Mills-Peninsula Cancer Care Symposium

1. NUTRITION AND CANCER

2. Obesity
 Adult Obesity Rate by State 1990

3. Obesity
 Adult Obesity Rate by State, 2014

4. BMI Scale
 A weight that is greater than what is
considered healthy for a given height
 BMI scale BMI
Overweight 25-29.9
Obese >30-34.9
Obese, severe 35-39.9
Obese, morbidity >40

5. Cancers Associated with Obesity
Breast Colon Rectum
Stomach Esophagus Kidney
Thyroid Pancreas Prostate
Gallbladder

6. So What’s the Relationship?
 Fat tissue produces excess estrogen
 Higher insulin levels/insulin-like growth factor-1
 Fat cells produce adiposkines
 Chronic low level inflammation
 Maybe related to food types

7. 3 Phases of Nutrition
Prevention
Treatment
Survivorship

8. Treatment Goals
 Prevent or resolve nutrition deficiencies
 Weight maintenance
 Preserve lean body mass
 Minimize nutrition-related side effects
 Maximize quality of life

9. Care Team
Rock Star RD

10. Nutrition Impact Systems
Fatigue Constipation Anorexia
Xerostomia Nausea Emesis
Gas/bloating Reflux SOB
Diarrhea Early Satiety Smell bother
TasteAlteration Mucositis Dysphagia
Weight Loss Weakness

11. Common Nutrition Questions
Can I drink alcohol during treatment?
1. RDs will discourage and defer
2. Alcohol may impair drug breakdown
3. Increase side effects
4. Sore mouth

12. Supplements & Vitamins
 Typically discouraged unless ordered
 Defer to Oncologist
 Encouraged whole foods with color

13. Does Sugar Feed Cancer?
 Recommendation is to avoid added sugars
 Avoid spikes in insulin levels
 Excess insulin = cell growth

14. Soy & Flaxseed
 If soy was a staple in your diet-continue to eat it-
if not, don’t start per the AICR
 A few servings per week as part of a plant based
diet
 Flaxseed: 2 small studies favorable for breast and
prostate cancer.
 Flaxseed is a great “FLAXative”

15. Red Meat
 Many organizations support a reduction or
avoidance of red and processed meats
 Links: Colorectal, Prostate, Stomach, Breast,
Ovarian and Lung
 High temp cooking / grilling higher fat meats
and the production of amines
 Heme iron may produce compounds damage
cells
 Nitrites
 Sugar Neu5Gc

16. World Cancer Research Fund and
AICR
‘The association between consumption of red and
processed meats and cancer, particularly
colorectal cancer is very consistent’
‘red or processed meats are convincing or
probable source s of some cancers’

17. Survivorship and Nutrition
AICR Recommendations for Cancer Prevention
1. Become lean but not underweight
2. Physical activity 30 mins/day every day
3. Avoid simple sugars
4. Eat more vegs, fruits, whole grains, beans
5. Limit red and processed meats
6. Limit alcohol (2) men and (1) women
7. Limit salty and processed foods
8. Do not take supplements to prevent cancer
9. No smoking

18. Moving to the Next Level
Lifestyle changes
Weight Management
Nutrition
Activity

19. Making Changes

20. Creating Change

22. AICR Prevention
 Diet with variety of vegetables, fruits, whole
grains, beans, low in red meat/processed meats
 2/3 plate vegetables, fruits, whole grains
 Nobody is perfect nor do we have to be
American Institute for Cancer Research/WorldCancer Fund (2007)

23. Red Meat
 Link with colorectal cancer
 NIH research
 World Cancer Research Fund and AICR
‘red or processed meats are convincing or
probably sources of some cancers’
 Research is limited but suggestive
• AIRC encouraging meatless meals or to use as
a condiment vs the main event

24. Alcohol
 AICR recommends to abstain
 Increases circulating estrogen levels
 1 –Women 2- Men
Links
Breast Esophageal Pancreatic
Liver Colon Throat
Mouth Rectum

25. Salt and Supplements
 Limit consumption of salty foods
 Limit consumption of processed foods
 Do not use supplements to protect against
cancer

26. Goal for Survivorship
Monitoring/Screenings
Weight Management
Dietary Modifications
Physical Activity