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February 2025 1 CCSN Complete Diet Guide.pptx

The document presents a comprehensive guide to an anti-cancer diet, emphasizing a diverse, mostly plant-based diet high in fiber, mindful eating habits, and the importance of avoiding ultra-processed foods. It discusses various aspects of nutrition, including the microbiome's role in health, dietary myths, and practical meal planning strategies. The overall message is to empower individuals in their dietary choices to enhance health, support cancer treatment, and promote longevity.

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T H E C O M P L E T E G U I D E T O T H E A N T I - C A N C E R D I E T W I T H O N C O L O G I S T R O B R U T L E D G E A S S O C I A T E P R O F E S S O R , D A L H O U S I E U N I V E R S I T Y
The Anti-cancer Diet and the PEP Program: The science and practice of nourishing yourself Rob Rutledge, MD, Oncologist Cancer Patient Empowerment Program
Take Home Points •Choose a diverse whole-food mostly plant-based diet high in fiber •Don’t eat for 12+ hours overnight (time-restrict eating) •Take a balanced and mindful approach, slowly changing your diet over weeks to months •Be kind to yourself especially during treatment
Healthy Diet Lecture Contents • How diet can influence cancer growth • Dietary patterns vs super foods • Principles of a healthy diet • Ultra-processed food-like substances • The microbiome • Dietary myths • Supplements • Shopping and meal planning • Time-restricted eating
Why a Healthy Diet? • Get through treatment more easily • Feel and function better immediately • Halt or reverse a chronic condition, and reduce the risk of other medical problems • Symbol of kindness towards yourself • Have a positive influence on those around you • Share your knowledge and your healthy food • Aim is for you to eat well for decades to come!!
How Cancer Starts • A cancer cell is a normal cell with dozens of mistakes • The cells grow fast and in an uncontrolled way • The transformation from normal to cancer typically takes many years
Don’t turn slow growing cancer cells into fast growing cells •Damage to the normal cells causes them to turn into cancer cells •Further damage to slow growing cancer cells cause them to become fast growing cells •What’s good for reducing risk of your type of cancer is good after a diagnosis •What’s known to increase risk of your type of cancer should be avoided
Epigenetics: Change the Soup! • The fluid around the cells contain chemicals which can drive cell growth • Inflammation in the body releases chemicals into the blood which can cause damage to the cells and increase cell turnover • Choose an anti-inflammatory lifestyle • Diet, exercise, meditation, stress reduction
Integrative Medical Care • Conventional care plus empowering yourself: • Understanding what’s happening to you • Getting the best from the medical system • Empowering yourself with healthy lifestyle - Exercise, diet, weight, sleep, relaxation techniques • Healing at level of the mind • Nurturing your spiritual life
Your gut bacteria influence your immune system and much more •The 100 trillion bacteria in your gut (microbiome) live along side 80% of your immune cells •An unhealthy microbiome causes inflammation in the rest of your body • Your gut bacteria influence many other body systems including your weight, sugar metabolism… all which can increase risk of cancer
How diet helps to heal cancer •Prevents slow growing cells from becoming fast growing •Anti-oxidants mop up damaging and stimulating chemicals •Turns off the signals for the cells to grow •High sugar levels prime insulin / growth •Change in the soup, change the conditions for cell growth •Improves immune function •Unleashes body’s innate healing potential
When to get expert dietary advice • Recommended for everyone! • Ask your physician, and see a Registered Dietitian • But especially for people who suffer • Weight loss or weight gain • Diarrhea / constipation • Difficulty eating • Issues with relationship with food
Dietary Pattern vs Superfoods • No one supplement or specific food has proven to be a cure-all for any medical condition • Eating, absorbing and metabolizing food is complex • Not the same as in a test tube • Many unknown interactions • Any one food may not work for you • Daily PEP program reminds you to eat a diverse diet and explore healthy options
Principles of a healthy diet • Eat food, mostly plants, not too much • 50%+ of your plate should be veggies (+ fruits) • Healthy complex carbos (neither low nor high carb diet) • Proteins and healthy fats from non-meat sources • Less meat or no meat, no red meat! • Healthy fluids and fiber!! • Multiple types of whole nutrient-dense foods at each meal • Combines vitamins, minerals • Supplement with Vitamin D (and B12 if vegan) • Talk to your physician if other supplements are needed • Adopt an eating pattern you will enjoy for the long term
The Big Five Food Groups •Veggies •Fruits •Whole (intact) grains •Legumes, beans, seeds and nuts •Mushrooms
Mushrooms • Physical and mental benefits • ergothioneine, ergosterol, vitamin D, beta-glucan, and selenium • Glycemic control, immune function, weight management, improved lipid profile, improved bone density, improved blood pressure, improved got health, prevention of cancer and boosted cognitive function
Ultra-Processed Food-Like Substances
The Food Industry is Driven by Profit • Minimize costs • Industrial production – cheaper ingredients • Extraction of food components (processing often strips foods of micronutrients) • Distribution often requires preservatives • Produce cheaper (ultra- processed) food-like substances
The Food Industry is Driven by Profit • Maximize profits • Food is designed to taste addictive: sugar, salt, fat (soft and energy dense) • Increases consumption (overeating is the goal) • Marketing is designed to make you feel good and buy more product • Iterative cycles of food design, testing, focus groups, marketing, market share, increasing profits
Novo Food Classification
Novo Food Classification
Defining Ultra-Processes Foods • Generally speaking they contain many ingredients • Extracts from foods • Chemicals you don’t recognize • Emulsifiers, preservatives, .. • Substances you wouldn’t have in your kitchen • You can’t make this food yourself • Examples – supermarket bread, breakfast cereals, most yogurt, energy bars, ‘food’ wrapped in plastic
Canada Food Guide of highly processed foods • sugary drinks • syrups and jams • chocolate and candies • potato chips and pretzels • sauces, dressings and gravies • ice cream and frozen desserts • bakery products like muffins and cakes • fast foods like French fries and burgers • frozen entrées like pasta dishes and pizzas • processed meats like sausages and deli meats
Ultra-Processed Food-like Substances as a percentage of our caloric intake •In the USA, UPF accounts for 50- 60% of our caloric intake •Similar in Canada and the UK •In children: 75% caloric intake •Associated with anxiety and depression, ADHD, obesity and diabetes
Eating Ultra-Processed Food-like substances is associated with • Poor mental health • Cancer • Obesity and diabetes • Alzheimers and other neurodegenerative disease • Many other medical conditions
• 20 overweight adults for 28 days held inside / measured++ • Randomly assigned to Healthy Diet vs UPF diet for two weeks – then cross over for 2 weeks • Unhealthy diet is 80% of calories made of UPF • Healthy diet 80% of calories with whole foods • Diets matched for calorie density, macronutrients, fibre, etc
Landmark UPF Study • Both groups had same feeling of satiety, enjoyment of food • UPF group ate 500 Kcal more per day!! • (2900 vs 2400 Kcal daily) • UPF group gained 2 lbs • Healthy group lost 2 lbs • Reason for weight gain? • Calorie density – don’t feel full until after overeating • Chemicals interfere with appetite
AVOID Junk •Sugar drinks and refined sugars •Fried foods •Processed foods •Red meat
What is the Gut Microbiome? What defines a healthy microbiome? •The trillions of organisms in your GI tract •More than 1000 species •More diversity is better •Having more bacteria can digest healthy foods
What Critical Functions do our Gut Microbiome play? •Digestion •Immune function •Neuro-transmitter production – helps with mood and brain health •Metabolism / weight / endocrine •Skin
How can you influence your microbiome as an adult? - Diet - Timing of eating - Exercise - Stress levels - Sleep habits
Prebiotics vs Probiotics •Pre-biotics – long-chain carbohydrate-like molecules that we don’t have the enzymes to digest •Our bacteria feed off these •Probiotics contain actual bacteria
Examples of Probiotics
The Microbiome Summary • Essential to digestion, immunity, hormone production • A diet of processed and refined foods will • Change the types and amount of bacteria in your gut • Irritate the lining of the gut (leaky gut syndrome) • Feed your bacteria • Fiber – from whole foods! • Probiotics add ‘good’ bacteria to your gut • Diversity – 30 different plant foods weekly
Myth: The sugar in fruit is not good for you • Refined sugars and high glycemic foods on their own can “spike” blood sugars • ↑ insulin = inflammation = cancer risk • Sugars in fruit come with fiber • Slows absorption / less sugar spike • Many other nutrients in food • Helps to eat fruit with other food • protein, fiber and healthy fats • Best to consume slow burning fuel
Eat Little or No Red Meat! •Red meat irritates your gut, kills off healthy bacteria and leads to inflammation •Filled with saturated fats and cholesterol •Associated with higher rates of heart disease, stroke, cancer, diabetes…. and death •High heating produces harmful chemicals in the meat
“You’re a Vegetarian ?!? But where do you get your protein???” • Where do bulls, rhinos, and horses get their protein? • Are people treated for protein deficiency?
Myth: we won’t get enough protein if we don’t eat meat • Vegetables contain the same amino acids (ie protein) as the muscle of animals • Eat several foods at each meal • Get a full complement of essential amino acids • Nuts, seeds, beans and legumes all have very high protein content • A balanced vegetarian diet contains more protein than our bodies can use
Our Protein Requirements •0.8 g per kilogram of ideal body weight is based on the minimum needs of 97% of the population to stay in balance •E.g. 80Kg person needs 64g per day •Almost all of us are getting way more protein than we need •Probably we only need about 40g of protein per day •In our diet is made up of about 17% of calories from protein •Of a 2000 calorie diet gives us 85g of protein
Comparing the Health of Vegetarians vs Meat-Eaters •Healthier weight •More energy •Stronger Immunity •Lower risk of all types of disease •Longer life
Healthy Sources of Protein • GRAINS – NUTS - BEANS • Nuts – almonds, peanut butter, pasticcios, pumpkin seeds, flax, sunflower, brazil nuts • Kidney beans, black beans, lentils, garbanzo, chick peas, edamame, amaranth • Sprouted grain bread
Healthy (intact) Whole Grains • Quinoa • Brown rice / wild rice • Flax seeds • Whole oats • Whole barley • Buckwheat • Cous cous
No sweet, no wheat, no dairy and no refined foods •Greatly increase vegetable and fruit intake •Eat organic foods •Drink filtered water
Supplements • Vitamin D – 1000-2000 IU • Probably a multi-vitamin good if older • Vitamin B12 is 2.4 mcg if vegan • Get your blood levels checked • Eat a varied and balanced diet and you won’t need to take supplements • unless directed by a physician • General supplement probably good for older folks • Omega 3 from algae if vegetarian
Healthy fluids •Reminder to stay hydrated – bottle close by •Tea: green, chaga mushrooms, saffron •Warm water with lemon in am •Reduce alcohol (eg. one drink per week) •Almond milk or oat milk (less water to produce)
Myth: Coffee is bad for you •Caffeine is a stimulant (hard to relax) •Drink your coffee earlier in the day •Enjoy your life fully!
Myth: Fat is bad for you • Trans and saturated fats are not good • We need healthy fats for our brain, nerves and many other cells • Good unsaturated fats (mono and poly) include veggie oils (olive, canola, sunflower, soy), nuts, seeds, and fish • Use smaller portion sizes
Healthy Oils •Olive – cold pressed, and less than a year old •Grape seed for salads •Avocado – good for cooking •Better to get from the plant •Get your healthy oils from multiple sources each day
Essential fatty acids - Omega 3 Do we need to eat fish? • Omega 3 reduces inflammation • Omega 3 parent molecule: alpha linolenic acid is found in flax, walnuts, chia seeds and small amounts in green vegetables (very stable and can convert in body to longer chains EPA and DHA) • Derivative molecules: EPA, DHA (fish oil) very unstable and can go rancid quickly (why fish smell fishy!) • Fish in small amounts is OK • Eg. one serving per week gives you the omega 3s • Beware of high metal levels (eg. tuna) • Canned wild salmon, sardines, cod, herring, mackerel
Diet that Elevates Mood • Low glycemic • Brazil nuts • Dark chocolate • Mangos • Oranges • Nettle leaf • Kiwis • Figs
Personalizing Your Diet •Use mindfulness to assess how you feel •Different foods cause spikes in blood sugar for different people •Continuous blood sugar monitors •Fecal sampling of diversity of microbiome
Brain food • Omega 3s / fish • Pumpkin seeds • Dark chocolate • Blueberries • Turmeric • Broccoli • Nuts • Apples
Anti-inflammatory spices •Turmeric -tea, curries, sautée vegetables, rice, soups, smoothies •Ginger - stir fry, tea, salad dressings, smoothie, stir fry, soup •Garlic - fresh salsa, roasted on top of pizza, salad, sandwich, homemade hummus
Healthy swaps • Water for soda pop • Piece of fruit for a cookie • Bean salad for a meat dish • Loaded oatmeal for cereal • Spaghetti squash for pasta • Roasted vegetables and whole grain (farro, quinoa, bulgur) vs white rice or pasta • Popcorn for chips • Apple and nut butter for granola bar
Dairy – Good or Bad? • Limit dairy • Need to replace calcium • Fortified plant milks • Chia Seeds • Almonds • Tofu • Leafy greens • Soybeans
Shopping! •Plan ahead •Don’t shop when you’re hungry or tired •Read the labels •Don’t buy unhealthy food
Read the label: Watch for high sugar and chemicals
Efficient Preparation •Spend a couple of hours doing meal prep one day a week - pot of whole grain, roasted vegetables, etc. •Pre-chopped veggies
Myth: Frozen foods lose nutrients •Message – good option for getting veggies and fruits
Frozen foods • Berries – blueberries, strawberries • Veggies • Broccoli and cauliflower, Brussel sprouts • Green beans and peas • Spinach • Cauliflower crust pizza • Frozen soups – corn and potato chowder, split pea, black bean
Examples of Healthy Breakfast • Oatmeal with plant milk, frozen blueberries, chia seeds, hemp hearts and ground flax • Egg frittata loaded with vegetables • Sprouted grain bread, avocado, hemp hearts • Sprouted grain bread, nut butter, chia seed jam
Very Smoothie •Berries •1/2 banana •Plant milk •Yogurt •Chia seeds, ground flax, hemp hearts, nuts, seeds •Cocoa/ginger/spices
Examples of healthy lunch •Soups - lentil, mung beans, beans, load up with vegetables, creamy with cashews •Salad - include nuts, seeds, avocado, protein, healthy fat •Veggies, hummus, whole grain crackers, fruit
Cauliflower / chickpea curry
Examples of Healthy Supper • Bean or lentil curry • Protein, whole grain, vegetables • “Buddha bowls” - whole grain, veggies, protein, hummus, herbs, dressing • Lentil walnut tacos with salad
Examples of Healthy Supper
Time-Restricted Eating - Intermittent Fasting • Fasting / time-restricted eating – focuses on timing and not the content of diet • When we eat a meal • Glucose from carbs goes to the cells, and becomes glycogen in the liver • Fatty acids go to cells, and stored in fat cells • When not eating: Once liver is drained of glycogen, it processes fatty acids to produce ketones (energy source for cells) • Ketones improve cell functions, make them more resistant to stress, enhance recovery and autophagy • Decrease inflammation • Allows your gut to repair itself
Sync Eating and Circadian Rhythm • All cells are linked to the daily cycle • Eat during the day, don’t eat at night • results in lower post-meal blood sugar and insulin levels, lower fat production, and better blood pressure control • Ideally don’t eat for the first hour after waking • Don’t eat within 2-3 hours of going to sleep • Coffee and tea (no sugar or milk) and water are allowed during the non-eating times
How to Time-Restrict Your Diet • Train your body over a 4-month period • Increase capacity to produce and metabolize ketones • Example • Month 1: Fast for 10 hours per day Monday to Friday • Month 2: Eat for 8 hours (eg. 10am-6pm) +/- eat normally on weekends • Month 3: Alternate days between eating for 6 hours and 8 hours • Month 4: Eat during 6 hours – but modify timing • Goal: ketosis for at least a few hours every day, which usually means not eating for at least 12-14 hours
Usually lasts 2-4 weeks
Vegan Diet •Vegan diet – no animal or dairy products •Can be a very nutrient-dense if focus is whole foods •Whole grains, vegetables, fruit, nuts, seeds •Need to supplement vitamin B12 and D- ask a dietitian •Get support to ensure good intake
Soy – good or bad? •Plant sources of estrogen are healthy •Phyto-estrogens in soy protect against breast cancer •Traditional forms: tofu, miso, tempeh, natto, edamame, soy milk •Organic
Organic - necessary? •Less pesticides •May mean better farming practices, better for environment •Local is best
Alcohol? •As little as possible •Men less than 3 drinks per week, women less
Low-Carb vs Low-Fat vs Fad X •Eat what makes you feel good in the long term •Use the healthy swaps •Don’t buy the unhealthy / ultra-processed junk •Eat your veggies and whole foods first •Will allow your hunger center to feel satiated •Look for a healthy eating pattern with variety! •Slow transition into foods you enjoy
Ketogenic Diet good for you? •Ketogenic diet is high-fat, adequate-protein, low- carb diet •Forces the body to burn fats rather than carbs •Keto diet is therapeutic for epilepsy •Very strict, missing many antioxidants •Can compromise fibre and bowel health
Tips to making this work •Eat at least one veggie at every meal (and work up to 50%+ of your plate) •Don’t buy the unhealthy foods •Look for healthy swaps •You can find cheaper foods •Beans and lentils are super healthy and cheap
Healthy Recipes inspirehealth.ca/resources/recipes
Diet during Chemotherapy • Talk to an expert if you are struggling • Nourish the normal cells and immune system • Maintain weight • Eat what you like • Smaller more frequent meals • Limit any supplements with anti-oxidants • Kindness, kindness, kindness • Focus on improving your diet in recovery and survivorship