Cancer Kitchen Pres

8/12/2019 Cancer Kitchen Pres

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The New School November 3, 2011

Jeanne M. Wallace, PhD, CNC

Graduate: Bauman College, Nutrition Consultant, 1997 Member, National Association of Nutrition Professionals

Board Certied in Holistic Nutrition Member, Society of Integrative Oncology

Nutritional Solutions

(435) 563-0053

eMail: [email protected]


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Diet & Nutrition?

For Cancer?

With our most aggressive

weapons, we arentwinning theWar Against Cancer .

How could somewimpy foods

have any effect?

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3

CancerType

Greater SurvivalAssociated With...

Reference

Breast

! 5 servings veggies/fruitper day plus exercise 30

min, 6x/wk (45% morelikely to survive 10 yrs)

Pierce JP: J Clin Oncol .,2007 Jun 10;25(17):

2345-51.

Ovarianhigh intake of cruciferousvegetables (45% more likelyto survive 5 yrs)

Nagle C, et al: Int JCancer , Aug 2003;106

(2):264-9.

Gastricless commercially-raisedmeat & animal fat

Palli D, et al: Cancer ,

Sept 2000;89:1205-13.

Pancreaticlower (omega-6) fat, higherber, avoid excess calorieintake

Carter JP, et al: J AmColl Nutr , Jun 1993; 12

(3):109-26.

Post-Diagnosis Dietand Cancer Survival


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COX-2

CRP

LOX-5

estrogen

leptin

adiponectinVEGF

IGF-1

! NFk

5-HETE

cortisolVEGF

bFGF

IL-6

TNF- "

# SHBG

! Copper

IL-10

brin

# Antioxidants

insulin

PDGF

! Iron

Hyper-coagulability

Inammation

InsulinResistance

HormoneImbalance

NutrientImbalance

s ImmuneIncompetence

Angiogenesis# Vit D

# Zinc

Oncometabolic Milieu

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GeneInstability


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Nutrition Can ChangeGene Expression

Flaxseed & Breast Cancer

! 70% reduction in her2neu expression

! 34% reduction in ki-67 (rate of cancer cell division and growth)

! 30% increase in apoptosis (programmed cell death)

STUDY: post-menopausal BrCa pts fed mufn with 25 grams(2 TBSP) axseed meal vs placebo mufn for 4-5 weeks.

Compared tumor characteristics from biopsy and subsequentlumpectomy.

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! Men with prostate cancer not electing

treatment (surgery, radiation, hormonetherapy)

! Gene expression compared after 3 monthson diet

! Expression of 500+ genes changed! Oncogenes were down-regulated!

Ornish D, et al: Changes in prostate gene expression in men undergoing anintensive nutrition and lifestyle intervention. Proc Natl Acad Sci USA. 2008 Jun

17;105(24):8369-74. 7

Healthy DietProfoundly AltersGene Expression

BEFORE

AFTER


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CancersMaster Switch

8

Aggarwal B, et al:Nuclear Factor-k: A holy grail incancer prevention and therapy. Curr Signal TransducTher, 2006:1:25-52 . Van Waes C: Nuclear factor-kappa in development, prevention, and therapy ofcancer. Clin Cancer Res, Feb 15, 2007;13(4):1076-82.

ACTIVATES 400+ genes involvedin tumor proliferation, survival,angiogenesis & invasion

TRIGGERS:carcinogens

oxidationviral infectioninammationradiationchemotherapy stress


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Spices Inhibit NFk

Aggarwal B & Shishodia S: Suppression of the nuclear factor-kappaactivation pathway by spice derived phytochemicals: reasoning for seasoning.

Ann NY Acad Sci , Dec 2004;1030:434-41.

The reasonto season?

To talk toyour genes!

anisebasilblack pepper

carawaycardamomchili pepper

cinnamon

clovecoriander

cuminfennelfenugreek

axseedgarlicgingerHoly basil

lemongrasslicorice

mintmustard seednutmeg

oreganoparsleyrosemarysaffron

tamarindturmeric

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Spices (combinations: curry, chai)

Broccoli sprouts (sulforaphane)

Brassica veggies (isothiocyanates)

Dark leafy greens (folate)

Garlic, onions, leeks, chives, shallots

Parsley, celery, red pepper (luteolin)

Peanuts/boiled, red grapes/wine (resveratrol)Red onions and capers (quercetin)

Green tea (theophylline, EGCG)

Fish, eggs, cheese, sunflower seeds,asparagus, almonds (B vitamins)

Top 10 Foods to Modify

Gene Expression1

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Three times a day,day after day,

we are eating foodsthat can inuence

our genes and helpus ght cancer... David Servan-Schreiber, MD

FOOD IS POWERFUL

MEDICINE


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Blood Glucose & Cancer SurvivalSurvival in Mice with

Injected Breast Cancer Cells

SOURCE: Santisteban GA, et al : Glycemic modulationof tumor tolerance in a mouse model of breast cancer.Biochem Biophys Res Commun, Nov 1985;132(3):1174-9.

% surviving70 days

Approx. Blood Glucose (mg/dl)

A1c

0

25

50

75

100

3.7% 4.7% 5.4%

33%

67%

90%

60 88 108

Survival of

Brain Tumor PatientsSurvival

in months

Mean Blood Glucose Level (mg/dl)

0

4

8

11

15

65-93 94-137 ! 138

14.5 mo

9.1 mo

SOURCE: Derr R, et al ., Association between hyperglycemiaand survival in patients with newly diagnosed

glioblastoma. J Clin Oncol , Mar 1, 2009;27(7):1082-6.

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! ! Recurrence - 3-fold " risk of recurrence in5 yrs in BrCa pts " rates of recurrence & livermets in colon cancer pts

! ! Post-Op Complications - " rate of post-op complications (40 vs 11%) and longerhospital stay (11 vs 8 days)

! Immune Suppression - " risk of infection inpts undergoing intensive chemotherapy

! ! Estrogen - increases circulating estrogen via" aromatase activity & # SHBG production

Derr R, et al : Antecedent

hyperglycemia is associated with anincreased risk of neutropenicinfections during bone marrowtransplantation. Diabetes Care , Oct2008;31(10):1972-7.

Lohsiriwat V, et al : Impact of metabolicsyndrome on the short-term outcomesof colorectal cancer surgery. Dis Colon

Rectum , Feb 2010;53(2):186-91.Pasanisi P, et al : Metabolic syndromeas a prognostic factor for breastcancer recurrences. Int J Cancer , Jul1, 2006;119(1):236-8.

Shen Z, et al : Metabolic syndrome isan important factor for the evolution ofprognosis in colorectal cancer:survival, recurrence, and livermetastasis. Am J Surg , 2010 May;80(5):331-6.

Vona-Davis L, et al : Adiposity, type 2diabetes and the metabolic syndromein breast cancer. Obes Rev , Sept2007;8(5):395-408.

Cancer patients withinsulin resistance have...

Influence of Insulin Resistance

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! ! DNA Damage leading to gene instability

! Mitosis stimulates damaged cells to divideand make daughter cells

! Inhibits Apoptosis (allows cancer cells toevade programmed cell death and surviveindenitely

! Stimulates Angiogenesis - " growth ofnew blood vessels to fuel tumor progression

! Promotes Cell Migration - invasion &

metastasis

Cowey S & Hardy RW: Themetabolic syndrome: A high-riskstate for cancer? Am J Pathol ,2006 Nov;169(5):1505-22.

Cancer Promoting Effectsof Insulin Resistance

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I N S U L I N


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Are youfacinginsulin

resistance?

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Diagnostic

Value

Optimal

RangeWaist-Hip

Ratiowomen: > 0.85men: >1.0

women: < 0.8men: < 0.9

FastingGlucose

> 100-110 mg/dl 60-90 mg/dl

A1c ! 6.0% 4.6-5.2%

Triglycerides > 150 mg/dl < 110 mg/dl

HDL

cholesterol

women : < 40

men: < 50> 50-55 mg/dl

Bloodpressure

> 135/85 $ 120/80

Uric Acid < 5.5 mg/dl


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Foods with High Glycemic Load

BEWARE!These wholesome-

appearing foodsmay be problematic

for you!

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Bread, whiteBread, whole wheat

CerealOatmealCrackers

MufnsBagels

CookiesPancakesWafes

Soda popFruit Juice

Dried fruitsCandy

ChipsSugar

HoneyFlour, white

Flour, whole wheat

CornCornmeal

PastaPotatoes

Potato chipsPretzels

Rice, whiteRice, brown

Fat-free foods

www.glycemicindex.comwww.nutritiondata.com


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Low Glycemic SubstitutionsINSTEAD OF THIS... TRY THIS ..

Food(1 cup portion)

GlycemicLoad*

Food(1 cup serving)

GlycemicLoad

White our

76 Almond Flour 0

Whole wheat our 44 Coconut Flour 0

Corn, sweet yellow 35 Baby Corn 5

Rice paper wrap 4

Hamburger bun 18 Portobello mushrooms 3

Romaine lettuce wrap 0

Brown rice 22 Cauliower rice 2

Spaghetti Squash 2

Pasta noodles 22 Zucchini noodles 1

Miracle Noodles 0

Mashed Potatoes 16 Mashed Cauliower 4

* Glycemic Load $ 10 is HIGH!


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Cinnamon

Berries: blueberries, goji, blk currant

Chamomile tea

Allium family: garlic, onions, leeks, chives

Parsley

Avocado

Olive oil

Flaxseed meal / Oat bran (soluble fiber)

Lemon

Nopal (prickly pear cactus)

Top 10 Foods to AidGlycemic Control

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Kaushik G, Satya S, Khandelwal RK, Naik SN. Commonly consumed Indian plantfood materials in the management of diabetes mellitus. Diab Metabol Syndr: ClinRes Rev . 2010;4(1):21-40. Yeh GY et al: Systematic review of herbs and dietary

supplements for glycemic control in diabetes. Diab Care 2003 Apr;26(4):1277-94.


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Inflammation & Cancer Survival

0%

20%

40%

60%

80%

100%

0 200 400 600 800 1000

LowHigh

McMillan DC, et al : Measurement of the systemic inammatory response predicts cancer-specicand non-cancer survival in patients with cancer. Nutr Cancer , 2001;41(1-2):64-9.

% patientssurviving

Time (in days)

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! ! Intake of fruits & vegetables (8+ servings/day)

! Ratio of " -6:3 fats about 1:1 to 3:1! # Vegetable oils, margarine, commercially-

raised meat, poultry, dairy, eggs

! ! Cold-water sh, organic grass-fed meat,poultry, dairy and omega-3 rich eggs, walnuts,hemp, chia and axseed meal, leafy greens

! Low glycemic diet ( # insulin-driven inammation)

Diet to AddressInammation

Find sources forgrass-fed foods atwww.eatwild.com

Wallace JM: Nutritional and botanicalmodulation of the inammatory

cascadeeicosanoids, cyclooxygenases,and lipoxygenasesas an adjunct in

cancer therapy. Integr Cancer Ther , Mar2002;1(1):7-37. Watzl B: Anti-

inammatory effects of plant-based

foods and of their constituents. Int JVitamin Nutr Res, Dec 2008;78(6):293-8. 25


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Spices (esp. curry, ginger, garlic, parsley)

Wild, cold-water fish

Grass-fed (pastured) meat, dairy, eggs

Hot peppers

Olive oil

Leafy green veggies (spinach, chard, kale)

Cruciferous vegetables

Pumpkin, butternut squash, yam, carrot

Dark chocolate (flavanols)

Berries (blueberries, cherries, raspberries)

Top 10 Foods toQuench Inflammation

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www.nutritiondata.com Reinagel M: The Inammation Free Diet Plan , McGraw-Hill,2007. Hamed MS, et al. Dark chocolate effect on platelet activity, C-reactive protein

and lipid prole: a pilot study. South Med J, 2008;101(12):1203-1208.


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TAKE HOME TIPS:

Anticancer Dietin 5 Easy Steps

! Low glycemic! High nutrient density

! Daily rainbow of phytonutrients

! Ample spices (NFkB reason to season)! Improved omega-6:3 ratio

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x

524 BrCa pts followed 5 yrs" dietary intake soy associated with # riskof recurrence in post-menopausal pts withER+ BrCa

Clinical Findings

Kang X et al : Effect of soy isoavones on breast cancerrecurrence and death for patients receiving adjuvantendocrine therapy. CMAJ. 2010 Nov 23;182(17):1857-62.

Q1

! Not estrogen, rather SERM -in vivo competes with estrogen andxenoestrogens

! Modulates estrogen via manypathways - " SHBG, # circulatingestrogen, " 2:16-OH estrogen ratio

! Other effects - anti-angiogenesis,tyrosine kinase inhibition, promotesdifferentiation, induces apoptosis,impedes invasion and metastasis

Shu XO et al : Soy food intake and breast cancer survival. JAMA. 2009 Dec 9;302(22):2437-43.

5,042 BrCa survivors, 20-75 yrs old, inChina, followed 5 yrs

Soy food intake inversely associated withmortality and recurrence

Guha N et al: Soy isoavones and risk of cancerrecurrence in a cohort of breast cancer survivors. BreastCancer Res Treat . 2009 Nov;118(2):395-405.

1,954 BrCa survivors, followed 6 yrsPostmenopausal women on tamoxifen,~ 60% reduction in recurrence cf highest tothe lowest isoavone intake

FAQ: Is soy safe forpatients with ER+

breast cancer?


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FAQ: Is vegetarian or veganthe best anti-cancer diet?

Q3

ADVANTAGES CONCERNS STRATEGIES

Opportunity for highintakes of

Increased Copper - low zinc indiet (vegetarian food sources ofzinc are also rich in copper)

Nuts/seeds with Zn:Cu Ratio ! 6:1(pumpkin, sunower, macadamia, sesameseeds). Zinc supplement as needed.

phytonutrients and

antioxidants

Insulin Resistance - may over-emphasize high glycemic load foods Follow low glycemic load diet

Avoids nitrates inprocessed meats andheterocyclic amines in

charred meats

Low CLA - avoidance of foodsources of conjugated linoleic acid(CLA)

CLA supplement (9-cis,11-trans) if avoidingdairy or eating only non- or low-fat dairy.Sunower seeds have CLA, but are 65%lower in 9-cis,11-trans isomer.

Reduces exposure totoxins whichbioaccumulate in

Low Omega-3s - walnuts,axseed/hemp seed oils have lessconversion of EPA & lack DHA

Include cold-water sh in diet, or puriedsh oil supplement (less toxin exposure)

animal foods (top offood chain)

Low Vitamin A - beta carotenenot converted to retinol in statesof insulin resistance or low thyroid

Ensure adequate thyroid function; addressinsulin resistance

Documents

Cancer Kitchen Pres