French cancer professor: Time to stop feeling food guilt

Head of oncology at a Paris hospital, Professor David Khayat tells Connexion how food balance not denial really is key, without it humans just 'explode'

8 March 2021
By Connexion journalist

Stop depriving yourself! Really? Absolutely. That is the message from the first president of the national institute of cancer (Inca).

Professor David Khayat, head of oncology at Paris’s Pitié Salpêtrière hospital, told The Connexion it is time we stopped feeling guilty about indulging in foods we like.

This is manna to those of us whose willpower wilts when faced with temptation.

“The diktats against salt, alcohol, sun, red meat, sex, sugar, charcuterie... it’s gone too far and it’s not true,” said Prof Khayat, whose book Arrêtez de vous priver! explores the subject. “We’ve all had enough of them.

“The promise that it’s possible to stay healthy forever and never die is false. Whatever we do, however we live, we will all get sick and die in the end.”

He does not advocate lounging on the sofa scoffing sugar and drinking wine all day, however. “I’ve never said that!

'It’s a question of understanding the difference between danger and risk'

“They are different. The shark, for example, is very dangerous to humans, so going into the sea can be very dangerous, but the risk of meeting a shark when swimming in the sea is very small.”

He says it works the same way for eating charcuterie.

If you eat a sandwich containing 50g of saucisson sec every day, you increase your risk of developing colon cancer by 18% – but since the risk is very small (around 2%), even if you eat two sandwiches a day (100g of saucisson sec) your risk only rises to 2.2%.

“We need to stop being ruled by fear. No one can follow all the rules: no fat, no sugar, no alcohol, etc. It’s got to the point where people feel guilty each time they eat a portion of chips, but it’s false.

“Some people weigh a few kilos too much but are in perfect health, so why should they bother losing weight?

“But there are other people of normal weight who have high cholesterol. So this idea that there is one single ideal weight, one ideal diet for human beings, is wrong.

“You can follow all the rules and still get cancer.”

'There’s too much guilt in France'

He also thinks guilt is not helpful. 

“This general idea that people with cancer must have somehow deserved it, they must have eaten sugar or smoked or drunk too much wine. God is punishing them for their sins.

“But it’s false. Whether or not you develop cancer depends on genetics, environment, lifestyle and sheer luck.”

He describes the proliferation of extreme diets aimed at women in France as horrible.

“Women lose enormous amounts of weight and the minute they stop, they put it all back on – when they only had a few kilos extra in the first place. What is the point?”

His view is that failed dieting is because human babies are programmed from birth to like the sweet taste of human milk.

“They learn that the sweet taste of food goes with contact, warmth, security and happiness – so we all associate sugar and happiness. This connects to the most primeval part of our brain which simply aims to ensure survival of the human race. It’s the part of the brain which urges us to eat and mate, however that can be done.

“The more civilised parts of the brain learn that if you eat too much, you get fat, if you eat too much sugar, you get diabetes. But that part always loses out to the part which is determined to eat and survive.”

Throughout history, he says, humans have had to withstand food shortages because of floods, drought, and failed harvests, and gradually the body has learned to store food against times of famine.

“The hormones produced in the pancreas act to store the calories in food for later in the form of fat. But foods which are high on the glycaemic index (GI - high carb foods) provoke this reaction more than those which are low GI.

“This explains why Italians eat pasta without getting fat but it makes French people fatter: Italians eat it ‘al dente’ but the French prefer it very well cooked, which increases its GI.

“Beetroot is another interesting case. Raw, it is low GI, but cooked, it becomes high GI.” His book contains guidelines on how to maintain a healthy weight for you, and adopt a healthier diet without going to extremes, and without depriving yourself of the odd indulgence. “I have developed a diet which works with the body to lose weight the right way.

“The idea is to find a balance. If you eat a large lunch, eat a small dinner. If you enjoy steak and chips, balance it with salad for a day or two.”

'We are not machines, we must respect our bodies and psychologies, our emotions. Without a proper balance, people just explode'

He advises the same approach to alcohol. “Each glass is calculated to contain 10 grams of pure alcohol, which is why beer is served in larger quantities than whisky.

“The recommended daily intake is 10-12 glasses a week, which amounts to around two glasses a day with a few days off.” The trick, he says, is to avoid extremes.

“Balance is the key. Work out a strategy which relies on little steps. Do a little bit of exercise.

“Rather than try to force yourself to go jogging for two hours a day, take the lift to the third floor and walk up to the fourth. Get off the Tube one stop before. Stand during phone calls at work. These things could become long-term habits because they’re easy.

“Avoid gurus promising extreme results. It isn’t possible to achieve the ultimate health they are promising because there is no one healthy lifestyle which would suit everyone.

“We are not all the same. It is important to enjoy life, to allow ourselves some pleasures.

“We are not machines, we must respect our bodies and psychologies, our emotions. Without a proper balance, people just explode.”

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