Cancer & Nutrition
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  • 1. Using food as your medicine By Jo Gamble BA (hons) Dip CNM MFNTP MBANT
  • 2. Let food be your medicine and medicine be your food Hippocrates
  • 3. The need for action• As a cause of death in the developed world, cancer is only surpassed by cardiovascular disease• Globally the number of people with cancer is projected to double by 2030• Currently, more than one in 3 people will develop cancer in their lives!(WCRF 1997, WCRF 2007, NS 2008)
  • 4. Understanding Cancer• Before understanding the impact of nutrition on cancer, it is first important to understand the biochemical and physiological determinants of the disease.• Cancers are as a result of the interaction of genetics, epigenetics and environment of the individual.• Cancer is a chronic disease
  • 5. What is cancer?• Healthy cells: balance between growth and programmed cell death is tightly regulated Cancer cells are cells that grow and divide at an unregulated pace.
  • 6. Environmental and chemical carcinogens• People are continuously exposed exogenously to varying amounts of chemicals that have been shown to have carcinogenic or mutagenic properties.• In the case of a solid tumour there is a 20-40 year interval from the time of exposure of an individual to a chemical or viral carcinogen until the clinical detection of a tumour.• By the time a tumour is apparent, cancer cells have aquired the ability to divide where normal cells ought not, to invade adjacent cellular architectures, to metastasize and to kill the host.
  • 7. Cancer is a preventable disease• Only 5-10 % of all cancer cases can be attributed to genetic defects, whereas the remaining 90- 95% have their roots in the environment and lifestyle.• The lifestyle factors include smoking, diet, alcohol, obesity, infectious agents, environmental pollutants and radiation• Of all cancer-related deaths; 25-30% are due to tobacco, 30-35% diet, 15-20% infections, 10-20% obesity, 4-6% alcohol, 10-15% others, which includes environmental and radiation.
  • 8. Good news we are in controlWorld Cancer Research Fund: high fruit and vegetable intake may reduce cancer incidence by 40- 64 % US National Research Council: high fruit and vegetable intake may reduce US cancer rates and mortality by 1/3, roughly equivalent to the reduction in mortality from infectious diseases brought about by improved hygiene and better healthcare during the 19th century In the November 2010 issue of Nutrition and cancer, a study indicated that women who consumed a greater amount of vegetables and seafood were 86% less likely to be diagnosed with breast cancer
  • 9. Good news we are in control• Newest Research: through good nutrition we can also improve survival rates of people with some cancers by calming down the genes responsible for cancer growth!(Ornish et al. 2005, Ornish et al. 2008, Saxe et al. 2006)
  • 10. Support goalsPrimary goals• Support tumourcidal effects of treatment• Reduce side effects of treatments• Support overall wellnessSecondary goals• Support immunity• Reduce tumour promoting factors• Inhibit metastasis and tumour progression• Promote appropriate apoptosis
  • 11. How diet can affect cancer
  • 12. Initiation-dietary carcinogens- aflatoxins (found in mouldy food)- heterocyclic amines (meat cooked at very high temperatures)- N-nitroso compounds (in some spoiled foods, protein foods,cured meat)- polycyclic aromatic hydrocarbons (PAH) (products of combustionfound in cooked foods, smoked foods and dark beer)these chemicals can start a cancer process by creating cancer cells(World Cancer Research Fund 1997; NRC 1982)
  • 13. Diet-red meat• Heavy consumption of red meat is a risk factor for several cancers, especially those of the gastrointestinal tract, but also for colorectal, prostate, bladder, breast, gastric, pancreatic and oral cancers.• The hetrocyclic amines produced during the cooking of meat are carcinognic. Charcoal cooking and/or smoke curing of meat produces harmful carbon compounds such as pyrolysates and amino acids which have a strong cancerous effect. Anand P et al, Cancer is a preventable disease that requires major lifestyle changes. 2008
  • 14. Diet: Fats and sugars• Saturated fatty acids, trans fatty acids and refined sugars and flour present in most foods have also been associated with various cancers (1)• Epidemiologic studies suggested a positive association between dietary fat and colon cancer. (2)• Frequent consumption of sugar and high-sugar foods may increase the risk of pancreatic cancer by inducing frequent postprandial hyperglycemia, increasing insulin demand, and decreasing insulin sensitivity. (3) (1) Anand P et al, Cancer is a preventable disease that requires major lifestyle changes. 2008 (2) Reddy, B Dietary Fat & Colon cancer. Chemistry & material science vol 27 no 10 807-813 (3) American Journal of Clinical Nutrition Vol 84 No 5 1171-1176 Nov 06
  • 15. Dietary Tumour Promoters: --excess fat - ↑ insulin, ↑ estrogens, ↑ oxidative stress, ↑ inflammation-excess protein -↑ insulin, ↑ IGF-1,-excess calories- ↑ insulin, ↑ IGF-1, ↑ oxidative stress, ↑ inflammation- excess Omega 6 EFA- ↑ oxidative stress, ↑ inflammation (Becci et al, 1979; Wood et al, 1983; Newberne and Rogers, 1986; Poirier et al, 1986;Kritchevsky and Klurfeld, 1987; Pariza, 1987; Sawada et al, 1990; Birt et al, 1992; Newmark andLipkin, 1992; Wattenberg, 1992; Yuspa, 1994; Heber et al. 2006 ) © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM
  • 16. Metabolic Tumour Promoters: -- insulin- promotes cancer cell proliferation and decreasesapoptosis- estrogens- induces cancer cell proliferation- oxidative stress- can act as cancer initiator and promoter- inflammation- strong association between chronic inflammationand cancer (mechanisms: promoting proliferation of cancer cells,formation of cancer blood vessels?-not entirely understood)- IGF-1- potent growth factor for many cancer lines(Heber et al 2006) © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM
  • 17. AlcoholColon Cancer Risk-increases by 10% if you drink 1glass of wine dailyColon Cancer Risk-increases by 25% if you drink 2glasses of wine or 1 pint of beer dailyDrinking as little as one pint of beer or one large glass of wine a dayincreases risk of breast cancer by more than 7%.Mouth, Oesophagus, Larynx, Throat Cancer-↑ 168% risk with 1 glass ofwine/d(World Cancer Research Fund 2007; Riboli et al 2002; American Cancer Society 2007; CancerResearch UK 2009a)
  • 18. Obesity/Excess Body Fat and Cancer
  • 19. Increase in Risk Cancer Associated with Obesity (Source: National Cancer Policy Board 2003; Pan et al 2004)Convincing Evidence Colon, Prostate, Breast Endometrial, Kidney, Esophageal Ovary, Non-Hodgkin’s Lymphoma, Leukemia, Multiple myeloma , Pancreas, Oesophagus ,Possible Gallbladder
  • 20. Dairy and Cancer-Possible Mechanisms   consumption of milk increases blood levels of IGF-1, which has been associated with increased prostate and breast cancer risk(Chan et al. 1998)
  • 21. Tumour Anti- Promoters:-folic acid (reducing likelihood of DNA damage)-antioxidants (preventing oxidative damage and lipid peroxidation, whichcompound DNA damage in tumor promotion)-phytochemicals (various mechanisms)- low-fat plant-based diet (various mechanisms, see above)(World Cancer Resarch Fund 1997, Wattenberg 1985) © CNM; by Gosia Desmond MA, MBS, BSc © Gosia Desmond MA, MBS, BSc Nut Med Nut Med Jo Gamble BA (hons) Dip CNM
  • 22. Promotion-Protectionlow fat; high fibre estrogens;adequate protein Insulin growth factors (IGF-1)adequate calories inflammationwhole plant foods downregulation of oncogenes upregulation of tumourO6: O3 ratio 2:1 suppressor genesPhysical activity © CNM; by Gosia Desmond MA, MBS, BSc(World Cancer Research Fund 2007; Heber 2006; Ornish et alCNM Nut Med Jo Gamble BA (hons) Dip 2008; Saxe 2006)
  • 23. promote synthesis of detoxification enzymes antioxidants Phytonutrients act as immune antiproliferative stimulants angiogenesis agents inhibitors(Omenn 1995; Talalay et al 1995; Wattenberg 1970; Engwerda et al 2001; Zawa and Duve 1997; Fotsiset al 1993)
  • 24. Phytonutrients• new evidence: official guidelines –’5 a day’ is not enough!!!• US National Cancer Institute: five is just the bare minimum.• men-at least 9 servings• women –at least 7 servings• children-at least 5 servings
  • 25. Phytonutrients –Flavonoids:-onions-kale-grape-citrus fruit-apple-pear-powerful inhibitors of many cancers includinghuman breast cancer cells(So et al 1996; Guthrie and Carroll 1998)
  • 26. Phytonutrients –Flavonoids:broccoli,brussel sprouts,cabbage,cauliflower,Chinese cabbage,cress,daikon,kalekohlrabiturnippotent carcinogen detoxifiers –inducers of detoxification enzymes(Zhang and Callaway 2002)
  • 27. Other anti-cancer nutrients:Other anticancer substances:-sulphur compounds of garlic (tumour growth inhibition;cancer formation inhibition)-folic acid (fruits and vegetables; DNA protection)-beta sitosterol (fruits and vegetables; tumour growthinhibition)(Fleischauer and Arab 2001; Awad et al 1996; Duthie 1999)
  • 28. Low Fat Vegan Diet Full of Unprocessed Plants promotes synthesis of lowers estrogens detoxification enzymes full of antioxidants lowers AGE, Low fat plant oxidative damageminimizes based dietcarcinogen exposure stimulates lowers IGF-1 immune lowers insulin response creates powerful low in Omega 6 anti-cancer environment
  • 29. Balancing Your PlateDivide your plate into 3 sections: 50% is vegetables, salad 25% is mixed whole grains or starch 25% is protein source – poultry, fish, beans, soy products Whole grains Veggies Protein
  • 30. Lifestyle Change is a JourneyIt takes 45 days to change a habitor incorporate a new one 5 10 15 20 25 30 35 40 45Live your life as if your health depends on it…because it does!
  • 31. What are the main components of a wellness diet?• Water 2 liters of hydrating fluid daily• Well balanced macro nutrients throughout the day• High levels of micro nutrients• Avoidance of anti-nutrients
  • 32. Macro nutrients• Complex carbohydrates• Protein• Essential fats
  • 33. Complex carbohydrates• Whole meal bread• Whole meal pasta• Brown rice• Oats• Beans and lentils• Root vegetables
  • 34. Protein• Eggs• Fish• Poultry• Meat• Beans and lentils• Nuts and seeds• Tofu• Quinoa
  • 35. Essential fats• Oily fish• Nuts and seeds• Avocados• Cold pressed oils• Olives
  • 36. Anti-oxidants• Have been studied individually and collectively for their potential to enhance physical performance.• Prevent exercise induced muscle tissue damage• Fight against chronic diseases such as cancer, cardio-vascular disease, strokes
  • 37. Hydrating fluid2 litres of hydrating fluid each day: * Water * Herbal teaAvoid dehydrating fluids * tea/coffee * Alcohol * fizzy drinks
  • 38. Avoid anti-nutrients• Aspartame• Trans fats• Refined carbohydrate• Processed foods• Sugar
  • 39. "The wise man should consider that health is the greatest of human blessings. Let food be your medicine." - Hippocrates
  • 40. Jo Gamble BA (hons) Dip CNM mBANT