Nutrition for Cancer Survivors
Transcription
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 and vegetables. Inflammation, Cancer and Diet 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 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 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 genes). 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, liver). Venil N. Cancer, Inflammation, and Insights from Ayurveda 2012 Inflammatory Anti-inflammatory Chronic inflammation is a chaotic cellular environment that creates disorder and contributes to abnormal cell growth. Inflammation Promotes Tumor Formation and Growth (Metastasis) • 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 Whole soy and green tea Curcumin suppresses these Cinnamon and cloves block this pathway 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 Inflammation 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 genes 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 (IGF-1). • 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 minerals. www.meatlessmonday.com Diagram Showing Effects of Whole Soy and Green Tea on Inflammation and Prostate Cancer Plants and Intestinal Bacteria • Gut bacteria comprise 70% of our immune system. – 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 death. • 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 Inflammation • Insulin growth factor (IGF-1) • 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 receptors. 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 consumption. – – – – 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 fats • 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 oils • 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 206-288-1161 [email protected]