Transcript Presentation - UNC Lineberger Comprehensive Cancer Center

Eating for Wellness
Jennifer Spring, RD, CSO, LDN
Outpatient Oncology Dietitian
North Carolina Cancer Hospital
“What should I eat?”
“What’s the best diet?”
“What super food is most important?”
Nutrition Recommendations
The World Cancer Research Fund/AICR Guidelines
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Be as lean as possible without becoming underweight
Be physically active for at least 30 minutes every day
Limit intake of energy-dense foods and avoid sugary drinks
Eat a variety of vegetables, fruits, whole grains, and
legumes/beans
Limit intake of red meat and avoid processed meat
Limit intake of salty foods and foods processed with salt
Limit alcoholic drinks
Don’t use supplements to prevent cancer
Limit intake of energydense foods and avoid
sugary drinks
Energy Dense Foods
 Sugary drinks—soft drinks, sweetened ice tea, juice
flavored drinks
 Baked goods—desserts, cookies, pastries, and cakes
 Candy
 Chips—potato, corn, pita
 Ice cream
 Processed meat—hot dogs, salami, pepperoni, bologna
 Fast food—French fries, fried chicken, and burgers
 Packaged and processed foods high in added sugars and
fats
Sugar and Cancer
 Glucose is the primary fuel for the body
 Glucose comes from foods that contain carbohydrates,
including sugar, vegetables, fruits, whole grains and low-fat
dairy sources. Our body even produces glucose from
protein we eat.
 Cancer cells need glucose (blood sugar) to grow just like
healthy cells
 Dietary sugar does not preferentially promote cancer
growth
Insulin
 Elevated levels of glucose stimulate the release of
insulin from the pancreas.
 Elevated levels of insulin in the blood over a long
period of time increase inflammation.
 Tumor cells use this inflammatory process to signal
cells to multiply.
 Metabolic stress can lead to secretion of insulin-like
growth factor (IGF-1)
How much is too much sugar?
 The American Heart Association recommendation for added sugar:
Women 6 teaspoons (25 grams)
Men  9 teaspoons (37 grams)
 Three Oreo cookies  14 grams
 a half cup of marinara sauce  7 grams
 1 tablespoon of grape jelly- 12 grams
Eat a variety of vegetables,
fruits, whole grains, and
legumes/beans
“Eat food. Not too much. Mostly plants.”
Michael Pollan
Popular Plant-Based Diets
 Mediterranean
 Asian
 DASH
 Vegan
 Vegetarian
Colorful Fruits, Vegetables, and Phytochemicals
Color
Phytochemicals
Fruits and Vegetables
White and
Green
allyl sulphides
Onions, garlic, chives, leeks
Green
sulforaphanes, indoles
Broccoli, Brussels sprouts,
cabbage, cauliflower, kale
Yellow and
Green
lutein, zeanzathin
Asparagus, collard greens,
spinach, winter squash
Orange and
Yellow
cryptoxanthin, flavinoids
Cantaloupe, nectarines,
oranges, papaya, peaches
Orange
alpha and beta carotenes
Carrots, mangos, pumpkin
Red and
Purple
anthocyanins,
polyphenols
Berries, grapes, plums
Red
lycopene
Tomatoes, pink grapefruit,
watermelon
HEAL Well: A Cancer Nutrition Guide AICR/Livestrong/ Meals-to-Heal ,2013
Antioxidants
Organic vs. Conventional
 Organic foods shown to have more antioxidant
activity than their non-organic counterparts
 Not enough strong evidence to say that organic foods
in general contain more vitamins, minerals or other
nutrients than non-organic foods
 EWG’s Dirty Dozen Plus/ Clean Fifteen
Herbs
Herb
Phytochemicals
Blends well with:
Basil
quercetin, camphor, methyl eugenol,
kaempferol
oregano, parsley, thyme
Bay Leaves
eugenol, geraniol, limonene, perillyl alcohol
oregano, basil, curry, cumin,
turmeric
Chives
allium compounds, kaempferol, saponins
dill, marjoram, paprika,
savory, thyme
Cilantro (a.k.a.
coriander)
apegenin, beta-carotene, kaemferol,
quercetin, rutin
chili powder, cumin, garlic,
onion, oregano
Dill
isorhamnetin, kaempferol, limonene,
myrcetin
celery seed, cumin, thyme
Oregano
luteolin, myrcetin
Parsley
apegenin, coumarin, ferulic acid, lutein,
luteolin, pthalides, quercetin
basil, cumin, chili powder,
parsley
almost any other herb or
spice
Rosemary
carnosol, fenchon, rosmanol, ursolic acid
cumin, parsley, thyme
carnosol, limonene, perillyl alcohol, vanillic
acid
isorhamnetin, terpenoids
phenolics ( such as: rosmarinic acid and
flavonoids)
celery seed, marjoram,
savory, thyme
parsley
basil, chives, dill, paprika,
sage
Sage
Tarragon
Thyme
Spices
 Many spices have been shown to decrease
inflammation and inhibit the growth of tumors
 Some spices studied include Turmeric, Garlic, Black
Pepper, Cinnamon, Allspice
Limit intake of red meat
and avoid processed meat
Common Food Carcinogens
 N-nitroso compounds
 Polycyclic aromatic hydrocarbons (PAHs)
 Heterocyclic amines (HCAs)
Limit intake of salty foods
and foods processed with
salt
Limit alcoholic drinks
Alcohol
 Limit alcoholic drinks to 2 for men and 1 for women a
day
 What is a drink?
 12 oz of beer
 4-5 oz of wine
 1.5 oz of liquor/spirits
Alcohol and Cancer Risk
 Tissues in the body damaged by direct exposure
 Heavy drinking may lead to liver damage
 Too much alcohol may reduce folate
 Excess calories may contribute to weight gain
Don’t use supplements to
prevent cancer
Micronutrient Malnutrition in
Older Adults
 Deficiency in some essential vitamins and trace
minerals may be common in older adults.
 Should older adults use supplements to maintain a
healthy immune system?
 Nutrient supplements, such as vitamin B6, zinc, vitamin
C, vitamin E may be important for health promotion and
prevention of certain diseases.
Probiotics/ Prebiotics and Immune
Response
 Germ free mice can exist and survive, but…
 Abnormalities of:
 Immune function
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Metabolic function
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Physiological function
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Trophic function
 Aging causes an increase in the number of putrefactive bacteria, and a
decline in the number of beneficial bacteria groups.
 Immunosenescence The natural aging process also leads to a marked
decline in immune function
Probiotics
 “Good" bacteria and yeast providing benefits to the
host
 Similar to those naturally found in gut
 Food examples: Kefir, yogurt, miso, tempeh, kimchi,
kombucha
 Supplement examples: Saccharomyces boulardii (a
yeast), and Lactobacillus and Bifobacterium
Prebiotics
 Natural, non-digestible food ingredients that are linked to
promoting the growth of helpful bacteria in your gut.
 “Good” bacteria promoters
 Examples: inulin, FOS, galacto-oligosaccharides, and
lactulose
 Food sources: Jerusalem artichokes, dandelion greens,
garlic, onions, asparagus, banana
Prebiotics
 44, free-living elderly people (28 women and 16 men),
average age of 69.3 years were enrolled in the study
 The study subjects were given a supplement
(galactooligosaccharide mixture called Bi2Muno)
which they consumed for 10 weeks.
 Decrease in less beneficial bacteria
 Increase in beneficial bacteria
Hydration
 Many older people do not drink enough fluids
 Sense of thirst declines
 Drink whether or not your feel thirsty
 Combat fatigue and prevent constipation
 8-12 cups of fluid each day.
80/20 Rule
80% of the time
eat healthy (AICR
guidelines)
 20% of the time
indulge a little