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.
2. What is on your mind?
• Many patients and survivors struggle with
weight gain as a result of their treatment
• Often patients are very confused with the
wealth of health information
– What about soy or dietary supplements?
– What is the best diet?
– How do I lose weight?
3. Some important questions to ask…
• Is there a magic bullet or miracle food?
• What can we do to help promote a healthy
weight and possibly reduce the risk of
cancer recurrence?
4. American Institute for Cancer
Research 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-dense
foods.
• Eat more of a variety of vegetables, fruits, whole grains and
legumes such as beans.
• Limit consumption of red meats (such as beef, pork and
lamb) and avoid processed meats.
• If consumed at all, limit alcoholic drinks to 2 for men and 1
for women a day.
• Limit consumption of salty foods and foods processed
with salt (sodium).
• Don't use supplements to protect against cancer.
5. Limit Alcoholic Beverages
• Current research – women who drink
one alcoholic beverage per day, may
have small increase in risk
– Those who drink more may increase their
risk even greater
– If estrogen sensitive cancer, use caution
with alcohol
Chen WY, et al. Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med 2002;
7. • Include folate rich foods in the diet to
reduce risk:
– Bananas, oranges, tomatoes
– Dark leafy greens
– Legumes, lentils
– Fortified cereals, whole grain
breads
– Supplement 400 micrograms of
folic acid under physician guidance
Include Foods Rich in Folate
8. Achieve and Maintain a Healthy
Weight
• Definition of “Healthy Weight”
– Ideal Body Weight +/- 10%
– BMI = weight in lbs x 700
height in inches2
BMI = 19-25 “Healthy Weight”
BMI = 26-30 Overweight
BMI > 30 Obese
9. Apple verses Pear Shape
Apple Shape
• A larger distribution of body fat around
the abdomen
Pear Shape
• A larger distribution of body fat around
the thighs and hips
Apple shapes may be at higher risk
10. What does this mean?
• Don’t get too caught up in numbers and
shapes
– These formulas do not take into account
amounts of lean muscle and physical
activity
– BMI and body shape should not be used
as sole predictors of someone’s health
status
11. Body Weight and Fat Distribution and
Risk of Breast Cancer
The theory is:
Hormones are stored in body fat tissue.
With a greater percentage of body fat, the
higher the level of estrogen storage.
These higher estrogen levels may increase
the risk of breast cancer.
12. How to Achieve a Healthy Weight
Higher Fiber
• Aim for 25-35 g/day
– Choose mostly whole
grains or complex
carbohydrates
• Avoid Simple
Carbohydrates
– Empty calories
Lower Fat
• Choose lean proteins
• Avoid unnecessary added
fats
• Choose low fat dairy
products
• Be mindful of hidden
sources of fat
13. Sources of Complex Carbohydrates
Grains
•Bulgur, Brown Rice, Whole Wheat Pasta, Kasha,
Millet
Cereals (aim for >=5g fiber per serving)
•Bran Flakes, Kashi, Muesli, Whole oats
Breads (aim for >= 3g fiber per slice)
•Whole Wheat, Multi Grain, Rye, Pumpernickel
Legumes and Nuts (1-2oz portion or palmful)
• Include all types of beans, lentils, variety of
unsalted nuts
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 per
week
15. How to Choose the Right Fats
1. Eat more omega-3 fat
• Fish, nuts, seeds, canola oil, flax, fish oil
supplementation.
2. Eat some monounsaturated fat
• Olive oil, avocados, canola oil, nuts,
seeds
3. Eat less omega-6 fat
• Processed foods like crackers, cookies,
chips
4. Eat less saturated fat
• Fast foods, full fat dairy, poultry skin,
tropical oils
16. The Importance of Physical Activity
• Strengthens immune system
• Improves digestion
• Helps control weight or increase weight
loss
• Can help decrease hormone levels
• Resistance exercise is also important to
increase metabolism
17. Physical Activity
The American Cancer Society
recommends:
150 minutes of moderate physical
activity
or
75 minutes of vigorous physical
activity
spread throughout the week
18. Benefits of Fruit and Vegetables
Phytochemicals
Naturally found in fruits and vegetables
Help destroy carcinogens in the body before
they can damage healthy cells
19. Benefits of Fruits and Vegetables
Antioxidants
Naturally found in fruits and vegetables
Help protect the body from free radicals
- the dangerous byproducts of some
natural metabolic processes in the body,
smoking, and exhaust from cars
- Free radicals have shown to play a role
as a cancer causing agent
20. Which are the best to choose?
• All fruits and vegetables contain potential
cancer fighting phytonutrients
• Eat a variety with varying colors to
ensure you are including the spectrum of
phytochemicals and antioxidants your
body may need
• Aim for 8 to 10 servings per day
• 2-4 fruit servings
• 4-7 vegetable servings
23. Soy and Cancer
• Soy contains phytoestrogens that may
compete with estrogen to prevent cancer
• Earlier concerns were that soy could increase
cancer recurrence in hormonal breast cancer
• Research to date has demonstrated that in
moderate amounts (1-2 servings per day) soy
intake from whole soy foods is safe
24. Phytoestrogens – Noteworthy
Observations
• Rates of colon, breast, and prostate cancers
are much lower in Asia, where soy is a
staple of diet
• Asian women have about one fifth the rate of
breast cancer as American women
• Asian women moving to the US develop an
increasing incidence of “Western” cancers
within 1-2 generations
25. Could the phytoestrogens in soy
products be responsible for these
findings?
• Mean daily soy intake 10-50 gm in Asia
and 1-3 gm in US
• Estrogen levels are 40% lower in Asian
populations
• It may be important at what stage of life
the body is exposed to phytoestrogens
– During the period of breast
development and adolescence or
before the first mutational step in
carcinogenesis has occurred.
Breast Cancer Res 2004; 6:119-127
26. Making the Decision about Soy
Foods and other Phytoestrogens
• Discuss with physician or registered
dietitian assessing:
– Stage of cancer with estrogen
status
– Family history
– Diet history and prior soy intake
– General diet and exercise habits
– Weight history
– Menopausal status
27. What is a serving of soy? Choose
WHOLE 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 foods
like burgers, nuggets, etc.
29. Guidelines for Optimal Nutrition
• A cancer fighting and healthy weight loss diet
comes down to more than just one food.
• A person’s whole eating pattern is vital for
cancer prevention and promotion of healthy
weight.
• Don’t make the mistake of focusing on one
food to get the job done.
– You will be missing out on the great
benefits of all of the others!
30. A Healthy CANCER-FIGHTING Diet
• Limit alcohol consumption to one or less drink
per day
• Maintain a healthy weight by limiting intake of
fatty foods especially of animal origin
• Choose whole grains, beans, and legumes to
increase fiber intake
• Increase intake of nuts, seeds, and fish to 2-3
times per week.
• Include regular physical activity
• Aim for 8-10 servings of vegetables and fruit per
day of varying colors
• Make educated decisions when choosing
supplements and evaluating food trends