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The Link Between Diet and Women's Cancers

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Audio and slides for this presentation are available on YouTube: http://youtu.be/Fs6wfCFeFOU …

Audio and slides for this presentation are available on YouTube: http://youtu.be/Fs6wfCFeFOU

Wendy Chen, MD, MPH, a breast oncologist in the Susan F. Smith Center for Women's Cancers at Dana-Farber, shares new data and research studies linking a healthy lifestyle to better treatment outcomes.

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  • 1. Diet, nutrition, and women’s cancer: Current status and future research Wendy Chen, MD MPH
  • 2. Willett,1992
  • 3. Study design – diet and cancer Observational studies Randomized trials Laboratory studies
  • 4. Challenges to studying nutrition and cancer • Many food items inter-related – People who eat more meat, eat less vegetables – Nutrition often related to weight/health behaviors • Long-term trends more important than short-term • Unlikely to have one magic bullet => Beware of findings from small individual studies!
  • 5. Alcohol
  • 6. Alcohol Intake and Breast Cancer 0.8 1 1.2 1.4 1.6 1.8 0 5 10 15 20 25 30 35 40 45 50 55 60 Alcohol Intake (g/d) RelativeRisk
  • 7. Feeding Studies • 51 postmenopausal women rotated through three 8- week periods of placebo, 15 g, or 30 g alcohol daily – Estrone sulfate↑↑ by 7.5 and 10.7% respectively – Androgen (DHEAS) ↑↑ by 5.1 and 7.5% Dorgan 2001, JNCI
  • 8. Alcohol and breast cancer survival • Although studies consistent on alcohol and getting breast cancer, survival studies mixed – breast cancer recurrence – heart disease risk = > Bottom line is moderation – Several glasses per week OK
  • 9. Soy
  • 10. Why the interest in soy? • Soy high in isoflavones – phytoestrogens – Isoflavones – similar chemical structure to estrogen • Some laboratory studies suggest that soy protein isolates  cancer growth • Soy intake studies show protective effect for breast /gynecologic cancers
  • 11. Soy and breast cancer survival Shanghai breast cancer study 0 0.2 0.4 0.6 0.8 1 1.2 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Isoflavone intake Recurrence Mortality Soy intake high throughout life Mainly dietary soy Shu JAMA 2009
  • 12. Tea
  • 13. Tea consumption =>Laboratory data show anti-cancer effect => Randomized trial of green tea for ovarian cancer survivors
  • 14. Dietary patterns Rather than evaluating individual nutrients, study dietary patterns since food items inter- related
  • 15. Dietary patterns and breast cancer • Prudent (fruits, vegetables, whole grain, legumes, poultry, fish) vs Western (refined grains, processed and red meat, dessert, high-fat dairy) – Prudent pattern may  breast cancer risk – Stronger association with ER negative breast cancer • Western diet  mortality from other causes – No associations with breast cancer development
  • 16. Women’s Health Initiative • Federally funded study of dietary modification, calcium/vitamin D, and menopausal hormones • Dietary modification arm – random assignment – 18 group sessions in 1st year then quarterly maintenance – Goal was 20% energy from fat and  fruit/vegetable and grain intake • Weight loss was not a goal of the intervention
  • 17. Women’s Health Initiative • Was this study a “failure”? After 8.1 yrs => no significant difference in total cancer => Only 14% of intervention group met goal of 20%
  • 18. • Was this study a “failure”? Breast Cancer Ovarian Cancer
  • 19. Conclusions • Alcohol – From breast cancer standpoint, should be limited to several servings per week • Diet – Diet high in fruits/vegetables and low in meat/saturated fat clearly associated with best overall health – Stick to food based sources rather than supplements
  • 20. • 1st began running at 55 • 1st ultramarathon at 61 • World record marathon holder for 85-89 yr olds – 5 hrs 36 minutes Helen Klein
  • 21. THANK YOU!

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