SHARE Webinar: Optimal Nutrition for Cancer Survivors


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SHARE hosted a webinar featuring this presentation on May 8, 2013. Jessica Iannotta, Chief Clinical Officer at Meals to Heal, reviewed the current guidelines for nutrition and cancer survivorship, including highlights of cancer-fighting foods that can help to decrease risk of recurrence. She provided helpful strategies on how to implement these recommendations into your current diet and lifestyle. questions related to nutrition and cancer.

The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment.

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  • Took for median of 6.1 years, recruited 1985 through 1988
  • SHARE Webinar: Optimal Nutrition for Cancer Survivors

    1. 1. Optimal Nutrition for CancerSurvivorsJessica Iannotta MS, RD, CSO, CDN
    2. 2. What is on your mind?• Many patients and survivors struggle withweight gain as a result of their treatment• Often patients are very confused with thewealth of health information– What about soy or dietary supplements?– What is the best diet?– How do I lose weight?
    3. 3. Some important questions to ask…• Is there a magic bullet or miracle food?• What can we do to help promote a healthyweight and possibly reduce the risk ofcancer recurrence?
    4. 4. American Institute for CancerResearch Guidelines• Be as lean as possible without becoming underweight.• Be physically active for at least 30 minutes every day.• Avoid sugary drinks. Limit consumption of energy-densefoods.• Eat more of a variety of vegetables, fruits, whole grains andlegumes such as beans.• Limit consumption of red meats (such as beef, pork andlamb) and avoid processed meats.• If consumed at all, limit alcoholic drinks to 2 for men and 1for women a day.• Limit consumption of salty foods and foods processedwith salt (sodium).• Dont use supplements to protect against cancer.
    5. 5. Limit Alcoholic Beverages• Current research – women who drinkone alcoholic beverage per day, mayhave small increase in risk– Those who drink more may increase theirrisk even greater– If estrogen sensitive cancer, use cautionwith alcoholChen WY, et al. Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med 2002;
    6. 6. Limiting Alcohol ConsumptionWhat is a serving?-12oz beer-6oz wine-1.5 oz hard liquor
    7. 7. • Include folate rich foods in the diet toreduce risk:– Bananas, oranges, tomatoes– Dark leafy greens– Legumes, lentils– Fortified cereals, whole grainbreads– Supplement 400 micrograms offolic acid under physician guidanceInclude Foods Rich in Folate
    8. 8. Achieve and Maintain a HealthyWeight• Definition of “Healthy Weight”– Ideal Body Weight +/- 10%– BMI = weight in lbs x 700height in inches2BMI = 19-25 “Healthy Weight”BMI = 26-30 OverweightBMI > 30 Obese
    9. 9. Apple verses Pear ShapeApple Shape• A larger distribution of body fat aroundthe abdomenPear Shape• A larger distribution of body fat aroundthe thighs and hipsApple shapes may be at higher risk
    10. 10. What does this mean?• Don’t get too caught up in numbers andshapes– These formulas do not take into accountamounts of lean muscle and physicalactivity– BMI and body shape should not be usedas sole predictors of someone’s healthstatus
    11. 11. Body Weight and Fat Distribution andRisk of Breast CancerThe theory is:Hormones are stored in body fat tissue.With a greater percentage of body fat, thehigher the level of estrogen storage.These higher estrogen levels may increasethe risk of breast cancer.
    12. 12. How to Achieve a Healthy WeightHigher Fiber• Aim for 25-35 g/day– Choose mostly wholegrains or complexcarbohydrates• Avoid SimpleCarbohydrates– Empty caloriesLower Fat• Choose lean proteins• Avoid unnecessary addedfats• Choose low fat dairyproducts• Be mindful of hiddensources of fat
    13. 13. Sources of Complex CarbohydratesGrains•Bulgur, Brown Rice, Whole Wheat Pasta, Kasha,MilletCereals (aim for >=5g fiber per serving)•Bran Flakes, Kashi, Muesli, Whole oatsBreads (aim for >= 3g fiber per slice)•Whole Wheat, Multi Grain, Rye, PumpernickelLegumes and Nuts (1-2oz portion or palmful)• Include all types of beans, lentils, variety ofunsalted nuts
    14. 14. Lower Fat Intake• Choose Lean Proteins– Dairy Products• Choose nonfat/skim milk only• Consume low fat or non fat cheese• Consume low fat or non fat yogurt– Meats• Choose white meat chicken and turkey,lean pork• Consume fish 2-3 times per week• Limit red meat intake to less than twice perweek
    15. 15. How to Choose the Right Fats1. Eat more omega-3 fat• Fish, nuts, seeds, canola oil, flax, fish oilsupplementation.2. Eat some monounsaturated fat• Olive oil, avocados, canola oil, nuts,seeds3. Eat less omega-6 fat• Processed foods like crackers, cookies,chips4. Eat less saturated fat• Fast foods, full fat dairy, poultry skin,tropical oils
    16. 16. The Importance of Physical Activity• Strengthens immune system• Improves digestion• Helps control weight or increase weightloss• Can help decrease hormone levels• Resistance exercise is also important toincrease metabolism
    17. 17. Physical ActivityThe American Cancer Societyrecommends:150 minutes of moderate physicalactivityor75 minutes of vigorous physicalactivityspread throughout the week
    18. 18. Benefits of Fruit and VegetablesPhytochemicalsNaturally found in fruits and vegetablesHelp destroy carcinogens in the body beforethey can damage healthy cells
    19. 19. Benefits of Fruits and VegetablesAntioxidantsNaturally found in fruits and vegetablesHelp protect the body from free radicals- the dangerous byproducts of somenatural metabolic processes in the body,smoking, and exhaust from cars- Free radicals have shown to play a roleas a cancer causing agent
    20. 20. Which are the best to choose?• All fruits and vegetables contain potentialcancer fighting phytonutrients• Eat a variety with varying colors toensure you are including the spectrum ofphytochemicals and antioxidants yourbody may need• Aim for 8 to 10 servings per day• 2-4 fruit servings• 4-7 vegetable servings
    21. 21. Milner JA. J Nutr2004; 134:2492S.
    22. 22. Making Educated Decisionswhen Choosing FoodSupplements and EvaluatingFood Trends
    23. 23. Soy and Cancer• Soy contains phytoestrogens that maycompete with estrogen to prevent cancer• Earlier concerns were that soy could increasecancer recurrence in hormonal breast cancer• Research to date has demonstrated that inmoderate amounts (1-2 servings per day) soyintake from whole soy foods is safe
    24. 24. Phytoestrogens – NoteworthyObservations• Rates of colon, breast, and prostate cancersare much lower in Asia, where soy is astaple of diet• Asian women have about one fifth the rate ofbreast cancer as American women• Asian women moving to the US develop anincreasing incidence of “Western” cancerswithin 1-2 generations
    25. 25. Could the phytoestrogens in soyproducts be responsible for thesefindings?• Mean daily soy intake 10-50 gm in Asiaand 1-3 gm in US• Estrogen levels are 40% lower in Asianpopulations• It may be important at what stage of lifethe body is exposed to phytoestrogens– During the period of breastdevelopment and adolescence orbefore the first mutational step incarcinogenesis has occurred.Breast Cancer Res 2004; 6:119-127
    26. 26. Making the Decision about SoyFoods and other Phytoestrogens• Discuss with physician or registereddietitian assessing:– Stage of cancer with estrogenstatus– Family history– Diet history and prior soy intake– General diet and exercise habits– Weight history– Menopausal status
    27. 27. What is a serving of soy? ChooseWHOLE foods• Soybeans ½ cup• Roasted soybeans ¼ cup• Soy milk 1 cup• Soy yogurt 1 cup• Soy cheese 1 oz• Soy flour ¼ cup• Tempeh ½ cup• Avoid soy supplements, powders• Limit high sodium processed soy foodslike burgers, nuggets, etc.
    29. 29. Guidelines for Optimal Nutrition• A cancer fighting and healthy weight loss dietcomes down to more than just one food.• A person’s whole eating pattern is vital forcancer prevention and promotion of healthyweight.• Don’t make the mistake of focusing on onefood to get the job done.– You will be missing out on the greatbenefits of all of the others!
    30. 30. A Healthy CANCER-FIGHTING Diet• Limit alcohol consumption to one or less drinkper day• Maintain a healthy weight by limiting intake offatty foods especially of animal origin• Choose whole grains, beans, and legumes toincrease fiber intake• Increase intake of nuts, seeds, and fish to 2-3times per week.• Include regular physical activity• Aim for 8-10 servings of vegetables and fruit perday of varying colors• Make educated decisions when choosingsupplements and evaluating food trends
    31. 31. Thank You!