Reducing your risk for cancer with diet & one important supplement

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Kick cancer in the butt with these research-backed amazing anti-cancer foods, and one stand-out supplement.

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  • Reference to “reducing risk 1/3” http://www.aicr.org/site/PageServer?pagename=reduceyourcancerrisk_home http://www.aicr.org/site/PageServer?pagename=reduce_cancer_by_numbers – REFERENCE: for 60-70%: Foods that Fight Cancer by Béliveau and Gingas page 19.
  • This concept of food being a source of health, beyond just energy, is not new. Hippocrates, the father of modern medicine, is credited with this long forgotten quote which sums up this philosophy very succinctly We will now leave the self-care section of this presentation and discuss in more detail the specific nutrition recommendations for reducing cancer risk
  • Foods that Fight Cancer. Richard Beliveau, Ph.D., Denis Gingras, Ph.D. McClelland & Stewart. 2005 ISBN: 13: 978-0-7710-1135-1 Anti Cancer. A New Way Life. David Servan-Schreiber, M.D., Ph.D. Collins 2008. ISBN:978-1-55468-221-8
  • Foods that Fight Cancer. Richard Beliveau, Ph.D., Denis Gingras, Ph.D. McClelland & Stewart. 2005 ISBN: 13: 978-0-7710-1135-1 Anti Cancer. A New Way Life. David Servan-Schreiber, M.D., Ph.D. Collins 2008. ISBN:978-1-55468-221-8
  • Many studies have shown an association between eating several servings of crucifers each week and lower rates of cancer Crucifers contain the largest variety of phytochemicals with anti-cancer properties: most importantly ‘glucosinolates’ Broccoli & Brussels sprouts are especially high in these anti-cancer compounds Chapter 6 (page 79+). Foods that Fight Cancer. Richard Béliveau and Denis Gingras
  • Caveat : the phytochemicals in this group of vegetables are in a latent state and are activated when mixed together via chewing and they are also heat sensitive and water soluble. Cooking in water for 10 minutes can reduce the content by half, and prolonged cooking substantially reduces the content. Best way to include them: eat some raw, lightly cooked in minimal water like steaming or quick stir fry, one study found that microwaving them reduce the phytochemical content by 85% Chp 6
  • Caveat : the phytochemicals in this group of vegetables are in a latent state and are activated when mixed together via chewing and they are also heat sensitive and water soluble. Cooking in water for 10 minutes can reduce the content by half, and prolonged cooking substantially reduces the content. Best way to include them: eat some raw, lightly cooked in minimal water like steaming or quick stir fry, one study found that microwaving them reduce the phytochemical content by 85% Chp 6
  • Seem to be most promising against cancers of the digestive tract: esophageal, stomach, and colon, may also help with preventing prostate cancer These foods are rich in sulfur-containing compounds which are responsible for their characteristic taste and odour A molecule in these food, alliin is lying in a dormant state, when these vegetables are chopped, crush, or chewed, a reaction occurs that converts alliin into allicin Allicin is then converted into three other compounds: diallyl sulfide (DAS), diallyl disulfide (DADS) and ajoene – these are believed to be the anti-cancer molecules Seems to be protective against nitrosamines, compounds formed in our intestines by the intestinal bacteria and nitrites: a class of food preservatives found abundantly in processed meats like deli, sausages, bacon, ham, salami etc DAS, DADS and ajoene also seem to stimulate the enzymes are that are responsible for flushing carcinogens out of the body They don’t seem to be heat sensitive and freshly cut, chopped, grated or crushed will have the highest amount of these compounds Chapter 7 (page 91+). Foods that Fight Cancer. Richard Béliveau and Denis Gingras
  • Seem to be most promising against cancers of the digestive tract: esophageal, stomach, and colon, may also help with preventing prostate cancer These foods are rich in sulfur-containing compounds which are responsible for their characteristic taste and odour A molecule in these food, alliin is lying in a dormant state, when these vegetables are chopped, crush, or chewed, a reaction occurs that converts alliin into allicin Allicin is then converted into three other compounds: diallyl sulfide (DAS), diallyl disulfide (DADS) and ajoene – these are believed to be the anti-cancer molecules Seems to be protective against nitrosamines, compounds formed in our intestines by the intestinal bacteria and nitrites: a class of food preservatives found abundantly in processed meats like deli, sausages, bacon, ham, salami etc DAS, DADS and ajoene also seem to stimulate the enzymes are that are responsible for flushing carcinogens out of the body They don’t seem to be heat sensitive and freshly cut, chopped, grated or crushed will have the highest amount of these compounds Chapter 7 (page 91+). Foods that Fight Cancer. Richard Béliveau and Denis Gingras
  • These foods make up a large part of the diets in Asia and are a rich source of a class of polyphenols known as isoflavones – the two more important ones are genistein & daidzein Polyphenols are plant compounds containing beneficial cancer-fighting chemicals. They are found in wine, beer, chocolate, tea, walnuts, berries, pomegranates and other fruits and vegetables These isoflavones are also referred to as phytoestrogens – because they have mild estrogen like properties that have anti-cancer properties Intakes vary greatly between Eastern and Western diets, the range of soy foods is about 40-65g per day Breast and prostate cancers are the primary cancers in Western society, they are are rare in Asian populations (page 107 Foods that Fight Cancer) Foods that Fight Cancer. Richard Béliveau and Denis Gingras. Pg 102 and 105
  • Reference: Pauline Wisdom-Gilliam RD Odette Cancer Centre
  • these are examples of processed soy foods, not considered ‘whole food’ soy, research on the benefits of soy are based on soy foods that have been eaten for centuries by those cultures that have traditionally included them, and studied in amounts of consumed as part of traditional diets of China, Japan, Indonesia etc these foods have never been studies in cancer prevention [or heart or bone health], and do not include the health promoting properties that tofu, tempeh, miso, soy nuts, or soy beverage [made from the whole soy bean] do and should be avoided
  • Bulk of studies have shown that a modest intake of soy foods that deliver as little as 25mg of isoflavones can reduce the risk for breast cancer Studies using isolated isoflavone supplements have not shown the same, and in fact were negative – in this case it is better to rely on whole food sources of soy [best research to day shows that modest amounts of soy consumption is safe and does not increase the risk for breast cancer development nor does it interfere with Tamoxfen treatment] Pg 102-106 Foods that Fight Cancer. Richard Béliveau and Denis Gingras.
  • You sometimes read about studies that show no change in breast cancer rates. However, studies that are conducted in U.S.A. generally have very low intakes of soy e.g. 3 g per day in the “high intake group”- these people are getting soy from soy added to industrially processed foods and not eating miso soup three times a day like they do in Japan (page 107) The goal from the previous page was to consume 50 g per day of real soy foods [providing about 25mg of total isoflavones], this chart shows the amount of beneficial natural isoflavones found in real soy foods and processed ones pg 104 Foods that Fight Cancer. Richard Béliveau and Denis Gingras.
  • Turmeric is a brilliant yellow powdered spice – plant found primarily in India and Indonesia Although known in early Europe, it never really caught on in Western culinary tradition As a therapeutic agent, it was listed as a medicinal plant (along with 250 others) and mentioned in a series medical books dating from 3000 BC There haven’t been any studies looking at the impact of the addition of turmeric on cancer development but it does show up in epidemiological studies as a possible explanation If you see “E 100” on your mustard label – that is tumeric. In mustard it is used as a food colouring. But the amount in the mustard is not enough to have a therapeutic effect (unless you are eating 4 kg of mustard a day) – page 116 Chapter 9 ( page 115) Foods that Fight Cancer. Richard Béliveau and Denis Gingras.
  • Cancer rates are based on rates per 100,000 population in 2001 (pg 118 Cooking with Foods) Turmeric seems to have the potential in preventing the appearance of tumours, and may help to reduce cancers of: stomach, intestinal, colon, skin and liver cancer Studies in laboratory with human cancer cells, show curcumin blocked the growth of the cells of leukemia, colon, breast and ovary cancers The principal active ingredient in turmeric is curcumin Seems to work at the initiation and promotion stages of tumour development Models using transgenic mice who spontaneously develop polyps in the colon, administration of curcumin reduced the spread of the tumours by 40% Turmeric typically makes up about 20-30% of total spice content of curry mixtures but the amount of turmeric can vary a lot, best to include turmeric on its own more often Chp 9 Foods that Fight Cancer. Richard Béliveau and Denis Gingras.
  • Contains hundreds of compounds that give tea its distinctive aroma, taste and astringency Catechins are the heavyweights responsible for the apparent anti-cancer activity of green tea Anti-fungal/anti-bacterial properties of catechins allow for the plant to resist disease etc, when we drink the tea, we get benefit from those compounds EGCG is the polyphenol/phytochemical that shows the most promise Catechin content varies: just because a label reads ‘green tea’ does not mean the produce will have sufficient levels of EGCG General rule: Japanese teas have more than Chinese teas Steeping time of less than 5 minutes allows for the extraction of 20% of the catechins that would be extracted with a brew/steep time of 8-10mins Goes without saying that these huge variations in catechin content may have an impact on the anti-cancer potential associate with green tea and most likely explains variations in and complications with analysis of clinical studies on the chemo-preventive effects of green tea In chart on page 129 – shows that Sencha-Uchiyama is the highest in EGCG – look for this on the label of Japanese Green tea Chp 10 Foods that Fight Cancer. Richard Béliveau and Denis Gingras. Page 123+
  • Catechin content varies: just because a label reads ‘green tea’ does not mean the produce will have sufficient levels of EGCG General rule: Japanese teas have more than Chinese teas Infusion time of less than 5 mins allows for the extraction of 20% of the catechins that would be extracted with a brew/steep time of 8-10mins Goes without saying that these huge variations in catechin content may have an impact on the anti-cancer potential associate with green tea and most likely explains variations in and complications with analysis of clinical studies on the chemo-preventive effects of green tea Chp 10
  • Everyone probably knows that citrus is a good source of vitamin C, what is less known is that citrus also contains several phytochemical compounds that are most likely responsible for their anti-cancer properties Orange: has sixty different types of polyphenols as well as several compounds of a fragrant class of molecules called terpenes (page 159) Citrus are the only plants containing significant amounts of a group of polyphenols called flavanones Many studies have consistently found a link between citrus consumption and a decreased risk of certain cancers Chp 14 Foods that Fight Cancer. Richard Béliveau and Denis Gingras. Page 159+
  • They help to preserve blood vessel integrity/strength and tone, inflammation can counter this, it is a key step in increasing blood vessel permeability, citrus helps to reduce permeability and is anti-inflammatory which could well be responsible for it’s anti-cancer effects Polyphenols in citrus seem to block tumour growth by direct action on the cancerous cells, restricting their ability to reproduce Citrus also modulates the body’s detoxification systems – they can help to maintain the levels of other anti-cancer compounds in the blood boosting their effectiveness Much of the polyphenols are found in the space between the rind and the flesh of the fruit [the white ‘stuff’], don’t be too eager to pick it away, try to eat it! This pith contains citrus bioflavonoids, hespendin, rutin and naringin Chp 14 pg 161
  • Whole fruit will have more of the bioflavonoids of interest since a lot of them are found in the flesh & pulp Much of the polyphenols are found in the space between the rind and the flesh of the fruit [the white ‘stuff’], don’t be too eager to pick it away, try to eat it! This pith contains citrus bioflavonoids, hisperidin, rutin and naringin Chp 14 pg 161
  • Fat is divided into 3 groups: saturated, monounsaturated and polyunsaturated fats All foods have varying amounts of these fats, if a food has more of one kind or is a unique source, we say that foods is a source of that fat.e.g. olive oil has all three fats but is very high in monounsaturated fats, so we say ‘olives are a good source of that monounsaturated fat’ Polyunsaturated fats are sub-divided as follows: omega-6 and omega-3 (omega-3 is found in both plants and animals) The greatest contribution of omega-6 fats in our diet are from grain and seed oils and their high use in food production Omega-3/6 fats are considered essential because the body cannot make them and they must be supplied by the diet Omega-6 is: Over consumed in typical Western diet Too much omega-6 may increase risk of cancer Omega-3, in North America, we don’t eat enough omega-3 fat (from fish and seafood, i.e. EPA/DHA), we get lots of the plant form of omega-3 fat ALA vs. EPA/DHA Both are needed for health EPA/DHA are more potent LA – linoleic acid ALA – alpha linolenic acid EPA – eicosapentanoic acid DHA – docosahexanoic acid Chp 12 pg 146-147
  • Omega-6 are very abundant in a lot of foods, the omega-3 are more scare in the typical western diet We eat an imbalance of omega6:omega3 and eat too much omega-6. The ideal ratio should be 4:1 [omega6:omega3] but experts put it closer to 15:1 Some research suggests this imbalanced ratio is pro-inflammatory which may promote cancer Both plant-based omega-3 fat ALA and animal-based EPA/DHA are needed for health but EPA/DHA found in fish and seafood are more potent and anti-inflammatory Chp 12 149
  • Omega-3 fats reduce inflammation Have fish 2x/week, eat more ground flax, walnuts, and whole soybeans [edamame] Consider an omega-3 fat supplement if you don’t like fish, if vegetarian, consider a vegetarian DHA supplement Why? Omega-3 fats, especially EPA and DHA Decrease inflammation which disturbs immunity Induces apoptosis and prevents angiogenesis Chp 12 p149
  • chocolate is an excellent source of phytochemicals called polyphenols, 50g of dark chocolate has 2x much as red wine and as much as green tea – page 180 Protective role in CVD is well established Protects LDL cholesterol from oxidation (oxidized cholesterol is damage, think of it as being sticky, oxidized LDL cholesterol is can more easily penetrate blood vessels, first step in plaque formation), it also causes the blood vessels to relax, increasing blood flow, decreases platelet aggregation or reduces platelets from clumping, helps to prevent damage to the lining of the blood vessels Early research [studies are just starting] suggests it can help to reduce the growth of certain cancers: lung. Because the polyphenol content is similar to that of other foods [green tea, apples, grapes, onions, berries, flax, salba, olives, olive oil], it is believed that chocolate will prove to be beneficial too Chp 16 pg 182 Foods that Fight Cancer. Richard Béliveau and Denis Gingras.
  • A tasty and fun way to take advantage of a potentially anti-cancer food but at the very least helps to reduce risk factors for cardiovascular disease it doesn’t take much, only 40g of chocolate with 70% cocoa content, eating darker chocolate give you more bang for your buck may want to experiment with raw chocolate RE: dutched or alkalized – reference: Ultimate foods for Ultimate Health by Liz Pearson and Marilyn Smith. Chp 16 pg 182 http://www.navitasnaturals.com/products/cacao.html
  • Berries (Chp 11, p 137-140) Research is preliminary: most done on lab-grown cancer cells and lab animals Ellagic acid, anthocyanidins, proanthocyanidins may help to prevent the activation of carcinogenic substances into cellular toxins, so the toxins lose their ability to damage DNA and induce mutations Ellagic acid inhibits VEGF and PDGF – two proteins required for tumour vascularization/angiogenesis Carrots Falcarinol found in raw carrots, juice or cooked carrots that haven’t been diced (increasing the surface area allows for more to be lost during cooking) May reduce colon tumour growth, early studies in lab animals http://www.sciencedaily.com/releases/2005/02/050212184702.htm http://www.nutraingredients.com/Research/Carrot-compound-fights-cancer-in-animal-tests Flax - Lignans metabolized into a type of phytoestrogen, beneficial for breast/prostate cancer http://www.nutraingredients.com/Research/Review-backs-flaxseed-lignans-cancer-fighting-potential Mushrooms – beta-glucan a carbohydrate that enhances activity of the immune system http://www.nutraingredients.com/Research/Phytosterols-may-prevent-cancer-development-Review
  • Research continues to pour in for vitamin D’s protective and possible treatment role against cancer Both the amount to take and the ideal blood level is still unknown The best evidence is to achieve a blood level of vitamin D that is associated with the lowest rates of cancers, a level that is easily achieved by adequate sunlight, a level that is naturally possible A level that all humans can achieve Canadian Cancer Association suggests 1000IU per day Background info: Vitamin D is not technically a vitamin but is a pro-hormone, it was mislabelled a vitamin in 1922 when it was discovered Research continues to find a possible protective role between adequate blood levels of vitamin D and several diseases As a pro-hormone, it has the ability to modify the some 2000 genes which is why it has such far reaching health benefits www.vitamindcouncil.org
  • essentially is list includes all members of Canadian Society
  • Those living in sun rich environments [Puerto Rico] have much better vitamin D levels that those living in the north Even lifeguards in Toronto, can achieve similar levels in as little as 3 months Vieth R, May 19, 1999, Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety Amer J Clin Nutrition, 69:842-862 Canadians at the end of winter have levels well below the ideal of 75nmol Agnes Gozdzik; Jodi Lynn Barta; Hongyu Wu; Dennis Wagner; David E Cole; Reinhold Vieth; Susan Whiting; Esteban J Parra Low Wintertime Vitamin D Levels in a Sample of Healthy Young Adults of Diverse Ancestry Living in the Toronto Area: Associations With Vitamin D Intake and Skin Pigmentation The Journal of the Federation of American Societies of Experimental Biology. Dec 2008 Level found to reduce cancer in a randomized control trial was 95nmol Lappe JM, Travers-Gustafson D, Davies KM, Rercker RR, Heaney RP. Am J Clin Nutr. 2007 Jun;85(6):1586-91.Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. www.vitamindcouncil.org www.grassrootshealth.net
  • as you can see, with the exception of fatty fish like salmon, there are virtually no reliable food sources of vitamin D most multivitamins will offer 400IU – 800IU per dose you can purchase individual doses of vitamin D ranging from 400IU – 1000IU per dose for Caucasians – adequate sun exposure can produce an appreciable amount of vitamin D (3000IU) in about 5-10mins or 10.000-15,000 IU in about 30 mins with adequate skin exposure [i.e. > 60% total skin exposed], the equivalent of shorts only for men, and bikini for women but only between 10 and 2:30 or so from May to about mid Sept. most people don’t have the opportunity to get enough sun, even during the summer all persons can make 10,000IU with near full body exposure (Caucasians in about 15 mins, then up to 2 hours at the other end of the complexion range in those with African descent). The point is we all have the ability to make large amounts of vitamin D, and our DNA/genes is designed to do just that 4000IU per day is perfectly safe per Institute of Medicine and Health Canada Background info: http://www.cancer.ca/Canada-wide/Prevention/Vitamin%20D/Getting%20the%20right%20amount.aspx?sc_lang=en
  • deficiency is the rule, not the exception in Canada even Caucasians who get adequate sun exposure during the summer will be below the minimum of 75nmol by spring time Agnes Gozdzik; Jodi Lynn Barta; Hongyu Wu; Dennis Wagner; David E Cole; Reinhold Vieth; Susan Whiting; Esteban J Parra Low Wintertime Vitamin D Levels in a Sample of Healthy Young Adults of Diverse Ancestry Living in the Toronto Area: Associations With Vitamin D Intake and Skin Pigmentation The Journal of the Federation of American Societies of Experimental Biology. Dec 2008
  • You can request a 25-hydroxyvitamin D blood test The Ontario government will no longer be covering the blood test for vitamin D. I contacted Lifelab (Oct 13) they reported that it is still be covered. When it is no longer covered by OHIP, the cost for the test will be $51.70 Talk to your oncologist about the amount you should supplement Canadian Cancer Society Recommendation (June 2007) therefore not recent, but the latest one on record Those at higher risk of lower vit D levels includes people:who are older;with dark skin;who don’t go outside often, and who wear clothing that covers most of their skin BUT we saw from the previous slide that essentially all Canadians are at risk for vitamin D deficiency (unless they work outdoors or actively get sun) The new upper intake level of 4000IU is an amount that is safe, the amount where there is zero evidence for toxicity in the scientific literature is 10,000IU per day or the “no observable adverse effect level”, Health Canada settle on 4000 as an amount which includes a large safety margin http://www.cancer.ca/Canada-wide/About%20us/Media%20centre/CW-Media%20releases/CW-2007/Canadian%20Cancer%20Society%20Announces%20Vitamin%20D%20Recommendation.aspx?sc_lang=en
  • The Western diet is one of excess: too much sugar, refined fats, refined carbohydrates, too much red and processed meats, and calories and therefore tends to be too low in fibre, fruit, and vegetables A plant based diet is the best anti-cancer diet – aim to have 2/3 or so of your intake based on whole fruits & vegetables, whole grains, nuts & seeds, rounding out with proteins (either animal or plant-based) Aim for a minimum of 7 servings of fruit & vegetables per day Include those fruits & vegetables that seem to be more anti-cancer, get some of the crucifers raw etc, follow the guidelines in this presentation Strive to have healthy fats like olive, avocado, and increase your intake of omega-3 fast (fish & seafood if you eat them, and plant based, consider a vegetarian DHA supplement if vegetarian) The goal is to use this knowledge to make important changes to your lifestyle and the foods you eat No food, in and of itself, is a miracle food – healthier food choices are tools in a tool box of overall healthy choices Pulses is the current and technically correct word for ‘legumes’ and include: chickpeas, lentils, beans and peas
  • I hope that you are feeling empowered by this presentation Make 1 new change a week and keep that change and the next week make a new one This is the recipe for long-term success One cancer battle is over, but another is just beginning
  • Reducing your risk for cancer with diet & one important supplement

    1. 1. Anti-Cancer Foods Reducing your risk for cancer with diet & supplements Doug Cook, RD MHSc Registered Dietitian/Nutritionist www.dougcookrd.com
    2. 2. Introduction <ul><li>Lifestyle: healthy diet, regular physical activity, & a healthy body weight can lower your risk of cancer. </li></ul><ul><li>Healthy eating can reduce risk by 30-40%. </li></ul><ul><li>Healthy eating + not-smoking + healthy body weight + regular exercise can decrease total risk by 60-70%. </li></ul><ul><li>This presentation will highlight some of the more promising foods & supplements that may reduce your risk. </li></ul><ul><li>Physical activity & healthy body weight will be discussed. </li></ul>
    3. 3. Let thy food be thy medicine and thy medicine be thy food Hippocrates (460-377BC)
    4. 4. Diet helps by <ul><li>Boosting the immune system </li></ul><ul><ul><li>White blood cells etc. need nutrients to work well </li></ul></ul><ul><li>Preventing ‘angiogenesis’ </li></ul><ul><ul><li>The formation of new blood vessels that tumours need to obtain nutrients </li></ul></ul><ul><li>Stimulates the body’s detoxification system </li></ul><ul><ul><li>Dietary compounds aid the liver in it’s function </li></ul></ul><ul><li>Regulates ‘apoptosis’ </li></ul><ul><ul><li>Cells normally ‘self destruct’ if not working properly, apoptosis helps to keep cancer cells from growing out of control </li></ul></ul><ul><li>Reduces inflammation </li></ul><ul><ul><li>A source of free radicals; damages cells/DNA </li></ul></ul>
    5. 5. Diet helps at all stages of cancer development
    6. 6. Crucifers <ul><li>Cabbage, broccoli*, turnip & bok choy </li></ul><ul><li>Cauliflower & Brussels sprouts* </li></ul><ul><li>Radish & watercress </li></ul><ul><li>Kale & collard greens </li></ul><ul><ul><li>* these vegetables are especially rich in the anti-cancer compounds </li></ul></ul>
    7. 7. Crucifers <ul><li>Benefits </li></ul><ul><ul><li>These vegetables contain the largest variety of anti-cancer phyto-nutrients </li></ul></ul><ul><ul><ul><li>Sulforaphane, indole-3-carbinol [over 100 different kinds] </li></ul></ul></ul><ul><ul><li>The phyto-nutrients help the liver to flush toxins out of the body </li></ul></ul><ul><ul><li>Shown to interfere with all stages of cancer development </li></ul></ul><ul><ul><ul><li>Initiation, promotion & progression </li></ul></ul></ul><ul><ul><li>Sulforaphane helps to stimulate ‘apoptosis’ or cell death </li></ul></ul><ul><ul><ul><li>This helps to keep cancer cells from growing out of control </li></ul></ul></ul>
    8. 8. Crucifers <ul><li>Caveats </li></ul><ul><ul><li>The anti-cancer phyto-nutrients in crucifers are easily destroyed </li></ul></ul><ul><ul><ul><li>Water-soluble & heat sensitive </li></ul></ul></ul><ul><ul><ul><li>Cook in minimal water </li></ul></ul></ul><ul><ul><ul><li>Use short cooking times </li></ul></ul></ul><ul><ul><ul><ul><li>Steam/stir-fry </li></ul></ul></ul></ul><ul><ul><li>Include several raw choices per week </li></ul></ul><ul><ul><li>Frozen better than none at all </li></ul></ul><ul><li>How much? </li></ul><ul><ul><li>Eat several servings per week </li></ul></ul><ul><ul><ul><li>One serving = ½ cup </li></ul></ul></ul>
    9. 9. Allium Family <ul><li>Onions, leeks </li></ul><ul><li>Shallots, chives & garlic </li></ul><ul><li>Benefits </li></ul><ul><ul><li>Sulfur-containing phyto-nutrients </li></ul></ul><ul><ul><li>Help the liver to flush toxins out of the body and prevent activation of carcinogenesis </li></ul></ul><ul><ul><li>Garlic appears to stimulate ‘apoptosis’, just like crucifers can </li></ul></ul>
    10. 10. Allium Family <ul><li>For onions, leeks, shallots & chives </li></ul><ul><ul><li>Not heat sensitive [like crucifers are] </li></ul></ul><ul><ul><li>Cooking them doesn’t diminish their anti-cancer properties </li></ul></ul><ul><li>Garlic </li></ul><ul><ul><li>Freshly crushed/minced has the most anti-cancer benefits </li></ul></ul><ul><ul><ul><li>Let it sit for 5 minutes before eating </li></ul></ul></ul><ul><li>How much? </li></ul><ul><ul><li>100g/3.5oz (~ ½ cup) of allium vegetables per day [ambitious!] </li></ul></ul>
    11. 11. Soy <ul><li>Soybeans (edamame), miso, roasted soybeans, tofu, tempeh, soy beverage </li></ul><ul><ul><li>Made from 100% whole soy food [not analogues!] </li></ul></ul><ul><li>Benefits </li></ul><ul><ul><li>Bind to cells that estrogen normally does thereby blocking the body’s estrogen </li></ul></ul><ul><ul><li>Reduces inflammation </li></ul></ul><ul><ul><li>Inhibits new blood vessel formation </li></ul></ul><ul><ul><ul><li>Starves micro tumours </li></ul></ul></ul><ul><ul><li> production of sex-hormone binding globulin </li></ul></ul><ul><ul><ul><li>Lowers estrogen levels </li></ul></ul></ul><ul><ul><li>Inhibits the enzyme aromatase </li></ul></ul><ul><ul><ul><li>Lowers estrogen levels </li></ul></ul></ul>
    12. 12. Whole Versus Processed Soy Foods <ul><li>Choose Whole Foods </li></ul><ul><li>Soy beans </li></ul><ul><li>Tofu </li></ul><ul><li>Tempeh </li></ul><ul><li>Plain Soy beverage </li></ul><ul><ul><li>‘ whole soy beans’ </li></ul></ul><ul><li>Miso </li></ul><ul><li>Miso soup </li></ul><ul><li>Organic, fermented, whole soy protein powder </li></ul><ul><li>Why? </li></ul><ul><li>Contains isoflavone and other ingredients in natural proportion </li></ul><ul><li>Avoid Processed Foods </li></ul><ul><li>Sports bars </li></ul><ul><li>Veggie dogs </li></ul><ul><li>Veggie bacon </li></ul><ul><li>Veggie burgers </li></ul><ul><li>Flavoured (sweetened) Soy beverage </li></ul><ul><li>Why? </li></ul><ul><li>Isoflavone content not as high/refined food </li></ul><ul><li>Like other processed foods, can contain less healthy ingredients </li></ul>
    13. 13. These are not whole soy foods! <ul><li>Processed (non-whole food) soy products </li></ul>
    14. 14. Soy <ul><li>How much? </li></ul><ul><ul><li>Eat traditional whole soy foods in amounts that provide about 25mg isoflavones per day </li></ul></ul><ul><ul><ul><li>Only requires small amounts , it’s not about going over-board </li></ul></ul></ul><ul><ul><ul><li>Soy is not goitrogenic if diet contains enough iodine </li></ul></ul></ul><ul><ul><ul><li>The amount research has found to reduce risk </li></ul></ul></ul><ul><ul><li>Isoflavone supplements </li></ul></ul><ul><ul><ul><li>Negative results </li></ul></ul></ul><ul><ul><ul><li>AVOID these supplements </li></ul></ul></ul>
    15. 15. Isoflavone Content of Foods Made from Soybeans Food Isoflavones (mg/100g) Soy flour 199 (1.2 cups) Dry roasted soybeans 128 (1/2 cup) Boiled green soybeans (edamame) 55 (1/2 cup) Miso 43 (1/3 cup) Tofu 28 (1/3 cup) Soy beverage 9 (1/2 cup) Tofu dog 3 (2.5 dogs) Soy sauce 1.7 Chickpeas 0.1 Soy oil 0
    16. 16. Turmeric <ul><li>Staple of India’s daily diet </li></ul><ul><ul><li>People from India consume 1.5 to 2 g per day </li></ul></ul><ul><li>Curry </li></ul><ul><ul><li>A mixture of spices (coriander, cumin, cardamom, fenugreek, red, black and cayenne pepper and 20-30% turmeric) </li></ul></ul><ul><ul><li>Amount of turmeric in curries can vary a lot </li></ul></ul><ul><ul><ul><li>Best to include extra turmeric in your diet as well </li></ul></ul></ul>
    17. 17. Turmeric <ul><li>Benefits </li></ul><ul><li>Curcumin </li></ul><ul><ul><li>Active ingredient in turmeric </li></ul></ul><ul><ul><li>Black pepper increases absorption </li></ul></ul><ul><ul><li>Potent anti-inflammatory and anti-oxidant properties </li></ul></ul><ul><ul><ul><li>Most likely anti-cancer at gene level too </li></ul></ul></ul><ul><li>How Much? </li></ul><ul><ul><li>Aim to get ½ to 1 teaspoon per day </li></ul></ul><ul><ul><li>Add to chicken, egg, or tuna salad, sprinkle of salads or in sandwiches, melt into olive oil or butter and drizzle over steamed vegetables, stir into soups and stews </li></ul></ul>
    18. 18. Green Tea <ul><li>Staple of Asian countries </li></ul><ul><ul><li>Loose leaf, tea bags, matcha </li></ul></ul><ul><li>Benefits </li></ul><ul><li>Contains flavanols [catechins], a type of polyphenol </li></ul><ul><ul><li>EGCG: “‘epigallocatechin gallate’ </li></ul></ul><ul><ul><ul><li>Main catechin of interest with anti-cancer activity </li></ul></ul></ul><ul><ul><li>Strong anti-angiogenesis potential </li></ul></ul><ul><ul><ul><li>Starves micro tumours </li></ul></ul></ul><ul><ul><li>Inhibits cell growth </li></ul></ul><ul><ul><li>Reducing inflammation </li></ul></ul><ul><ul><li>Enhance immunity </li></ul></ul>
    19. 19. Green Tea <ul><li>EGCG - caveat </li></ul><ul><ul><li>Content varies </li></ul></ul><ul><ul><ul><li>Area of cultivation </li></ul></ul></ul><ul><ul><ul><li>Diversity of plants </li></ul></ul></ul><ul><ul><ul><li>Harvest season </li></ul></ul></ul><ul><ul><ul><li>Processing techniques </li></ul></ul></ul><ul><ul><ul><li>** brewing time: </li></ul></ul></ul><ul><ul><ul><ul><li><5mins (20% EGCG extracted) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>≥ 8-10mins (100% EGCG extracted) </li></ul></ul></ul></ul><ul><ul><li>Japanese more than Chinese </li></ul></ul><ul><li>How much? </li></ul><ul><ul><li>As little as 3 cups per day </li></ul></ul>
    20. 20. Citrus <ul><li>Lemons & oranges </li></ul><ul><li>Grapefruit </li></ul><ul><li>Mandarins, tangerines & Clementines </li></ul><ul><li>Lime is a different species </li></ul><ul><ul><li>Doesn’t count in this example with respect to cancer risk reduction </li></ul></ul>
    21. 21. Citrus <ul><li>Benefits </li></ul><ul><li>Contains the phytochemicals ‘bioflavonoids’ </li></ul><ul><ul><li>Terpenes, hisperidin, quercetin </li></ul></ul><ul><ul><li>Preserves blood vessel integrity </li></ul></ul><ul><ul><li>Anti-inflammatory </li></ul></ul><ul><ul><li>Enhances detoxification of carcinogens </li></ul></ul><ul><ul><ul><li>May help to keep concentration of other dietary anti-cancer compounds elevated in the body for longer periods of time </li></ul></ul></ul><ul><ul><ul><ul><li>Enhancing those compounds </li></ul></ul></ul></ul>
    22. 22. Citrus <ul><li>Whole fruit is best </li></ul><ul><ul><li>Great source of bioflavonoids </li></ul></ul><ul><ul><li>Bioflavonoids are highly concentrated between rind & flesh </li></ul></ul><ul><ul><ul><ul><li>‘ pith’ or the white stuff </li></ul></ul></ul></ul><ul><li>How much? </li></ul><ul><ul><li>Several servings per week </li></ul></ul><ul><ul><li>Be sure to eat as much of the pith as you can stand! </li></ul></ul>
    23. 23. Omega-3 fat <ul><li>Polyunsaturated fat </li></ul><ul><li>Omega-6 – linoleic acid </li></ul><ul><ul><li>Chicken, safflower, corn, sunflower, hemp, soybean, and grapeseed, wheat germ & walnut oil </li></ul></ul><ul><ul><ul><li>We eat an excess of these, best to avoid these oils </li></ul></ul></ul><ul><li>Omega-3 - Alpha linolenic acid (ALA) </li></ul><ul><ul><li>Flaxseed, chia/salba, soy, walnuts, canola oil </li></ul></ul><ul><li>Omega-3 - EPA/DHA </li></ul><ul><ul><li>Fish & seafood (sardines, mackerel, salmon, trout) </li></ul></ul><ul><ul><li>Omega-3 fortified eggs </li></ul></ul><ul><ul><ul><ul><li>Liquid and shelled </li></ul></ul></ul></ul>
    24. 24. Omega-3 fat <ul><li>Omega-3 fats from fish, seafood & fortified egg products </li></ul><ul><li>Benefits </li></ul><ul><ul><li>Decrease inflammation which disturbs immunity </li></ul></ul><ul><ul><ul><li>Unlike excess omega-6 fats, they promote inflammation </li></ul></ul></ul><ul><ul><li>Induces apoptosis </li></ul></ul><ul><ul><ul><li>Keep cancer cells from reproducing </li></ul></ul></ul><ul><ul><li>Prevents angiogenesis </li></ul></ul><ul><ul><ul><li>Starves cancer cells from access to new blood vessels </li></ul></ul></ul><ul><ul><ul><ul><li>Helps to prevent cancer cells from getting nutrients </li></ul></ul></ul></ul>
    25. 25. Omega-3 fat <ul><li>Most North Americans don’t get enough EPA/DHA </li></ul><ul><ul><li>Eat fatty fish 2 to 3 times per week </li></ul></ul><ul><ul><li>Include omega-3 eggs </li></ul></ul><ul><ul><ul><li>Shelled and/or liquid </li></ul></ul></ul><ul><ul><li>Consider a supplement </li></ul></ul><ul><ul><ul><li>Fish, squid or algae oil </li></ul></ul></ul><ul><li>ALA </li></ul><ul><ul><li>We get enough </li></ul></ul><ul><ul><li>Continue to use small amounts of freshly ground flax/chia seed, other nuts & seeds, soy </li></ul></ul>
    26. 26. Chocolate <ul><li>Polyphenols </li></ul><ul><ul><li>50g of 70% dark chocolate has 2x the polyphenol content of a glass of red wine and as much as a cup of green tea </li></ul></ul><ul><ul><li>Potent antioxidant activity </li></ul></ul><ul><li>Benefit in cardiovascular disease </li></ul><ul><ul><li>Reduces blood pressure, increases blood flow, prevents LDL cholesterol from oxidation </li></ul></ul><ul><li>Preliminary anti-cancer benefits </li></ul><ul><ul><li>Early research: inhibits cancer cell growth by stimulating angiogenesis </li></ul></ul><ul><ul><ul><li>Starves cancer cells & micro tumours </li></ul></ul></ul>
    27. 27. Chocolate <ul><li>How much? </li></ul><ul><ul><li>40-50g of 70% cocoa per day </li></ul></ul><ul><ul><li>80, 85 & 90% dark chocolate </li></ul></ul><ul><ul><ul><li>Need less, about 25g </li></ul></ul></ul><ul><li>Raw cocoa powder </li></ul><ul><ul><li>Not “Dutched” or alkalized </li></ul></ul><ul><ul><li>1 tablespoon per day </li></ul></ul><ul><li>Raw cocoa nibs </li></ul><ul><ul><li>4 teaspoons per day </li></ul></ul><ul><li>Limit milk chocolate </li></ul><ul><li>White ‘chocolate’ is not chocolate </li></ul>
    28. 28. Honourable mentions <ul><li>Berries </li></ul><ul><ul><li>polyphenols </li></ul></ul><ul><ul><ul><li>ellagic acid, anthocyanidins, proanthocyanidins </li></ul></ul></ul><ul><li>Carrots </li></ul><ul><ul><li>falcarinol </li></ul></ul><ul><li>Ground flax </li></ul><ul><ul><li>lignans </li></ul></ul><ul><li>Tomato products </li></ul><ul><ul><li>Lycopene, other compounds </li></ul></ul><ul><li>Brazil nuts </li></ul><ul><ul><li>selenium </li></ul></ul><ul><li>Mushrooms </li></ul><ul><ul><li>beta-glucan, lentinan, ergothioneine </li></ul></ul><ul><li>Chili peppers and jalapenos </li></ul><ul><ul><li>capsaicin </li></ul></ul>
    29. 29. Vitamin D & Cancer <ul><li>Research supports its role </li></ul><ul><ul><li>Prevention </li></ul></ul><ul><ul><ul><li>Some 20+ cancers </li></ul></ul></ul><ul><ul><li>Treatment </li></ul></ul><ul><ul><ul><li>Those with higher levels at diagnosis have better prognosis </li></ul></ul></ul><ul><li>How much to take? Ideal blood level? </li></ul><ul><ul><li>Unknown - Unknown </li></ul></ul><ul><li>Best evidence </li></ul><ul><ul><li>Achieve a blood level similar to those with a more natural relationship with the sun </li></ul></ul>
    30. 30. Risk factors for vitamin D deficiency <ul><li>breast-fed infants & pregnant women </li></ul><ul><li>those who avoid all sun exposure during spring/summer including those residing in institutions (or get minimal exposure, including those who predominantly work or spend a lot of time indoors) </li></ul><ul><li>persons with heavily pigmented skin </li></ul><ul><li>persons who wear concealing clothing (for religious reasons or ‘office clothes’ or who do not regularly wear shorts, short-sleeved shirts or sleeveless shirts) during the late spring/summer </li></ul><ul><li>obese persons (due to the sequestering of vitamin D in excess adipose tissue) </li></ul><ul><li>persons with medical conditions causing fat malabsorption </li></ul><ul><li>persons who do not consume foods rich in vitamin D </li></ul><ul><li>adults over 50 years due to decreased production of cholecalciferol by the skin and due to decreased production of calcidiol by the liver </li></ul>
    31. 31. Vitamin D levels To convert nmol/L to ng/L, ÷ by 2.5 Situation Vitamin D blood level nmol/L Puerto Rican farmers / hospital workers 125 / 85 Heavily pigmented indigenous peoples (Africa & Australia etc) 100 - 125 Toronto lifeguards 125 - 150 Canadians – end of winter 30 – 55 Level found to reduce cancer: RCT study 96 Level associated with rickets 25 2000IU per day supplement 50 - 75 4000-5000IU per day 100 - 120 Level suggested by experts 100 - 150
    32. 32. a Canadian sources unless otherwise indicated. b Vitamin D 2 (ergocalciferol) is a less potent form of the vitamin found in certain plants and fungi. Source Serving Vitamin D content Fortified foods Milk (cow, goat) 1 cup ~ 100 IU vitamin D 3 Margarine 1 tsp ~ 30 IU vitamin D 3 Yogurt (selected brands) ½ cup ~ 30 IU vitamin D 3 Orange juice/soy/almond beverage (calcium-fortified) 1 cup ~ 100 IU vitamin D 3 Natural foods Salmon 3 oz ~ 500 – 800 IU vitamin D 3 Sardines, mackerel, tuna 3 oz ~ 200 - 250 IU vitamin D 3 Shiitake mushrooms 3.5 oz ~ 100IU vitamin D 2 b Egg yolk 1 large ~ 20 IU vitamin D 3 Supplements Prescription 1 capsule 50,000 IU vitamin D 2 Multivitamins 1 capsule 400 - 1000 IU vitamin D 3 Vitamin D 1 capsule 400 - 1000 IU vitamin D 3 Cod liver oil 1 tsp ~ 400 - 1000 IU vitamin D 3 Sunlight exposure [times are for fair complexions] Arms + legs Full body exposure 5-10 min 15-30 min ~ 3000 IU vitamin D 3 ~ 10,000-15,000 IU vitamin D 3
    33. 33. Vitamin D <ul><li>Canadians </li></ul><ul><ul><li>Among those at the highest risk for deficiencies </li></ul></ul>43 degrees latitude <ul><li>43 degrees latitude – unable to make any vitamin D from mid-October to mid-April, due to low levels of UVB rays </li></ul><ul><li>actually longer since no one is wearing shorts and t-shirts until June or so… </li></ul>
    34. 34. Vitamin D <ul><li>Current recommendations from the Canadian Cancer Society (June 2007): </li></ul><ul><ul><li>Adults living in Canada should consider taking 1,000 IU a day during the fall and winter </li></ul></ul><ul><ul><li>Adults at higher risk of having lower Vitamin D levels should consider taking it year round </li></ul></ul><ul><ul><li>**this amount was simply half the original Upper Intake Level of 2000 IU </li></ul></ul><ul><li>Institute of Medicine & Health Canada (Nov, 2010): </li></ul><ul><ul><li>No Observable Adverse Effect Level 10,000IU/day </li></ul></ul><ul><ul><ul><li>The amount where no adverse effects have been seen </li></ul></ul></ul><ul><ul><li>Doubled the Upper Intake Level to 4000IU/day </li></ul></ul><ul><ul><ul><li>Includes a large safety margin </li></ul></ul></ul>
    35. 35. Vitamin D <ul><li>It’s has a lot of promise in reducing many chronic diseases including many cancers </li></ul><ul><li>It’s inexpensive </li></ul><ul><li>It’s safe </li></ul><ul><li>You have nothing to lose and everything to gain </li></ul><ul><li>Talk to your doctor if you’d like a blood test </li></ul>
    36. 36. THE SPACE ON YOUR PLATE <ul><li>Protein: </li></ul><ul><li>Chicken </li></ul><ul><li>Fish </li></ul><ul><li>Beef </li></ul><ul><li>Pork </li></ul><ul><li>Turkey </li></ul><ul><li>Lamb </li></ul><ul><li>Egg </li></ul><ul><li>Grains: </li></ul><ul><li>Rice </li></ul><ul><li>Pasta </li></ul><ul><li>Barley </li></ul><ul><li>Potato </li></ul><ul><li>Millet </li></ul><ul><li>Kamut </li></ul><ul><li>Couscous </li></ul><ul><li>Pulses [chickpeas, lentils, beans & peas] </li></ul>Starch-rich carbohydrates Fresh/frozen lower-starch vegetables Proteins <ul><li>Fats: </li></ul><ul><li>unsalted butter </li></ul><ul><li>olive oil </li></ul><ul><li>avocado oil </li></ul><ul><li>macadamia nut oil </li></ul><ul><li>sesame oil </li></ul>Model your plate after this!
    37. 37. Take-Home Messages <ul><li>Individual lifestyle choices play a major role in reducing cancer risk </li></ul><ul><li>About one-third of all cancers are directly related to diet and exercise </li></ul><ul><li>Enjoy a diet rich in minimally processed whole foods, that includes fruits & vegetables and just enough calories to avoid weight gain </li></ul><ul><li>Consider working with a Registered Dietitian </li></ul>Doug Cook RD MHSc www.dougcookrd.com 416-413-9095

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