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.

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Eat Right, Feel Right

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