The Role of Diet and Nutrition in Cancer Prevention in the Philippines

Cancer is a significant health concern in the Philippines, ranking as the third leading cause of death ¹. In 2022, over 110,000 deaths were attributed to cancer, with nearly 190,000 new diagnoses ¹. While factors like genetics and environmental exposures contribute to cancer risk, diet, and nutrition play a crucial role in prevention. This article explores the link between diet, nutrition, and cancer prevention, with a specific focus on the Filipino context.

The Link Between Diet and Cancer Prevention

The World Health Organization estimates that lifestyle factors, including diet, account for 30–40% of the global cancer burden ². This highlights the significant impact of individual choices in preventing cancer. While no single food can prevent cancer, a balanced and nutritious diet can significantly reduce your risk ³.

To provide a broader perspective on healthy eating, the Australian Guide to Healthy Eating suggests consuming a variety of foods from the following five food groups: ⁴

Vegetables and legumes/beans
Fruit
Grain (cereal) foods, mostly wholegrain and/or high cereal fiber varieties
Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
Milk, yogurt, cheese, and/or alternatives, mostly reduced fat

These food groups provide similar amounts of key nutrients. For example, the milk, yogurt, cheese, and alternatives group includes calcium and protein ⁴.

In addition to consuming a balanced diet, specific protective elements play a crucial role in cancer prevention. These include: ⁵

Selenium
Folic acid
Vitamin B-12
Vitamin D
Chlorophyll
Antioxidants such as carotenoids (α-carotene, β-carotene, lycopene, lutein, cryptoxanthin)

Key Dietary Recommendations for Cancer Prevention

The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) provide evidence-based recommendations for cancer prevention through diet and nutrition. These recommendations include: ²

Recommendation	Explanation
Maintain a Healthy Weight	Obesity increases the risk of several cancers ².
Limit Alcohol Consumption	Alcohol is linked to an increased risk of various cancers, including mouth, pharynx, larynx, esophagus, liver, colorectum, and breast cancer ².
Eat a Diet Rich in Whole Grains, Vegetables, Fruit, and Beans	These foods are rich in fiber and antioxidants, which protect against cancer ².
Limit “Fast Foods” and Processed Foods	These foods are often high in unhealthy fats, starches, and sugars, contributing to weight gain and increasing cancer risk ².
Limit Red and Processed Meat	Red meat includes beef, pork, and lamb, while processed meat refers to meats transformed through salting, curing, or smoking. Both have been linked to an increased risk of colorectal cancer ².
Limit Sugar-Sweetened Drinks	These drinks contribute to weight gain and increase the risk of obesity-related cancers ².

How Diet Impacts Cancer Risk

The food we consume provides our bodies with the necessary nutrients for energy and cell function. However, certain foods can also contain components that may influence cancer development ⁷. For example:

High-fat, low-fiber diets may increase the risk of bowel, lung, prostate, and uterine cancers ⁴.
Diets high in refined starch and sugar may increase the risk of stomach and bowel cancer ⁴.
Obesity can cause long-term inflammation and hormonal imbalances, increasing the risk of certain cancers ⁷.
Red and processed meats contain compounds linked to cancer, especially colorectal cancer ⁸.
Excessive sugar intake can lead to obesity, a known risk factor for cancer ⁸.

On the other hand, a diet rich in fruits, vegetables, and whole grains provides antioxidants and fiber, which have protective effects against cancer ³. Studies have shown that these foods contain compounds that protect against cell damage and inflammation, reducing the risk of cancer development.

Cancer Prevalence in the Philippines

The Philippines faces a significant cancer burden, highlighting the urgency of addressing cancer prevention in the country ¹. In 2020, the estimated number of new cancer cases was 33,828 in males and 37,628 in females ¹⁰. This translates to age-standardized rates of 199.5/100,000 in males and 180.6/100,000 in females ¹⁰. The most common cancers in males are lung, liver, colorectal, and prostate cancers, while in females, they are breast, cervix, lung, and colorectal cancers ¹⁰.

The Philippines has one of the highest rates of premature cancer-related deaths in Southeast Asia ¹. This underscores the need for effective cancer prevention strategies, including promoting healthy dietary habits.

Adding to the challenge is a severe lack of cancer care providers in the Philippines ¹¹. For every 100,000 Filipinos, there are only 0.32 medical oncologists, 0.15 surgical oncologists, 0.09 radiation oncologists, 0.13 gynecologic oncologists, and 0.03 hospice and palliative medicine specialists ¹¹. This shortage of healthcare professionals further emphasizes the importance of prevention and early detection.

Dietary Habits in the Philippines

The traditional Filipino diet, with its focus on rice, vegetables, and fish, can be a healthy foundation for cancer prevention ¹². It is crucial to maintain these traditional practices and be mindful of the influence of Western dietary patterns.

Traditionally, the Filipino diet is centered around rice, corn, root crops, and vegetables ¹³. Poultry and fish are the primary sources of protein, with pork, chicken, and water buffalo (carabao) also consumed ¹³. Common cooking methods include steaming, grilling, and stir-frying, which help preserve the natural flavors and nutritional value of ingredients ¹⁴.

However, with the influence of Western culture, the Filipino diet has seen an increase in the consumption of processed foods, red meat, and sugary drinks ¹⁵. This shift in dietary patterns may contribute to the rising incidence of cancer and other chronic diseases in the country ¹⁵.

The average Filipino eats five meals a day: breakfast, morning snack, lunch, afternoon snack, and dinner ¹⁶. Rice is a staple in almost every meal, and Filipinos often enjoy a variety of flavorful sauces and dips with their dishes ¹⁶. The Spanish colonization also significantly influenced Filipino cuisine, introducing Mediterranean-style cooking and ingredients like corn, flour, squash, avocado, sausage, beef, guava, and papaya ¹⁶.

Traditional Filipino Foods and Cancer Prevention

Traditional Filipino cuisine offers a variety of nutritious foods that can contribute to cancer prevention ¹⁷. Many traditional Filipino foods offer a balance of macronutrients and micronutrients, making them suitable for a healthy diet ¹⁷.

Some examples of healthy traditional Filipino dishes include:

Tinola: A chicken soup with ginger, papaya, and chili leaves, providing protein, vitamins, and fiber ¹⁷.
Sinigang: A sour soup with tamarind and various vegetables, offering hydration and electrolytes ¹⁷.
Laing: A dish made from dried taro leaves cooked in coconut milk, providing healthy fats and complex carbohydrates ¹⁷.
Arroz Caldo: Filipino rice porridge with chicken and ginger, offering warmth and aiding recovery ¹⁷.
Munggo Guisado: Mung bean stew, rich in fiber and plant-based protein ¹⁷.

These dishes, when prepared with lean protein sources and a variety of vegetables, can be incorporated into a healthy diet for cancer prevention.

However, some traditional Filipino foods can also pose risks if consumed in excess ¹⁵. The perception of Filipino food as unhealthy is often based on “fiesta food” and not the traditional daily diet ¹⁵. Fiesta food often includes dishes high in fat, salt, and sugar, such as lechon (roasted pig), adobo (meat stew), and kare-kare (oxtail stew) ¹⁵. It’s important to consume these dishes in moderation and balance them with healthier options.

Filipino cuisine is also known for its diverse flavors, influenced by Malay, Chinese, Spanish, and American cultures ¹⁴. This diversity allows for a wide range of dishes that can be adapted to different diet plans, making it easier to maintain healthy eating habits ¹⁸.

It’s important to note that changes in dietary practices due to acculturation can also pose health risks. For example, studies have shown that Filipino Americans may experience an increased risk of obesity, hypertension, and diabetes due to shifts in food choices and intake after immigrating to the United States ¹⁹.

Furthermore, food safety is an important aspect of cancer prevention. The first recorded food-borne disease outbreak in the Philippines was caused by Vibrio cholerae in 1583 during the Spanish colonization ²⁰. This highlights the importance of safe food handling and preparation practices to prevent illnesses that may increase cancer risk.

Access to Healthy Foods and Nutrition Education in the Philippines

Access to healthy and affordable food is crucial for cancer prevention. However, in the Philippines, around a third of households cannot afford a healthy diet for their children ²¹. The 2021 Expanded National Nutrition Survey (ENNS) revealed that 33.4% and 2% of Filipino households experience moderate and severe food insecurity, respectively ²¹. This means that a significant portion of the population faces challenges in accessing the nutritious foods needed to reduce their cancer risk.

Several factors contribute to this challenge, including poverty, limited access to markets, and the high cost of nutritious food ²³. The lack of adequate agricultural infrastructure, such as farm-to-market roads and storage facilities, also contributes to higher food prices and limited access, especially in rural areas ²⁵.

Nutrition education is also essential in promoting healthy eating habits. The Philippine Plan of Action for Nutrition (PPAN) includes nutrition education as a key intervention to encourage positive dietary changes ²⁶. However, there are challenges in the implementation and impact of nutrition education programs ²⁷.

One example of a government initiative promoting healthy eating habits is the School-Based Feeding Program (SBFP) ²⁸. This program addresses undernutrition in school children by providing nutritious meals and milk. The SBFP aims to improve enrollment, attendance, and the nutritional status of students ²⁸.

The Global School Feeding Sourcebook, which provides data on school feeding programs worldwide, found that in the Philippines, the School-Based Feeding Program operated in 34,778 public schools in 2020–2021, reaching over 3.5 million children with meals and 3.1 million children with milk ²⁹. The program emphasizes domestic procurement of foods to support local farmers ²⁹.

These programs demonstrate the efforts being made to improve nutrition among children in the Philippines. However, challenges remain in ensuring access to healthy foods and effective nutrition education for all Filipinos.

Resources and Organizations in the Philippines

Several organizations in the Philippines are dedicated to promoting healthy eating and cancer prevention. These organizations provide valuable resources and support for individuals and communities seeking to improve their diet and reduce their cancer risk.

Some of these organizations include:

Nutrition Foundation of the Philippines, Inc. (NFP): A non-profit organization promoting nutrition education and community-based programs ³⁰.
Rise Against Hunger Philippines: An organization working to improve food security and reduce malnutrition through programs like Good Food Farm and Good Food Grocer ³¹.
Philippine Cancer Society (PCS): A non-profit organization engaged in cancer prevention and control programs, including education, patient services, and advocacy ³².
Philippine Cancer Center (PCC): The country’s center of excellence in cancer care, research, and capacity development ³³.

In addition to these organizations, several initiatives are focused on promoting healthy eating and nutrition education in the Philippines. One such initiative is the Integrated School Nutrition Model, a collaborative effort between the International Institute of Rural Reconstruction (IIRR), the Department of Science and Technology – Food and Nutrition Research Institute (DOST-FNRI), and the Department of Education ³⁴. This model promotes healthy meals, school gardens, and nutrition education to enhance students’ health and learning outcomes ³⁴.

Another initiative is the Fruit and Vegetables for Sustainable Healthy Diets (FRESH) initiative of CGIAR ³⁵. This initiative focuses on increasing fruit and vegetable consumption, enhancing diet quality, and improving health outcomes while promoting sustainable livelihoods ³⁵.

Life-Saver Events Management Services and Bonnet The Cause

In the Philippines, where the cancer burden is significant, organizations like Life-Saver Events Management Services (Life+Saver) play a crucial role in raising awareness and providing support for those affected by cancer. Life+Saver is a pioneering force in event management, dedicated to transforming healthcare in the Philippines through impactful events that educate, inspire, and create lasting change.

One of Life+Saver’s notable programs is “Bonnet The Cause,” which aims to raise not just awareness but also funds to help those who are braving cancer, their carers, friends, and loved ones who support them throughout their battle. This initiative involves creative bonnet design competitions, fashion shows, and bonnet sales to generate funds for cancer research, treatment, and support services. By celebrating resilience and beauty through fashion, “Bonnet The Cause” empowers and unites a community of cancer patients, survivors, and their supporters, fostering a sense of solidarity and hope.

Ongoing Studies and Initiatives

Research on diet and cancer prevention is ongoing in the Philippines and globally. Culturally informed interventions are crucial for promoting healthy lifestyles and preventing cancer recurrence, especially among specific populations like Filipino women ³⁶. This emphasizes the need for tailored approaches to cancer prevention.

Some recent studies and initiatives include:

The Traditional and New Lifestyle Interventions to Prevent Breast Cancer Recurrence (TANICA) study: This study focuses on developing culturally informed lifestyle interventions for breast cancer survivors, including dietary recommendations ³⁶.
The National Integrated Cancer Control Program (NICCP) Strategic Framework (2024–2028): This framework outlines the vision and mission of the National Integrated Cancer Control Council (NICCC) and projects the desired impact to be achieved in cancer prevention and control ³⁷. The NICCP is guided by six pillars: (1) cancer prevention and early detection; (2) diagnosis, treatment, and care; (3) pain relief and palliative care; (4) survivorship; (5) human resources development; and (6) monitoring and evaluation ³⁷.
The National Cancer Research Agenda (NCRA) (2024–2028): This agenda guides cancer-related research efforts in the Philippines, including studies on diet and nutrition ³⁸. The NCRA focuses on six themes: (1) cancer treatment outcomes; (2) health systems strengthening; (3) health promotion, prevention, and early detection; (4) data management and sharing; (5) epidemiological research on cancer burden; and (6) multidisciplinary and holistic care ³⁸.

Ongoing research is exploring the benefits of specific foods and nutrients in cancer prevention. For example, studies suggest that: ³⁹

Apple phloretin may inhibit the growth of breast cancer cells.
Berries, particularly bilberries, and lingonberries, may inhibit tumor formation and cancer growth in digestive tract cancers.
Cruciferous vegetables, such as broccoli, contain sulforaphane, which may inhibit cancer cell growth and stimulate cell death in colon cancer cells.
Carrots, especially raw carrots, may protect against lung cancer, pancreatic cancer, and leukemia.
Grapes contain resveratrol and other nutrients with antioxidant and potentially cancer-fighting properties.

These initiatives and research findings demonstrate the ongoing commitment to understanding the role of diet and nutrition in cancer prevention and improving cancer care in the Philippines.

Conclusion

Diet and nutrition play a vital role in cancer prevention in the Philippines. By adopting a healthy lifestyle that includes a balanced diet, regular physical activity, and limiting alcohol consumption, individuals can significantly reduce their cancer risk. Access to healthy foods and nutrition education are crucial in empowering Filipinos to make informed dietary choices. Traditional Filipino cuisine offers a variety of nutritious options, but it’s essential to be mindful of portion sizes and balance them with healthier choices. The ongoing research and initiatives in the Philippines demonstrate a commitment to improving cancer prevention and care through dietary interventions.

The interconnectedness of dietary habits, access to healthy foods, and cancer prevalence in the Philippines is evident. By understanding the link between these factors, individuals can take proactive steps towards a healthier future. This includes making informed food choices, supporting initiatives that promote healthy eating, and advocating for policies that improve access to nutritious and affordable food for all Filipinos.

Ultimately, a collaborative effort involving individuals, communities, and the government is crucial for creating a healthier Philippines with a reduced cancer burden. By working together, we can empower Filipinos to make healthy choices and reduce their risk of cancer. Life+Saver’s “Bonnet The Cause” is a testament to this collaborative spirit, uniting communities and raising awareness to combat cancer in the Philippines.

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