New CA- Nutrition and cancer prevention

An emerging body of research points to sedentary behavior, independent from physical activity, as a risk factor for cancer, possibly because of its effect on ____, ____, and ___

insulin levels, waist size, and inflammation

Regardless of sodium restrictions for cardiovascular health, reducing sodium intake substantially below 2,400 IS/IS NOT associated with further protection from cancer.

is not

Small or moderate amounts of alcohol may protect against coronary heart disease. Alcohol consumption IS/IS NOT recommended as a heart healthy strategy.

is not

Fat cells produce other hormones, such as ____. Increased ____ levels associated with obesity may promote cell proliferation and angiogenesis while inhibiting apoptosis

leptin;leptin

Research indicates that diets rich in ___ protect against weight gain, overweight, and obesity. by supporting ____ this diet helps prevent cancer

low energy-density foods; a healthy body weight

Overweight and obesity are associated with a state of _____ that can promote cancer development through elevations in DNA-damaging free radicals and cell-to-cell signaling proteins.

low-grade chronic inflammation

Second only to not using tobaccos, _____ may be the most important lifestyle factor to reduce cancer risk.

maintaining a healthy body weight throughout life

Some early studies in rodents suggest that genistein increased growth of estrogen receptor positive breast cancer and promote breast cancer growth. However, recent research shows that is not true. Why?

mic and rats metabolize phytoestrogens such as genistein differently than humans

Observational studies show _____ regarding an associated between lignin intake and breast cancer.

mixed results

There is convincing evidence that alcoholic drinks cause cancers of the ____, ___ and ___, ___, ____a nd ____ and are probably causes of cancer of the ____ and ___

mouth, pharynx and larynx, esophagus, colrectum (men), and breast (premenopausal and postmenopausal); colorectum (women) and liver

Foods that supply carotenoids, such as dark leafy greens and orange vegetables and fruits, help protect against caner of the ____ , ___, ____, and ____

mouth, pharynx, larynx, and lung

Non-starchy vegetables and fruits protect against cancers of the ___, ___, __, ___ and __

mouth, pharynx, larynx, esophagus, stomach, and lung

The intestinal microbiota, trillions of bacteria that live in the colon, act on fermentable fiber and resistant starches to produce butyrate, a short-chain fatty acid that promotes ____ and ____

normal colon cell development and may reduce inflammation

Foods high in energy density include: These types of foods tend to have higher amounts of __ and ___

oils, fats, chips, crackers, and most cookies; fat and/or sugar

Not all energy-dense foods should be avoided. some ___, ___, and ___ provide important nutrients.

oils, nuts, and seeds

Plants are rich in ____, __ and ___ that, as part of the whole food, protect against caner.

phytochemicals, vitamins, and minerals

The soy isoflavones genistein and daidzein are classified as ____ and can bind with estrogen receptors. In cell and animal studies, these compounds have ___ the growth of cancer cells.

phytoestrogens; slowed

In cell and animal studies, tea _____ may directly inhibit development of varies type of cancer.

polyphenols

Not all animal foods are associated with cancer. There is lack of substantial evidence that ___, __, or __ are associated with either an increase or decrease in cancer risk

poultry, fish, eggs

Emerging evidence suggests that a ______ may provide greater protective effects than consumption of any particular nutrients, compounds, or individual foods.

predominantly plant based diet

Foods that contain selenium and foods containing lycopene protect against ____ cancer.

prostate

In cell and animal studies, flaxseed or enterolactone has been shown to inhibit growth and metastasis of ___ cancer

prostate

Selenium from food and supplements may play a role in reducing the risk of _____ cancer, especially in its aggressive form

prostate

Beyond breast cancer, only limited research in human links soy or total isoflavone consumption to lower risk of cancer of the ____, ____, ____ and ____

prostate, stomach, lung, colon

Physical activity also prevents many cancers indirectly through ____

protection of weight gain, overweight, and obesity.

AICR/WCRF recommendations for cancer prevention including limiting consumption of ____ such as ___, ____, and ____, and avoiding consumption of ____

red mead ; beef, pork, lamb; processed meat

___ and ____ are probably a cause of stomach cancer.

salt and salt preserved foods

Obtaining nutrients and other compounds from ___ rather than ___ provides potential for beneficial and synergistic effects against carcinogenesis

food; dietary supplements

Processed meats include

ham, bacon, frankfurters, hot dogs, pastrami, salami, and other sausages prepared by these methods

Red meat contains _____, which can lead to the production of free radicals, resulting in oxidative damage to DNA, protein and cell membranes.

heme iron

Cooking meats at high temperatures or over open flames causes production of ____ and ____, both of which are carcinogenic in animals

heterocyclic amines and polycyclic aromatic hydrocarbons

Consumption of plant foods may affect ____ influential in the cancer process. For example, high dietary fiber intake and reduced breast cancer may result from _____ and ___

hormones ; reduced levels of circulating insulin and related factors (such as IGF-1) that promote cell proliferation; decreased circulating estrogen levels due to its decreased reabsorption in the digestive tract

It is established that breastfeeding offers ___ to babies, and as an additional benefit, babies who are breastfed are less likely to ____

immune and other health benefits; become overweight or obese in later childhood

Soy may affect cancer risk in some people more than others due to ______

individual differences in genetics and gut bacteria that ferment soy compounds into their active form

Lab studies suggest that omega-3 fatty acids from both marine and plant sources may protect against cancer by acting to decrease ____, ____, and ____ while increasing ____.

inflammation, cell proliferation, and angiogenesis

Tissue specific alcohol-related cancer risk may reflect direct tissue damage resulting in ______, _____ and ____

inflammation, interactions with folate, interference with estrogen pathways

Soy foods DO/DO NOT increase cancer risk

DO NOT

There has been a concern whether, as phytoestrogens, the lignans in flaxseeds could increase incidence of recurrence of breast cancer, or interfere with tamoxifen. Studies DO/DO NOT support this association, and according to animal studies, flaxseed may ____ tamoxifen's effectiveness

DO NOT; enahnce

Soy consumption is associated with lower risk of ___ cancer in Asia, where throughout their lives women consume moderate amounts of soy

breast

Results surround green tea are inconsistent, but show potential for reducing risk of several cancers, such as ___, ____, and ___

breast, ovary, and endometrium

Energy density is also called:

calorie density

When discussing energy density with the public, it may be helpful to use the term _____, as the meaning of "energy" is often misunderstood by consumers

calorie density

Five population studies of breast cancer survivors and one pooled analysis study concluded that moderate consumption of soy foods DOES/DOES NOT increase risk of breast cancer reoccurrence risk, including estrogen receptor-positive types

does not

Foods containing Vitamin C and foods containing beta-carotene protect against ___ cancer

esophageal

Greater lifetime duration of breastfeeding is associated with ____

greater reduction in breast cancer risk

Observational studies in humans suggest that soy may _____ against some forms of cancer.

protect

_____ is a phytochemical found in red wine that laboratory studies link with anti-carcinogenic effects.

resveratrol

People who consume red meat should consume ____ oz per week and ____ processed meat

<18 oz; very little, if any

What are the mechanisms by which breastfeeding may protect against breast cancer

1) Breastfeeding contributes to elimination of cells with potential DNA damage through exfoliation of breast tissue during lactation and a major apoptosis of epithelial cells at the end of breastfeeding 2) Breastfeeding tends to lead to amenorrhea, which reduces lifelong exposure to estrogen

Alcohol increases cancer risk by what pathways?

1) Ethanol in alcoholic beverages is classified as a human carcinogen, and when it is metabolized it forms acetaldehyde another human carcinogen. Ethanol acts as a solvent, enhancing penetration of carcinogens into cells 2) alcohol metabolism generates reactive oxygen species that can damage DNA cells 3) Alcohol acts synergistically with tobacco multiplying the risk of mouth and throat cancer for people exposed to both. 4) Tissue specific alcohol-related cancer risk may reflect direct tissue damage resulting in inflammation, interactions with folate, interference with estrogen pathways

What are the 5 mechanisms through which body fatness can influence cancer risk?

1) Excess body fat is associated with Insulin resistance, resulting in elevated levels of insulin and increased bioavailable IFG-1. This increase in IGF-1 can stimulate a mitogen-activated protein kinase pathway, promoting growth and reproduction of cancer cells and inhibiting apoptosis (programmed cell death) 2) Adipose tissue is the primary site of estrogen production in postmenopausal women. Obese women tend to have higher levels of estrogen, which is associated with endometrial cancer and postmenopausal breast cancer. 3) Fat cells produce other hormones, such as leptin. Increased leptin levels associated with obesity may promote cell proliferation and angiogenesis while inhibiting apoptosis 4) Excess body fat is linked with decreased levels of the adipose hormone, adiponectin. Adiponectin is a protective hormone that decreases insulin resistance and inflammation and promotes apoptosis. 5)Overweight and obesity are associated with a state of low-grade chronic inflammation that can promote cancer development through elevations in DNA-damaging free radicals and cell-to-cell signaling proteins.

What potential mechanisms can excessive salt intake possibly lead to stomach cancer

1) Excessive salt intake may damage the protective mucosa lining of the stomach, leading to hyperplasia that increases inflammation and potential for mutations 2) Salt has been shown to increase formation of endogenous N-nitroso compounds 3)A high-salt diet may enhance H. Pylori colonization and interact synergistically with these bacteria and with carcinogens

What are the plausible mechanisms to explain the association between consumption of red meat or processed meat and colorectal cancer?

1) Red meat contains heme iron, which can lead to the production of free radicals, resulting in oxidative damage to DNA, protein and cell membranes. Heme iron promotes formation of NCOs within the gut. 2) NCOS are formed with nitrites used to preserve meat combine with amines from amino acids; they can also be created during the curing process as well as in the stomach. 3) Cooking meats at high temperatures or over open flames causes production of heterocyclic amines and polycyclic aromatic hydrocarbons, both of which are carcinogenic in animals

What are the mechanisms through which physical activity could influence cancer risk?

1) reduced weight gain and easier maintenance of a healthy level of body fat 2) improved insulin sensitivity and reduce insulin levels 3) decreased levels of bioavailable sex steroid hormones 4) more rapid gut transit time, which reduces exposure of colon cells to carcinogens 5) improved immune function

Moderate soy consumption is considered _____ daily of whole foods such as ______. One serving averages about _____ gm protein and ___ mg isoflavones

1-2 standard servings daily; tofu, soy milk, edamame, or soy nuts; 7; 25

Evidence suggests that consuming ____ of ground flaxseed daily appears to be safe, and may contribute to lower risk of breast cancer.

1-4 tablespoons

An estimated _____ of the most common cancers and ____ of cancer overall could be prevented by healthy patterns of diet and physical activity

1/3; 1/4

The American Cancer Society recommends that adults get ____ minutes of moderate activity or ___ minutes of vigorous activity each week.

150 minutes; 75 minutes

The risk of colorectal cancer increased by an estimated ___% for every 100 gm of red meat consumed daily and ___% for ever 50 gm of processed meat consume

17; 18

Approximately ____% of the cancers in the US are attributed to overweight and obesity

20%

AICR recommends that waist circumference by no larger than ____ inches in men and ___ inches in women.

37; 31.5

_____ servings of non-starchy vegetables and fruits daily meet recommendations to reduce cancer risk in addition to being linked with cardiovascular health benefits

5 or more servings a day

AICR/WCRF recommends that individuals limit consumption of salt and processed foods with added salt, aiming for an intake of ________ of sodium daily.

<2.400 mg

Flaxseed is also a source of ____, which can be converted into the body to long-chain omega-3 fats EPA and DHA.

ALA

Studies have primarily focused on ___ and ___ present in flaxseed.

ALA and lignans

____ from fish and ____ from plants protect against cancer by acting to suppress biosynthesis of tumorigenic, pro-inflammatory eicosanoids; altering cell membrane structure and receptor function; and influencing transcription factor activity, gene expression, signaling pathways, and production of reactive oxygen species

EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) from fish and ALA (alpha-linolenic acid)

A high-salt diet may enhance _______ and interact synergistically with these bacteria and with carcinogens

H.Pylori colonization

Visceral fat stores are associated with ___ and influence the body's response to _____.

Hyperinsulinemia; inflammation

Some studies suggest that lignans may decrease ____ and other growth factors that decrease cell proliferation and the angiogenesis that enables tumor growth.

IGF-1

Excess body fat is associated with ____, resulting in elevated levels of ____ and increased ______. This increase in ____ can stimulate a mitogen-activated protein kinase pathway, promoting growth and reproduction of cancer cells and inhibiting apoptosis (programmed cell death)

Insulin Resistance; insulin; bioavailable insulin-like growth factor 1(IGF-1)l IGF-1

___ are formed with nitrites used to preserve meat combine with amines from amino acids; they can also be created during the curing process as well as in the stomach.

N-Nitroso compounds (NOCs)

Salt has been shown to increase formation of endogenous __________

N-nitroso compounds

Many vitamins and minerals, such as carotenoids, flavonoids, and other polyphenols, and allyl sulfur compounds act as antioxidants, and are important for _____. Alpha-carotene and beta-carotene promote ____ that helps control cell growth.

Protecting DNA; gap junction intercellular communication (cell-to-cell communication)

What does AICR/WCRF stand for?

The American Institute for Cancer Research and the World Cancer Center Research Fund

Most recent research on flaxseed and cancer has focused on ____ cancer.

breast

The concept of a _______ refers to research showing supplementation with a particular nutrient in people with low dietary intake or low body levels of a nutrient may be beneficial, whereas supplements may have no effect or even be harmful in people who have already had adequate amounts or if given to achieve super-physiologic levels

U-shaped curve

Excess body fat is linked with decreased levels of the adipose hormone, _______. ______ is a protective hormone that decreases insulin resistance and inflammation and promotes apoptosis.

adiponectin; adiponectin

______ generates reactive oxygen species that can damage DNA cells

alcohol metabolism

Breastfeeding tends to lead to ____, which reduces lifelong exposure to estrogen

amenorrhea

Examples of dietary supplements associated with increased risk for cancer include __ &____

beta-carotene and vitamin E

There is convincing evidence that breastfeeding reduces a mother's risk of _______

both pre- and postmenopausal breast cancer

A modest increase in ___ cancer risk occurs even at intakes of the recommended maximum of one standard drink per day

breast

AICR/WCRF advises that if possible, the recommendations for _____ to be followed by cancer survivors. As cancer survivors life increasingly longer, they are at risk of developing______ and are likely to benefit from this guidance.

cancer prevention; new primary cancers as well as other chronic diseases.

Heme iron promotes formation of _______ within the gut.

carcinogenic N-nitroso compounds (NOCs)

Breastfeeding contributes to elimination of ____ through exfoliation of breast tissue during lactation and a major apoptosis of epithelial cells at the end of breastfeeding

cells with potential DNA damage

All forms of physical activity protect against cancers of the ____, __ and ___

colon, breast (postmenopausal), and endometrium

There is convincing evidence that red meat and processed meats are causes of ______ cancer

colorectal

Available evidence on milk, cheese, and other dairy products is difficult to interpret and appears to be conflicting regarding _____ and ____

colorectal cancer (decreased risk) and prostate cancer (increased risk)

Calcium supplements probably protect against ____ cancer, but at levels above 1500 mg calcium daily, risk for ____ cancer increases

colorectal; prostate

Many soy foods are good sources of ___ and _____ and some are fortified with ___

dietary fiber and selenium; calcium

The AICR/WCFR Expert Panel concluded that the overall body of evidence DOES/DOES NOT support the use of dietary supplements as an effective strategy to reduce cancer risk.

does not

Abdominal fatness is associated with increased risk of cancers of the _____, ____, ____, and ____

endometrium, breast (postmenopausal), colorectal, pancreas

___ describes how concentrated foods are in calories and is defined as the calories per gram or per 100 grams of food.

energy (or calorie) density

When plant lignans are consumed, they are converted by the intestinal bacteria to ____, which can be absorbed by the colon and circulate in the blood. The amount of these ____ produced and absorbed varies substantially from person to person.

enterolignans

The epigenetic effects of tea polyphenols have been found to stimulate ____, decrease ___, increase ____, and restrain ____

enzymes that deactivate carcinogens, decrease tumor growth, increase apoptosis, restrain the ability of cancer cells to spread

Interest in green tea and cancer primarily relates to its ____ content

epigallocatechin fallate (EGCG)

There is convincing evidence that body fatness is a cause of cancer of the ___, ___, ____, ___, ___, and ___ and evidence that body fatness probably is a cause of cancer of the ____

esophagus (adenocarcinoma), pancreas, colorectum, breast (postmenopausal), endometrium, and kidney; gall bladder

In some, but not all studies, lignin consumption seems to promote a shift in women's serum _____ to a form less likely to promote cancer.

estrogen

Adipose tissue is the primary site of ____ in postmenopausal women. Obese women tend to have higher levels of ______, which is associated with endometrial cancer and postmenopausal breast cancer.

estrogen; bioavailable estrogen

_____ in alcoholic beverages is classified as a human carcinogen, and when it is metabolized it forms ____, another human carcinogen

ethanol; acetaldehyde

The term "processed meat" refers to meats (usually red meads) preserved by

smoking, curing, or salting, or by the addition of chemical preservatives

Ethanol acts as a ____, enhancing penetration of carcinogens into cells

solvent

Allium vegetables such as garlic, onion, and leeks protect against ____ cancer; garlic and foods that contain dietary fiber protect against _____ cancer.

stomach; colorectal

Steps for promoting low energy-density diets in weight management include

substituting foods low in energy density such as vegetables, fruits, and relatively unprocessed grains for high energy-density foods (particularly those with added fats and sugars)

Studies have shown that soy consumption has any harmful effects with _____, an anti-estrogen medication

tamoxifen

The extent to which alcohol increases cancer risk depends on ______ and _____

the amount of alcohol consumed and the type of cancer being studied

Small studies in humans show that drinking tea can raise ____

the antioxidant capacity

Excessive salt intake may damage ____, leading to hyperplasia that increases inflammation and potential for mutations

the protective mucosa lining of the stomach

Alcohol acts synergistically with _____, multiplying the risk of ___ and __ cancer for people exposed to both.

tobacco; mouth and throat

In men with prostate cancer, flaxseed has lowered ____ and ___

tumor biomarkers and pre-surgery rates of cell proliferation

Even within the normal range of body mass index, both large waist size and excessive adult weight gain are associated with ____ and ___

unhealthy metabolic changes and increased risk of some cancers

Selecting a _____ is important to ensure a broad spectrum of protective compounds and that apparent additive and synergistic effects between them

variety of vegetables and fruits

___ and ___ diets have been associated with reduced incidence of cancer in many ways

vegan and vegetarian

Many low energy-density foods include:

vegetables, fruits, legumes, whole grains

Studies show that high-dose _____ supplements may promote a modest increase in risk of prostate cancer

vitamin E

It is important to emphasize that regular physical activity is not aimed only at ____, but it can also provide ____ regardless of body weight.

weight loss; cancer protective benefits

The term cancer survivor refers to people who ______ including ___

who have been diagnosed with cancer, including those who have recovered from the time of diagnosis onward