Transcript Nutrition & Prostate Cancer - Prostate Awareness Foundation

Nutrition & Prostate Health:
Are they related?
Presented by
Natalie Ledesma, MS, RD
UCSF Comprehensive Cancer Center
Nutrition & Prostate Cancer
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“Scientific evidence suggests that
differences in diet & lifestyle may account
in large part for the variability of prostate
cancer rates in different countries” (Heber et
al., 1998).
Guidelines for a Healthy Diet
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Plant-based diet
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Fruits, vegetables, whole grains,
beans/legumes, & other plant protein sources
Low fat diet with emphasis on healthy fats
Limit simple & refined sugars
Adequate fluids
Stop smoking if you smoke
Limit alcohol consumption
Be physically active
Insulin & Cancer
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A Western lifestyle -- characterized by low physical activity,
& high dietary intake, animal protein, saturated fats,
trans fats, & rapidly digestible carbohydrates -- is
associated with  risks of many cancers.
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May be mediated by alterations in the metabolism of insulin
and insulin-like growth factors (IGFs).
 serum insulin & IGF-I levels and insulin resistance 
development & promotion of cancer.
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(Hsing et al., 2001; Barnard et al., 2003; Ngo et al., 2002; Moyad, 2003; Yu &
Berkel, 1999; Giovannucci, 2003; Aksoy et al., 2004; Li et al., 2003; Cardillo et
al., 2003; Kaaks, 2001)
Insulin & Cancer (cont.)
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Elevated serum insulin & IGF-1 levels (Hsing et al.,
2001; Barnard et al., 2003; Ngoet al., 2002; Moyad, 2003;
Yu & Berkel, 1999; Giovannucci, 2003; Aksoy et al., 2004;
Li et al., 2003; Cardillo et al., 2003; Kaaks, 2001) as well
as insulin resistance (Hsing et al., 2003) appear to
lead to both the development & promotion of
cancer.
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Additionally, hyperinsulinemia is associated with
increased risk of heart disease, type 2 diabetes,
and weight gain (obesity).
Limit Simple Carbohydrates
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Sources: candy, cookies, pastries, alcohol,
drinks/juices, & WHITE refined breads, pastas,
crackers, etc.
High sugar foods are usually highly processed &
refined, low in nutrient value, & low in fiber.
 serum insulin & serum IGF-I levels & contribute to
insulin resistance
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(Hsing et al., 2003; Snyder et al.,1989; Reiser et al., 1981; Manolio et al., 1991).
High-Fiber Diet
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A diet rich in natural fiber obtained from fruits,
vegetables, legumes, & whole grains may reduce
cancer risk &/or prevent prostate cancer progression.
While the results regarding fruit & vegetable
consumption & prostate cancer risk are not
conclusive, they are promising (Hodge et al., 2004;
Cohen et al., 2000; Jain et al., 1999; Deneo-Pellegrini et al.,
1999).
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Fiber binds to toxic compounds & carcinogens, which
are then later eliminated by the body (Harris et al.,
1993).
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Additionally, fiber  circulating hormone levels
(Tariq et al., 2000; Tymchuk et al., 2001; Slavin, 2000).
Low Fat Diet
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 fat   testosterone   cancer
A comprehensive review reported that 20 of
30 studies found positive, although not all
statistically significant, associations between
dietary fat intake and prostate cancer risk
(Fleshner et al., 2004).
Recommendation: 20% of total calories from
fat, with <8% of total calories from saturated
fat.
Types of Free Fatty Acids
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Saturated
 Fatty acids are saturated with
hydrogen molecules
 Semi-solid or solid at room
temperature
Monounsaturated (omega-9)
 Fatty acid contains one double
bond
 Liquid at room temperature
Polyunsaturated (omega-6 &
omega-3)
Fatty acid contains 2 or more
double bonds
 Liquid at room temperature
Hydrogenated
 Industrial hardening of edible
oils to make products hard at
room temperature
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Saturated Fats
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Many studies indicate a positive association
between saturated fat intake from meat & dairy
products & prostate cancer.
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Intakes of red meat
(Giovannucci et al., 1993; Michaud et al.,
and dairy products
(Michaud et al.; Ramon et al.; Bosetti et al.; Bairati et al.) appear to
also be related to increased risk of metastatic prostate
cancer.
2001; Ramon et al., 2000; Bairati et al., 1998)
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Recommendation: Limit use of meats, dairy,
products, butter, mayonnaise, & baked goods
due to high saturated fat & total fat content.
Essential Fatty Acids (EFA)
Balance of omega-6 to
omega-3 oils is critical to
proper prostaglandin
metabolism.
Most American diets
contain excessive omega-6
fats.
Consuming a diet rich in
omega-3 acids can restore the
balance between the two fatty
acids & can possibly reverse
these disease processes.
EFA Dietary Sources
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Omega-6 Dietary Sources:
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Include meats (especially grain-fed), butter,
whole milk, egg yolks, sunflower oil, safflower oil,
cottonseed oil, corn oil, & processed foods made
with these oils.
Omega-3 Sources:
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Include cold-water fish (i.e., salmon, trout,
sardines, herring), flaxseed, walnuts, pumpkin
seeds, canola oil, & soybeans.
Omega-3 Fatty Acids
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Studies show omega-3 fatty acids reduce
risk of prostate cancer.
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Men who consumed cold-water fish 34x/week had a reduced risk of prostate
cancer.
Researchers in New Zealand reported that
men with high levels of EPA & DHA had a
40% lower risk of prostate cancer than those
with low blood levels.
Omega-9 Fatty Acids
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Offer cardio-protective benefits, may offer
cancer protection.
Results suggest a neutral relationship between
these fats & prostate cancer (Hodge et al., 2004; Norrish et
al., 2000; Veierod et al., 1997; Hughes-Fulford et al., 2001).
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Good sources: olives, extra-virgin olive oil,
canola oil, avocadoes, & almonds.
Remember, however, to use oils only in
moderation.
Healthy Fat Recommendations
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Keep saturated fats to 8% total kcals from fat.
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Limit fatty meats, whole milk dairy products, cheese,
mayonnaise, butter, & baked goods.
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Avoid hydrogenated oils.
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Aim for 1:1 to 4:1 omega-6:omega-3.
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Limit processed foods
Inquire about type of oil used at restaurants
Use olive, almond, or canola oil for cooking/salads.
Increase sources of omega-3’s daily
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Fish, flaxseed, walnuts, pumpkin seeds
EPA/DHA supplement if appropriate
Body Weight & Physical Activity
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Higher body mass & physical inactivity may
contribute to prostate cancer risk.
A large prospective study observed a significant
positive association between BMI& prostate
cancer risk.
A cohort study reported obese men to have a
20% increased risk of dying from prostate cancer
& those men who were severely obese had a 34%
elevated risk.
This research was further supported by recent
evidence that obesity is a risk factor for
aggressive prostate cancer.
What Can A Healthy Diet Do For Me?
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May help to inhibit cancer growth
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Reduce risk of chronic diseases
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Enhance immune system
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Increase energy levels
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Facilitate recovery –  toxicities of treatment
Healthy Prostate Cancer Diet
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8-10 colorful fruit & vegetable servings daily
25-35 grams of fiber daily
Limit processed & refined grains/flours/sugars
Limit meats & dairy
Healthy fats  cold-water fish (i.e., salmon,
trout, herring, sardines), flaxseed, walnuts,
soybeans, olive oil, avocadoes, almonds
Selenium (200 mcg)  Brazil nuts, supplement
Lycopene (30 mg)  ¾ C tomato sauce, 12 fl oz
tomato juice
Vitamin E (200 IU) natural form with -tocopherol
Green Tea  1-4 cups daily
Vitamin D
Pomegranate  1 oz concentrate, 8 oz juice
Resources
Books
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The ABC’s of Nutrition & Supplements and Prostate
Cancer – written by Mark Moyad, 2000
The Color Code –
written by James Joseph, PhD, Daniel Nadeau,
MD, & Anne Underwood 2002
Natural Health, Natural Medicine : The Complete
Guide to Wellness and Self-Care for Optimum
Health – written by Andrew Weil, MD 2004
How to Prevent & Treat Cancer with Natural
Medicine – written by Michael Murray, 2002
Resources (cont.)
Cookbooks
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Cancer Lifeline Cookbook
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One Bite at a Time
2004
– written by Kimberly Mathai,
– written by Rebecca Katz, 2004
Websites
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http://www.aicr.org
http://www.cancernutritioninfo.com
http://cancer.ucsf.edu/crc
http://www.cancerproject.org