Transcript NUTRITION AND GOOD MENTAL PERFORMANCE

Abundant Life Dietetics Services
Private Practice & Consultancy Services
Nutrition & Dietetics
Presents
NUTRITION AND
CANCER
Village Medical Centre
Plot 4921 Mosebele Road, Village, Gaborone
Kgomotso P. Vasco, Dietitian RD
Kings College London University
NUTRITION AND CANCER
OUTLINE
 Evidence for an anti-cancer diet
 Purpose of Nutrition care
 Drug and nutrient interaction
EVIDENCE
FOR AN ANTI-CANCER DIET
“An estimation of 30-40 percent of cancers
can be prevented by lifestyle and dietary
measures alone.”(Donaldson,2004)
DIETARY FACTORS THAT PROMOTE
CANCER RISK
 Obesity - second leading cause of cancer (fat)
 Nutrient sparse foods - concerntrated sugar
- refined flour products
Foods with a high glycaemic load are associated to cancer (Risk with
gastric, upper aero digestive tract, endometrial, ovarian and colon or
colorectal cancers)
Impaired Glucose Metablolism – strong link between diabetes, (High
HbA1C, elevated fasting insulin) and colorectal cancer
Food contributing to hyperinsulinemia should be avoided
DIETARY FACTORS THAT PROMOTE
CANCER RISK
 Low fibre diets
Dairy products, eggs, all meats and refined grains
There is an inverse correlation of high fibre foods with rectal
cancer
Fibre is also rich in micro nutrients which have anti cancer
properties
 Red meat
Meat and meat products and heterocyclic amines formed in
cooking promote colorectal and breast cancers.
DIETARY FACTORS THAT PROMOTE
CANCER RISK
 Imbalance of omega 3 and omega 6 fats
Omega 3 fats (alpha-linolenic acid, EPA,DHA) - protective of
cancer
Omega 6 fats (linoleic acid, arachidonic acid) – cancer
promoting fats
Breast tumour suppressor genes BRCA1 and BRCA2
 Flax seed – lignan fraction
Good source of dietary fibre and omega 3 fats
Lignan in flax seed is digested to enterodiol and
enterolactone which have esterogenic activity.
Lignan fraction secoisolariciresinol diglycoside
(SDG) and the flax seed can reduce metastsis and
reduce tumor growth.
 Fruits and vegetables
(Block et al,1992) found that 128 out of 158 studies found fruits and
vegetables to be protetive against cancer.
They are protective to the stomach, oesophagus, lung, oral cavity and
pharynx, endometrium, pancreas and colon.
Vegetables especially raw are more protective.
- Alllium vegetables ( onions, garlic, leeks, and scallions)
- Cruciferous vegetables (cabage,cauliflower, brussel sprouts, brocolli) /
sulforophane much richer in brocolli sprouts
- Green vegetables - chlorophyll
- Carrots - carotenoids
There are many nutrients and phytochemicals that are found in fruits and
vegetables such that the protective effect can not be due to one nutrient
or phytochemical.
 Selenium
A mineral with anti cancer properties
Selenium Functions
- Present in active site of many enzymes, including thioredoxin reductase
which catalysis oxidation-reduction reaction.These reactions may
encouage cancer cells to under apoptosis.
- Component of anti oxidant enzyme glutathione peroxidase
- Causes formation of natural killer cells
- P450 enzymes in the liver may be induced by selenium, leading to
detoxification of some carcinogenic molecules.
- Inhibits prostaglandins that cause inflamation
- Improves the immune systems‘ ability to respond to infection
- Can decrease rate of tumour growth
Dietary sources - whole grains, legumes, brazil nuts, sunflower, yeast
o
 Chloropphyll
Green colour in plants, the light collecting molecule.
- Chlorophyl and its derivatives are very effective at binding
polycyclic aromatic hydrocarcarbons (carcinogens
largely from incomplete combustion of fuels), heterocyclic
amines (generated whe grilling food), aflotaxins (toxin
from molds in foods which causes liver cancer), and other
hydrophobic molecules.
- The chlorophyl-carcinogen complex is difficult for the body
to absorb, therefore most of it is swept out with the stool.
 Vitamin B-12
Evidence of anti cancer effect havs been seen in experimental studies.
Not yet proven. Cohort studies need to be carried out.
 Folic Acid
- Dark green leafy vegetable vitamin.
- Follic acid works with B6 and B12. If Folic acid is insufficient, uracil is
substituted for thymidine in DNA, which leads to strand breakage.
This then promotes DNA methylation.
- Folate reverses DNA methylation.
- Alcohol is an antagonist to folate
- Folate may be important for the rapidly dividing tissue like the colonic
mucosa.
 Alpha and Beta Carotene and other Carotenoids
Alpha caroteinoids (carrots, pumpkin, winter squash) are more protective
from cancer than Beta cartenoids.
Lycopene – more abundant in tomato. More bioavailable in cooked tomato
than the raw. Protect against prostrate cancer.
 Vitamin C
More effective given intraveneously. Oral dose of Vit C do not give
adequate serum concerntration as when injected.
1.25g orally
- 135umol
1.25 intraveneously - 885umol
 Other Antioxidants
Grape seed extract – proanthocyanidin (anti carcinogenic)
Green tea- flavanol, epigallocatechin-3-gallate (EGCG)
 Probiotics
Still being studied. To increase pro biotics you have to eat a lot of prebiotics
(Fibre).
 Oral Enzymes
Most cancer patients will have impaired digestion or intestinal tract disoder.
Therefore lessen the digestive side effects
Proteases - if they reach the circualory system they have anti tumour effect.
Enzyme suplementation reduces side effects of cancer therapy
Need more evidence – more studies to be carried out to confirm findings.
Conclusion
 The American Institute for Cancer Research have the
following cancer prevention guifdelines
- Eat a plant based diet. Eat atleast 5 servings of fruit and
vegetables daily. Include beans in the diet and eat grain
products (such as cereals, breads, and pasta)
- Choose foods low in fat
- Choose foods low in salt
- Get to and stay at a healthy weight
- Be at least moderately active for 30 minutes on most days
of the week
- Limit alcohol drinks
- Prepare and store food safely
- Do not use tobacco in any form
FOOD PYRAMID
Purpose of Nutrition care
 To restore or conserve nutitional status,
body composition, and functional status
prior, during and after cancer treatment.
 To minimise food related discomforts
associated with cancer and its treatment
 To improve strength and well being and
quality of life.
Effects of treatment of
cancer on nutritional status
 Sugery - (dumping syndrome, fat malabsorption, steatorrhea,and
deficiencies in iron, calcium, fat solublevitamins and vitamin B12)
 Chemotherapy - (anorexia, nausea, vomiting, diarrhea,
stomatitis, constipation, taste changes)
 Radiation therapy - (nausea, vomiting, diarrhea,
stomatitis,dry mouth, swallowing problems, oesophageal reflux, fistular,
oesophageal fibrosis or stricture, dysphagia, tiredness)
Nutrition Therapy
 Diet modification
- High Calorie High Protein
- texture modification
- restricted fibre
- High fibre
 Nutrition Supplement drinks
 Enteral Nutrition
 Parenteral Nutriton
Advaned Cancer
 Palliative care
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Less solid food and clear liquids better tolerated.
- Terminally ill will feel less hungry and eat less.
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View food as a source of enjoyment
-
Dietary restriction not ussually neccessary unless if the diet may
cause complications such as bowel blockage.
DRUG NUTRIENT
INTERACTION
- grapefruit may increase a drug‘s
effects
Methotrexate - Alcohol may cause liver damage
Plicamycin
- Supplements of calcium and vit D
may decrease the drug‘s effect
Procarbazine - Alcohol may cause a reaction that
includes flushing of the skin,
breathing difficulty, nausea, and low
blood pressure. Caffeine may raise
blood presure.
Temozolomide - Food may slow or decrease the
drugs effect.
 Bexarotene
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Good nutrition, Adequate
Exercise and rest will add
more good years to your
life.
Try it!
THANK YOU!