NUTRITION AND CANCER

Obesity Adult Obesity Rate by State 1990

Obesity Adult Obesity Rate by State, 2014

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

Cancers Associated with Obesity

Breast Colon Rectum Stomach Esophagus Kidney Thyroid Pancreas Prostate Gallbladder

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

3 Phases of Nutrition

Prevention

Treatment

Survivorship

Treatment Goals

Prevent or resolve nutrition deficiencies

Weight maintenance

Preserve lean body mass

Minimize nutrition-related side effects

Maximize quality of life

Care Team

Rock Star RD

Nutrition Impact Systems

Fatigue Constipation Anorexia Xerostomia Nausea Emesis Gas/bloating Reflux SOB Diarrhea Early Satiety Smell bother Taste Alteration Mucositis Dysphagia Weight Loss Weakness

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

Supplements & Vitamins

Typically discouraged unless ordered

Defer to Oncologist

Encouraged whole foods with color

Does Sugar Feed Cancer?

Recommendation is to avoid added sugars

Avoid spikes in insulin levels

Excess insulin = cell growth

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”

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

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’

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

Moving to the Next Level

Lifestyle changes

Weight Management

Nutrition

Activity

Making Changes

Creating Change

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/World Cancer Fund (2007)

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

Alcohol AICR recommends to abstain Increases circulating estrogen levels 1 – Women 2- Men

Links Breast Esophageal Pancreatic Liver Colon Throat Mouth Rectum

Salt and Supplements

Limit consumption of salty foods Limit consumption of processed foods

Do not use supplements to protect against

cancer

Goal for Survivorship

Monitoring/Screenings

Weight Management

Dietary Modifications

Physical Activity