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Eat Right, Feel Right


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Karon Rzad of Sylvester Comprehensive Cancer Center presented "Eat Right, Feel Right" at the 2011 WellBeingWell Conference in Miami.

Karon Rzad of Sylvester Comprehensive Cancer Center presented "Eat Right, Feel Right" at the 2011 WellBeingWell Conference in Miami.

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  • 1. Energy Balance:Banking Currency in the Body
    Karon Rzad RD LDN CDE CPT
    Lic. Stress Management Coach
    Integrated Medicine Practitioner
  • 2. Disclaimer: RD/Clinical Nutritionist
    The Registered Dietitian/Clinical Nutritionist is a trained expert in human nutrition and nutrition science.
    RD’s utilize health promotion, for disease prevention and treatment strategies that support communities and individuals to make healthy eating and active living choices. These strategies are well recognized as important in reducing the incidence of chronic illness and reducing health care costs.
    Their primary focus is to
    prevent and correct
    nutrient deficiency symptoms.
    Ref. ADA position paper.
  • 3. References
    Americana Dietetic Association, position papers.
    Shils, M. E. et al, “Modern Nutrition in Health & Disease” 3rd ed., ISBN: 0 7817 4133 5; 2006 Lippincott Wms & Walker.
    Quillin, P., PhD, RD CNS, Beating Cancer with Nutrition, Nutrition Times Press, Inc., 2002. pgs. 71,
    Hirsch, Julie B., Ph.D., Wellgen, Inc., Communication Structure-function: Why not call ‘antioxidants’ ‘anti inflammatories’ if that is what they do?Nutr. In Complementary Care, winter, 2007, Vol. 9. Issue 3, page 37.
    World Cancer Research Fund/American Institute of Cancer Research, Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, Washington, DC: AIRC, 2007.
    Silva, O., MD-Onc, spec. BrCa-UM/SCCC, Conversations in CA-:What’s Next”. 10/08.
    Rzad, K. M., RD LDN CDE LSMC CAM, “Know Your Numbers”, 2002 – 2003, Florida Keys.
    Silver. J Am Geriatr Soc. 1988.
    Kotler, Ann Intern Med. 2000.
    Tisdale, Langenbecks Arch Surg. 2004
    Acharya et al. J Clin Invest. 2004
    Inui, CA Cancer J Clin. 2002.
    Ref. :MEGACE ES625mg/5ml (Strativa Pharm. Formerly PAR)
    Heber, D., L. O. Byerley & N. S. Tchekmedyian, “Hormonal & Metabolic Abnormalities in the Malnourished Cancer Patient: Effects on Host-Tumor Interaction”, JPEN J Parenter Enteral Nutr 1992 16:60S, DOI: 10:1177/014860719201600605.
    Dempsey, DT, et al, “Energy expenditure in malnourished gastrointestinal CA patients.” Cancer 53:1265-1273, 1984 , Foods That fight Cancer., Herbs for Cancer, Cancer Prevention.
  • 4. Objectives
    Participants will:
    Verbalize the energy balance equation
    Define the difference faces of malnutrition
    Define Energy Balance
    Identify Foods to use
    Identify Activities that enhance the
    wellness experience
  • 5. Definitions
    Under nutrition:
    Over nutrition:
    Sarcopenia or unexplained weight loss,
    Functional Foods:
    Going Green
  • 6. Presence of Obesity
    65% of Americans are overweight to
    obese, & of that,
    >65% of Females are overweight to obese
    Ref. “Know Your Numbers” campaign., 2003 Florida Keys.
  • 7. Nutrition and Disease
  • 8. The Presence of Malnutrition Ref. Quillin, P., PhD, RD CNS, Beating Cancer with Nutrition, ; Heber, et. al.,JPEN J Parenter Enteral Nutr 1992
    >40% CA patients die from malnutrition NOT Cancer;
    “The overall incidence ranges between 30% and 87%” data from different populations studied.
  • 9. Malnutrition - What is it?
    It is a state of starvation – a physical condition
    Caused from inadequate “CAR” :
    Consumption, Absorption & Retention
    Protein for building & repairing
    Carbs & Fats for energy & metabolism
    Or both called PCM
    = Protein Calorie Malnutrition.
    Ref. Shils, M.E. et. Al., “Modern Nutrition in Health & Disease”, 10th Ed., ISBN: 0 7817-4133-5, 2006. ppgs. 730-747.
  • 10. Some Nutrient Deficiencies Happen Over Time.
    Go unnoticed until it is too late!
    Weight loss or poor diet is not recognized as a problem.
    Macronutrients imbalance:
    Protein, Carbohydrates, Fat
    Micronutrients: Minerals, Vitamins
    Phytochemicals, Antioxidants.
  • 11. Definitions
    Anorexia: Side effect of therapies resulting in poor oral intake of foods (PEG, PEJ,)
    Cachexia: Pure Malnutrition = 25% to 67% of all CA patients
    Protein-Calorie Malnutrition = 80% have reduced levels of serum albumin.
    Sarcopenia: Age related wasting: poor nutrient intake and utilization
  • 12. The Many Faces of Malnutrition
  • 13. Potential Causes of Malnutrition
    Inattentive caregivers Alcoholism
    Inappropriate tablemate Anorexia nervosa
    Poor lighting Dementia
    Unpleasant odors Depression
    Excessive noise Late-life paranoia
    Insufficient time to eat Pacing & wandering
    Cancer Decline in usual activities
    Diabetes Embarrassment diarrhea,
    Renal Failure vomiting…..
    Difficulty Breathing Loneliness
    Digestive Issues Temperature of food + -
    Tires easily
    Silver. J Am Geriatr Soc. 1988.
    A Life Change
  • 14. Activity: Energy Balance
    Issues of Aging and Disease
    No exercising or moving!
  • 15. Cachexia Population Statistics Ref. :MEGACE ES625mg/5ml (Strativa Pharm. Formerly PAR)
  • 16. Consequences of Malnutrition
    Body composition changes
    Metabolic process changes
    Impaired immunity
    Decreased wellness & Quality of Life
    Nutrient deficiencies:
    Macronutrient: protein, carbohydrates, fat
    Micronutrient: minerals, vitamins, phytochemicals (antioxidants)
    Ref. Shils, M.E. et. Al., “Modern Nutrition in Health & Disease”, 10th Ed., ISBN: 0 7817-4133-5, 2006. ppgs. 730-747.
  • 17. Taking a Look at Malnutrition
    Loss of appetite, Anorexia;
    Cachexia = involuntary weight loss;
    There are ↑cytokines;
    Metabolism is accelerated;
    Muscle & fat mass become quickly depleted;
    Blood sugars may be ↑ and/or go Out-of-Control.
    Ref: 1. Kotler, Ann Intern Med. 2000. 3. Tisdale, Langenbecks Arch Surg. 2004
    2. Acharya et al. J Clin Invest. 2004 4. Inui, CA Cancer J Clin. 2002.
  • 18. “Eat Whatever You Want To..”
    A clinical statement
    made to someone with
    no clinical knowledge.
  • 19. Dirty Dozen & Clean Fifteen
  • 20. Functional Foods
    • “Are "those foods that encompass potentially healthful products including any modified food or ingredient that may provide a health benefit beyond the traditional nutrients it contains," as defined by the Institute of Medicine.
    • 21. Can include foods like cereals, breads and beverages which are fortified with vitamins, herbs and Nutraceutical.
    • 22. The healing power of foods focuses on how "super foods" can have health protecting properties.
    • 23. These Medicinal foods or "nutritionally high powered foods" have been part of the natural products industry for a long time. Through emerging scientific research and growing public interest, they have reached the mainstream.”
  • Functional Foods
  • 24. Natural Foods Work Best
    Less Processed
    Eating Like a Cave Man!
    It is not just twigs, bark, and twine!
    It is colors!
  • 25. The Super Foods
  • 26. Super Foods 2
  • 27. Nutraceutical
    A Nutraceutical may be a food or part of a food with a nutrient-rich or medicinally active component such as garlic or soybeans, or it may be a specific component of a food, such as the omega-3 fish oil that can be derived from salmon and other cold-water
  • 28. Going Green with Food
    A Marketing Idea: These are products and services based on environmental factors or awareness. 
    Companies involved in green marketing make decisions relating to the entire process of the company’s products, such as methods of processing, packaging and distribution.
  • 29. Feeding to Fight Cancer
    Beans-Legumes Flaxseed Green Tea
    Berries Garlic Soy
    Cruciferous Grapes/Jc Tomatoes
    Dark Leafy Herbs Whole Grain
  • 30. The Warrior Foods &, Herbs for Cancer
  • 31. Pleasure for the Palate Herbs
  • 32. Size DOES MatterNo One Size Fits All Here!
    During starvation: A decrease in glucose production, protein synthesis and protein catabolism.
    Fat derived fuels, ketone bodies, are used for energy.
    Of the 54,000 kcal of protein stored in the body cell mass only 50% is available for energy production.
    Metabolically active muscle is preserved.
    Ref.Heber,, JPEN, 1992.
  • 33. How Can You Eat and Lose Weight?
    Some truth about food:
    4 small meals are better than 1 - 2 large meals!
    Nibbling just means calories are out-of-control!
    Drinking juices is not low calories!
    Eat your carbs before sundown!
    Exercising on an empty stomach can ↑ appetite.
    Foods eaten while standing or on the run Count as Kcals!
    Keep active AFTER eating.
  • 34. Solutions: Energy Balance as a Lifestyle
  • 35. What is the Difference?
    Lean Body Mass vs. Fat Mass?
    Hypothesis: The malnourished cancer patient may be hypermetabolic relative to the amount of lean body mass.
    Conclusion: This difference was due to both a decrease in body cell mass and Increased REE before the onset of the weight loss.
    Ref.Heber,, JPEN, 1992.
  • 36. What About Exercise?
    What is it?
    Walk after each meal
    Conduct an orchestra using upper body movement
    Rock in a rocking chair “toes to nose” technique
    If bedridden:
    Move by rolling from side to side every 2-4 hours
    Roll to one side; sit up slowly; swing legs to the side; slowly stand
    No scooting or sliding to get out of bed
  • 37. Non-CA, Normal: Talk & Walk
    Exercise: 60 to 90 Minutes Daily
    ↓Insulin Resistance
    ↑Oxygenation to cells & Wellness
    Walking continuously gives the greatest benefit.
    Ref. Silva
  • 38. Why Walking?
    • Walk: 5 hours/week ↓BrCa by 50%
    • 39. For males walking 5hr/wk ↓Prostate Ca by 25%
    • 40. And, generally, 90 minutes of walking daily ↓colon Ca by 30%!
    • 41. Ref. Silva
  • Begin thinking Wellness
    Teach your family wellness
    Practice good eating and activity behavior
    Set good examples
    If pregnant, eat well
  • 42. Summary: Strategies Should be Taught & Used to Enhance Survival
    We are a nation that can rescue, once someone has fallen off the cliff.
    We now need to put up stop signs that say:
    Eat Right and Stay Active