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Every Bite Counts!Every Bite Counts!
Nutrition Tips forNutrition Tips for
Breast and OvarianBreast and Ovarian
CancerCancer
Presented by
Ronnie Fortunato, MS, RDN
Jamie Lopez, MS, RDN
Role of nutrition
Power of plants – plant-based diet
Superfoods to prioritize
Healthy Fats
Bone Health
OutlineOutline
Diet is important during periods of
intense treatment, but also during
recovery
Lifestyle and eating choices can
help the body’s repair process
Today’s focus is on
 Nutritional needs
 Promotion of overall health
 Well-being and prevention of tumor
re-growth
Role of NutritionRole of Nutrition
 Plants have a variety of cancer fighting
properties:
 Antioxidants – vitamins and minerals
 Phytochemicals
Plant Based DietPlant Based Diet
Research shows a
diet high in plant
based foods
reduces the risk of
cancer
Plant based diets are high in fiber
which may reduce:
 Estrogen levels
 Insulin and insulin-like growth factors
Plant based diets are high in anti-
oxidants and phytochemicals which:
 Protect cells by inhibiting cancer cell
growth
Plant Based DietPlant Based Diet
Definition: “Plant Chemicals” that work
in combination with vitamins and
minerals to prevent, stop, reduce disease
 Greatest benefit: eating whole foods
 Whole foods: foods that are minimally and
simply processed
 Retain more nutrients to promote health
compared to processed foods or supplements
PhytochemicalsPhytochemicals
 Phytochemicals are often found in pigments
(or color) of fruits and vegetables
 For example:
ResveratrolResveratrol LycopeneLycopene
EatEat CCoolloorrffuull Foods!Foods!
CarotenoidsCarotenoids
More examples….
CyanidinCyanidin AllicinAllicin
EatEat CCoolloorrffuull Foods!Foods!
ApigeninApigenin
SuperfoodsSuperfoods
Superfoods
 Nutrient-rich
 Beneficial for health and well-being
 Include vegetables, fruits, whole
grains, legumes, nuts, and seeds
Cruciferous VegetablesCruciferous Vegetables
Cruciferous vegetables - kale, broccoli,
cabbage, and Brussels sprouts
Contain phytochemicals - may help
fight cancer by:
 Detoxifying carcinogens
 Stopping growth of tumor cells
 Changing the activity of estrogen
Incorporate to your diet on a regular
basis
Flax SeedsFlax Seeds
 Flaxseed - may stop tumors from forming
and growing
 Grind seeds to get all benefits
 Purchase already ground, or grind
yourself in a spice grinder
 Once ground, sprinkle onto foods like
yogurt or oatmeal
 Store whole or ground seeds in the
refrigerator or freezer for up to six
months
Research found that soy products high
in soy isoflavones do not cause breast
cancer
In post-menopausal women it may
reduce risk but more research is
needed…..
Good soy products are:
 Edamame, tofu, tempeh, miso soup
 Whole vs. Processed (“soy protein
isolates”)
Truth on SoyTruth on Soy
Fat – an important source of energy for
the body
All fats are not the same!
Which fats are most healthful?
Dietary FatsDietary Fats
Emphasize
Healthy fats
Minimize
Unhealthy fats
MonounsaturatedMonounsaturated
PolyunsaturatedPolyunsaturated
Saturated FatsSaturated Fats
Trans-fatsTrans-fats
 Monounsaturated and polyunsaturated
fats can reduce blood cholesterol
levels, lowering risk of heart disease
 Omega 3 fatty acids – anti
inflammatory!
 Reduce inflammation
 Benefit immune system
 May reduce risk of
metastatic disease
Healthy FatsHealthy Fats
 Monounsaturated
 Nuts, nut oils and nut butters; olive,
canola, safflower oil; avocado
 Polyunsaturated
 Sunflower, corn, and sesame oils
 Omega-3s
 Fatty fish like salmon, tuna, herring,
mackerel and sardines; nuts and
seeds (walnuts, flaxseed)
Healthy FatsHealthy Fats
Limit saturated fat and trans-fat
Saturated fat found mainly in animal products
Commercially baked goods contain saturated
fat and trans-fat
Less Healthy FatsLess Healthy Fats
Bone HealthBone Health
Cancer treatments, in addition to aging and
menopause, can lead to bone loss
 Increase risk of fractures and loss of independence
5 Tips for Bone Health5 Tips for Bone Health
1. Exercise on a regular basis*
 Exercise helps to strengthen bones
and reduce bone loss.
2. Eat more green vegetables
 Kale, spinach, broccoli and Brussels
sprouts are high in vitamin K,
magnesium and calcium that work
together to maintain bone health
5 Tips for Bone Health5 Tips for Bone Health
3. Eat enough protein-rich foods
 Protein builds, repairs, and replaces body tissue
 Meat, fish, soy and beans are all excellent sources
of protein
 Eggs and dairy – high in protein and have the
added benefit of calcium and vitamin D
5 Tips for Bone Health5 Tips for Bone Health
4. Maintain healthy body weight
 Carrying excess body weight puts extra stress on
your bones
 If you’re overweight, make healthy weight loss a
priority by exercising and following a balanced diet
5 Tips for Bone Health5 Tips for Bone Health
5. Spend time in the sun
 Your body makes vitamin D from the sun’s
ultra-violet rays
 During the summer months, 10-15 minutes of
sun exposure at least 3 times a week without
sunscreen is adequate
Good Food Sources of
Vitamin D:
Egg yolk
Mushrooms
Fish
Fortified milk
Physical activity is key to a healthy
lifestyle!
Recommend 150 minutes per week
 30 min/ 5 days week
Physical ActivityPhysical Activity
TYPES OF EXERCISE
Aerobic exercise: Walking, running, cycling, dancing, or swimming.
Promotes fat loss, proper blood circulation, and strengthens the heart
Resistance exercise: Calisthenics, yoga, resistance bands or weights.
Helps to build muscle mass to restore strength and balance.
Stretching: Increases flexibility and prevents injury. Should be done
before (as a warm-up) and after exercise (cool down).
The two most important changes that you can
make to reduce your risk are:
Eating 5-7 servings of
fruits and vegetables
per day
Getting regular
physical activity
30 minutes, 5 days
per week
Preventing ReoccurrencesPreventing Reoccurrences
Increase physical activity
Increase fruits and vegetables
Stick with a plant based diet
 Include Omega 3 fatty acids found
in fish
Avoid weight gain after treatment
Stop smoking
Reduce alcohol consumption
ConclusionConclusion
Every Bite CountsEvery Bite Counts
To order please contact the
Nutrition Services Department at:
Email nutrition@glwd.org or call 212.294.8103
Questions?Questions?
 Word Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Report: Diet,
Nutrition, Physical Activity and Breas Cancer. 2017.
 Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W. Soy food intake and breast cancer survival. JAMA. 2009 Dec 9;
302(22):2437-43.
 Tuso P.J. Ismail M.H, Ha B.P., Cartolotto C.B. Nutritional Update for Physicians: Plant-Based Diets. Perm J. 2013 Spring;
17(2): 61-66
 Link L.B, Canchola A.J., Bernstein L., Clarke C.A., Stram D.O., Ursin G., Horn-Ross P.L. Dietary patterns and breast cancer
risk in the California Teachers Study cohort.
 Nahum A., Hirsch K., Danilenko M., Watts CK., Prall O.W., Levy J., Sharoni Y. Lycopene inhibition of cell cycle progression
in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kip1) in the
cyclin E-cdk2 complexes. Oncogene. 2001 Jun 7; 20(26):3428-36.
 Hu W., Khor T.O., Shu L., Su Z., Fuentes F., Lee J.H., Kong A.N.T. Plants Against Cancer: A Review on Natural
Phytochemicals in Preventing and Treating Cancers and Their Druggability. Anticancer Agents Med Chem. 2012 Dec;
12(10): 1281-1305
 Khankari N.K., Bradshaw P.T., Steck S.E. Dietary Intake of Fish, Polyunsaturated Fatty Acids, and Survival After Breast
Cancer: A Population-Based Follow-Up Study on Long Island, New York. Cancer. 2015 Jul 1: 121(13): 2244-2252.
 Patterson R.E, Flatt S.W, Newman V.A, Natarajan L, Rock C.L, Thomson C.A, Caan B.J, Parker B.A, Pierce J.P. Marine Fatty
Acid Intake Is Associated with Breast Cancer Prognosis. J. Nutr. 2011: 141: 201-206.
 Hamer J, Warner E. Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall
health. CMAJ 2017 Feb 21;189:E268-74.
 Lahart I.M, Metsios G.S, Nevill A.M, Carmichael A.R. Physical activity, risk of death and recurrence in breast cancer
survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica. 54:5, 635-654.
 Lahart I.M, Metsios G.S, Nevill A.M, Carmichael A.R. Diet and Breast Cancer Prognosis: Making Sense of the WHEL and
WINS Trials. Curr Opin Obstet Gynecol. 2009 Feb; 21(1): 86-91.
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Every Bite Counts! Nutrition Tips for Breast and Ovarian Cancer

  • 1. Every Bite Counts!Every Bite Counts! Nutrition Tips forNutrition Tips for Breast and OvarianBreast and Ovarian CancerCancer Presented by Ronnie Fortunato, MS, RDN Jamie Lopez, MS, RDN
  • 2. Role of nutrition Power of plants – plant-based diet Superfoods to prioritize Healthy Fats Bone Health OutlineOutline
  • 3. Diet is important during periods of intense treatment, but also during recovery Lifestyle and eating choices can help the body’s repair process Today’s focus is on  Nutritional needs  Promotion of overall health  Well-being and prevention of tumor re-growth Role of NutritionRole of Nutrition
  • 4.  Plants have a variety of cancer fighting properties:  Antioxidants – vitamins and minerals  Phytochemicals Plant Based DietPlant Based Diet Research shows a diet high in plant based foods reduces the risk of cancer
  • 5. Plant based diets are high in fiber which may reduce:  Estrogen levels  Insulin and insulin-like growth factors Plant based diets are high in anti- oxidants and phytochemicals which:  Protect cells by inhibiting cancer cell growth Plant Based DietPlant Based Diet
  • 6. Definition: “Plant Chemicals” that work in combination with vitamins and minerals to prevent, stop, reduce disease  Greatest benefit: eating whole foods  Whole foods: foods that are minimally and simply processed  Retain more nutrients to promote health compared to processed foods or supplements PhytochemicalsPhytochemicals
  • 7.  Phytochemicals are often found in pigments (or color) of fruits and vegetables  For example: ResveratrolResveratrol LycopeneLycopene EatEat CCoolloorrffuull Foods!Foods! CarotenoidsCarotenoids
  • 8. More examples…. CyanidinCyanidin AllicinAllicin EatEat CCoolloorrffuull Foods!Foods! ApigeninApigenin
  • 9. SuperfoodsSuperfoods Superfoods  Nutrient-rich  Beneficial for health and well-being  Include vegetables, fruits, whole grains, legumes, nuts, and seeds
  • 10. Cruciferous VegetablesCruciferous Vegetables Cruciferous vegetables - kale, broccoli, cabbage, and Brussels sprouts Contain phytochemicals - may help fight cancer by:  Detoxifying carcinogens  Stopping growth of tumor cells  Changing the activity of estrogen Incorporate to your diet on a regular basis
  • 11. Flax SeedsFlax Seeds  Flaxseed - may stop tumors from forming and growing  Grind seeds to get all benefits  Purchase already ground, or grind yourself in a spice grinder  Once ground, sprinkle onto foods like yogurt or oatmeal  Store whole or ground seeds in the refrigerator or freezer for up to six months
  • 12. Research found that soy products high in soy isoflavones do not cause breast cancer In post-menopausal women it may reduce risk but more research is needed….. Good soy products are:  Edamame, tofu, tempeh, miso soup  Whole vs. Processed (“soy protein isolates”) Truth on SoyTruth on Soy
  • 13. Fat – an important source of energy for the body All fats are not the same! Which fats are most healthful? Dietary FatsDietary Fats Emphasize Healthy fats Minimize Unhealthy fats MonounsaturatedMonounsaturated PolyunsaturatedPolyunsaturated Saturated FatsSaturated Fats Trans-fatsTrans-fats
  • 14.  Monounsaturated and polyunsaturated fats can reduce blood cholesterol levels, lowering risk of heart disease  Omega 3 fatty acids – anti inflammatory!  Reduce inflammation  Benefit immune system  May reduce risk of metastatic disease Healthy FatsHealthy Fats
  • 15.  Monounsaturated  Nuts, nut oils and nut butters; olive, canola, safflower oil; avocado  Polyunsaturated  Sunflower, corn, and sesame oils  Omega-3s  Fatty fish like salmon, tuna, herring, mackerel and sardines; nuts and seeds (walnuts, flaxseed) Healthy FatsHealthy Fats
  • 16. Limit saturated fat and trans-fat Saturated fat found mainly in animal products Commercially baked goods contain saturated fat and trans-fat Less Healthy FatsLess Healthy Fats
  • 17. Bone HealthBone Health Cancer treatments, in addition to aging and menopause, can lead to bone loss  Increase risk of fractures and loss of independence
  • 18. 5 Tips for Bone Health5 Tips for Bone Health 1. Exercise on a regular basis*  Exercise helps to strengthen bones and reduce bone loss. 2. Eat more green vegetables  Kale, spinach, broccoli and Brussels sprouts are high in vitamin K, magnesium and calcium that work together to maintain bone health
  • 19. 5 Tips for Bone Health5 Tips for Bone Health 3. Eat enough protein-rich foods  Protein builds, repairs, and replaces body tissue  Meat, fish, soy and beans are all excellent sources of protein  Eggs and dairy – high in protein and have the added benefit of calcium and vitamin D
  • 20. 5 Tips for Bone Health5 Tips for Bone Health 4. Maintain healthy body weight  Carrying excess body weight puts extra stress on your bones  If you’re overweight, make healthy weight loss a priority by exercising and following a balanced diet
  • 21. 5 Tips for Bone Health5 Tips for Bone Health 5. Spend time in the sun  Your body makes vitamin D from the sun’s ultra-violet rays  During the summer months, 10-15 minutes of sun exposure at least 3 times a week without sunscreen is adequate Good Food Sources of Vitamin D: Egg yolk Mushrooms Fish Fortified milk
  • 22. Physical activity is key to a healthy lifestyle! Recommend 150 minutes per week  30 min/ 5 days week Physical ActivityPhysical Activity TYPES OF EXERCISE Aerobic exercise: Walking, running, cycling, dancing, or swimming. Promotes fat loss, proper blood circulation, and strengthens the heart Resistance exercise: Calisthenics, yoga, resistance bands or weights. Helps to build muscle mass to restore strength and balance. Stretching: Increases flexibility and prevents injury. Should be done before (as a warm-up) and after exercise (cool down).
  • 23.
  • 24. The two most important changes that you can make to reduce your risk are: Eating 5-7 servings of fruits and vegetables per day Getting regular physical activity 30 minutes, 5 days per week Preventing ReoccurrencesPreventing Reoccurrences
  • 25. Increase physical activity Increase fruits and vegetables Stick with a plant based diet  Include Omega 3 fatty acids found in fish Avoid weight gain after treatment Stop smoking Reduce alcohol consumption ConclusionConclusion
  • 26. Every Bite CountsEvery Bite Counts To order please contact the Nutrition Services Department at: Email nutrition@glwd.org or call 212.294.8103
  • 28.  Word Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Report: Diet, Nutrition, Physical Activity and Breas Cancer. 2017.  Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W. Soy food intake and breast cancer survival. JAMA. 2009 Dec 9; 302(22):2437-43.  Tuso P.J. Ismail M.H, Ha B.P., Cartolotto C.B. Nutritional Update for Physicians: Plant-Based Diets. Perm J. 2013 Spring; 17(2): 61-66  Link L.B, Canchola A.J., Bernstein L., Clarke C.A., Stram D.O., Ursin G., Horn-Ross P.L. Dietary patterns and breast cancer risk in the California Teachers Study cohort.  Nahum A., Hirsch K., Danilenko M., Watts CK., Prall O.W., Levy J., Sharoni Y. Lycopene inhibition of cell cycle progression in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kip1) in the cyclin E-cdk2 complexes. Oncogene. 2001 Jun 7; 20(26):3428-36.  Hu W., Khor T.O., Shu L., Su Z., Fuentes F., Lee J.H., Kong A.N.T. Plants Against Cancer: A Review on Natural Phytochemicals in Preventing and Treating Cancers and Their Druggability. Anticancer Agents Med Chem. 2012 Dec; 12(10): 1281-1305  Khankari N.K., Bradshaw P.T., Steck S.E. Dietary Intake of Fish, Polyunsaturated Fatty Acids, and Survival After Breast Cancer: A Population-Based Follow-Up Study on Long Island, New York. Cancer. 2015 Jul 1: 121(13): 2244-2252.  Patterson R.E, Flatt S.W, Newman V.A, Natarajan L, Rock C.L, Thomson C.A, Caan B.J, Parker B.A, Pierce J.P. Marine Fatty Acid Intake Is Associated with Breast Cancer Prognosis. J. Nutr. 2011: 141: 201-206.  Hamer J, Warner E. Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health. CMAJ 2017 Feb 21;189:E268-74.  Lahart I.M, Metsios G.S, Nevill A.M, Carmichael A.R. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica. 54:5, 635-654.  Lahart I.M, Metsios G.S, Nevill A.M, Carmichael A.R. Diet and Breast Cancer Prognosis: Making Sense of the WHEL and WINS Trials. Curr Opin Obstet Gynecol. 2009 Feb; 21(1): 86-91. ResourcesResources

Editor's Notes

  1. Soy food intake and breast cancer survival.Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W JAMA. 2009 Dec 9; 302(22):2437-43. Nutritional Update for Physicians: Plant-Based Diets. Tuso P.J. Ismail M.H, Ha B.P., Cartolotto C.B Perm J. 2013 Spring; 17(2): 61-66 Dietary patterns and breast cancer risk in the California Teachers Study cohort1–5 Lilli B Link, Alison J Canchola, Leslie Bernstein, Christina A Clarke, Daniel O Stram, Giske Ursin, and Pamela L Horn-Ross http://ajcn.nutrition.org/content/98/6/1524.full.pdf Lycopene inhibition of cell cycle progression in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kip1) in the cyclin E-cdk2 complexes https://www.ncbi.nlm.nih.gov/pubmed/11423993 Plants Against Cancer: A Review on Natural Phytochemicals in Preventing and Treating Cancers and Their Druggability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017674/ - Dietary Intake of Fish, Polyunsaturated Fatty Acids, and Survival After Breast Cancer: A Population-Based Follow-Up Study on Long Island, New York Nikhil K. Khankari, PhD, MPH1; Patrick T. Bradshaw, PhD2; Susan E. Steck, PhD, MPH Marine Fatty Acid Intake Is Associated with Breast Cancer Prognosis1,2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021439/pdf/nut1410201.pdf Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health http://www.cmaj.ca/content/189/7/E268.full.pdf+html Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies Ian Matthew Lahart, George S. Metsios, Alan Michael Nevill & Amtul Razzaq Carmichael http://www.tandfonline.com/doi/pdf/10.3109/0284186X.2014.998275?needAccess=true  Diet and Breast Cancer Prognosis: Making Sense of the WHEL and WINS Trials https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636962/pdf/nihms90120.pdf Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health http://www.cmaj.ca/content/189/7/E268.full.pdf+html