CANCER PREVENTION FOOD

Prof. Irena Drmić HofmanUniversity of Split School of Medicine

University Hospital SplitCROATIA

City of Split, Croatia

Learning with heart

OUTLINE

• Cancer etiology

• Pathophysiology

• Nutrition and carcinogenesis

• Nutrients for cancer prevention

1. CANCER ETIOLOGY

• Cancer involves the abnormal division and reproduction of cells that can spread throughout the body

• Usually thought of as a single disease, actually consists of >100 distinct types

Non-lethal damage of the cell is a basis of cancerogenesis

Let’s start with numbers…

• Am Cancer Soc (2009) Predicts lifetime risk for developing cancer: ~1/2 men and little more than 1/3 women

• Although fewer Americans are dying from cancer (survival rate now 66% vs 50% in the 1970s)

Data suggests

• 1/3 of 560,000 cancer deaths may be attributed to nutrition and lifestyle

• Poor diet, physical inactivity, alcohol use, and overweight and obesity

• Almost an additional 171,000 deaths are caused by tobacco use (Brawer et al., 2009)

• 30% of cancer deaths attibuted to poor nutrition!

• Standards of Practice and Standards of Professional Performance for Oncology Nutrition Practice (Robien et al., 2010)

MOST PREVALENT TYPES OF CANCER IN MEN

• Prostate

• Lungs and bronchus

• Colorectal

• Urinary bladder

MOST PREVALENT TYPES OF CANCER IN WOMEN

• Breast

• Lung and bronchus

• Colorectal

• Uterine cancer

CANCER PREVENTION GUIDELINES

• Protection from the sun

• Reducing tobacco use

• Maintaining a healthy body weight

• IMPROVING DIET

• Increasing regular physical activity

2. PATHOPHISIOLOGY

• Carcinogenesis is the origin or development of cancer

• Changes in gene function cause normal cells to transform into cancerous cells

GENOMICS

• Oncogenes are altered genes that promote tumor growth and change programed cell death (apoptosis)

• Tumor supressor genes are the opposite of oncogenes, they became dactivated in cancer cells

• Only 5-10% cancers are result of inherited genetic alteration

CANCEROGENESIS

WHAT IS CARCINOGEN?

• Physical, chemical or viral agent that induces cancer

• Carcinogenesis is a biologic, multistage process that proceeds in three distinct process:

Initiation, promotion and progression

CANCEROGENESIS IS STEPWISE PROCESS

PHASES OF CARCINOGENESIS

• 1. INITIATION involves transformation of cells produced by the interaction of chemicals, radiation or viruses with cellular DNA

• Transformation occurs rapidly, but cells can remain dormant for a variable period until they are activated by a promoting agent (years or even decades)

PHASES OF CARCINOGENESIS

• 2. PROMOTION: initiated cells multiply and escape the mehanism set in place to protect the body from the growth and spread of such cells

• Neoplasm, new and abnormal tissue with no useful function, is established

PHASES OF CARCINOGENESIS

• 3. PROGRESSION: tumor cells aggregate and grow into a fully malignant neoplasm or a tumor

COLON CANCER

NUTRITION AND CANCEROGENESIS

• Nutrition may modify the carcinogenic process at any stage, including carcinogen metabolism, cellular and host defense, cell differentiation, and tumor growth

• Nutrition and diet contribute approx. 35% to causal factors for cancer (Greenwald et al., 2006)

NUTRITION AND CANCEROGENESIS

• Diets contain both inhibitors (antioxidants: vit. C, E, A and carotenoids, Se and Zn and phytochemicals)

• and enhancers of carcinogenesis (polycyclic aromatic hydrocarbons-PAH, that form with a grilling meat at high heat; alcohol)

CANCER PREVENTING FOOD PLAN

NUTRITION AND RISK FACTORS FOR CANCER

OBESITY AND BODY WEIGHT

OBESITY

• Risk factor for cancer and may account for 6% of all cancers (Polednak, 2008)

• Currently, 68% of all American adults are overweight or obese (Flegal et al., 2010)

• Caloric restriction, without malnutrition, have a positive effect on cancer prevention in animals (Longo et al., 2010)

• Translate to humans?

OBESITY

• Positive association of BMI and cancers of the esophagus, pancreas, gallbladder, liver, breast (postmenopausal), endometrium, kidney, colon and rectum (Toles et al., 2008; WCRF and AICR, 2007)

• BMI should be between 21 and 23 (throughout childhood at lower end of normal BMI)

• Obesity, age, hyperglycemia and the incidence of metabolic syndrome play a role in the circulating levels of insulin-like growth factor-1 (IGF-1)

• Stimulates the growth of cancer cells (prostate, breast, lung, colon) and inhibit their death (Blackburn, 2007; Pollack, 2008)

REDUCE FAT

DIETS HIGH IN FAT

• Often contain significant ammounts of meat

• Link between meat and colorectal cancer: production of carcinogens from a high-fat diet, from heterocyclyc amines (HCAs), and/or polycyclic aromatic hydrocarbons (PAHs) from cooking; formation of carcinogenic N-nitroso compounds (NOCs) from processing (WCRF and AICR,2007)

DIETS HIGH IN FAT

• Saturated fat in red meats may be associated with an increased risk of colorectal, endometrial, and possibly lymphoid and hematologic cancers (Ferguson, 2010; WCRF and AICR, 2007)

Reduce Fat

• saturated fats may increase the risk of developing cancer. Further, diets high in fat have been linked to obesity which in turn has been linked with increased risk of some cancers

Why reduce fat

• Reduce the amount of saturated fat in your diet by limiting your consumption of red meat and full-fat dairy products and avoid foods that trans fats

• Keep your overall fat intake to less 20% of your total calories each day (for a 2,000-calorie diet, < 45 grams) and choose foods that are rich in -3 essential fatty acids

FRENCH FRIES OR CANCER FRIES?

French fries are made with hydrogenated oils and then fried at high temperatures (80X more fat). They also contain cancer- causing acryl amides which occur during the frying process.

Consumption of Red Meat

Eliminate or Limit Red Meat

• The China Study and several medical studies indicate a relationship between consuming animal proteins and increased risk for cancer

• It's been suggested that diets high in animal fat may increase the body's levels of bile, which can feed tumors. In cultures where meat is minimally consumed or not consumed at all, the incidences of certain cancers are markedly lower than in the Western countries

Eliminate or Limit Red Meat

• Consider eliminating or limiting your consumption of red meat and other animal proteins, seem to reduce the risk of developing breast and prostate cancer. Consider using soy milk?

Processed meats and bacon

Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer

ALCOHOL

• Increased risk for cancers of the mouth, pharynx, larynx, esophagus, lung, colon, rectum, liver and breast (World Cancer Research Fund, and American Institute for Cancer Research, 2007)

Reduce salt

•Contains 55 mg Na / bottle ~ as in 1 pizza•↑ Na, ↑ thirsty•↑ salt, ↑ sugar to improve the taste

FOOD ADDITIVES?

SHORT LIST OF DANGEROUS ADDITIVES

• Artificial Sweeteners (Aspartame, Acesulfame-K ; Stevia is the choice)

• Monosodium Glutamate • Artificial Food Colorings • Sodium Nitrate/Sodium Nitrite • Sulfur Dioxide and bisulphite• High Fructose Corn Syrup• Trans Fats • Butylated hydroxyanisole (BHA) and butylated

hydrozyttoluene (BHT)• Potassium Bromate …

http://www.healthytimesblog.com/wp-content/uploads/2011/02/honest_labels_600.jpg

Increase Fiber

Increase Fiber

• Help move potential carcinogens through the intestines faster, lessening the amount of time the intestinal wall is exposed to them

• Fiber is also thought to help absorb bile acids, thus preventing decaying food from encouraging harmful changes in cells

Increase Fiber

• Try to eat at least 25 gr of fiber today from a variety of sources, with an emphasis on whole grains, legumes and fresh vegetables

• Start by trading your favorite breakfast for bran cereal or slow-cooked oatmeal, adding beans to soups and salads and transitioning from "white foods" like bread and pasta to their whole-grain counterparts

Eat More Raw Fruits and Vegetables

More Raw Fruits and Vegetables

• Gradually increase intake until you're eating 5 to 9 servings daily. If you don't like your vegetables raw, prepare them lightly steamed or blanched (3 min)

Eat More Raw Fruits and Vegetables

• Plants produce phytochemicals to protect themselves and these phytochemicals may support the body's immune system and many have antioxidant properties that help prevent certain types of cancer.

• FRUITS AND VEGETABLES ALKALIZE YOUR BODY!

Change Your Oil

Change Your Oil

• Avoid vegetables oils that are high in saturated fats. Choose cold, expeller-pressed olive oil, canola oil, sunflower oil, flaxseed oil or walnut oils for cooking, each of which contains good amounts of heart-healthy monounsaturated fats and offers a higher ratio of -3 to -6 essential fatty acids

Change Your Oil

• On the occasions when you do cook with oil, be sure to cook at medium to medium-low heats. Heat changes oil's molecular structure and heating to the point of smoke may create carcinogenic compounds in the oil. For high-heat cooking needs look for specially formulated high-heat canola oils or choose grapeseed oil which retains its molecular structure at higher temperatures

Drink Green Tea

• Green tea and black tea contain the antioxidant-rich polyphenols, which appear to prevent cancer cells from dividing. Dry green tea leaves also contains catechins, which may inhibit the growth of cancer cells. Consider transitioning from coffee to tea or making hot and cold teas your beverage of choice throughout the day

DRINK WATER

• 8 glass of water (“daily eight”)

• Important in diet burdened with salt and fat

• Detoxification (meat hormons, pesticide residues, industrial chemicals, refined sugars)

Have a Glass of Wine

Have a Glass of Wine

• Red grapes and the wine contain polyphenols, antioxidants that may protect against several types of cancer, as well as resveratrol which blocks a key protein that cancer cells need to survive. Although several cancer studies find in favor of drinking red wine, drinking large amounts is discouraged. Drink red wine in moderation by having one 1-2 glasses daily at mealtime

NUTRITION FOR BREAST CANCER PREVENTION

1. Broccoli

• Most attention as a breast cancer prevention food

• Research has shown it blocks tumor growth, preventing the further spread of cancer if it does occur

• anti-cancer benefit from other cruciferous veggies, including cauliflower, cabbage, Brussels sprouts, and kale - eat one or more of these vegetables every day

2. Garlic

•Garlic seems to have an impact on cell cycling (process by which a normal, healthy cell might become cancerous)

•Credit for regulating this goes to the component of garlic called allyl sulfide Allyl sulfides are found throughout the onion family

•Prevents breast cancer

3. Apples

An apple a day may keep cancer away — but there’s a catch.

•Peeling apple-tossing away a rich source of fiber, antioxidants, and other compounds needed for anti-cancer nutrition.

•Lab studies show that apple peel can actually fight the spread of cancer cells.

4. Pomegranates

•Early stages research

•Cell culture study suggests that the fruit contains a compound that might help fight cancer’s growth — especially estrogen-dependent cancers (breast, endometrium).

•Also help fight heart disease and prostate cancer.

5. Walnuts

•Walnuts contain many helpful nutrients and healthy -3 fatty acids, which help your body fight inflammation

•Research also suggests that walnuts may actually slow the growth of breast cancer tumors, so this tasty nut could play a role in breast cancer management even after diagnosis

6. Fish

•Great sources of -3 fatty acids include certain fish and fish oil (salmon, mackerel, sea bass, and tuna)

•Smart protein source since nutrition recommendations include limiting intake of red meat and processed meats, such as bacon and packaged deli meats

7. Flaxseed

•Flaxseed oil, or the seed itself, ground into a flour-like dust•Milled flaxseed has a component called lignans•Lignans may decrease cancer growth; perfect for a breast cancer management diet •Buy ground flaxseed or grind the seeds using a coffee grinder, then sprinkle the flaxseed on salads or in muffins

8. Soybeans

•Mixed reviews regarding adult breast cancer prevention, but preteen girls could eat two servings of soybean products a day, and get anti-cancer nutrition benefits later in life

•On the other hand, against adult women taking soy or isoflavone supplements these products contain estrogen-like compounds

9.Orange Fruits and Vegetables

•Carrots, cantaloupe, and sweet potatoes — foods rich in the form of vitamin A – carotenoids (and 600 different carotenoids)

•Higher levels of carotenoids in a bloodstream- lower risk for breast cancer

•Increase intake of orange, red, yellow, and even dark green foods

10. Berries

•Blueberries, blackberries, raspberries, and strawberries add color, variety, and flavor

•Also power-packed with vitamins, minerals, and antioxidants

•Recent research suggests that blueberries enhance the effect of the often-prescribed drug tamoxifen in fighting breast cancer cells.

11. Green Tea

•Green tea and white tea contain catechins, extracts that seem to show some benefit in cancer prevention

•Green tea is particularly effective at protecting cells against environmental exposures that might increase the risk for cancer

•Drink four or more cups a day - to achieve this effect

12. Turmeric

•The spice that gives curry its beautiful yellow color contains a chemical called curcumin

•Lab studies using curcumin supplements have shown that it could play a role in helping fight tumors when combined with certain drug-based therapy

•Also anti-inflammatory effect that could protect overall health

A healthy diet isn't a magic bullet against cancer

CHANGE THE HABITS!