There’s a very large group of people across Europe who take part in the long-running “European Prospective Investigation into Cancer and Nutrition,” or EPIC for short. From Wikipedia:

With over half a million participants, it’s the largest study of diet and disease to be undertaken.

The EPIC study is good to consult if you’re looking for associations between diet and cancer, not only because it’s large, but because:

The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers.

I was looking at EPIC studies for associations between coffee/tea consumption and cancer and found these 5 studies:

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1. Coffee, Tea And Melanoma Risk: Findings From The European Prospective Investigation Into Cancer And Nutrition, International Journal of Cancer, March 2017

In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date.

Consumption of caffeinated coffee was inversely associated with melanoma risk among men (HR for highest quartile of consumption vs. non-consumers 0.31, 95% CI 0.14–0.69) but not among women (HR 0.96, 95% CI 0.62–1.47). There were no statistically significant associations between consumption of decaffeinated coffee or tea and the risk of melanoma among both men and women.

2. Coffee, Tea And Decaffeinated Coffee In Relation To Hepatocellular Carcinoma In A European Population: Multicentre, Prospective Cohort Study, International Journal of Cancer, September 2014

Inverse associations of coffee and/or tea in relation to hepatocellular carcinoma (HCC) risk have been consistently identified in studies conducted mostly in Asia where consumption patterns of such beverages differ from Europe.

We found that increased coffee and tea intakes were consistently associated with lower HCC [liver cancer] risk. The inverse associations were substantial, monotonic and statistically significant. Coffee consumers in the highest compared to the lowest quintile had lower HCC risk by 72% [HR: 0.28; 95% confidence intervals (CIs): 0.16–0.50, p-trend < 0.001]. The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22–0.78, p-trend = 0.003).

The inverse, monotonic associations of coffee intake with HCC were apparent for caffeinated (p-trend = 0.009), but not decaffeinated (p-trend = 0.45) coffee for which, however, data were available for a fraction of subjects.

3. Coffee And Tea Consumption And Risk Of Pre- And Postmenopausal Breast Cancer In The European Prospective Investigation Into Cancer And Nutrition (EPIC) Cohort Study, Breast cancer Research, January 2015

Caffeinated coffee intake was associated with lower risk of postmenopausal breast cancer. … For every 100 ml [3.4 ounces] increase in caffeinated coffee intake, the risk of ER-PR- breast cancer was lower by 4%. Decaffeinated coffee intake does not seem to be associated with breast cancer. Tea intake was neither associated with pre- nor post-menopausal breast cancer.

4. Coffee And Tea Intake And Risk Of Brain Tumors In The European Prospective Investigation Into Cancer And Nutrition (Epic) Cohort Study, American Journal of Clinical Nutrition, September 2010

No reduction in brain cancer per se, but they did find lower risk for gliomas, tumors of the glial cells that support nerve cells. Gliomas often occur in the brain.

A significant inverse association was observed for glioma risk among those consuming ≥100 mL coffee and tea per day compared with those consuming <100 mL/d. [100 ml is about 3.4 ounces, not much.]

Conclusions: In this large cohort study, we observed an inverse association between total coffee and tea consumption and risk of glioma that was consistent with the findings of a recent study.

Since “most of the coffee consumed in this population was caffeinated,” they couldn’t comment on decaffeinated consumption.

5. Coffee, Tea, Caffeine Intake, and Risk of Adult Glioma in Three Prospective Cohort Studies, Cancer Epidemiology, Biomarkers, and Prevention, January 2010

This is that recent study mentioned in number 4 above. The 3 cohorts were the Nurses’ Health Studies I and II, and the Health Professionals Follow-Up Study. Large populations, similar to that seen in EPIC, except participants were from the US.

Consumption of five or more cups of coffee and tea daily compared with no consumption was associated with a decrease risk of glioma. … No association was observed between decaffeinated coffee and glioma risk.

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In sum, drinking coffee was found to lower risk for 4 cancers: skin (melanoma), liver, breast, and tumors in brain (glial).

I was surprised, not only that EPIC was specifically queried for these associations, but that there was a recurring finding in favor of consumption … consumption of primarily caffeinated coffee. Decaf coffee usually showed a weaker association if at all, as did tea.

I used to use a French press to make coffee. A few years ago I received an AeroPress as a gift. I’m hooked. It’s simple to use, fast, doesn’t require electricity (camping, travel), and best of all, it produces a crema, that creme-colored froth you see in the photo at the top. (Mine does, but the coffee in this video doesn’t. Probably used too coarse a grind.)

A blended meal can keep you from feeling hungry for longer than the same foods whole. This is a chickpea, turnip, and lemon soup from Pickled Plum.

Into the category of Learn Something Every Day goes the concept of gastric sieving:

Preventing Gastric Sieving by Blending a Solid/Water Meal Enhances Satiation in Healthy Humans, The Journal of Nutrition, July 2012

Separation of solids and liquids within the stomach allows faster gastric emptying of liquids compared with solids, a phenomenon known as sieving. We tested the hypothesis that blending a solid and water meal would abolish sieving, preventing the early rapid decrease in gastric volume and thereby enhancing satiety.

We carried out 2 separate studies. Study 1 was a 2-way, crossover, satiety study of 22 healthy volunteers who consumed roasted chicken and vegetables with a glass of water (1008 kJ) or the same blended to a soup. They completed satiety visual analogue scales at intervals for 3 h.

Study 2 was a 2-way, crossover, mechanistic study of 18 volunteers who consumed the same meals and underwent an MRI to assess gastric emptying, gallbladder contraction, and small bowel water content (SBWC) at intervals for 3 h.

In Study 1, the soup meal was associated with reduced hunger (P = 0.02).

In Study 2, the volume of the gastric contents after the soup meal decreased more slowly than after the solid/liquid meal (P = 0.0003). The soup meal caused greater gallbladder contraction (P < 0.04). SBWC showed a biphasic response with an initial “gastric” phase during which SBWC was greater when the solid/liquid meal was consumed (P < 0.001) and a later “small bowel” phase when SBWC was greater when the soup meal was consumed (P < 0.01).

They concluded:

Blending the solid/liquid meal to a soup delayed gastric emptying and increased the hormonal response to feeding, which may contribute to enhanced postprandial satiety.

So … What can make you feel full for longer?
1. Roasted chicken and vegetables with a glass of water.
2. The same meal, blended into a soup.

The soup!

I saw this study on James Hamblin’s post, The Trick Smoothies Play on the Stomach. He interviewed Robin Spiller, a lead researcher in the study:

Spiller and his team compared the two options head to head in a study, and they found that when people drank the blended “soup,” it kept them from feeling hungry for about an hour longer than the whole-food meal.

“What we showed is that food separates in layers in the stomach,” said Spiller. Until pretty recently, that was only an assumption. “If, for example, you take a dense material like rice and a glass of water, the rice will sink into the dependent part of the stomach. Then the water will seep out. That means that when you stop ingesting your meal, the size of your stomach will go down much faster than had you mixed the rice and the water up into a homogenous gruel.”

This next part, I didn’t know. I kind of love how the body titrates food into itself:

The rate of stomach emptying is regulated by feedback from the duodenum, which has receptors that can tell the body about nutrient value of a meal. It uses this to adjust so that, more or less, you deliver one to two calories per minute into the small intestine. This ensures efficient digestion. If you overwhelm the intestine, it can’t cope. But at a regulated rate it can be very efficient at absorbing energy.

There are many variables that affect the speed at which the stomach empties, and so, how long you’ll feel full, including … how much fat is in the meal (fattier is slower), the meal’s temperature (hotter is slower), gastroparesis (a diabetes complication), the body’s position when eating (laying down is slower). To these I guess I’ll be adding viscosity.

Which of these bird species spends more time aloft than any other?

1. Wandering Albatross
2. Common Swift
3. Great Frigatebird
4. California Condor

The answer is the common swift:

Common swift skimming a pond for a drink. Audobon says “most birds can’t pull off a daredevil, in-flight drink because they just aren’t built for it.”

Here’s what How-To Geek says:

When you think of a bird that spends its life on the wing, it would be easy to focus on huge birds, like the wandering albatross, that can effortlessly glide for several hours without so much as a pump of their broad wings. The reality, however, is quite different: the bird that spends most of its life and certainly the longest spans of time aloft is the common swift.

Except for their time nesting to raise a new brood, common swifts spend practically every moment of their lives in the air. They eat insects they catch during flight, drink moisture that condenses on their wing feathers, they even mate and sleep (bursts of microsleep), all while in the air. In fact, researchers attached tiny data trackers to groups of swifts and found that many of them stayed aloft for upwards of ten months at a time, typically only stopping to roost because extreme weather briefly grounded them.

Not only do they spend nearly their entire lives aloft, but they are quite speedy — their very name, swift, is well earned as they have a maximum horizontal flying speed of 69 miles per hour (111.6 kilometers per hour), and over the course of their lives, they can easily cover millions of miles in flight.

I guessed the albatross. I never would have thought a little swift. Ten months in the air!

A diet consisting primarily of starchy foods, including those pictured, was shown to reduce weight, BMI, waist circumference, cholesterol, and other markers of health.

This study is a big deal. It shows that high-carb, plant-based diets work out in the real world where people are pressed for time, don’t have a lot of money* or cooking expertise, don’t want to feel hungry or be denied in other ways:

The BROAD Study: A Randomised Controlled Trial Using A Whole Food Plant-Based (WFPB) Diet In The Community For Obesity, Ischaemic Heart Disease Or Diabetes, Nutrition and Diabetes, 20 March 2017

Conclusions: This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise.

I want to repeat that … the diet did not limit calories. No weighing or measuring or fretting over serving sizes. Participants ate until they were satisfied (ad libitum).

The key difference between this trial and other approaches to weight loss was that participants were informed to eat the WFPB diet ad libitum and to focus efforts on diet, rather than increasing exercise. The mechanism for this is likely the reduction in the energy density of the food consumed (lower fat, higher water and fibre).

They lost weight (mean weight loss at 6 months was 26 lbs, dropped from 209 to 183 lbs), lowered their BMI and waist circumference, lowered their cholesterol (from 209 to 174 mg/dl in 3 months), lowered their blood glucose. How can this not be a good diet?

This is what they were eating:

Intervention participants followed a low-fat plant-based diet (approximately 7–15% total energy from fat). We chose a low-fat iteration of the plant-based diet as this has been shown with previous research to achieve optimal outcomes, especially for heart disease and weight loss. This dietary approach included whole grains, legumes, vegetables and fruits. Participants were advised to eat until satiation. We placed no restriction on total energy intake. Participants were asked to not count calories. We provided a ‘traffic-light’ diet chart to participants outlining which foods to consume, limit or avoid (Supplementary Table S1). We encouraged starches such as potatoes, sweet potato, bread, cereals and pasta to satisfy the appetite. Participants were asked to avoid refined oils (e.g. olive or coconut oil) and animal products (meat, fish, eggs and dairy products). We discouraged high-fat plant foods such as nuts and avocados, and highly processed foods. We encouraged participants to minimise sugar, salt and caffeinated beverages. We provided 50 μg daily vitamin B12 (methylcobalamin) supplements.

Here’s their Supplementary Table S1. It’s just a guide, not a dictum. Click to enlarge:

Since all of these participants were overweight, researchers restricted nuts and seeds. Whole nuts and seeds, as Dr. McDougall explains in his books, can be consumed if weight loss is not a goal. I personally think that a diet with nuts and seeds is better than a diet without them.

In the discussion section, they compared their intervention (WFPB diet) to other interventions, including very-low-calorie diets, gastric bypass surgeries, and low-carb diets. This is what they said about low-carb diets:

However, studies on the effects of low-carbohydrate diets have shown higher rates of all-cause mortality, decreased peripheral flow-mediated dilation, worsening of coronary artery disease, and increased rates of constipation, headache, halitosis, muscle cramps, general weakness and rash.

I keep saying … low carb diets may help you lose weight, but you mortgage your health doing it.

Eat starch. Eat carbs. You’ll lose weight. You’ll lose your diabetes, blood pressure, cholesterol meds. You’ll lower your risk for cancer. You’ll feel better. The thing people do to muck this up is  eat the carbs with fat and animal food. Totally negates the benefit, as I’ve discussed in my various “meat-and-potatoes” posts.

* “The intervention involved patients from a group general practice in Gisborne, the region with New Zealand’s highest rates of socioeconomic deprivation, obesity and type 2 diabetes.”

Here’s the actual study behind my post about the Tsimane. I meant to include it there, but it’s here now:

Coronary Atherosclerosis In Indigenous South American Tsimane: A Cross-sectional Cohort Study, The Lancet, 17 March 2017

From their abstract:

Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date.

These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined.

I like this photograph of a Tsimane village, from Sci-News, who also said:

Their diet is largely carbohydrate-based (72%) and includes non-processed carbohydrates which are high in fiber such as rice, plantain, manioc, corn, nuts and fruits.

I knew this would be a problem:

The Unintended Consequences Of A Gluten-Free Diet, Epidemiology, online 15 March 2017

Reseachers found higher levels of arsenic and mercury in the urine and blood, respectively, of participants eating a gluten-free diet compared to non-gluten-free controls.

To our knowledge, this is the first analysis to suggest that Americans on gluten-free diets may be exposed to higher levels of arsenic and mercury.

Why?

Rice may be contributing to the observed higher concentrations of metal biomarkers among those on a gluten-free diet as the primary substitute grain in gluten-free products.

This is from Howard G. Smith MD at Business Insider:

Studies have shown that rice accumulates these toxic metals from fertilizers, pesticides, the soil, the rocks and the water from which it is grown.

Although it is a deadly poison in huge quantities, arsenic in small quantities can still increase the risk of bladder, lung, and skin cancers, as well as heart disease and Type 2 diabetes. Mercury, on the other hand, produces neurological, psychological, and hearing issues.

Air pollution is also contributing. Coal-fired power plants are the biggest industrial emitters of arsenic and mercury … which fall onto soil and into the flooded paddies in which rice is grown. Even organic rice has high levels of arsenic. Fixing this problem means cleaning the air, which means regulating power plants, which is done in part by the EPA, which is an agency being defunded by the current administration.

Related (Thanks to Shaun):
Low Gluten Diets May Be Associated With Higher Risk Of Type 2 Diabetes, American Heart Association Meeting, Presentation 11, 9 March 2017

A Tsimane man transports bananas in La Embocada town, Bolivia on Sept. 16, 2011. David Mercado, Reuters.

After reading the title of this article…

These People Eat Monkeys And Piranhas. They Also Have The Lowest Rates Of Heart Disease Ever Measured, Washington Post, 17 March 2017

… and looking at the accompanying photograph of a father and son hunting, and reading the first paragraph describing daily meals of monkey, hog, fish, and other animals, you may come away thinking this modern-day group of hunter-gatherers had low rates of heart disease because of a meat-rich diet. But read this:

By calorie count, about 14% of the Tsimane diet is protein, 14% is fat and 72% is carbohydrate. (By contrast, the typical U.S. adult diets has more fat — about 16% protein, 33% fat and 51% carbohydrate.)

So, 72% of 1800 calories (as an example) is 1296 calories or about 324 grams of carbs a day. That is a lot of carbohydrate. Compare that to the less than 30 grams carb/day in the diet I just posted about, the one that says it reverses diabetes.

The Tsimane’s macronutrient breakdown is similar to that of the Cuban’s during their Special Period (I just reposted it.) during which their rates of diabetes, heart disease, and cancer dropped. Cubans were eating 77% carb and 13% fat, a diet researchers described as “more vegan in character.”

Another news outlet, NBC, decribed the Tsimane’s diet, more appropriately I think, as consisting of mostly starches (“filling up on starchy food”):

Their staple foods are home-grown rice, plantains and corn. If they want meat, they go catch it.

Large populations throughout millennia have subsisted on starches, and have achieved health and longevity because of it. Whether it’s the diets of native Africans (corn meal), Okinawans (sweet potatoes and rice), Cubans (rice and beans), or Tsimanes (rice, plantains, corn), “filling up on starchy food” seems like some good diet advice.

Related:
Tsimane Study In The Lancet