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Food for Thought: Taking a Closer Look at Nutrition and Cancer Messages in the Media Cancer Connections July 23, 2016 Jocelyn Lutkus RD, CSO, LDN Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims • Eating Right Shouldn’t Be Complicated Sugar and Cancer • Sugar is converted into a substance called acetyl CoA which fuels healthy cells and cancer cells alike1 - Cancer cells more active than normal cells • No carbohydrate consumed, acetyl CoA is still produced - Breakdown of fat/protein - Cancer cells can’t process breakdown of fat/protein as well1 Sugar and Cancer • Investigating the idea that cancer may respond more to insulin in bloodstream released from eating high carbohydrate foods2 • Insulin is considered a growth factor which can turn on other reactions and cancer cell growth2 • Increased sugar intake can lead to weight gain2 - Increased weight/obesity can lead to inflammation, release of hormones (ex: insulin) which promote cell growth - Higher weight can lead to more insulin available in the bloodstream - Inflammation and promotion of cell growth can lead to cancer formation Sugar and Cancer • Critical look: - How does a cell determine sugar from a piece of cake or an apple? - Excess sugar can lead to weight gain • Higher weight can increase risk for various types of cancer • Bottom line: Everything in moderation - Save the piece of cake for special occasions, not every day - Try to choose less refined sugars - Use the Plate Method3 The Plate Method http://platemethod.com/ Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims Artificial Sweeteners & Cancer • Synthetic substances as an alternative to sugar • Types of artificial sweeteners: - Asparatame (NutraSweet®/Equal®) - Saccharin (Sweet n’ Low®) - Sucralose (Splenda®) Artificial Sweeteners & Cancer • Aspartame4 - The Food and Drug Administration says aspartame is "one of the most exhaustively studied substances in the human food supply, with more than 100 studies supporting its safety.“ - Animal studies • Showed increased incidence of cancer in mice exposed to 4000 g/kg/day - Human studies • Study suggested increased rate of brain tumors in 80’s linked to aspartame • National Cancer Institute showed evidence that tumors spiked in the 70’s and often in population >70, a group exposed to the least amount of aspartame • Aspartame was introduced in the early 80’s • NCI looked at 500,000 people and cancer incidence; no higher levels found in those who drank beverages with artificial sweeteners vs those who did not Artificial Sweeteners & Cancer • Aspartame4 - Critical look: • FDA set acceptable daily intake (ADI) for humans at 50 mg/kg/day (on average drinking 19 cans of diet soda daily or using 107 packets of sweetener) • ADI set to be 100 times less than the amount which could cause health concerns Artificial Sweeteners & Cancer • Saccharin5 - In 1977, a study was published linking exposure of rats to saccharin caused bladder cancer • FDA removed saccharin from market - Again, rats had been exposed to very high doses of saccharin • Additional studies found that rats form a substance in their urine when exposed to high levels of saccharin that can lead to damage to the lining of the bladder and encourage cancer cell growth • Humans have not been observed to have the same reaction as rats • Saccharin reintroduced in the early 2000’s Artificial Sweeteners & Cancer • Sucralose (Splenda)6 - Relatively new sweetener - Some studies show health concerns regarding consumption • Insulin resistance • May consume more calories, crave sweet foods - Because it is newer, long term effects unknown Artificial Sweeteners & Cancer • Bottom line: - Research indicates consumption of aspartame and saccharin are safe at typical levels of consumption - Some choose to eliminate these substances from their diet altogether out of caution. Also OK! Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims Alkaline Diet • An alkaline diet is based off the idea that your body breaks down food and leaves behind a residue or “ash”. This can be defined as acidic or alkaline. 6 • Proponents of the diet propose that cancer thrives in an acidic environment, therefore they aim to switch their body to an alkaline environment through the foods they eat. Alkaline Diet • Critical look: - Blood pH is tightly regulated and is slightly alkaline at 7.46 • Kidneys and lungs work to keep it tightly regulated • Shifts in blood pH can be due to major medical conditions, not able to be affected by something you ate - Urine pH may be affected by diet6 • Cancer cells are not affected by urine pH, but blood pH • Bottom line: - Plant-based diet can have many health benefits - Choose more plant-based foods for overall health - Many “acidic” foods are also nutritious • Whole grains, blueberries, beans, nuts Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims Juicing and Cancer • Many people start juicing to dramatically increase their intake of fruits and vegetables • Often extract the juice to drink but leave behind the pulp - Pulp has fiber and other nutrients that aren’t consumed • Bottom line: Juicing can be part of a healthy regimen, as long as it complements your intake of fruits and vegetables - By eating whole fruits/vegetables, you also eat fiber and other nutrients lost with juicing - May be beneficial for those with eating difficulty - Try to eat a protein source if drinking more than 4-6 ounces • Cheese, yogurt, egg, handful of nuts, peanut butter Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims • Eating Right Isn’t Complicated Supplements & Cancer • Various “miracle cures” by using various herbs, vitamins, minerals • Not regulated by the FDA - Unsure if they may interact with treatment - Unsure of effectiveness - Unsure of purity - Unsure of truthful amounts on the label • American Institute for Cancer Research “recommends against relying on supplements to protect against cancer”. 7 Supplements & Cancer • Critical look: 7 - Certain nutrients may be better absorbed through whole foods versus in a pill - Fiber, other nutrients may act together to help increase absorption versus in a pill alone - Often lack trials/evidence that they may not interfere with treatment or other medications • Bottom line: Discuss any supplement use with your MD and/or dietitian Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims • Eating Right Isn’t Complicated Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims Separating Fact from Fiction in the Media • Information can often be skewed or sensationalized in the media - May not provide an accurate picture - May not provide the whole picture • Nutrition is an ever-evolving science • People’s bodies are different and may respond differently to different environments/exposures to certain foods Separating Fact from Fiction in the Media • When reading or listening to a news story ask yourself: - Is the information reported based on one study? • Decisions need to be made based on totality of evidence Separating Fact from Fiction in the Media • When reading or listening to a news story ask yourself: - Is the information reported based on one study? • Decisions need to be made based on totality of evidence - Was this a lab study (cells in a petri dish)/animal study/human study? • Animal studies may help us understand some ways nutrients interact in the body, but not always exactly the same Separating Fact from Fiction in the Media • When reading or listening to a news story ask yourself: - Is the information reported based on one study? • Decisions need to be made based on totality of evidence - Was this a lab study (cells in a petri dish)/animal study/human study? • Animal studies may help us understand some ways nutrients interact in the body, but not always exactly the same - How big was the sample size? • The bigger the sample size the better • Reduces likelihood that cause was through chance alone Separating Fact from Fiction in the Media • When reading or listening to a news story ask yourself: Is the information reported based on one study? • - Was this a lab study (cells in a petri dish)/animal study/human study? • - The bigger the sample size the better Reduces likelihood that cause was through chance alone What type of study was it? • • • - Animal studies may help us understand some ways nutrients interact in the body, but not always exactly the same How big was the sample size? • • - Decisions need to be made based on totality of evidence Gold standard is a double-blind, randomized, control trial This allows for comparison between a “treatment” versus “no treatment” This accounts for a potential for a researcher to intentionally or unintentionally skew data based on their own bias • Often costly, time-consuming, may be unethical • Next best is human prospective cohort studies • Large groups of people observed over time for development of diseases/medical conditions What else did they look at? • • Could another factor influence? People who carry lighters are at an increased risk for lung cancer Talk to a Registered Dietitian • Registered Dietitians have received unique training - Only those who have completed at least 4 years of undergraduate coursework, a 1 year supervised practice, and completed a comprehensive exam to ensure competency may call themselves dietitians - Receive training in rigorous courses such as anatomy, physiology, biochemistry, metabolism - Take classes in statistics to learn how to decipher results of studies - Uniquely trained to take complex scientific information and translate it to the general public to provide easy-to-understand, evidence-based information - Adhere to a strict code of ethics • Anyone can call themselves a nutritionist • College educated vs weekend seminar • Buyer beware Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims How to Evaluate a Nutrition Message • When listening to a nutrition message, ask yourself: - Does this person have something to sell/gain by presenting this message? • Someone promoting a supplement that they sell • Make sure they are unbiased - Does this sound too good to be true? • Anything claiming a cure should be a red flag - Where is the evidence? • Are there studies cited that can be reviewed? Overview • Review popular nutrition & cancer claims - Sugar and cancer - Artificial sweeteners and cancer - Alkaline diet - Juicing and cancer - Supplements and cancer • Learn how to decipher fact from fiction - How to evaluate science in the media - Signs of bogus claims • Eating Right Isn’t Complicated Eating Right Isn’t Complicated Resources for Nutrition and Cancer Risk Reduction • American Institute for Cancer Research - www.aicr.org • Academy of Nutrition and Dietetics - www.eatright.org • International Food Information Council - www.foodinsight.org References 1. Klement, R and Kammerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer? Nutr Metab (Lond). 2011; 8: 75. 2. http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=13631&news_iv_ctrl=0&abbr=res_ 3. http://www.choosemyplate.gov/ 4. http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/aspartame 5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198517/ 6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/ 7. http://preventcancer.aicr.org/site/PageServer?pagename=tellmeabout_supplements Questions? Jocelyn Lutkus RD, CSO, LDN [email protected] 312-695-1192