Over 40% of cancers due to lifestyle, says review(bbc.co.uk)
bbc.co.uk
Over 40% of cancers due to lifestyle, says review
http://www.bbc.co.uk/news/health-16031149
Nearly half of cancers diagnosed in the UK each year - over 130,000 in total - are caused by avoidable life choices including smoking, drinking and eating the wrong things, a review reveals.
26 comments
I have a lifestyle cancer: melanoma.
That said, I didn't realize "going outside with short hair and no hat" was a bad lifestyle choice until it was too late, so I'm posting here:
Hey fair skinned folks! Just wearing sunscreen IS NOT ENOUGH. Wear a hat if you're going to spend more than a short time outside! If you have a family history of skin cancer, ask your barber to keep an eye out for moles when you're getting your hair cut.
That said, I didn't realize "going outside with short hair and no hat" was a bad lifestyle choice until it was too late, so I'm posting here:
Hey fair skinned folks! Just wearing sunscreen IS NOT ENOUGH. Wear a hat if you're going to spend more than a short time outside! If you have a family history of skin cancer, ask your barber to keep an eye out for moles when you're getting your hair cut.
Using sunscreen reduces the body's production of vitamin D, a potent anti-cancer agent:
http://greathealinggetaways.com/Sunscreenarticle.html
Sunscreens often contain carcinogens:
http://en.wikipedia.org/wiki/Potential_health_risks_of_sunsc...
Consequently staying indoors and using sunscreen may _increase_ your likelihood of developing cancer.
Children who avoid sunshine will get rickets, a disease that was once almost absent from the US population:
http://www.telegraph.co.uk/health/healthnews/8128781/Middle-...
Nonetheless, the fair-skinned must balance their exposure carefully. Good news is that their skin produces vitamin D more efficiently than darker skin, so the fair-skinned can obtain vitamin D in a shorter exposure period (minutes a day):
http://www.usatoday.com/news/health/painter/2009-04-19-your-...
http://greathealinggetaways.com/Sunscreenarticle.html
Sunscreens often contain carcinogens:
http://en.wikipedia.org/wiki/Potential_health_risks_of_sunsc...
Consequently staying indoors and using sunscreen may _increase_ your likelihood of developing cancer.
Children who avoid sunshine will get rickets, a disease that was once almost absent from the US population:
http://www.telegraph.co.uk/health/healthnews/8128781/Middle-...
Nonetheless, the fair-skinned must balance their exposure carefully. Good news is that their skin produces vitamin D more efficiently than darker skin, so the fair-skinned can obtain vitamin D in a shorter exposure period (minutes a day):
http://www.usatoday.com/news/health/painter/2009-04-19-your-...
Vitamin D deficiency is extremely common in the US. If you are going to take a single supplement, make it 1000 UI/day of D.
http://en.wikipedia.org/wiki/Hypovitaminosis_D#Cancer
That said, if you are going to spend time outside, the benefits of wearing sunscreen and a hat undoubtedly outweigh whatever risk they may induce.
http://en.wikipedia.org/wiki/Hypovitaminosis_D#Cancer
That said, if you are going to spend time outside, the benefits of wearing sunscreen and a hat undoubtedly outweigh whatever risk they may induce.
I read somewhere (never can remember) wearing sunglasses fools your thymus (?) into reacting as if it's dark outside so less melanin is produced making you more likely burn.
My compromise is a 20-30 minute run during the day, each day. I get almost no other sunlight but I think that is enough.
"Dr Rachel Thompson, of the World Cancer Research Fund, said the report added to the 'now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.'
"Dr Harpal Kumar, chief executive of Cancer Research UK, said leading a healthy lifestyle did not guarantee a person would not get cancer but the study showed 'we can significantly stack the odds in our favour.'"
Many of these lines of evidence where developed originally by looking at environmental differences among different countries, as well as time series in cancer rates as lifestyles changed in countries over time, and comparisons of immigrants of varying ages of arrival (who adopt the lifestyles of new countries either as children or as adults) with relatives who stay in the old country. Then the best-understood models of cancer risk factors are further investigated through controlled experimentation on laboratory animals or on cell lines in vitro. Today it's plain enough that avoiding smoking, eating a varied, balanced diet, and maintaining normal weight through a combination of exercise and moderate eating offers substantial reduction of risk in all-cause mortality, including but not limited to death from cancer.
After edit: the second reply here asked how a diet higher rather than lower in fruits and vegetables can protect from cancers other than colon cancer. According to what I've read about the research, it's thought that some tendencies of healthy body cells to go into uncontrolled growth (cancer) are made worse by lack of micronutrients, which may be lacking in the diets of people who don't eat varied diets. It's also thought that the evolutionary arms race between plants (which tend to evolve tough husks but also phytotoxins as protections against being eaten) and animals (which have to eat some food source ultimately derived from autotrophic organisms, that is mostly plants) results in complex animals being selected for incidental adaptation of phytotoxins to kill off errant cell lines. What's poison in a large does can sometimes be medicine in the therapeutic dose and in the right time and place. All human beings eventually die of something, but the epidemiological evidence (and some laboratory evidence) shows that plant intake reduces chances of dying young of cancer, and these mechanisms are some of those suggested as reasons for that observation.
"Dr Harpal Kumar, chief executive of Cancer Research UK, said leading a healthy lifestyle did not guarantee a person would not get cancer but the study showed 'we can significantly stack the odds in our favour.'"
Many of these lines of evidence where developed originally by looking at environmental differences among different countries, as well as time series in cancer rates as lifestyles changed in countries over time, and comparisons of immigrants of varying ages of arrival (who adopt the lifestyles of new countries either as children or as adults) with relatives who stay in the old country. Then the best-understood models of cancer risk factors are further investigated through controlled experimentation on laboratory animals or on cell lines in vitro. Today it's plain enough that avoiding smoking, eating a varied, balanced diet, and maintaining normal weight through a combination of exercise and moderate eating offers substantial reduction of risk in all-cause mortality, including but not limited to death from cancer.
After edit: the second reply here asked how a diet higher rather than lower in fruits and vegetables can protect from cancers other than colon cancer. According to what I've read about the research, it's thought that some tendencies of healthy body cells to go into uncontrolled growth (cancer) are made worse by lack of micronutrients, which may be lacking in the diets of people who don't eat varied diets. It's also thought that the evolutionary arms race between plants (which tend to evolve tough husks but also phytotoxins as protections against being eaten) and animals (which have to eat some food source ultimately derived from autotrophic organisms, that is mostly plants) results in complex animals being selected for incidental adaptation of phytotoxins to kill off errant cell lines. What's poison in a large does can sometimes be medicine in the therapeutic dose and in the right time and place. All human beings eventually die of something, but the epidemiological evidence (and some laboratory evidence) shows that plant intake reduces chances of dying young of cancer, and these mechanisms are some of those suggested as reasons for that observation.
>After edit: the second reply here asked how a diet higher rather than lower in fruits and vegetables can protect from cancers other than colon cancer. According to what I've read about the research, it's thought that some tendencies of healthy body cells to go into uncontrolled growth (cancer) are made worse by lack of micronutrients, which may be lacking in the diets of people who don't eat varied diets. It's also thought that the evolutionary arms race between plants
antioxidant is keyword here:
http://www.cancer.gov/cancertopics/factsheet/prevention/anti...
antioxidant is keyword here:
http://www.cancer.gov/cancertopics/factsheet/prevention/anti...
The top comment is from a healthy smoker of 65. People always love to discuss how they or someone they know has smoked their entire life and never had a problem. I know lots of smokers who still aren't convinced of the health issues. Seems like there's still a long way to go.
Susceptibility to lung cancer due to smoking is at least partly genetic. If you have certain variants of a specific gene (don't have time for the lit search right now), smoking won't significantly increase your chances of lung cancer.
The problem is not everyone has this gene variant, and you probably don't want to be playing Russian Roullette with your health.
The problem is not everyone has this gene variant, and you probably don't want to be playing Russian Roullette with your health.
OK, the gene is called CHRNA5 and it seems to be related to a nicotine receptor. Here's where I found that: http://www.nature.com/ng/journal/v40/n5/abs/ng.109.html
According to that article, the SNPs in question are rs1051730 and rs8034191. 23andme tests for both.
(My results indicate that I'm at lower risk, but I'm still not going to pick up a pack of cigarettes anytime soon :)
According to that article, the SNPs in question are rs1051730 and rs8034191. 23andme tests for both.
(My results indicate that I'm at lower risk, but I'm still not going to pick up a pack of cigarettes anytime soon :)
I find it surprising that a nicotine receptor-related gene would have anything to do with lung cancer risk, since it's supposed to be the tar in cigarette smoke that causes most of the carcinogenic effect, not the nicotine. I wonder if that means smokeless e-cigarettes aren't much healthier than normal cigarettes.
Does this mean a person can potentially get tested for this, and find out that they have a free pass to smoke as much as they want?
That would be a very interesting scenario. few hours of testing, and we get a report like this
"Here bob, you can smoke these (a, b, c) but you can't smoke these (d,e,f). Also you can drink everything, except these (1,2,3). Now go have fun"
"Here bob, you can smoke these (a, b, c) but you can't smoke these (d,e,f). Also you can drink everything, except these (1,2,3). Now go have fun"
Smoking also causes heart disease, lung problems, etc.
Don't forget that, even if the health-care costs are zero, the financial costs of smoking are non-trivial. In addition to the costs of the cigarettes themselves, there is associated wear on one's home, car and clothes.
You can also make arguments for the opportunity costs of time spent smoking, but that's harder to measure.
Don't forget that there are significant benefits to smoking as well.
Yes, even for people who it will kill. (In fact, that's probably one of the benefits for some.)
Yes, even for people who it will kill. (In fact, that's probably one of the benefits for some.)
Could you expand on that? I'd be interested in hearing what the benefits are, as it doesn't seem to be something that is talked about (taboo against discussing the positive aspects of things seen as societally undesirable?).
I am a user of the e-cigarettes for these benefits he mentioned. I don't like that term, I prefer personal vaporizer, since cigarettes contain much more than just nicotine and vegetable glycol. Particularly for me, I like the increased awareness, concentration, and focus that come from the stimulant effect. When I need to do a code sprint or do a double shift, that plus coffee will keep me awake, focused, and able to work longer than I would normally have been able to. The drug is also useful for appetite suppression (similar again to coffee). Again useful for code sprints or late shifts when getting up for a snack or going for lunch would be counter-productive.
Some people claim nicotine is a relaxant in the correct dose. I have not personally experienced this, the same may not be true of the pure nicotine found in my delivery method of choice.
I won't say it's without risk. Even with e-cigs, there's not enough data to show any long term harm that they may have (although the ingredients separately and with a different vaporization method have been medically approved and are commonly found in asthma inhalers, minus the nicotine). Any stimulant use/abuse carries risks. You have to take that into account before deciding to use one, and limit yourself to using it only when you need the benefits.
Here's the Wikipedia article that explains with some sources how nicotine affects the body.
(https://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects)
Some people claim nicotine is a relaxant in the correct dose. I have not personally experienced this, the same may not be true of the pure nicotine found in my delivery method of choice.
I won't say it's without risk. Even with e-cigs, there's not enough data to show any long term harm that they may have (although the ingredients separately and with a different vaporization method have been medically approved and are commonly found in asthma inhalers, minus the nicotine). Any stimulant use/abuse carries risks. You have to take that into account before deciding to use one, and limit yourself to using it only when you need the benefits.
Here's the Wikipedia article that explains with some sources how nicotine affects the body.
(https://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects)
Ever try a nicotine patch?
I have not, no. I like the e-cig because I can carry it around in my pocket and I can use it at work only when I need the pick-me up. No worries fumbling about undoing my clothes to find a place to stick a patch. Personal vaporizers are cheaper too, and can have any flavor I like.
I smoked for a while through college and for a few years afterwards. I don't know if there are real physical benefits, but I found it relaxing. Also, going outside for a smoke break was a nice way to meet people I wouldn't talk to otherwise.
Also, it was a nice way to take a break think over what I was working on. It would also help me concentrate afterwards.
That said, now that I've quit I'll never start again...
Also, it was a nice way to take a break think over what I was working on. It would also help me concentrate afterwards.
That said, now that I've quit I'll never start again...
My sister smoked in college. We're both of us somewhat anxiety-prone, and she said smoking helped her a lot around finals time, when papers were due, stuff like that.
Consider that she was addicted to nicotine, and she felt less anxious when she had nicotine. It's difficult to separate the "got what she was addicted to" from the "reduced anxiety."
She claimed that she smoked her first cigarette when she was feeling very anxious, and that it helped.
Also, she's never really been very addicted - she only smokes off and on.
Also, she's never really been very addicted - she only smokes off and on.
No it's not difficult to separate the two. You test a bunch of people that have never smoked and see what the effects are.
I bet this has been done before.
I bet this has been done before.
It's difficult for someone who is self-reporting to do - if all you have is an anecdote. It's not difficult with good experimental design, which is part of my point.
I quit over two decades ago and I've not been anywhere near as lucid a thinker since. Seriously. The other night on The Doctors we saw this guest who is a doctor and never smoked in his life and nearly died from lung cancer.
edit: I'm not suggesting people should start smoking.
edit: I'm not suggesting people should start smoking.
Smoking appears to offer some mental benefits. Some acuity-related, as described by other responders. I've also heard that smoking has mental-health benefits for some people. (We know that many folks don't respond to existing standard drugs.)
I don't actually care about what the benefits are. Instead, I think that it's important to acknowledge that they do exist.
And yes, benefits clearly do exist for some people. That's why they smoke.
I don't actually care about what the benefits are. Instead, I think that it's important to acknowledge that they do exist.
And yes, benefits clearly do exist for some people. That's why they smoke.
There is a reduction in the incidence of Parkinson's and Alzheimer's disease in smokers.
Smoking causes cells to mutate. So no. Mutation is unpredictable and there is no "immutable" cell. Just some are more susceptible to the effects of certain common mutations than others.
Not getting cancer doesn't avoid all the other health problems. Those may not kill you but do have a significant effect on quality of life.
But sure, informed consent is a good thing.
But sure, informed consent is a good thing.
[deleted]
If only it were easier to find the blog comments of the 65-year-old smokers who died of lung cancer at age 57.
A lot of the problem is that too many organisations shy away from harm reduction. They will make villains of much safer alternatives like snus or e-cigs. Many people who smoke are self-medicating. Reducing the risk to nicotine exposure from smoke exposure would go a very long way.
It depends on the person,
I got a nan, 96, walks to town 3 times a week, still rides her bike, been smoking 60 a day for 40 years, and recently cut back to 40. If i compare her to my other nan 86 frail and pretty much falling apart, now guess which one has had the better lifestyle? the second, very well off always comfortable.
At 96 i think she gets up to keep smoking, and if that keeps her alive then keep doing it.
I got a nan, 96, walks to town 3 times a week, still rides her bike, been smoking 60 a day for 40 years, and recently cut back to 40. If i compare her to my other nan 86 frail and pretty much falling apart, now guess which one has had the better lifestyle? the second, very well off always comfortable.
At 96 i think she gets up to keep smoking, and if that keeps her alive then keep doing it.
This is like saying the dangerousness of Russian roulette "depends on the person," because you have a grandmother who's played a bunch of times and didn't die.
That's probably not correct. The grandmother playing Russian Roulette is truly the beneficiary of random chance. She's still susceptible to bullets.
The centenarian smoker likely was never susceptible to smoking-induced lung cancer in the first place.
The centenarian smoker likely was never susceptible to smoking-induced lung cancer in the first place.
The hammer is cocked when your embryo is conceived, and you can find out if the chamber was empty a few decades later.
Unfortunately you have to live your whole life to discover whether you're an exception or a statistic. I'll go with the statistics for my personal choices.
But most smokers will be exceptions. Most smokers will not get cancer. They get cancer significantly more often than non-smokers, but that's not scary sounding enough, I guess.
To give specific numbers, according to one study (http://www.ncbi.nlm.nih.gov/pubmed/7895211), the lifetime risk of developing lung cancer is:
male smokers: 17%
female smokers: 12%
nonsmokers: 1%Which backs up what I said. It's really unusual to see anyone talk about the actual lifetime risk. It's not as scary as saying "your chances are X times greater"... greater than what?
If those numbers are accurate, and entirely due to the effects of smoking (not just other lifestyle behaviors more common with smokers, like drinking) that's easily reason enough to quit. But even in the worst case, the fact remains, most smokers will not get cancer.
If those numbers are accurate, and entirely due to the effects of smoking (not just other lifestyle behaviors more common with smokers, like drinking) that's easily reason enough to quit. But even in the worst case, the fact remains, most smokers will not get cancer.
"X times greater risk" refers to the likelihood ratio over the Bayesian prior, assuming that this bit of evidence (smoking/not) is independent of other known evidence. Usually the prior is "all people" or "people of <X> ethnotype" or something like that.
You can compute the lifetime risk if you have a prior for the lifetime risk of lung cancer (1% in above example), just by multiplying.
You can compute the lifetime risk if you have a prior for the lifetime risk of lung cancer (1% in above example), just by multiplying.
I'm not sure where your argument leads. Are you justifying smoking as a choice, based on the numbers? Are you attempting to explain why people choose to smoke, based on the likelihood of cancer? Something else?
Regardless, smoking increases your overall risk pressure along with all of the other risky choices you can make. It's cumulative with the rest of life's choices.
Regardless, smoking increases your overall risk pressure along with all of the other risky choices you can make. It's cumulative with the rest of life's choices.
What about heart disease?
Smoking causes problems other than cancer.
Yes, but I'm talking about cancer. The fact still remains that the statement "Most smokers will not get lung cancer" is a controversial statement for some reason, even though it is demonstrably true.
60 a day, at 96 years old???!! wow, that is unbelievable
This was on BBC news the other day.
Apparently eating well, drinking in moderation, not smoking and regular exercise reduce the risk of cancer.
When interviewed, man hiding under rock expressed surprise and gratitude for the update.
Apparently eating well, drinking in moderation, not smoking and regular exercise reduce the risk of cancer.
When interviewed, man hiding under rock expressed surprise and gratitude for the update.
eating well
I'm not sure "eating well" has the same meaning for everybody. :) Perhaps we should say "eating safely" or something.
I'm not sure "eating well" has the same meaning for everybody. :) Perhaps we should say "eating safely" or something.
Interestingly though, the article doesn't directly mention exercise. Obviously, obesity and lack of exercise are related, but I'm surprised that exercise isn't helpful in its own right. Or maybe the study or the article just didn't cover it, which I would find rather surprising as well.
Not to mention reduction in heart disase, joint pain, shortness of breath and the quality of life.
Which is why so few people do it.
Which is why so few people do it.
Related to this topic I think you might find Dr. Terry Wahls' story fascinating, she pretty much 'cured' herself from Multiple Sclerosis by adopting a 'paleo' diet. She presented her findings at the 2011 Neuroscience conference ("Effects of intensive directed nutrition, progressive exercise program and neuromuscular electrical stimulation on secondary progressive multiple sclerosis (PDF)[1]") She also had a TED talk[2] taking us through the process of getting out of her wheelchair and the specific food she ate.
I know this immediately turns on your B.S. sensors, but she changed her lifestyle after spending hours on Pubmed doing research on nutrition's impact on the brain and specifically the mitochondria. I highly recommend the talk, it is both very informative and very moving. And there are some saddening statistics about the lack of vitamins and minerals in the American population.
[1] http://www.sfn.org/am2011/pdf/prelim/SUN_Poster_PM_v2.pdf [2] http://www.youtube.com/watch?v=KLjgBLwH3Wc&feature=playe...
I know this immediately turns on your B.S. sensors, but she changed her lifestyle after spending hours on Pubmed doing research on nutrition's impact on the brain and specifically the mitochondria. I highly recommend the talk, it is both very informative and very moving. And there are some saddening statistics about the lack of vitamins and minerals in the American population.
[1] http://www.sfn.org/am2011/pdf/prelim/SUN_Poster_PM_v2.pdf [2] http://www.youtube.com/watch?v=KLjgBLwH3Wc&feature=playe...
As a Paleo eater, I'm happy to see this in the research.
(also replying as a form of bookmark)
(also replying as a form of bookmark)
So if these 40% of cancers were eliminated, what's the chances that the survivors would have ended up with one of the remaining 60%?
You have to die of something. What's important is years of high-quality life, rather than merely avoiding death from any specific ailment. And of course, quality is ultimately a subjective measure. All the behaviours that you must conform to, to avoid these specific deaths, may themselves detract from your quality of life.
You have to die of something. What's important is years of high-quality life, rather than merely avoiding death from any specific ailment. And of course, quality is ultimately a subjective measure. All the behaviours that you must conform to, to avoid these specific deaths, may themselves detract from your quality of life.
Eating healthy and exercising improves the quality of your life right now, as well as in the future. As does cutting back on alcohol, and smoking.
That seems like it depends heavily on what you consider "quality of life". In any case, it needs a lot more data to determine (alcohol in particular seems to have both complex health effects, and complex, culture-dependent sociological/psychological effects).
I could just as easily assert the opposite: eating fewer steaks and drinking less reduces your quality of life, right now.*
* But may increase it in the future, depending on various factors.
I could just as easily assert the opposite: eating fewer steaks and drinking less reduces your quality of life, right now.*
* But may increase it in the future, depending on various factors.
Almost all food advertised or described as "healthy", I've found to be neutral at best, to actively unpleasant. High fibre, lots of vegetables, fruit, etc.; I actively dislike almost all of it. My favourite foods are lamb, butter, cheese and freshly baked goods, to the point that my morning ritual, before breakfast, involves a (scooter) trip to a bakery.
Similarly, I've never enjoyed exercise. I used to cycle to and from school every day, about 6 miles, fairly high intensity (due to my laziness, I'd start late). My aerobic capacity was certainly higher then; I could run for perhaps 30 minutes, where I'd hazard a guess that I'd be out of breath after 10 minutes now. I'm not overweight, have no difficulty walking, jumping, running, climbing hills etc. when I get the occasion to on vacation and such. But the thought of actively exercising fills me with weariness. Not enjoyable.
What I'm getting at is that I have a lifestyle that I massively enjoy, and it took a lot of experimentation and experience to discover the things I like best. Whether it is specifically healthy or not is secondary, by a long way, to how enjoyable it is.
Similarly, I've never enjoyed exercise. I used to cycle to and from school every day, about 6 miles, fairly high intensity (due to my laziness, I'd start late). My aerobic capacity was certainly higher then; I could run for perhaps 30 minutes, where I'd hazard a guess that I'd be out of breath after 10 minutes now. I'm not overweight, have no difficulty walking, jumping, running, climbing hills etc. when I get the occasion to on vacation and such. But the thought of actively exercising fills me with weariness. Not enjoyable.
What I'm getting at is that I have a lifestyle that I massively enjoy, and it took a lot of experimentation and experience to discover the things I like best. Whether it is specifically healthy or not is secondary, by a long way, to how enjoyable it is.
Some of that falls into my "healthy" category, some not. As to palatability, much depends on preparation. I like fruit and vegetables, but you'll find that some herbs and spices, heating (especially roasting) and a bit of oil (olive oil, butter) really bring out flavors. Mostly for me it's veggies, a few whole grains, some fruit, ample protein (from clean sources) and healthy fats (good mix of saturated/unsaturated & Omega3) from meat, dairy, fish, olive oil, coconut, and grapeseed.
My list of unhealthy foods is largely: processed/highly processed foods, industrially raised meats/eggs/dairy, processed carbs, sugar, HFCS, soda, flour, baked goods (sorry), trans-fats, white rice/potatoes. Few vegetable fats (corn, canola, soybean, etc. oils). Allowable in very small quantities, but frankly few of these appeal to me at all after a few years of eating clean.
And the quality-of-life benefits are huge.
The other underappreciated element to fitness is strength training. One article that's been featured at HN before that's particularly good at highlighting what's wrong with conventional wisdom on fitness is "Everything You Know About Fitness is a Lie": http://www.mensjournal.com/everything-you-know-about-fitness...
My list of unhealthy foods is largely: processed/highly processed foods, industrially raised meats/eggs/dairy, processed carbs, sugar, HFCS, soda, flour, baked goods (sorry), trans-fats, white rice/potatoes. Few vegetable fats (corn, canola, soybean, etc. oils). Allowable in very small quantities, but frankly few of these appeal to me at all after a few years of eating clean.
And the quality-of-life benefits are huge.
The other underappreciated element to fitness is strength training. One article that's been featured at HN before that's particularly good at highlighting what's wrong with conventional wisdom on fitness is "Everything You Know About Fitness is a Lie": http://www.mensjournal.com/everything-you-know-about-fitness...
A still useful definition of eating healthy is to eat approximately the correct amount of calories.
Obviously the what is also going to have impact, but it is easy to observe that the great majority of people are not walking around with severe nutritional deficiencies.
Obviously the what is also going to have impact, but it is easy to observe that the great majority of people are not walking around with severe nutritional deficiencies.
Debatable. They clearly have enough calories, but you need more than just that to live and be healthy. I would strongly argue that omega-3's and vitamin D3 are essential nutrients that a substantial portion of the population are deficient in.
I said severe because there are clear complications for severe deficiencies (rickets, scurvy, etc.). The science surrounding correct levels and consequences of not quite correct levels of such nutrients is much less settled.
So among the group of people that are not basically falling apart from a nutrient deficit, the ones that eat about the right amount of calories tend to be (quite a lot!) healthier than the ones that eat far more or far less calories.
So among the group of people that are not basically falling apart from a nutrient deficit, the ones that eat about the right amount of calories tend to be (quite a lot!) healthier than the ones that eat far more or far less calories.
One or two drinks a day is shown to have health benefits in other studies.
Two glasses of red wine due to the Resveratrol content, I don't think hard liquor counts in the 2 drink total.
the effect in humans isn't all that clear. the reports of longevity and other benefits come from extremely high doses in rodents AFAIK.
In more depressing news: 60% of cancers may not be due to lifestyle. The correct phrase would probably be "known lifestyle choices". But seriously, shouldn't people be surprised lifestyle only accounts for 40%. What if I rewrote the entry paragraph in the following way:
Nearly half of low intelligence diagnosed in the UK each year - over 130,000 in total - are caused by avoidable life choices including not reading, debating, or thinking about interesting problems.
Nearly half of low intelligence diagnosed in the UK each year - over 130,000 in total - are caused by avoidable life choices including not reading, debating, or thinking about interesting problems.
How many of the remaining cancers are colon or insulin resistance related?
I look around at my colleagues and see apparent misuse of the body. Carbs and fat for lunch every day, smoking, no exercise, sitting in a chair all day long, buckets of coffee, stress, poor posture and body alignment, doing the same shit every day, poor outlook on life, no sunshine on you during half of the year, etc. Of course this is going to wreck a person.
Yet no one seems to even be conscious of the wrongness of this.
Yet no one seems to even be conscious of the wrongness of this.
Yup. Problem is poor health doesn't produce visibly harmful results right now, so it's hard for us to envision the long term effects.
Where is the evidence that dietary fat and coffee increase cancer risk?
OTOH, discounting tobacco, most cases of cancer (78%) are unrelated to lifestyle choices. I also have problems coming to terms with the idea that occupational hazards are lifestyle choices.
Can someone explain how lack of fruit and vegetables leads to cancer?
I can understand it leading to colon cancer, but does it also lead to other kinds of cancer?
AFAIK even if you never eat fruits/vegetables you aren't lacking any micronutrients?
I can understand it leading to colon cancer, but does it also lead to other kinds of cancer?
AFAIK even if you never eat fruits/vegetables you aren't lacking any micronutrients?
I'm not sure if a lack of fruits and veggies leads to cancer. It leads to malnutrition. But, fruits and veggies have many benefits to prevent cancer: fiber helps your poo move through your bowels better; antioxidents fight free radicals; vitamins in natural form do lots of cool things (metabolism, brain function, etc.) that help your body's cells replicate normally.
I supposed you could argue for multivitamins. My approach is to not bet against 6000+ years of human biochemistry.
I supposed you could argue for multivitamins. My approach is to not bet against 6000+ years of human biochemistry.
I don't think the study makes that claim. They are claiming that 6% of men with cancer don't eat enough fruits and vegetables (i'm not sure what enough is). There is no way to infer whether or not the lack of fruits and vegetables was the root cause of cancer in those cases.
Given that it's specific to men, I'd say fiber and prostate cancer. There's some evidence, specifically with respect to cancer, (I don't know if it's strong or not), that it helps clean out toxins and it helps regulate hormones.
There are more complex things at play here. Some foods actually contain compounds that reduce or prevent tumor growth. Cabbage for example has highest levels of two anti-cancer glucosinolates and protects against breast cancer and bread crust; has highest levels of Interlukin-B which protects against colon cancer.
As a real world example; Polish women have the lowest incidence of breast cancer and the highest consumption of cabbage.
As a real world example; Polish women have the lowest incidence of breast cancer and the highest consumption of cabbage.
Fruits and vegetables contain antioxidants.
Antioxidants may not do anything to prevent cancer.
(http://scienceblog.cancerresearchuk.org/2009/10/02/antioxida...)
(http://scienceblog.cancerresearchuk.org/2009/10/02/antioxida...)
From the headline I expected this article to be about over working and exhaustion, a topic I'm sure many here can relate to in some way. In the authorised biography of Steve Jobs, he comments on how he believes the exhaustive hours worked in 1997 when driving back and forth between Apple and Pixar were the cause for his cancer. In a similar vein, there seems to be a higher ratio of cancer sufferers in high pressured environments like financial trading. As a developer wanting to achieve amazing things, working what others consider crazy hours, the worry does occasionally cross my mind. I love what I do, but I do wonder how much harm can be caused by over working, regardless of the fact that there's nothing else I'd rather do with my time.
"Steve Jobs […] comments on how he believes the"
Steve was lots of things, but I think few would say he was an expert in medicine. For another data point with more or less the same weight: If I had to guess, I would blame his stay in India, in particular the hepatitis he reportedly got there. I know that is an unverifiable statement, and am willing to change position once a fact presents itself, though.
"there seems to be a higher ratio of cancer sufferers in high pressured environments like financial trading"
Believes aren' worth anything here. Show me the numbers. For what it is worth (zero), I would guess on lower incidence, due to higher risks of heart attacks and of accidents with fast cars, all others being equal.
Summary: nothing to worry about, there, except for your own worries.
Steve was lots of things, but I think few would say he was an expert in medicine. For another data point with more or less the same weight: If I had to guess, I would blame his stay in India, in particular the hepatitis he reportedly got there. I know that is an unverifiable statement, and am willing to change position once a fact presents itself, though.
"there seems to be a higher ratio of cancer sufferers in high pressured environments like financial trading"
Believes aren' worth anything here. Show me the numbers. For what it is worth (zero), I would guess on lower incidence, due to higher risks of heart attacks and of accidents with fast cars, all others being equal.
Summary: nothing to worry about, there, except for your own worries.
Thank god coffee wasn't on the list.
Most of the research on coffee that I've seen is mixed-to-modestly positive for moderate amounts (1-2 cups day). Essentially: if you're having a few cups, have no problems with it, and enjoy it, no need to stop. Some people do experience sleep and stress problems.
I've found that relying on tea through the course of the day (after a morning mug of espresso) keeps my energy levels more even. Dittos knocking off the carbs -- much more even energy levels, and no post-lunch slump.
I've found that relying on tea through the course of the day (after a morning mug of espresso) keeps my energy levels more even. Dittos knocking off the carbs -- much more even energy levels, and no post-lunch slump.
Coffee prevents liver cancer.
Does anyone know why there's a little thumbnail of "reproduction" there?
My understanding is that in women, a lack of reproduction causes cancer. Basically, each period you have adds to your risk of breast cancer. Did the BBC just get it wrong or is there something I'm missing?
My understanding is that in women, a lack of reproduction causes cancer. Basically, each period you have adds to your risk of breast cancer. Did the BBC just get it wrong or is there something I'm missing?
Right, I'm off to find some fruits and vegetables! Or do I get enough antioxidants as a tea-drinker? I'm conflicted because I know I don't get enough fruit in my diet, but the recommended daily amount of fruit seems difficult to get in the winter.
Buy frozen fruit, make smoothies for breakfast. Easy, tasty, and not particularly expensive.
http://www.foodnetwork.com/recipes/alton-brown/buff-smoothie...
Since going vegan, that's been my nightly ritual: throw frozen fruit, bananas (one large or two small), juice, and vanilla soy milk in the blender carafe and put it in the refrigerator. I like to add ground flaxseed for the ALA as well.
http://www.foodnetwork.com/recipes/alton-brown/buff-smoothie...
Since going vegan, that's been my nightly ritual: throw frozen fruit, bananas (one large or two small), juice, and vanilla soy milk in the blender carafe and put it in the refrigerator. I like to add ground flaxseed for the ALA as well.
I eat fruits with every meal. Not a ton of them, just making sure I get some nice tasty "vegetable candy" every time I eat food.
Also focus on getting enough fiber. Auto-magically this will ensure you get a lot of veggies, minerals, vitamins, and so on - as long as you don't rely on artificial means such as fiber supplements. Lettuce, cucumbers, cabbage, tomatoes, stuff like that - all those are good.
I do eat meat, eggs, dairy and so on, I'm not a vegetarian by any means. I just try to avoid eating too much red meat, or stuff heavy on cholesterol and saturated fat. I emphasize fish, turkey, chicken, lean meat, etc. Once in a while I will enjoy a good steak - it's not like you'll drop dead from eating it, and cholesterol is actually used by your body to make hormones and so on.
As a remnant from my weight lifting days, I try to eat some protein with every meal, and I try to avoid carbs-only meals. I think the low fat diets are ridiculous; controlling the calories overall, and the carbs in particular, and exercising, are far more important.
I reduced very drastically starchy foods. Bread, rice, potatoes - gone or greatly diminished. Eat a salad instead (for dressing, use oil and vinegar, not the sugary junk that most people use). Popcorn and potato chips are blacklisted in my household. Ice cream - I'll eat some once in a while when the kids are craving it. No candy. No soda.
I do eat a small amount of chocolate, Nutella, or drink some hot chocolate, almost every day in fact, in the evening; cocoa has antioxidants too, and the sweet taste gives you a serotonin boost when you're tired. This is the "vice" that I indulge in. :)
My preferred drink is green tea. Black is fine too. I drink lots.
I take one fish oil capsule in the evening, unless I had fish for lunch or dinner, in which case I skip it. I take one resveratrol capsule in the morning, one in the evening; there is some controversy re: this substance, but overall it still looks good; if the science changes, I'll change my habits accordingly.
I don't always drink alcohol, but when I do (sorry for the rage comics pun) I drink red wine. Mostly on social occasions.
I do strength exercises ("weight lifting") twice a week, maybe half an hour; often this is just going out to a park and doing pull-ups on a tree branch or something, then a few sets of clapping push-ups on soft ground, then one-leg squats holding on to a tree, stuff like that; the gym is nice, but it's optional. I ride the bicycle a few hours every week-end; I've a nice road bike that takes me far over the hills, towards the ocean, or wherever I wanna go. I walk every day about an hour - often I'll eat my lunch walking instead of sitting in a restaurant. When I take a break from work, I go out and walk; it's very relaxing and mind-expanding; a lot of innovative, out of the box ideas come to you when you're outdoors daydreaming.
At 182cm (6') tall, I weighed 61kg (135lb) a decade ago and I was a couch potato geek with awful eating habits. Then I started working out, changed lots of things. After a while I weighed 85kg (187lb), no fat, and I was bench pressing 100kg (220lb). Nowadays I scaled back lifting a lot, I eat less calories, I weigh somewhat less, maybe 78kg (172lb) - I don't know for sure and I don't care. The bathroom scale is full of bullsXXt, the mirror will tell you the truth. I feel I'm in great shape, and I was told I do look very much "in shape".
Sounds like a lot, but all this stuff was just a gentle, slow, very gradual change in habits over a long period of time, years really. I never forced the issues. If you take a vow and fail, so what? Tomorrow is another day. You turn around and try again. This is not a sprint, it's a decades-long marathon. Once the habits are changed, it takes no effort to keep the regimen. Nowadays my diet is the way it is because I actually like it. E.g. I developed an intense dislike for popcorn (tastes like flavored cardboard) and fast food (it's way too salty and greasy). The body gets used to exercising and it gets restless if you don't work out.
Slow gradual gentle changes, never forcing the issues, drive the habits deep into the psyche. If you feel you can't keep this up for decades to come, you're trying too hard - so scale back a notch. That's it. Good luck.
Also focus on getting enough fiber. Auto-magically this will ensure you get a lot of veggies, minerals, vitamins, and so on - as long as you don't rely on artificial means such as fiber supplements. Lettuce, cucumbers, cabbage, tomatoes, stuff like that - all those are good.
I do eat meat, eggs, dairy and so on, I'm not a vegetarian by any means. I just try to avoid eating too much red meat, or stuff heavy on cholesterol and saturated fat. I emphasize fish, turkey, chicken, lean meat, etc. Once in a while I will enjoy a good steak - it's not like you'll drop dead from eating it, and cholesterol is actually used by your body to make hormones and so on.
As a remnant from my weight lifting days, I try to eat some protein with every meal, and I try to avoid carbs-only meals. I think the low fat diets are ridiculous; controlling the calories overall, and the carbs in particular, and exercising, are far more important.
I reduced very drastically starchy foods. Bread, rice, potatoes - gone or greatly diminished. Eat a salad instead (for dressing, use oil and vinegar, not the sugary junk that most people use). Popcorn and potato chips are blacklisted in my household. Ice cream - I'll eat some once in a while when the kids are craving it. No candy. No soda.
I do eat a small amount of chocolate, Nutella, or drink some hot chocolate, almost every day in fact, in the evening; cocoa has antioxidants too, and the sweet taste gives you a serotonin boost when you're tired. This is the "vice" that I indulge in. :)
My preferred drink is green tea. Black is fine too. I drink lots.
I take one fish oil capsule in the evening, unless I had fish for lunch or dinner, in which case I skip it. I take one resveratrol capsule in the morning, one in the evening; there is some controversy re: this substance, but overall it still looks good; if the science changes, I'll change my habits accordingly.
I don't always drink alcohol, but when I do (sorry for the rage comics pun) I drink red wine. Mostly on social occasions.
I do strength exercises ("weight lifting") twice a week, maybe half an hour; often this is just going out to a park and doing pull-ups on a tree branch or something, then a few sets of clapping push-ups on soft ground, then one-leg squats holding on to a tree, stuff like that; the gym is nice, but it's optional. I ride the bicycle a few hours every week-end; I've a nice road bike that takes me far over the hills, towards the ocean, or wherever I wanna go. I walk every day about an hour - often I'll eat my lunch walking instead of sitting in a restaurant. When I take a break from work, I go out and walk; it's very relaxing and mind-expanding; a lot of innovative, out of the box ideas come to you when you're outdoors daydreaming.
At 182cm (6') tall, I weighed 61kg (135lb) a decade ago and I was a couch potato geek with awful eating habits. Then I started working out, changed lots of things. After a while I weighed 85kg (187lb), no fat, and I was bench pressing 100kg (220lb). Nowadays I scaled back lifting a lot, I eat less calories, I weigh somewhat less, maybe 78kg (172lb) - I don't know for sure and I don't care. The bathroom scale is full of bullsXXt, the mirror will tell you the truth. I feel I'm in great shape, and I was told I do look very much "in shape".
Sounds like a lot, but all this stuff was just a gentle, slow, very gradual change in habits over a long period of time, years really. I never forced the issues. If you take a vow and fail, so what? Tomorrow is another day. You turn around and try again. This is not a sprint, it's a decades-long marathon. Once the habits are changed, it takes no effort to keep the regimen. Nowadays my diet is the way it is because I actually like it. E.g. I developed an intense dislike for popcorn (tastes like flavored cardboard) and fast food (it's way too salty and greasy). The body gets used to exercising and it gets restless if you don't work out.
Slow gradual gentle changes, never forcing the issues, drive the habits deep into the psyche. If you feel you can't keep this up for decades to come, you're trying too hard - so scale back a notch. That's it. Good luck.
This is fantastic advice, especially for many of my fellow Americans. For me, however, I think the problem is that fruits don't fit into my lifestyle. My meals mostly consist of fish, miso, rice, seaweed, tofu and various vegetables seasonally available. Quality fresh fruit is not as readily available at reasonable prices in the winter.
I'm 6'2" and I've never weighed over 175lbs (thanks to running), so it's not an overt health issue. My deep-seated fear is that I'm doing long-term damage to my body by not eating enough fruit compared to the amount of vegetables I consume. Health guidelines almost never make it clear if there are suitable replacements for things like fruits in other food categories.
I'm 6'2" and I've never weighed over 175lbs (thanks to running), so it's not an overt health issue. My deep-seated fear is that I'm doing long-term damage to my body by not eating enough fruit compared to the amount of vegetables I consume. Health guidelines almost never make it clear if there are suitable replacements for things like fruits in other food categories.
> Sounds like a lot, but all this stuff was just a gentle, slow, very gradual change in habits over a long period of time, years really.
This is the key. I like what you've said. So many people want a quick fix, but if you are looking for a quick fix, then most likely it's temporary.
This is the key. I like what you've said. So many people want a quick fix, but if you are looking for a quick fix, then most likely it's temporary.
tl;dr: I believe in taking care of myself, and a balanced diet and a rigorous exercise routine. In the morning, if my face is a little puffy, I'll put on an ice pack while doing my stomach crunches. I can do a thousand now. After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub. Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine. I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older. Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion.
Perfect.
prunes. quite high in antioxidants and as a bonus high in fiber so the glycemic load isn't too bad. also very easy to buy in bulk, they don't spoil quickly like most fruits.
What about the other 60%?
I'd argue that for, a lot of people living in developed countries, things like exposure to poor air quality should be considered a lifestyle choice.
I'd argue that for, a lot of people living in developed countries, things like exposure to poor air quality should be considered a lifestyle choice.
Such things aren't choices in any conventional sense of the word - they're package deals, and you don't get to renegotiate the package. You can live in London for the opportunities and culture, but you can't easily escape the crime and traffic pollution.
That's true, but I think that's an overlooked factor in some other "lifestyle choices" as well. For example, people who significantly reduce their alcohol consumption often report changing social groups and activities to do so, so in at least some cases it can be a package deal. I don't think there are very many choices that are completely isolated, independent from all other choices, and free of consequence on any other aspect of your life, though there's definitely a spectrum of being more or less so.
I'll agree it isn't a lifestyle choice in the conventional sense of the word. But I personally think each person should individually strive to make it so. Mobility is hugely underrated. And some packages are better than others.
And it's illegal or impossible to leave London? You can't renegotiate the package, but you can always choose a different package.
Perhaps, but the health benefits may be outweighed by moving from a city with a large economy out to the country where you'll have to subsistence farm for a living.
You are confusing the UK with India and China.
I don't smoke nor drink alcohol (at all), but I can't remember the last time I had vegetables or fruit in large quantities either. Time to get some ;)
Eating https://en.wikipedia.org/wiki/Turmeric powder will prevent cancer.
Lots of spices do that. Cinnamon is pretty good too. Ginger. Horseradish. Garlic. Goes on and on.
Go easy on the cassia cinnamon though - it contains coumarin, which is a known hepatotoxin. http://en.wikipedia.org/wiki/Coumarin#Toxicity_and_use_in_fo...
The thing that I dislike about cancer reporting (and don't get me wrong I'm all for improving ones lifestyle through better nutrition, exercise and social engagement) is that cancer is fundamentally different from a disease like the flu. If 40% of all flu cases were caused my lifestyle then it would be reasonable to say that you could change your lifestyle and dramatically cut down on the number of flu cases. But cancer is a disease of old age. Basically all of us are going to die and the long you live the more likely it is that you'll die of cancer, if not of the esophagus, then of the stomach, if not of the stomach then brain cancer, or pancreas cancer. So a healthy life style on average will delay the onset of cancer, but will by no means reduce the like-hood that you'll get cancer in your lifetime by 40%. Actually it probably has the perverse effect of making you much more resistant to cardiovascular decease, and therefor MORE likely to die of cancer, albeit at a more advanced age than you would have otherwise.
What I always wondered about eating healthy is, is it the unhealthy foods on their own that is the root cause, or the fact that unhealthy eaters don't eat wholesome foods?
For example, if I eat McDonalds, but then I also eat a bunch of fruits and veggies, would that mitigate the risk?
For example, if I eat McDonalds, but then I also eat a bunch of fruits and veggies, would that mitigate the risk?
I don't get one thing, which is by luck...Steve Jobs died of cancer...and he was vegetarian
That's not how statistics work.
May be this is related:
http://www.fourhourworkweek.com/blog/2010/09/19/paleo-diet-s...
http://www.fourhourworkweek.com/blog/2010/09/19/paleo-diet-s...
there is trend in the 'key cause of cancer' down in the article, throat and colon cancer follow power distribution, while breat cancer kinda follows uniform dist
for breast cancer: the highest offender = obesity is 8.7%, only a multiple of two to the mean <4%
to me it only means that the cause of throat and colon cancer is relatively known (smoke and meat) while it's gray area for breast cancer
smoke -> throat kinda makes sense meat -> bowel? (turns out meat contains no fiber, and lack of fiber accounts for 12.2% so lumping meat and lack of fiber equal a whopping 33.3%) ... makes sense?
for breast cancer: the highest offender = obesity is 8.7%, only a multiple of two to the mean <4%
to me it only means that the cause of throat and colon cancer is relatively known (smoke and meat) while it's gray area for breast cancer
smoke -> throat kinda makes sense meat -> bowel? (turns out meat contains no fiber, and lack of fiber accounts for 12.2% so lumping meat and lack of fiber equal a whopping 33.3%) ... makes sense?
Reproduction is a key cause of cancer? WTF is that?
The incidence of breast and uterine cancer is lower the more children you have.
I think the link is tentative, but pregnancy and breast feeding reduces your lifetime exposure to estrogen which can be a promoter of certain types of cancers.
I think the link is tentative, but pregnancy and breast feeding reduces your lifetime exposure to estrogen which can be a promoter of certain types of cancers.
It's at least not that rare that women who get their first child after the age of 35 get breas cancer (don't quote me on this). Maybe that's what they mean.
i find it interesting that 'meat' is not written (thus not searchable) in the main article (it's down there in 'key causes of cancer' as icon)
FTA (scroll down): Colorectal / Bowel : meat 21.1%, obesity 13%, lack-of-fibre 12.2%
it's not surprising meat and lack-of-fibre are correlated (meat contains no fibre)
FTA (scroll down): Colorectal / Bowel : meat 21.1%, obesity 13%, lack-of-fibre 12.2%
it's not surprising meat and lack-of-fibre are correlated (meat contains no fibre)
While the study did consider fruits and veggies, it did not account for factory farmed meat and dairy consumption, genetically modified foods, animal protein intake, food dyes, cell towers, etc. In 20 years from now we might finally realize that genes alone play a very small role in development of cancer cells. Time will tell.
i wonder where in the world the "occupational hazard" number is highest, and what the number looks like
With socialized medicine, these people are stealing from the state. Britain should outlaw smoking, drinking, and eating fatty foods. Two servings of vegetables per day is now compulsory, enforceable by a fine of 20 shillings.
There's an interesting question about where to draw the line, but in any extant country there are individual behaviors that can increase costs for the state, which doesn't necessarily mean we should ban them. For example, in countries with a state-provided fire department, one might argue candles, propane grills, and halogen lamps should be banned. In countries with a state-provided police department, perhaps we ought to ban controversial speeches and parades that induce extra police protection (not to mention enforce a strict nighttime curfew). And in countries with state-provided pensions, perhaps we ought to make various lifespan-reducing behaviors mandatory, to discourage people from living more than their fair share of years.
I wouldn't go that far, but it is reasonable to tax those things in order to internalize that cost to the individual. The trick is getting the politicians to spend the tax mitigating the effects instead of selling favors.
Not sure if you're being sarcastic, but don't forget that Britain is also a country with socialized pensions. Dying shortly after retirement might even reduce the overall financial burden on the public.
And this kind of financial view ignores that the whole purpose of doing something collectively is to support what the collective, on average, _wants_ to do. It makes no sense to apply some supposedly objective standard of how people should lead their lives.
And this kind of financial view ignores that the whole purpose of doing something collectively is to support what the collective, on average, _wants_ to do. It makes no sense to apply some supposedly objective standard of how people should lead their lives.
Actually, smokers cost less to the state, since their lives are shortened:
http://www.usatoday.com/news/health/2009-04-08-fda-tobacco-c...
http://www.usatoday.com/news/health/2009-04-08-fda-tobacco-c...
Or they should drop socialized medicine so that people can do whatever they want.
"people can do whatever they want"
People can do whatever they want in the UK when it comes to healthcare - you can go to the NHS or go private if you want. Nobody makes you go to an NHS hospital.
Of course, what you can't opt out of is the tax bill that pays for the NHS - but as the NHS is reasonably efficient I don't mind paying for it if it means that everyone in the country has access to decent health care.
People can do whatever they want in the UK when it comes to healthcare - you can go to the NHS or go private if you want. Nobody makes you go to an NHS hospital.
Of course, what you can't opt out of is the tax bill that pays for the NHS - but as the NHS is reasonably efficient I don't mind paying for it if it means that everyone in the country has access to decent health care.
Of course, people might not be able to do everything they want without socialized medicine, whether it's because they can't afford the risk, privatized medicine costs too much, etc. A liberty principle doesn't cut evenly one way or the other on this issue.