Nutrition for Cancer Survivors



Nutrition for Cancer Survivors
Hello -Please take 5 minutes to write down all the whole plant foods you ate
over the last two days
Think nonstarchy plant
foods like fruits
Inflammation, Cancer and
Linda Kasser, RD, CSO, CD
Certified Specialist in Oncology Nutrition
Medical Nutrition Therapy at Seattle Cancer Care Alliance
Plan for Today
• What is chronic inflammation?
• How does inflammation contribute to cancer cell
• What you can do to minimize inflammation
Eat mostly plants
Maintain a healthy weight
Minimize alcohol consumption
Increase omega 3 fatty acids
Drink plenty of fluids
Figure 1
Mechanisms of Cancer Development
Cell 2011 144, 646-674DOI: (10.1016/j.cell.2011.02.013)
Copyright © 2011 Elsevier Inc. Terms and Conditions
Figure 3
Cell 2011 144, 646-674DOI: (10.1016/j.cell.2011.02.013)
Copyright © 2011 Elsevier Inc. Terms and Conditions
Short Term and Chronic Inflammation
• Short-term inflammation has anti-infective and
anti-cancer effects, whereas prolonged or
chronic inflammation can promote disease.
Inflammation and Disease
Cancer Causing Inflammation Happens in Two Ways
1. Cells changed by various genetic events (oncogenes,
gene amplification, or inactivation of tumor-suppressor
2. External inflammatory or infectious conditions (viruses
like hepatitis) increase the risk of developing cancer at
certain sites (e.g., the colon, prostate, and pancreas,
Venil N. Cancer, Inflammation, and Insights from Ayurveda 2012
Chronic inflammation is a chaotic cellular environment that creates
disorder and contributes to abnormal cell growth.
Inflammation Promotes Tumor Formation and Growth
• Chronic inflammation can indirectly
enhance tumor formation.
Mantovani, “Cancer related
inflammation,” Nature 2008
• Chronic inflammation contributes to
1/3 of all cancers.
. McMillan, “Systemic inflammation, nutritional status and
survival in patients with cancer,” Current Opinion in Clinical Nutrition and Metabolic Care, 2009.
Cellular Inflammatory Pathways
soy and
and cloves
block this
Prasad et al, Preventative Medicine 2012
What Can You Do to Minimize Inflammation ?
Eat a Plant Focused Diet
• In cell and animal studies, nutrients and
phytochemicals found in plant foods show
effects on
Cell cycle regulation
Processes of angiogenesis (blood vessel growth)
Apoptosis (programed cell death)
DNA repair
Consume 5 or More Servings of Non-Starchy
Vegetables and Fruits Daily
Eat the Rainbow!
Plant Focused Diet
• In laboratory studies, plant compounds influence
– Histone acetylation
– DNA methylation
– RNA transcription
• These changes either silence or promote
expression of genes such as tumor suppressor
Plant Focused Diet is High in Fiber
• Plant foods are higher in fiber so there is
decreased absorption of carbohydrate and lower
circulating insulin and related growth factors
• Higher fiber will decrease circulating estrogen
levels because of decreased reabsorption from
the digestive tract.
Plants are Antioxidants
• Antioxidants protect DNA from damage
– Carotenoids
– Flavonoids
– Sulfur compounds
– Carotenoids are known to promote cell-to-cell
communication that helps control cell growth
Eat More Plant Proteins
• Legumes are a great
source of plant
proteins and also
provide antioxidants,
fiber, vitamins and
Diagram Showing Effects of Whole Soy and Green Tea on Inflammation and Prostate
Plants and Intestinal Bacteria
• Gut bacteria comprise 70% of our immune
– Increased fermentable fiber and resistant starches
produce butyrate which may reduce inflammation.
Spices and Herbs are Plants
Maintain a Healthy Weight
Adiposity and Influence on Cancer Risk
• Excess body fat is associated with insulin
resistance and increased insulin growth factor
(IGF-1). This can stimulate cancer growth
pathways, promoting growth and reproduction of
cancer cells and inhibiting programmed cell
• Adipose tissue is the main site of estrogen
production in post menopausal women
Adiposity and Cancer Risk
• Fat cells produce hormones including leptin.
Increased leptin may promote cell proliferation
and blood vessel development while inhibiting
programed cell death.
• Reduced amount of hormone adiponectin which
is protective and decreases insulin resistance
and inflammation. It also promotes programmed
cell death
Adiposity and cancer risk
• Overweight and obesity are associated with a
constant state of low-grade chronic inflammation
that can promote cancer development.
• Abdominal adiposity has clear associations with
increased risk of breast, pancreas, colon and
endometrial cancers
Evil Doers of Increased Adiposity that Contribute to Chronic
• Insulin growth factor
• Leptin
• Abdominal fat
• Estrogen
Drawing courtesy of Darren Wiebe
Maintain a Healthy Weight
Alcohol – Less is Better
Why Limit Alcohol ?
• Alterations in blood hormone levels, especially
elevated estrogen-related hormones, have been
reported in humans
• Increased estrogen levels may increase the risk
of breast cancer through increases in cell
proliferation and alterations in estrogen
Oyesanmi O, Alcohol consumption and cancer risk: understanding possible
causal mechanisms for breast and colorectal cancers. 2010
Alcohol and Colon Cancer
• Intestinal mucosal damage after ethanol
Increased degradation of folate.
Stimulation of rectal carcinogenesis.
Increased cancer cell proliferation.
Increased effect of carcinogens
Hypothesized nonlinear relation between folate status and breast cancer risk.
Ulrich C M Am J Clin Nutr 2007;86:271-273
©2007 by American Society for Nutrition
Eat More Omega 3 Fatty Acids
•alpha-linolenic acid (ALA)
•eicosapentaenoic acid (EPA)
•docosahexaenoic acid (DHA)
Types of Fats That Contribute to Inflammation
• A recent study of healthy men and women found
that the ratio of omega-6/omega-3 fatty acids
showed the strongest positive correlations with
increased levels of most inflammation markers,
suggesting that this ratio may constitute a
predictor of low-grade, chronic inflammation.
• Omega 6 fatty acids are high in soy, corn,
sunflower and cottonseed oils. Eat less of these.
Omega 3’s and Anti-Aging
• Omega 3 fatty acids may protect against the
shortening of the telomeres at the ends of
chromosomes which is a process that has been
identified as a marker of cell aging and
associated with cancer risk.
Eat Foods Rich in Omega 3 Fatty Acids
• Dark green leafy vegetables
• Wild cold-water fish such as wild salmon, sardines,
mackerel, bluefin tuna, albacore tuna, bluefish
• Walnuts, macadamia nuts
• Soybeans, edamame and tofu
• Flaxseed, chia and pumpkin seeds
• Flaxseed, walnut, wheat germ and hemp oils
• Game meat or grass-fed meats, dairy products from
grass-fed animals
• Omega 3 eggs
Eat Nuts and Seeds
• Eat them in moderation
• Excellent source of fiber minerals and healthy
• As a snack; measure out a small handful and
close the container to avoid mindless or overeating
• Quality matters and rancid nuts and seeds
should be avoided. Keep them in the freezer.
Easy Ways to Add Anti-Inflammatory Foods to Your Diet
• Add ground flaxseeds to oatmeal or yogurt
• Add chopped chard, kale or dark leafy greens to soups
and salads
• Make variations of hummus using white beans,
edamame or lentils
• Snack on roasted pumpkin seeds instead of chips
• Add chopped walnuts to salad or hot cereal
• Make homemade salad dressings using olive or flaxseed
• For meat-eaters, use grass-fed meats and wild fish or
eat less animal protein
Drink More Fluids
Your Body’s Detox
• Water hydrates your cells and
flushes out waste products
from food, medications and
the environment
• Aim for 8 cups daily
• Drink more on hot days and
with exercise
Our Detoxification System
Key points from today
• Inflammation contributes to cancer cell growth
• What you can do to minimize inflammation
Eat mostly plants
Maintain a healthy weight
Minimize alcohol consumption
Increase omega 3 fatty acids
Drink plenty of fluids
Questions ?
Linda Kasser, RD, CSO, CD
[email protected]