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  1. 1. Using food as your medicine By Jo Gamble BA (hons) Dip CNM MFNTP MBANT
  2. 2. Let food be your medicine and medicine be your food Hippocrates
  3. 3. The need for action • As a cause of death in the developed world, cancer is only surpassed by cardiovascular disease • Globally the number of people with cancer is projected to double by 2030 • Currently, more than one in 3 people will develop cancer in their lives! (WCRF 1997, WCRF 2007, NS 2008)
  4. 4. Understanding Cancer • Before understanding the impact of nutrition on cancer, it is first important to understand the biochemical and physiological determinants of the disease. • Cancers are as a result of the interaction of genetics, epigenetics and environment of the individual. • Cancer is a chronic disease
  5. 5. What is cancer? • Healthy cells: balance between growth and programmed cell death is tightly regulated Cancer cells are cells that grow and divide at an unregulated pace.
  6. 6. Environmental and chemical carcinogens • People are continuously exposed exogenously to varying amounts of chemicals that have been shown to have carcinogenic or mutagenic properties. • In the case of a solid tumour there is a 20-40 year interval from the time of exposure of an individual to a chemical or viral carcinogen until the clinical detection of a tumour. • By the time a tumour is apparent, cancer cells have aquired the ability to divide where normal cells ought not, to invade adjacent cellular architectures, to metastasize and to kill the host.
  7. 7. Cancer is a preventable disease • Only 5-10 % of all cancer cases can be attributed to genetic defects, whereas the remaining 90- 95% have their roots in the environment and lifestyle. • The lifestyle factors include smoking, diet, alcohol, obesity, infectious agents, environmental pollutants and radiation • Of all cancer-related deaths; 25-30% are due to tobacco, 30-35% diet, 15-20% infections, 10-20% obesity, 4-6% alcohol, 10-15% others, which includes environmental and radiation.
  8. 8. Good news we are in control World Cancer Research Fund: high fruit and vegetable intake may reduce cancer incidence by 40- 64 % US National Research Council: high fruit and vegetable intake may reduce US cancer rates and mortality by 1/3, roughly equivalent to the reduction in mortality from infectious diseases brought about by improved hygiene and better healthcare during the 19th century In the November 2010 issue of Nutrition and cancer, a study indicated that women who consumed a greater amount of vegetables and seafood were 86% less likely to be diagnosed with breast cancer
  9. 9. Good news we are in control • Newest Research: through good nutrition we can also improve survival rates of people with some cancers by calming down the genes responsible for cancer growth! (Ornish et al. 2005, Ornish et al. 2008, Saxe et al. 2006)
  10. 10. Support goals Primary goals • Support tumourcidal effects of treatment • Reduce side effects of treatments • Support overall wellness Secondary goals • Support immunity • Reduce tumour promoting factors • Inhibit metastasis and tumour progression • Promote appropriate apoptosis
  11. 11. How diet can affect cancer
  12. 12. Initiation-dietary carcinogens - aflatoxins (found in mouldy food) - heterocyclic amines (meat cooked at very high temperatures) - N-nitroso compounds (in some spoiled foods, protein foods, cured meat) - polycyclic aromatic hydrocarbons (PAH) (products of combustion found in cooked foods, smoked foods and dark beer) these chemicals can start a cancer process by creating cancer cells (World Cancer Research Fund 1997; NRC 1982)
  13. 13. Diet-red meat • Heavy consumption of red meat is a risk factor for several cancers, especially those of the gastrointestinal tract, but also for colorectal, prostate, bladder, breast, gastric, pancreatic and oral cancers. • The hetrocyclic amines produced during the cooking of meat are carcinognic. Charcoal cooking and/or smoke curing of meat produces harmful carbon compounds such as pyrolysates and amino acids which have a strong cancerous effect. Anand P et al, Cancer is a preventable disease that requires major lifestyle changes. 2008
  14. 14. Diet: Fats and sugars • Saturated fatty acids, trans fatty acids and refined sugars and flour present in most foods have also been associated with various cancers (1) • Epidemiologic studies suggested a positive association between dietary fat and colon cancer. (2) • Frequent consumption of sugar and high-sugar foods may increase the risk of pancreatic cancer by inducing frequent postprandial hyperglycemia, increasing insulin demand, and decreasing insulin sensitivity. (3) (1) Anand P et al, Cancer is a preventable disease that requires major lifestyle changes. 2008 (2) Reddy, B Dietary Fat & Colon cancer. Chemistry & material science vol 27 no 10 807-813 (3) American Journal of Clinical Nutrition Vol 84 No 5 1171-1176 Nov 06
  15. 15. © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM - -excess fat - ↑ insulin, ↑ estrogens, ↑ oxidative stress, ↑ inflammation -excess protein -↑ insulin, ↑ IGF-1, -excess calories- ↑ insulin, ↑ IGF-1, ↑ oxidative stress, ↑ inflammation - excess Omega 6 EFA- ↑ oxidative stress, ↑ inflammation (Becci et al, 1979; Wood et al, 1983; Newberne and Rogers, 1986; Poirier et al, 1986; Kritchevsky and Klurfeld, 1987; Pariza, 1987; Sawada et al, 1990; Birt et al, 1992; Newmark and Lipkin, 1992; Wattenberg, 1992; Yuspa, 1994; Heber et al. 2006 ) Dietary Tumour Promoters:
  16. 16. © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM - - insulin- promotes cancer cell proliferation and decreases apoptosis - estrogens- induces cancer cell proliferation - oxidative stress- can act as cancer initiator and promoter - inflammation- strong association between chronic inflammation and cancer (mechanisms: promoting proliferation of cancer cells, formation of cancer blood vessels?-not entirely understood) - IGF-1- potent growth factor for many cancer lines (Heber et al 2006) Metabolic Tumour Promoters:
  17. 17. Colon Cancer Risk-increases by 10% if you drink 1 glass of wine daily Colon Cancer Risk-increases by 25% if you drink 2 glasses of wine or 1 pint of beer daily Drinking as little as one pint of beer or one large glass of wine a day increases risk of breast cancer by more than 7%. Mouth, Oesophagus, Larynx, Throat Cancer-↑ 168% risk with 1 glass of wine/d (World Cancer Research Fund 2007; Riboli et al 2002; American Cancer Society 2007; Cancer Research UK 2009a) Alcohol
  18. 18. Obesity/Excess Body Fat and Cancer
  19. 19. Convincing Evidence Colon, Prostate, Breast Endometrial, Kidney, Esophageal Ovary, Non-Hodgkin’s Lymphoma, Leukemia, Multiple myeloma , Pancreas, Oesophagus , Possible Gallbladder Increase in Risk Cancer Associated with Obesity (Source: National Cancer Policy Board 2003; Pan et al 2004)
  20. 20. consumption of milk increases blood levels of IGF-1, which has been associated with increased prostate and breast cancer risk Dairy and Cancer-Possible Mechanisms (Chan et al. 1998)
  21. 21. © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM -folic acid (reducing likelihood of DNA damage) -antioxidants (preventing oxidative damage and lipid peroxidation, which compound DNA damage in tumor promotion) -phytochemicals (various mechanisms) - low-fat plant-based diet (various mechanisms, see above) (World Cancer Resarch Fund 1997, Wattenberg 1985) © Gosia Desmond MA, MBS, BSc Nut Med Tumour Anti- Promoters:
  22. 22. © CNM; by Gosia Desmond MA, MBS, BSc Nut Med Jo Gamble BA (hons) Dip CNM Promotion-Protection estrogens; Insulin growth factors (IGF-1) inflammation downregulation of oncogenes upregulation of tumour suppressor genes (World Cancer Research Fund 2007; Heber 2006; Ornish et al 2008; Saxe 2006) low fat; high fibre adequate protein adequate calories whole plant foods O6: O3 ratio 2:1 Physical activity
  23. 23. immune stimulants Phytonutrients act as antiproliferative agents antioxidants promote synthesis of detoxification enzymes (Omenn 1995; Talalay et al 1995; Wattenberg 1970; Engwerda et al 2001; Zawa and Duve 1997; Fotsis et al 1993) angiogenesis inhibitors
  24. 24. Phytonutrients • new evidence: official guidelines –’5 a day’ is not enough!!! • US National Cancer Institute: five is just the bare minimum. • men-at least 9 servings • women –at least 7 servings • children-at least 5 servings
  25. 25. -onions -kale -grape -citrus fruit -apple -pear -powerful inhibitors of many cancers including human breast cancer cells (So et al 1996; Guthrie and Carroll 1998) Phytonutrients –Flavonoids:
  26. 26. broccoli, brussel sprouts, cabbage, cauliflower, Chinese cabbage, cress, daikon, kale kohlrabi turnip potent carcinogen detoxifiers –inducers of detoxification enzymes (Zhang and Callaway 2002) Phytonutrients –Flavonoids:
  27. 27. Other anticancer substances: -sulphur compounds of garlic (tumour growth inhibition; cancer formation inhibition) -folic acid (fruits and vegetables; DNA protection) -beta sitosterol (fruits and vegetables; tumour growth inhibition) (Fleischauer and Arab 2001; Awad et al 1996; Duthie 1999) Other anti-cancer nutrients:
  28. 28. stimulates immune response Low fat plant based diet lowers IGF-1 full of antioxidants promotes synthesis of detoxification enzymes lowers insulin lowers estrogens lowers AGE, oxidative damage minimizes carcinogen exposure low in Omega 6 creates powerful anti-cancer environment Low Fat Vegan Diet Full of Unprocessed Plants
  29. 29. Balancing Your Plate Divide your plate into 3 sections: 50% is vegetables, salad 25% is mixed whole grains or starch 25% is protein source – poultry, fish, beans, soy products Protein Whole grains Veggies
  30. 30. Lifestyle Change is a Journey It takes 45 days to change a habit or incorporate a new one 5 10 15 20 25 30 35 40 45 Live your life as if your health depends on it… because it does!
  31. 31. What are the main components of a wellness diet? • Water 2 liters of hydrating fluid daily • Well balanced macro nutrients throughout the day • High levels of micro nutrients • Avoidance of anti-nutrients
  32. 32. Macro nutrients • Complex carbohydrates • Protein • Essential fats
  33. 33. Complex carbohydrates • Whole meal bread • Whole meal pasta • Brown rice • Oats • Beans and lentils • Root vegetables
  34. 34. Protein • Eggs • Fish • Poultry • Meat • Beans and lentils • Nuts and seeds • Tofu • Quinoa
  35. 35. Essential fats • Oily fish • Nuts and seeds • Avocados • Cold pressed oils • Olives
  36. 36. Anti-oxidants • Have been studied individually and collectively for their potential to enhance physical performance. • Prevent exercise induced muscle tissue damage • Fight against chronic diseases such as cancer, cardio-vascular disease, strokes
  37. 37. Hydrating fluid 2 litres of hydrating fluid each day: * Water * Herbal tea Avoid dehydrating fluids * tea/coffee * Alcohol * fizzy drinks
  38. 38. Avoid anti-nutrients • Aspartame • Trans fats • Refined carbohydrate • Processed foods • Sugar
  39. 39. "The wise man should consider that health is the greatest of human blessings. Let food be your medicine." - Hippocrates
  40. 40. Jo Gamble BA (hons) Dip CNM mBANT