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Chemoprevention
Specific compounds or drugs used to prevent, delay, or retard the development of cancer NSAIDS may protect against colon cancer Being tested: polyphenols from fruits and vegetables; green tea; curcumin from curry; resveratrol from grapes and berries
Cancer Tx Protein
Hematopoietic cell transplant (1.5 - 2 g/kg/day) Severe stress (1.5 - 2.5 g/kg/day) Fluids Assure adequate hydration and electrolyte balance to prevent dehydration General recommendation: 30-35 ml/kg/day
Cancer Tx Caloric goals
Nutrition therapy goal: maintain body weight and prevent weight loss associated with cancer Estimated energy needs of people with cancer
Meat consumption, in the form of red meat and processed meat, have showing an increased risk for several types of cancer WHICH ONES?
(colon, rectum, prostate) Red or processed meat and colorectal cancer have the strongest link
Cartenoids
5 are plentiful in human serum (βcarotene, α carotene, lycopene, lutein/zeaxanthin, β cryptoxanthin) -Concentrated sources: fruits and vegetables -β carotene has been studied for lung cancer
Recommendation VITAMIN D
: 2000 IU of vitamin D daily to achieve levels of 40-60 ng/mL
Proposed mechanism: fat to cancer
: obesity, hyperglycemia, and metabolic syndrome increase insulin-like growth factors-1, a potentially cancer causing compound. It may stimulate the growth of cancer cells and inhibit their death. (Fuel for cancer cells!!)
recommendation: toxic environments
A high intake of antioxidant-rich foods and nutrient rich diet (not supplementation) is suggested to combat this exposure
ACS cancer prevention recommendations
Adopt a physically active lifestyle Engage in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week and 45-60 minutes of intentional activity at least 5 days per week Achieve and maintain a healthy body weight throughout life Eat a variety of healthy, colorful foods, with an emphasis on plant sources Limit consumption of alcohol
Cancer Tx neutropenia
Avoid foods that contain unsafe levels of bacteria (raw meat, spoiled or moldy foods, and unpasteurized foods/beverages) Thorough hand washing Special handling of raw meats, game, poultry, and eggs, utensils, cutting boards, and countertops Avoidance of untested well water Storage of foods at appropriate temperatures (below 40®F and above 140 ®F)
Recommendation
BPA free products
Bisphenol A (BPA)
BPA is an industrial chemical used since the 1960s in the manufacturing of many hard plastic bottles and the lining of metal-based food and beverage cans -It is an ingredient in the production of epoxy resin used in paints and adhesives -Recent studies have raised health concerns, especially in developing fetuses, infants, and children -The US department of Health and Human Services supports the elimination of BPA from all infant products and food - related production -Leaches from plastic in hot and cold temperatures
Cancer prevention recc (american institute of cancer research)
Body fatness: be as lean as possible Physical activity: be physically active as part of everyday life Limit food and drinks that promote weight gain Limit energy dense foods (junk food) Avoid sugary drinks Plant foods: eat mostly foods of plant origin Animal foods: limit intake of red meat and avoid processed meat Alcoholic beverages: limit alcoholic beverages Preservation, processing, preparation: limit consumption of salt. Avoid moldy cereals and legumes Dietary supplements: aim to meet nutritional needs through diet alone Remember, high doses of some supplements can increase cancer risk in certain populations. Ex: beta carotene Breastfeeding: mothers to breastfed; children to be breastfed Cancer survivors: follow the same recommendations
Calcium & Vitamin D
Calcium supplementation and diary, especially from milk, may be associated with a lower colorectal cancer risk -However, some studies have shown a increased risk of prostate cancer -Higher vitamin D levels have been associated with lower incidence of colon, breast, ovarian, renal, pancreatic, prostate, and other cancers
Eating more omega-3 fatty acids
Eating more omega-3 fatty acids fatty acids in relation to omega-6 fatty acids may reduce the risk of colon and prostate cancers
Folate & Folic Acid
Folate affects DNA methylation, synthesis, and repair -High intake has been associated with lower colorectal cancer and breast cancer -Genetic polymorphisms and alcohol consumption complicate the interaction
Cancer Tx interaction with chemotherapy
Food and drug interactions with common chemotherapy agents
fruits and vegetables
Fruit intake is protective against cancers of the mouth, pharynx, larynx, esophagus, cervix, lung, and stomach -Nonstarchy vegetables protect against mouth, pharynx, larynx, and esophageal cancers -Contain antioxidants and phytochemicals -Many different substances are likely protective so food is much better than supplementation -Recommendation: Eat at least 2.5 cups of vegetables and fruits each day
Grilling food
Grilling, or charring meat at high temperatures over an open flame (400 degrees or more) can cause the formation of polycyclic aromatic hydrocarbons (PAHs)
fiber
High fiber intake is protective against the development of gastrointestinal, breast, endometrial, and liver cancer -Proposed mechanism: decreasing insulin resistance, modulation of immunity, and DNA damage-repair -Recommendation: Consume 30 grams of fiber per day (ACS)
coffee & tea
May be a good source of various antioxidants and phenolic compounds -Caffeine may also be protective -Green tea contains catechins that possess biologic activity with antioxidant, antiangiogenesis, and antiproliferative properties for cancer prevention
Preservatives
Nitrates are added as preservatives to processed meats: used to smoke, salt, or pickle food Sodium and potassium nitrate are present in a variety of processed foods (deli meat, hot dogs, etc) nitrosamines and nitrosamides
SWEETENERS
Nonnutritive sweeteners (acesulfame -K, aspartame, neotame , saccharin, and sucralose) -REASONABLE amounts = safe Stevia, sugar alcohols (mannitol, sorbitol, etc) and blue agave also appear safe
Cancer Tx specific nutrition
Nutritional Intervention Strategies for Patients with Cancer (see Table 37-5 that is attached)
recommend: folate and folic acid
Obtain adequate amounts of folate from vegetables, fruits, and enriched or whole-grain products
Recommendation
Physical activity of at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week (American Cancer Society) and achieve a normal weight
Recommendation:
Physical activity of at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week (American Cancer Society) and achieve a normal weight
Mechanism of meat-->cancer
Production of carcinogens from a high fat diet heterocyclic amines or polycyclic aromatic hydrocarbons from cooking of meat N-nitroso compounds (NOCS) from processed heme iron in red meat may stimulate endogenous NOC production
Soy and Phytoestrogens
Soy contains phytoestrogens and isoflavones that protect against hormone - dependent cancers The use of soy in women already diagnosed with hormone-sensitive breast cancer and for postmenopausal women is controversial due to the estrogenic properties of soy The American Cancer Society advises breast cancer survivors to limit the consumption of soy foods to no more than 3 servings per day and to avoid supplements and powders Men with hormone-sensitive cancers may benefit from soy foods due to the cancer being testosterone driven (estrogens are agonists)
toxic environments
The Environmental Protection Agency (EPA) was established in 1970 to oversee the acute and long-term health threats caused by substances in the environment
Cancer Tx supplements
Watch for patients who are taking large amounts of supplements to enhance immune system or even try to reverse the disease state The American Institute for Cancer Research recommends against the use of high dose supplementations because some supplements can have cancer-promoting effects A MVI with no more than 100% of the DRIs is considered safe Some supplements such as vitamins A, C, E, beta carotene, zinc, and selenium may inhibit or enhance the antitumor effects of radiation and chemotherapy; therefore they should be avoided Recommendations: Avoid supplementation and get your vitamins and minerals from a well balanced diet
Being overweight or obese
also appears to increase the risk of cancer recurrence and decreases cancer survival
alcohol increases risk of
cancers of the mouth, pharynx, larynx, esophagus, lung, colon, rectum, liver, and breast
Recommendation: Preservatives
consume a diet that is high in fruits and vegetables that contain vitamin C and phytochemicals to retard the conversion of nitrites to NOCs
Being overweight as a chil
has been correlated with a 2 fold increased risk of death from colon cancer
women
increased BMI correlates with endometrium, gallbladder, kidney, and esophageal cancers
men
increased BMI correlates with esophageal, thyroid, colon, and kidney cancers
recommendation: MEAT
limit red and processed meats`