soda/pop drinks then so much the better.

Tea also helps you recover after a stressful event
Not only does tea appear to have cardio-vascular and anti-tumor benefits, it also helps you to recover more quickly from stressful events. (Did our grandparents not know this already?!). Professor A. Steptoe explained that in a study, involving 75 young male volunteers split into two groups, a set of stressful tasks was given to the subjects after drinking tea or fake tea disguised so the subjects didn't know which they were drinking.

The tasks triggered substantial increases in blood pressure, heart rate and subjective stress ratings in both of the groups. However, 50 minutes after the task, cortisol levels (a measure of stress in the body) in the blood had dropped by an average of 47% in the tea-drinking group compared with 27% in the fake tea group. Blood platelet activation - linked to blood clotting and the risk of heart attacks - was also lower in the tea drinkers. In addition, this group reported a greater degree of relaxation in the recovery period after the task.

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3.4.4 Coffee's protective effects

Coffee has been much maligned in the past, but it has positive benefits as well as the drawbacks.

A report on WeBmed says: " Consider this: At least six studies indicate that people who drink coffee on a regular basis are up to 80% less likely to develop Parkinson's, with three showing the more they drink, the lower the risk. Other research shows that compared to not drinking coffee, at least two cups daily can translate to a 25% reduced risk of colon cancer, an 80% drop in liver cirrhosis risk, and nearly half the risk of gallstones.

Now it also seems that moderate to high consumption of coffee can inhibit the onset of type 2 diabetes.

Coffee even offsets some of the damage caused by other vices, some research indicates. People who smoke and are heavy drinkers have less heart disease and liver damage when they regularly consume large amounts of coffee compared to those who don't.

Coffee contains caffeine and a high level of antioxidants, both of which are thought to be the cause of its beneficial effects.

On the other hand, it's clear that coffee isn't for everyone. Excessive doses - that is, more than whatever your individual body can tolerate - can increase nervousness, hand trembling, and cause rapid heartbeat. Also, caffeine has a diuretic effect (removal of water from the body by increasing the rate of urination), so drinkers should ensure they also drink enough water to counteract it, otherwise they may become dehydrated. Coffee may also raise cholesterol levels in some people and may contribute to artery clogging.

However, most recent large studies show no significant adverse effects on most healthy people, although pregnant women, heart patients, and those at risk for osteoporosis may still be advised to limit or avoid coffee."

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3.4.5 Olive Oil and Fish Oil

Olive Oil
Olive oil is central to the Mediterranean diet, which has long been associated with numerous health benefits, including decreased risk of stroke, heart disease, breast cancer, lung cancer and some dementias.

There are three basic types of olive oils: extra virgin, virgin and pure olive oil. Olive oil is pressed from the ripe olives after they are harvested. Oil from the first cold pressing is classified as virgin. Extra virgin simply means an oil from the first pressing that is particularly low in acid — less than 1%. It is considered the finest oil, and is likely to have the fruitiest and most pronounced flavor. Virgin olive oil may have as much as 4% acid. There can be no refined oil in virgin olive oil. Oils labeled as Pure olive oil or Olive oil are usually a blend of refined olive oil and one of the above two categories of virgin olive oil.

After the first pressing, more oil is extracted in subsequent operations using a combination of pressure, heat, and chemical solvents. These refined oils may be blended with virgin oil to replace some of the flavor lost in the processing, and are sold as pure olive oil or just olive oil. There is also a light olive oil, which is not lower in calories, but which has been so finely filtered as to remove most of its color and fragrance (and flavor).

Researchers at the Monell Chemical Senses Centre team in Philadelphia have recently (Aug'05) discovered an ingredient in olive oil which acted as an anti-inflammatory. Inflammation has been linked to a wide range of conditions such as heart disease and cancer. They found 50gm of extra-virgin olive oil was equivalent to about a tenth of a dose of ibuprofen. The team said while the effect was not strong enough to cure headaches, it may explain the Mediterranean diet benefit.

They said that "the active ingredient - found in greater concentrations in fresher olives and less concentrated in non extra-virgin olive oil - is called oleocanthal and inhibits the activity of enzymes involved in inflammation in the same way as non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen. Now that we know of oleocanthal's anti-inflammatory properties, it seems plausible that it plays a causal role in the health benefits associated with diets where olive oil is the principal source of fat."

Another study (Mar'07) showed that even after adjustments were made to account for a variety of other variables -- including body mass index, smoking, physical activity level, educational status, a family history of heart disease, high blood pressure, high cholesterol and diabetes -- exclusive use of olive oil was associated with a 47% lower likelihood of having coronary heart disease.

The down side to this fat rich oil (although comprising the healthier mono-unsaturated fat) is that it is very high in calories, one tablespoon (~16 ml) contains about 130 calories, and the 50gm dose mentioned above provides over 400 calories! So you need to use olive oil as a replacement for other unhealthy fats and not just in addition to your normal diet!

Fish Oil
Oily fish are also well known for their beneficial effects on the heart (and joints). Omega-3 fatty acids benefit the heart of healthy people, and those at high risk (e.g.smokers) of — or who have — cardiovascular disease.

The American Heart Association recommends eating fish (particularly fatty fish) at least two times a week. Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in omega-3 fatty acids.

The Need for a little fat with salads/vegetables
Two research studies recently undertaken show that when eating salads and vegetables, you need to have some fat with the meal to help absorb the antioxidants.

In the first study, one of the researchers, Dr. Steven Schwartz from Ohio State University (who was involved with both studies) said that " essentially no absorption of carotenoids (alpha-carotene, beta-carotene and lycopene) was observed when salads with fat-free salad dressing were consumed. A substantially greater absorption of carotenoids was observed when salads were consumed with full-fat than with reduced-fat salad dressing".

Dr. Schwartz commented that "Many fruits and vegetables are rich in beneficial carotenoids, but most fruits and vegetables are virtually fat free, which may limit the body's ability to absorb some of these nutrients".

This sounds counter intuitive, since it seems unlikely that in the natural hunter gatherer evolution of our digestive system it would not have optimised the extraction of antioxidants from pure fruit and vegetables - on the basis that when fruit was available, presumably the group would exist on mainly fruit, with the same for whatever vegetable came into season. Alternatively, it could be that our systems evolved to extract the amount which is sufficient for our needs. Nuts and seeds (containing fats) could have been eaten with fruits since they appear at the same time of year.

In the second study they used avocado, a naturally fatty food containing vitamins, minerals and monounsaturated fatty acids to provide the source of fat. Dr. Schwartz said they found that about three to five times more carotenoids were absorbed when study participants consumed a salad with avocados, the avocados offering nutritional advantages over other sources of fat like salad dressings.

This may not be too much of a problem in practise however, since most meals will include some form of fat anyway. For pure salads, without any other form of fat, one could always either adopt the avocado strategy or use a small amount of olive oil as dressing (taking care to consider the extra calories involved).

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3.4.6 Herbs and Spices

Surprisingly, Rune Blomhoff and researchers at the University of Oslo say that herbs and spices are extremely rich in antioxidants.

Spices are dried herbs, and condiments are spices and other flavorings added to food at the table. Since prehistoric times, herbs have also been the basis for nearly all medicinal therapy until synthetic drugs were developed in the 19th century. Today, herbs are still found in 40% of prescription drugs. In addition, herbs are used for many other purposes including beverages such as tea, dyeing, repellents, fragrances, cosmetics, charms, smoking and industrial uses.

They found the amount herbs and spices contribute to a person's total intake of dietary antioxidants to be significant. They demonstrated that there is a greater than 1000-fold difference among total antioxidants in various herbs.

Of the dried culinary herbs tested, cloves, oregano, allspice, cinnamon, sage, peppermint, thyme and lemon balm had the highest levels. As little as 1 gram (about 1/2 teaspoon) of cloves will contribute more dietary antioxidant than a 1/2-cup serving of blueberries or cranberries, two foods famous for their antioxidant levels. And 1/2 teaspoon dried oregano contains the antioxidant of 1/2 cup sweet potatoes. In a normal diet, intake of 1 g of these herbs may therefore make a relevant contribution to the total intake of plant antioxidants, and be an even better source of dietary antioxidants than many other food groups.

Blomhoff says both fresh and dried varieties work: "Many fresh herbs contain so much antioxidant that when dried they are still very good sources." And benefits can even come in the form of teas, which, according to Blomhoff, "may be a significant dietary source."

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3.5 Alcohol..... and Red Wine

It is clear that the relationship between use of alcohol and overall human health is complex, although there is well accepted evidence of a beneficial effect of moderate alcohol consumption on the heart and circulatory system.

Scientific debate continues on whether it is just the alcohol itself that confers the cardiovascular benefit, or whether additional components contained in some drinks are the primary cause.

The comprehensive "Second Expert Report (2007)"by the World Cancer Research Fund and the American Institute for Cancer Research (see later in Section 3.10 below), states that alcohol intake at any level is carcinogenic for the mouth, throat, oral cavity, oesophagus and larynx, with less strong direct relations observed for cancers of the colon, rectum, liver, and breast.

However, they then go on to recommend the moderate consumption of alcohol (1-14 Units of alcohol per week - a Unit is half a pint of beer or a small glass of wine) on the basis of the benefit it has for the heart and circulatory system. This is odd for a review which is concerned with avoiding cancer, and one must assume that below the limit of 14 units of alcohol per week the risk of contracting cancer is extremely small - otherwise they wouldn't recommend it?

Smoking and Drinking Together
Another major study, the European Code Against Cancer (2003), had earlier reflected similar views. They also indicated that around 90 per cent of oral cancers occur after exposure to tobacco or alcohol or a combination of both. The rate of incidence of oral cancers in those who neither smoke nor drink is extremely low.

In commenting on the issue of smoking and drinking together, they indicated that there was strong evidence that smoking and drinking together enhance the risks significantly, with risks rising substantially for very heavy drinkers and heavy smokers as they showed in the diagram alongside (derived from a study of cancer of the larynx in Southern Europe). 8–10 g of ethanol corresponds to one unit of alcohol (half pint of beer or one small glass of wine).

Relative risk of laryngeal cancer for tobacco smoking and alcohol drinking So if you smoke less than 7 cigarettes a day and drink the equivalent of 2 pints of beer a day (up to 40 mg ethanol), then your risk of oral cancer compared to someone who doesn't drink or smoke rises by a factor of about 2. If you smoke 20 cigarettes per day and drink the equivalent of between 2 to 4 pints per day your risk goes up to a factor of about 12. For 30 cigarettes per day and consumption of around 4 to 6 pints per day the risk goes up to a factor of 20, and so on.... Clearly this risk response is just an estimated profile, but it does show the rapid rise for heavy smoking and drinking together.

However, note their additional comment about these increased risks :

"a diet poor in fruits and vegetables, typical of heavy drinkers, is also likely to play an important role".

The implication for smokers and drinkers is that they can probably reduce these risks by judiciously adopting the lifestyle and diet changes described in this Smokers' Health Page.

Annual mortality by alcohol consumption for all causes of death in men. Alcohol by itself
With regard to alcohol consumption alone, they said there is strong evidence for a J-shaped pattern of risk across all causes of death and for cardiovascular disease. They referred to a study carried out by Doll, Peto, Hall et al in 1994 on Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. It involved a 13 year study of the drinking habits of 12,000 UK male doctors aged between about 50 and 90 years. The diagram alongside shows the annual mortality for all causes of death as a function of alcohol consumption.

This classic pattern is one of lower risk of death for light to moderate drinkers compared with non-drinkers, and then an increasing risk for drinkers as alcohol consumption increases.

One unit of alcohol corresponds to 8–10 gm of ethanol (half a pint of beer or a small glass of wine). It does seem from this graph that the limits currently being proposed (1-14 Units of alcohol per week) are on the conservative side, since one has to drink (in isolation from other factors such as smoking of course) around 40 units per week to raise the risks to the same as those for non-drinkers.

As the men studied were over 50 years old, the researchers indicated that the same conclusion might not apply to younger men or to women, in whom the mix of causes of death is different.

In fact, a more recent study in the UK in 2002 suggests that drinking only benefits older people. They recommend revised limits and a reduction in drinking limits for younger people.

Recommended daily limits for men aged :
16 to 34: one unit
35 to 44: two units
45 to 54: three units
55 to 84: four units
85 plus: five units

Recommended daily limits for women
16 to 44: one unit
45 to 74: two units
75 plus: three units

Overall, taking all the above points into consideration, the current medical wisdom from the The World Cancer Research Fund and the American Institute for Cancer Research - "Second Expert Report (2007)" (see in more detail in Section 3.10 below) suggests that, to broadly minimise the risks from alcohol in terms of cancer and cardiovascular disease, the limit of alcohol consumption should not exceed 20 g of ethanol (2 Units) per day for men (i.e. approximately one pint of beer or two small glasses of wine) and for women it should be as low as 10 g per day (half a pint of beer or one small glass of wine).

The effect does not appear to depend on whether the drink is beer, wine or spirits, rather the total amount of ethanol ingested appears to be the key factor.

Red Wine
The above recommendations on alcohol consumption do not differentiate the drinks through which alcohol is delivered, but since it is a very high level and broad ranging review it must necessarily simplify the messages around the most definitive of the evidence they have.

Whether proven absolutely or not, there does seem to be fairly convincing evidence that red wine in particular seems to provide additional specific health benefits, particularly for your heart and circulation system, with some indication that it may also help to destroy cancer cells. It appears that the key active ingredients occur in red wine but not white wine.

This is the so-called "French paradox", where the French seem to have lower levels of heart disease despite eating as much fatty food as other northern European countries. While a link has been suggested, this has not yet been proved convincingly. There are some who argue that this is due to other factors such as under reporting and death through other causes before their circulatory problems become life threatening!

It seems that overall, hedging one's bets, a regular drink would be better than none at all, and drinking red wine as part of your alcohol diet is likely to deliver additional benefits!

And if you insist on smoking as well, then improving your diet and lifestyle must be the most sensible way to help reduce the risks.

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3.6 Exercise

It is now well accepted that exercise is fundamental to the well-being of the human body, and the BMJ (British Medical Journal) indicates that increasing evidence has been built up of the benefits exercise brings to health and avoidance of disease.

The scientific evidence is based on many studies--epidemiological, clinical, and physiological. Coronary heart disease and stroke are identified as key priorities to tackle in improving the health of the nation. For these two diseases individual risk is dramatically reduced by a change in lifestyle and an increase in physical activity. Other important benefits must not be overlooked. The list of benefits is extensive but falls into four categories: enhancing function, maintaining reserve capacities, preventing disease, and ameliorating the effects of age and chronic disease.

There is consistent evidence that some form of regular physical activity is associated with a reduction in the risk of colon cancer. There is also a suggestion of a risk reduction in relation to cancer of the breast, endometrium and prostate.

Recent evidence (Dec 2007) suggests that exercise, and a diet including fresh vegetables (salads) substantially reduces the risk of lung cancer, with the vegetables providing proportionally greater reductions in risks for smokers and former smokers than for never-smokers.
Said Michele Forman, Ph.D., a professor of epidemiology at the University of Texas. "Although this is a very preliminary analysis, it gives us some important clues about how everyone - smokers and non-smokers alike - might be able to reduce their risk of developing lung cancer".

The BMJ suggests that "The objective should be to take enough regular exercise to improve or maintain stamina, to strengthen muscles, and to improve or maintain the range of joint movement. To improve stamina the effort needs to be somewhat greater than that to which the person is accustomed. This means that those who have previously been sedentary will show an improvement in some capacities even with a low intensity of exercise. The degree of improvement also depends on the duration and frequency of the activity. If an increased level of activity is sustained then the cumulative effects of training build up over many months. These decline again if the exercise is discontinued. Harmful effects are unlikely, provided that the intensity of exercise is increased gradually"

•••• PLEASE NOTE••••
The latter point cannot be over-emphasised. If you are overweight, or have done little exercise for many years, or have any medical condition that might be affected by exercise, then see your doctor first to ensure you do not over-stress your body and to agree an exercise strategy. ALWAYS START SLOWLY WITH SMALL AMOUNTS OF EXERCISE AND GRADUALLY BUILD UP AS YOUR BODY'S CAPABILITY DEVELOPS. If you feel unwell at any stage then reduce the exercise or stop - use your common sense - get advice from your doctor if you don't feel things are improving.

Ideally it is best to aim for some form of intensive physical activity on a daily basis, the intensity and duration (15mins - 30 mins) being sufficient to raise the heartbeat and break into a sweat, but it is appreciated that today's working and family commitments may make this difficult. A minimum aim should be to undertake half an hour per day three times per week. More vigorous activity several times per week will provide additional benefits.

Exercise also increases the body's level of endorphins, chemicals in the brain that reduce pain and induce a sense of well-being. Thus, exercise appears to help improve mood and energy levels and may even help relieve depression. Exercise may also help boost self-esteem by improving a person's overall health and appearance.

The protective effect of physical activity on cancer risk improves with increasing levels of activity (the more the better) though such a recommendation should be moderated in individuals with cardiovascular disease. Regular physical activity that involves some exertion may be needed to maintain a healthy body weight, particularly for people with sedentary lifestyles.

As a smoker you have increased risks of coronary heart disease, stroke and lung cancer. So, if you are not prepared to give up smoking, then exercise is essential if you want to reduce future health risks.

The more you exercise and the greater intensity of exercise (within reason), the better you will feel, and the better your body will be at coping with the impact of smoking.

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3.7 Aspirin for over 50s

There is still some debate about whether a low dose (75mg) of aspirin should be routinely prescribed to all middle aged people over 50 years old.

Cardiovascular benefit
Doctors already recommend aspirin for patients who have a higher than normal chance of having a heart attack or stroke, as long as there are no other medical reasons not to prescribe the drug, such as unwanted side effects.

The drug can cut the risk of heart attacks and possibly strokes, but there are concerns it can increase some people's risk of experiencing bleeding in the brain or stomach. Experts outline their opposing viewpoints:

At a low dose, undesirable effects are unusual and seldom serious, and probably 90 to 95% of the population could take low dose aspirin without problems. They are likely to accept a small increased risk of a bleed or other side-effect in exchange for a reduced risk of a heart attack or stroke.

The benefits of taking aspirin certainly do outweigh the risks for people already known to be at a high risk of heart disease or stroke. Unfortunately, predicting the benefits and hazards of aspirin in someone without known disease is far less straightforward.
We should not contemplate an age threshold approach to primary prevention with aspirin until we have much better evidence of its benefits in older people.

Cancer prevention
To add fuel to the debate, further evidence suggests that aspirin may reduce the chances of developing lung cancer and cancer of the oesophagus. A study at New York University's School of Medicine claimed that women who take aspirin on a regular basis cut their risk of developing the most common type of lung cancer by more than half. The study, involving more than 14,000 women, suggested the drug's anti-inflammatory effects reduce the chances of developing any form of lung cancer by a third. The US team said that not smoking is still the best protection against the disease.

So, if you are a committed middle-aged smoker then, as you have elevated risks for heart disease, stroke, and cancers of the mouth, throat, oesophagus and lung, you could well benefit from taking a regular small (75mg) dose of aspirin. Ask your doctor whether you have any overriding health problems which would suggest you should not take the aspirin.

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3.8 Food combining for health

The human body has evolved natural defences against illness and disease, and when performing at peak efficiency can to some extent protect itself against toxins and other alien substances which it encounters. Hence, it seems reasonable that as smokers subject the body to such contaminants, it is best to ensure the body is operating at optimum efficiency to minimise any health risks.

Food is the key factor and, according to the food combining philosophy, if the wrong foods are eaten together then the digestive system becomes "out of sorts" and the body spends a unecessary effort trying to resolve its problems, producing toxic by products which leaves the whole body susceptible to infection and, in the long term, more chronic disease development. It claims to prevent or alleviate a wide range of modern illnesses including chronic digestive problems, diabetes, allergies, skin diseases, headaches, and arthritis to name but a few.

This eating regime, known as the Hay Diet, was developed around 1911 by Dr William H Hay 1866-1940. It has received much criticism over the years from various quarters, but most of them cannot have tried it! The bottom line is that is definitely works for most people, you feel less bloated, less tired and less lethargic after meals, more alert and energetic....... Dr Hay believed that degenerative diseases were merely the long term manifestations of the food we eat - over consumption, particularly of refined/processed food products, and incompatible combinations. It is suggested that "long term" can mean a degeneration period of 20 to 30 years before the diseases finally manifest themselves.

Read this extract from the book "Food Combining for Health by Doris Grant and Jean Joice (first published 1984)"

"There is a generally held belief today that people are living longer than formerly. Although more children survive to reach adult life, middle-aged people have scarcely improved upon the life-expectancy of their great-grandparents. The unpleasant truth is that, instead of living longer to a healthy and enjoyable old age, we are merely taking longer to die.

Moreover, with each generation there is an increase in the ordinary diseases of degeneration, and these are appearing at ever earlier ages than formerly. All the 'tremendous new discoveries' in the drug field have been unable to stem this increase. Belief in the curative power of drugs has contributed to this increase by diverting attention from the positive promotion of health.

As a result, the disillusioned drug-givers and drug-takers are now showing a healthy interest in the doctrine of 'holism' - treating the whole person rather than just the disease symptoms. This is completely in line with Dr Hay's commonsense principles, which more than ever before are shown to be valid. He advocated the treatment of the patient himself - not the symptoms - and argued that it was childish in the extreme to suppose we can restore a person to full health without first rooting out the cause of his disease; to do otherwise was just as stupid as bailing out a leaky boat without first finding and stopping the leak.

Dr Hay also argued that this cause, in every case, is one and the same thing - food (over-consumption of refined carbohydrate, and incompatible combinations) - and pointed out that the degenerative diseases are just different manifestations of this one cause. The cure, he pointed out, 'therefore lies in food always and only."

Dr Hay's comments were written during the beginning of the 20th century, when widespread chemical contaminants in our food and environment and the prevalence of sedentary lifestyles had not really raised their heads, so it is not surprising that he concentrates on the food aspect. All the additives nowadays put into food, particularly processed food, would seem to make his argument even more compelling, and though we now have additional factors to take into account, these should not detract from the sense behind his message. It seems surprising that it is nearly 100 years later that finally the wider medical profession is coming round to this point of view.

Brief Summary of Concept and Rules
Food combining is based on the principle that highly concentrated protein foods and highly concentrated starch foods require different levels of acids and alkalis in the stomach to digest properly. Mixing the two groups in one meal results in fermentation and putrefaction of incompletely digested food, mainly the carbohydrate. This partially digested food only very slowly travels down the alimentary canal, with the resulting toxic by-products generally causing immediate problems of bloating, excess flatulance, indigestion, constipation, foul smelling stools and the like, and in the longer term the likely development of more serious disease.

(The criticism often levelled at food combining is that most foods contain a mixture of protein and carbohydrate so how can they be kept separate? The answer is that the body can cope well with protein and carbohydrate in the ratios naturally occuring in most foods - which seems common sense since the body has evolved to deal with them in this way - so if consumed alone in their natural form, they will not cause a problem. Problems arise, for example, when concentrated protein as in meat is mixed with the concentrated starches in cereals, potatoes, etc. One can imagine that in our original hunter-gatherer groups, when meat was caught (relatively infrequently) then the group ate mostly meat, when berries and nuts were around, they concentrated on those - it is only modern society that has provided us with the full range of foods for consumption together at any time of the year.)

The other key foods are fats, vegetables and fruit, and these should only be combined with proteins and starches in specific ways. Fats and vegetables can be eaten with proteins, and also eaten with starches; but do not combine concentrated proteins and concentrated starches. Fruit is classified into two groups - Acid and Sweet - acid fruits can be eaten with protein, sweet fruits with starches.

There are five basic rules to observe :-

1. Starches and sugars should not be eaten with proteins and acid fruits at the same meal.
2. Vegetables, salads and fruits should form the major part of the diet.
3. Proteins, starches and fats should only be eaten in small quantities.
4. Eat only whole grain and unprocessed starches - avoid all refined and processed foods.
5. Allow an interval of 4 hours or more between meals of different character.

(Note how closely rules 2, 3, and 4 resemble the diet guidelines of the recent "Second Expert Report (2007)" on avoiding cancer through diet and exercise (see in more detail in Section 3.10 below))

A summary table of compatible foods is shown in three columns, the left hand column listing foods for protein based meals, the right hand column for starch based meals. The central column lists neutral foods, which can be combined with either proteins on the left or starches on the right. For more detail on recipes for appropriate meals you will need to purchase a book on Food Combining, e.g. like this one.

Do not mix Columns 1 and 3. Column 2 will go with either 1 or 3.

Column 1

Protein Based Meals

Column 2

Neutral Foods

Column 3

Starch Based Meals

All Meats
( including Soya) - milk should not be served with meat - combines best with fruit)

Melons are best eaten alone
Passion Fruit

Kidney beans
Butter beans (Lima)
Chick Peas (garbanzos)
Pinto beans
Haricot beans etc

Wine - Red and White
All green and root vegetables except for potatoes and jerusalem artichokes

NUTS - All except peanuts
Egg Yolks
Olive Oil



Very Ripe fruits - high sugar
Bananas if ripe
Sweet Grapes

Sweet Potatoes
Jerusalem Artichoke


The Hay diet has also been promoted by some as a weight loss diet although this is not its primary purpose. However, if you follow the basic rules you are likely to reduce consumption of calories, e.g. where you would normally have a meat and two veg dinner including potatoes, you must leave out (or substitute with veg) the potatoes since they are starch based. Also, eating is no longer a free for all to gobble up any type of food you can get your hands on whenever you feel hungry, particularly as you should have a 4 hr gap between meals. Being careful of what you eat in combination will naturally tend to reduce your calorie intake.

You can purchase a range of books to help with your understanding of this scheme of eating, the degenerative diseases it claims to prevent and help, and recipes and meal plans which only use the required food groups together.

Some people are better at tolerating mixed food groups than others, but most people feel better, some extraordinarily so, when following this regime.

It has to be said that following the regime requires some forward planning, and eating out can be difficult. But if you adopt it for most of the time, the occasional lapse shouldn't cause you a major problem - and you will be much better off overall in the long term.

So, as a smoker, if you want to improve your health and raise your body's ability to cope with toxins, try this approach, you should be convinced within a week!

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3.9 Organic food

being developed.....

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3.10 Ten ways to avoid cancer

Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective.
Published in November 2007, taking over 5 years to complete and produced by the World Cancer Fund and the American Institute for Cancer Research, this extensive review of all current scientific cancer-related literature, pulls together all the evidence and comes out with key recommendations on how to avoid cancer.

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....being developed....

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I have compiled the information on this page with the best of intentions and to the best of my understanding. If I have misrepresented or misunderstood any medical fact then please send your comments to me via the e-mail link below.
Many thanks.

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