P ti CP ti CPreventing Cancer Preventing Cancer RecurrenceRecurrenceRecurrenceRecurrence

Nutrition and Supplement Nutrition and Supplement ToolboxToolboxPeggy A Wright, PhD, RD, CNSPeggy A Wright, PhD, RD, CNSggy g , , ,ggy g , , ,

Martin P Albert, MDMartin P Albert, MD

Cancer Promoting DietsCancer Promoting Diets An estimated more than 30–40 %of all cancers

can be prevented by lifestyle and dietary p y y ymeasures alone

Contributors from Standard American Diet (SAD)Excess calories Excess calories

Impaired glucose metabolism (Obesity, nutrient poor foods such as concentrated sugars and refined flour products)products)

Low fiber intake Low fruit and vegetable intake Consumption of red meat Excess of omega-6 relative to omega-3 fats

Nutrition and cancer: A review of the evidence for an anti-cancer diet Michael S Donaldson

Diet & Cancer PreventionDiet & Cancer PreventionDiet & Cancer PreventionDiet & Cancer Prevention

When a diet is compiled according to theWhen a diet is compiled according to the guidelines here it is likely that there would be at least a 60-70 percent decrease inbe at least a 60 70 percent decrease in breast, colorectal, and prostate cancers, and even a 40-50 percent decrease inand even a 40 50 percent decrease in lung cancer, along with similar reductions in cancers at other sitesin cancers at other sites.Nutrition and cancer: A review of the evidence for an

anti-cancer diet Michael S Donaldson

How diet affects our risk ofHow diet affects our risk of cancercancerHow diet affects our risk of How diet affects our risk of cancercancer

Cancer initiators (carcinogens)Cancer initiators (carcinogens)( g )( g ) Cancer promotersCancer promoters Foods Foods and nutrients that decrease riskand nutrients that decrease risk

F dF d d i f ifid i f ifi Foods Foods and nutrients for specific cancersand nutrients for specific cancers SupplementsSupplements

AlcoholAlcoholBroiled meatsBroiled meatsPickled foodsPickled foodsSmoked and preserved meatsSmoked and preserved meats

DIETARY CARCINOGENSDIETARY CARCINOGENS

Smoked and preserved meatsSmoked and preserved meatsHigh temperature baked or fried starchy foodsHigh temperature baked or fried starchy foods

DIETARY CARCINOGENSDIETARY CARCINOGENS(CANCER INITIATORS)(CANCER INITIATORS)

AlcoholAlcohol A 2011 European study found A 2011 European study found thatthat alcoholalcohol intake accounted forintake accounted forthat that alcoholalcohol intake accounted for intake accounted for 1 in 10 1 in 10 cancercancer cases in men and cases in men and 1 in 30 for women who tend to 1 in 30 for women who tend to drink lessdrink lessdrink less.drink less.

Acetaldehyde, a product of Acetaldehyde, a product of alcohol metabolism, impairs a alcohol metabolism, impairs a ppcell's natural ability to repair its cell's natural ability to repair its DNA, resulting in a greater DNA, resulting in a greater likelihood that mutations causinglikelihood that mutations causinglikelihood that mutations causing likelihood that mutations causing cancer initiation cancer initiation

May result in May result in overexpressionoverexpression of of

EsophagusEsophagusMouthMouthPh d LPh d L certain certain oncogenesoncogenes in human in human

cells, triggering cancer promotion.cells, triggering cancer promotion. Acts as a “coActs as a “co--carcinogen ”carcinogen ”

Pharynx and LarynxPharynx and LarynxLiver (through Liver (through cirrhosis)cirrhosis) Acts as a coActs as a co--carcinogen.carcinogen.cirrhosis)cirrhosis)

Heterocyclic Amines and Poly Aromatic Heterocyclic Amines and Poly Aromatic H d b (PAH )H d b (PAH )Hydrocarbons (PAHs)Hydrocarbons (PAHs)

FFormed ormed naturally upon overcooking of meats, naturally upon overcooking of meats, y p g ,y p g ,poultry and poultry and fishfish

Formed in smoked and charbroiled meatsFormed in smoked and charbroiled meats EEpidemiology pidemiology suggests association with human suggests association with human

breast, colon, and breast, colon, and prostate cancerprostate cancer. .

Pickled Vegetables & Stomach CancerPickled Vegetables & Stomach CancerPickled Vegetables & Stomach CancerPickled Vegetables & Stomach Cancer

AcrylamideAcrylamide Formed when starchy foods are baked or fried at high Formed when starchy foods are baked or fried at high

temperatures temperatures Considered a cancerConsidered a cancer--causing chemical by the Office of causing chemical by the Office of

Environmental Health Hazard AssessmentEnvironmental Health Hazard Assessment Package warnings are required by law in CaliforniaPackage warnings are required by law in California Package warnings are required by law in CaliforniaPackage warnings are required by law in California By how much do the chips exceed the level required by By how much do the chips exceed the level required by

California for California for warning?warning? Cape Cod Robust Russet: 910 timesCape Cod Robust Russet: 910 times Kettle Chips (lightly salted): 505 timesKettle Chips (lightly salted): 505 times Kettle Chips (honey Kettle Chips (honey dijondijon): 495 times): 495 timesp ( yp ( y jj )) Pringles Snack Stacks (pizzaPringles Snack Stacks (pizza--flavoredflavored):):

170 170 timestimes Lay's Baked: 150 Lay's Baked: 150 timestimes Other sources are Other sources are FFrench fries and rench fries and

andand cigarette smoke.cigarette smoke.

AlcoholAlcoholRed meat (high Red meat (high hemeheme iron)iron)Trans fatsTrans fatsEstrogens in fullEstrogens in full--fat dairy productsfat dairy productsHighHigh glycemicglycemic diets (sugar and refined carbohydrates)diets (sugar and refined carbohydrates)

DIETARY CANCERDIETARY CANCER

High High glycemicglycemic diets (sugar and refined carbohydrates)diets (sugar and refined carbohydrates)Low nutrient dietsLow nutrient diets

DIETARY CANCER DIETARY CANCER PROMOTORSPROMOTORS

AlcoholAlcohol N t i t d fi i iN t i t d fi i iAlcoholAlcohol Nutrient deficienciesNutrient deficiencies Folic acidFolic acid

N d d t d t if h f lN d d t d t if h f lBreastBreast •• Needed to detoxify harmful Needed to detoxify harmful estrogen metabolites.estrogen metabolites.

•• Need to repair DNANeed to repair DNA

BreastBreastThe Nurses' Health The Nurses' Health Study found that Study found that drinking as little asdrinking as little as Need to repair DNA Need to repair DNA

damagedamage ZincZinc

drinking as little as drinking as little as half a drink a day half a drink a day increased a increased a woman's breast woman's breast

•• Healthy immune systemHealthy immune systemcancer risk by 30%.cancer risk by 30%.

ColonColon2 drinks/day 2 drinks/day ––64% 64% increase risk in men; increase risk in men; 84% increase in 84% increase in womenwomenwomen.women.

Estrogens in U.S. Dairy ProductsEstrogens in U.S. Dairy Productsg yg y Milk and dairy supply 60Milk and dairy supply 60--70% 70%

total estrogen intake from foodtotal estrogen intake from food Buttermilk has highest amount Buttermilk has highest amount

of estrogen and more active of estrogen and more active tt Increased estrogen intake due Increased estrogen intake due

to change in farming practicesto change in farming practices 33x more 33x more estroneestrone sulfate in sulfate in

estrogenestrogen Skim milk has the least Skim milk has the least

estrogen and less active estrogen and less active “ j t d” f“ j t d” fmilk from pregnant than nonmilk from pregnant than non--

pregnant cows.pregnant cows. Goat milk contains less Goat milk contains less

“conjugated” form“conjugated” form Butter has highest amountButter has highest amount Even organic cow milk is high Even organic cow milk is high

estrogenestrogen BGH given to cow’s to BGH given to cow’s to

increase milk productionincrease milk production

in estrogen.in estrogen.

Adults with high milk intake Adults with high milk intake showed 10showed 10--20% increase in 20% increase in circulating IGFcirculating IGF--11

IGFIGF--1 can function as a growth1 can function as a growth IGFIGF 1 can function as a growth 1 can function as a growth factor for cancers. factor for cancers.

Red & Processed MeatsRed & Processed MeatsRed & Processed MeatsRed & Processed Meats

Breast cancerBreast cancer Colon cancerColon cancer Breast cancerBreast cancer EstrogenEstrogen

•• Estradiol and Estradiol and estroneestrone levels levels levelslevels of USA beef (3 8 1 0)of USA beef (3 8 1 0)

Colon cancerColon cancer Not entirely clear how Not entirely clear how

promotes.promotes.levelslevels of USA beef (3.8, 1.0) of USA beef (3.8, 1.0) were 600 times and 10 times, were 600 times and 10 times, respectively, higher than respectively, higher than those of Japanese beef (0.0, those of Japanese beef (0.0, 0 1)0 1)

Compounds that may Compounds that may damage lining of gut damage lining of gut and promote cancerand promote cancer0.1).0.1).

•• Eating meat increases the Eating meat increases the body’s production of body’s production of estrogensestrogens

and promote cancerand promote cancer Increased Increased

inflammatory omegainflammatory omega--6 6 Increased Increased

inflammatory omegainflammatory omega--6 6 fats (fats (arachidonicarachidonic acid)acid)

fats (fats (arachidonicarachidonic acid)acid) Meat changes the Meat changes the

bowel flora which maybowel flora which mayfats (fats (arachidonicarachidonic acid)acid) Inflammatory proteinsInflammatory proteins

bowel flora, which may bowel flora, which may affect the colonaffect the colon

Trans Trans Fats in FoodsFats in Foods Foods containing Foods containing

artificial trans fats may artificial trans fats may

MADE FROM: UNBLEACHED ENRICHED WHEAT MADE FROM: UNBLEACHED ENRICHED WHEAT FLOUR (FLOUR, NIACIN, REDUCED FLOUR (FLOUR, NIACIN, REDUCED IRON,THIAMINE MONONITRATE [VITAMIN B1], IRON,THIAMINE MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), DARK RIBOFLAVIN [VITAMIN B2], FOLIC ACID), DARK C OCO (S G C OCO Q OC OCO (S G C OCO Q O

yycontain up to 45% of fat contain up to 45% of fat as trans fat.as trans fat.

Baking shorteningsBaking shortenings

CHOCOLATE (SUGAR, CHOCOLATE LIQUOR, CHOCOLATE (SUGAR, CHOCOLATE LIQUOR, CHOCOLATE LIQUOR PROCESSED WITH CHOCOLATE LIQUOR PROCESSED WITH ALKALI [DUTCHED], COCOA BUTTER, BUTTER ALKALI [DUTCHED], COCOA BUTTER, BUTTER OIL, SOY LECITHIN, VANILLA EXTRACT), OIL, SOY LECITHIN, VANILLA EXTRACT), SUGAR, SUGAR, VEGETABLE OILS (PALM AND/OR VEGETABLE OILS (PALM AND/OR INTERESTERIFIED AND HYDROGENATEDINTERESTERIFIED AND HYDROGENATED Baking shortenings Baking shortenings

generally contain 30% of generally contain 30% of fat as trans fat.fat as trans fat.

Margarines notMargarines not

INTERESTERIFIED AND HYDROGENATED INTERESTERIFIED AND HYDROGENATED SOYBEAN AND/OR HYDROGENATED SOYBEAN AND/OR HYDROGENATED COTTONSEED), COTTONSEED), EGGS, CONTAINS 2 PERCENT EGGS, CONTAINS 2 PERCENT OR LESS OF: CORNSTARCH, EGG WHITES, OR LESS OF: CORNSTARCH, EGG WHITES, DEHYDRATED SKIM MILK, SALT, SOY DEHYDRATED SKIM MILK, SALT, SOY LECITHIN,NATURAL FLAVORS AND LEAVENING LECITHIN,NATURAL FLAVORS AND LEAVENING

Margarines not Margarines not reformulated to reduce reformulated to reduce trans fats may contain trans fats may contain up to 15% trans fat byup to 15% trans fat by

,,(BAKING SODA).(BAKING SODA).

up to 15% trans fat by up to 15% trans fat by weight.weight.

Look for “partially Look for “partially hydrogenated ________ hydrogenated ________ oil”oil”

Sugar and High Refined CarbohydratesSugar and High Refined CarbohydratesSugar and High Refined CarbohydratesSugar and High Refined Carbohydrates

Mediated by Mediated by Insulin and IGFInsulin and IGF--1 (growth factors)1 (growth factors) InflammationInflammation Increased estrogen production (more active Increased estrogen production (more active

aromatase)aromatase) Decreased nutrientsDecreased nutrients

•• FiberFiber•• BB--vitaminsvitamins•• ChromiumChromium

Ph t t i tPh t t i t•• PhytonutrientsPhytonutrients•• ZincZinc

••Inflammation and Oxidative stressInflammation and Oxidative stress••Growth factors (IGFGrowth factors (IGF--1)1)••AngiogenicAngiogenic signals (VEGF, PDGF, HIFsignals (VEGF, PDGF, HIF--1alpha)1alpha)••Hormone balanceHormone balance••Supporting immunitySupporting immunity

MODIFYING THE TERRAIN THROUGHMODIFYING THE TERRAIN THROUGH

Supporting immunitySupporting immunity••Supporting detoxificationSupporting detoxification

MODIFYING THE TERRAIN THROUGH MODIFYING THE TERRAIN THROUGH FOOD, SPICES, AND HERBSFOOD, SPICES, AND HERBS

FarmFarm--acyacy versus Pharmacyversus PharmacyFarmFarm acyacy versus Pharmacyversus Pharmacy

The Natural FarmThe Natural Farm--acyacyThe Natural FarmThe Natural Farm acyacy

In traditional foods and herbsIn traditional foods and herbs there are athere are a In traditional foods and herbs, In traditional foods and herbs, there are a there are a wide variety of active wide variety of active phytochemicalsphytochemicals, , includingincludingincludingincluding flavonoidsflavonoids, , terpenoidsterpenoids, , lignanslignans, sulfides, , sulfides,

polyphenolicspolyphenolics carotenoidscarotenoids coumarinscoumarinspolyphenolicspolyphenolics, , carotenoidscarotenoids, , coumarinscoumarins, , saponinssaponins, sterols, , sterols, curcuminoidscurcuminoids, and , and isothiocynatesisothiocynates

which which possess important actions in health possess important actions in health promotion and disease prevention.promotion and disease prevention.promotion and disease prevention.promotion and disease prevention.

Phytonutrients: Mechanisms of Cancer Phytonutrients: Mechanisms of Cancer P tiP tiPreventionPrevention

ProtectProtect DNA from oxidation andDNA from oxidation and Protect Protect DNA from oxidation and DNA from oxidation and consequent DNA breakdownconsequent DNA breakdown

Detoxification and removal of carcinogensDetoxification and removal of carcinogensDetoxification and removal of carcinogens Detoxification and removal of carcinogens AntiAnti--inflammatoryinflammatory Insulin regulationInsulin regulation Interfere with tumor cell operationsInterfere with tumor cell operationspp Induce normal cell death (apoptosis) when Induce normal cell death (apoptosis) when

DNA breakdown occursDNA breakdown occursDNA breakdown occursDNA breakdown occurs

MultiMulti-- versus Monoversus Mono-- taskingtasking

AntiAnti--cancer cancer SuperfoodsSuperfoods Cruciferous vegetablesCruciferous vegetables

Broccoli sproutsBroccoli sprouts Pomegranate (juice Pomegranate (juice

concentrate)concentrate)T t ( k d)T t ( k d) Broccoli, Broccoli, bokbok choychoy, ,

cabbage, collards, kale, cabbage, collards, kale, etc.etc.

Tomato (cooked)Tomato (cooked) Soy foods, naturalSoy foods, natural SpicesSpices

BerriesBerries Blueberries, cranberries, Blueberries, cranberries,

strawberries, blackberries, strawberries, blackberries,

tumerictumeric, ginger, black , ginger, black cumin, cumin, cardamoncardamon, , cinnamon, citrus peel, cinnamon, citrus peel,

bilberries, etc.bilberries, etc. EPA sources: wild caught EPA sources: wild caught

salmon, sardines, herring, etc.salmon, sardines, herring, etc.

fennel, fenugreek, holy fennel, fenugreek, holy basil, cayenne pepper, basil, cayenne pepper, black pepperblack pepper

Flax and sesame seedsFlax and sesame seeds Garlic and onionsGarlic and onions Green teaGreen tea

NutsNuts Whey proteinWhey protein

Green teaGreen tea Mushrooms (white button, Mushrooms (white button,

shitake)shitake)

AntiAnti--cancercancer Vitamins & MineralsVitamins & MineralsAntiAnti cancer cancer Vitamins & MineralsVitamins & Minerals Vitamin D

S l i Selenium Folic acid B 2/Rib fl i B-2/Riboflavin B-6/Pyridoxine Carotenoids (α carotene β carotene lycopene Carotenoids (α-carotene, β-carotene, lycopene,

lutein, cryptoxanthin) Tocopherols, especially tocotrienols Tocopherols, especially tocotrienols Zinc Vitamin C Vitamin K

••Cancer stem cellsCancer stem cells••Cell regulation and apoptosis (p53)Cell regulation and apoptosis (p53)

TWEAKING THE CANCERTWEAKING THE CANCER

Cell regulation and apoptosis (p53)Cell regulation and apoptosis (p53)••BclBcl--22

TWEAKING THE CANCER TWEAKING THE CANCER CELLCELL

Potential inhibitors of Potential inhibitors of C S C llC S C llCancer Stem CellsCancer Stem Cells

Vitamin D3Vitamin D3 Low inflammatory loadLow inflammatory load Genistein from soyGenistein from soy SulforaphaneSulforaphane from from

yy Oxygenation of blood and Oxygenation of blood and

tumortumorcruciferous vegetablescruciferous vegetables

Curcumin from Curcumin from tumerictumeric SilibininSilibinin from milk thistlefrom milk thistle

Exercise, soy, Exercise, soy, grapeseedgrapeseed extract, extract, EGCG (green tea),EGCG (green tea),

SilibininSilibinin from milk thistlefrom milk thistle Resveratrol (mostly from Resveratrol (mostly from

Japanese knotweed)Japanese knotweed)

EGCG (green tea), EGCG (green tea), guggulsteronesguggulsterones, , PanaxPanax ginsengginseng

M tf iM tf ip )p )

PiperinePiperine from black from black pepperpepper

Metformin Metformin AndrographisAndrographis ParthenolideParthenolide (feverfew)(feverfew)

Pomegranate extractPomegranate extract ParthenolideParthenolide (feverfew)(feverfew)

How How PhytonutrientsPhytonutrients Help Prevent Help Prevent C I iti ti Th 53 P t iC I iti ti Th 53 P t iCancer Initiation: The p53 ProteinCancer Initiation: The p53 Protein

•• Mutation of the p53 tumor suppressorMutation of the p53 tumor suppressor•• Mutation of the p53 tumor suppressor Mutation of the p53 tumor suppressor gene is the gene is the most common genetic most common genetic alteration in human canceralteration in human cancer..alteration in human canceralteration in human cancer. .

•• The p53 protein is often called the The p53 protein is often called the guardian of the genome.guardian of the genome.guardian of the genome. guardian of the genome.

•• p53 prevents replication of damaged DNA p53 prevents replication of damaged DNA in normal cells and promotes suicide orin normal cells and promotes suicide orin normal cells and promotes suicide or in normal cells and promotes suicide or apoptosis of cells with abnormal DNA. apoptosis of cells with abnormal DNA.

Mederi Foundation, Donald R. Yance, MH, CN, RH (AHG)

Natural Compounds that Inhibit p53 MutationNatural Compounds that Inhibit p53 MutationDiets rich in refined sugars and starches, as well as rich in Diets rich in refined sugars and starches, as well as rich in g ,g ,

red meat promote p53 mutation. red meat promote p53 mutation.

Quercetin Quercetin Tocotrienols Tocotrienols (vitamin E)(vitamin E)QQ onions, apples, citrus fruits, onions, apples, citrus fruits,

dark berriesdark berries

ResveratrolResveratrol

( )( ) Palm oilPalm oil Coconut oilCoconut oil Annatto seed oilAnnatto seed oil ResveratrolResveratrol

Peanuts, especially Peanuts, especially sprouted, mulberries, dark sprouted, mulberries, dark grapes, red wine, plums,grapes, red wine, plums,

Annatto seed oilAnnatto seed oil Rice bran and rice bran oilRice bran and rice bran oil Whole grains, especially Whole grains, especially

barleybarleygrapes, red wine, plums, grapes, red wine, plums, dark berriesdark berries

OPCs (OPCs (OligomericOligomericProanthocyanidinsProanthocyanidins))

barleybarley Curcumin Curcumin ((tumerictumeric)) 66--Gingerol Gingerol (ginger)(ginger)

ProanthocyanidinsProanthocyanidins)) Apples, maritime pine bark, Apples, maritime pine bark,

grape seed, red wine, grape seed, red wine, bilberry cranberry blackbilberry cranberry black

EGCG EGCG (green tea)(green tea) Folate Folate (dark green leafy (dark green leafy

veggies, oranges, cantaloupe)veggies, oranges, cantaloupe)bilberry, cranberry, black bilberry, cranberry, black currant, green and black currant, green and black tea, cocoa beanstea, cocoa beans

AshwagandhaAshwagandha

BClBCl--2 Down2 Down--regulationregulationBClBCl 2 Down2 Down regulation regulation

CurcuminCurcumin AndrographisAndrographis CurcuminCurcumin EGCG green teaEGCG green tea Chinese skullcapChinese skullcap

AndrographisAndrographis EPA from fish oilEPA from fish oil YarrowYarrow Chinese skullcapChinese skullcap

HibiscusHibiscus RosemaryRosemary

YarrowYarrow ChelidoniumChelidonium alkaloids alkaloids

(Greater celandine(Greater celandine-- RosemaryRosemary GingerGinger PanaxPanax ginsengginseng

(Greater celandine(Greater celandinetoxic in moderate toxic in moderate doses)doses)

PanaxPanax ginsengginseng Grape seed extractGrape seed extract

F fF f FeverfewFeverfew

••NFKBNFKB••TNFTNF--alphaalpha

ANTIANTI--INFLAMMATORIESINFLAMMATORIES ANDAND

TNFTNF alphaalpha••ROSROS

ANTIANTI INFLAMMATORIESINFLAMMATORIES AND AND ANTIOXIDANTSANTIOXIDANTS

Food reducers of inflammationFood reducers of inflammation

GingerGinger Soy proteinSoy protein Cold water oily fish/Fish oilCold water oily fish/Fish oil

PomegranatePomegranate Blueberries, Blueberries,

cranberries, cranberries,

Cold water, oily fish/Fish oilCold water, oily fish/Fish oil WalnutsWalnuts Sesame oilSesame oil

strawberries, bilberriesstrawberries, bilberries Tart and Tart and bingbing cherries cherries

(muscle pain post(muscle pain post--))

Virgin coconut oilVirgin coconut oil ExtraExtra--virgin virgin

olive oilolive oilexercise)exercise)

Dark purple and red Dark purple and red grapesgrapes

Green tea Green tea Dark chocolate Dark chocolate

((polyphenolspolyphenols)) Broccoli and other dark Broccoli and other dark

green cruciferous green cruciferous vegetables vegetables (( lf hlf h ))

((p ypp yp )) CoffeeCoffee Black tea Black tea

((theaflavintheaflavin))((sulforaphanessulforaphanes)) Tomato (Tomato (lycopenelycopene))

((theaflavintheaflavin))

Smoothies: an easy way to prepare Smoothies: an easy way to prepare h lth f it d t blh lth f it d t blhealthy fruits and vegetableshealthy fruits and vegetables

½ to 1 cup water½ to 1 cup water Handful of kale or spinachHandful of kale or spinach 1/2 peeled cucumber1/2 peeled cucumber 22--4 celery stalks in 2” pieces4 celery stalks in 2” pieces 1 medium carrot, trimmed 1 medium carrot, trimmed

and quarteredand quartered 1 apple or pear, stemmed 1 apple or pear, stemmed

and q artered (seeds in)and q artered (seeds in)and quartered (seeds in)and quartered (seeds in) ¾ cup frozen raspberries or ¾ cup frozen raspberries or

blueberries (will change the blueberries (will change the color) (also try peeled kiwi)color) (also try peeled kiwi)color) (also try peeled kiwi)color) (also try peeled kiwi)

Small piece of peeled gingerSmall piece of peeled ginger Makes 2 large servings or 4 Makes 2 large servings or 4

smaller servingssmaller servingss a e se gss a e se gs

Herbal mediators of Herbal mediators of inflammationinflammation

Curcumin/Curcumin/tumerictumeric Cat’s clawCat’s claw Resveratrol (Japanese Resveratrol (Japanese

knotweed)knotweed) Holy basilHoly basil

RR

PycnogenolPycnogenol (French (French maritime pine)maritime pine)

HopsHopsB l i ( i l )B l i ( i l ) RosemaryRosemary

BoswelliaBoswellia Chinese (Baikal) skullcapChinese (Baikal) skullcap

Bromelain (pineapple core)Bromelain (pineapple core) NettlesNettles Borage oil, evening Borage oil, evening

primrose oilprimrose oil Magnolia barkMagnolia bark AndrographisAndrographis White willow barkWhite willow bark

primrose oilprimrose oil Reishi mushroomReishi mushroom Corydalis (Chinese)Corydalis (Chinese)

ASU ( dASU ( d FeverfewFeverfew Celery seed extractCelery seed extract

ASU (avocadoASU (avocado--soy soy unsaponifiablesunsaponifiables))

GreenGreen--lipped mussel extractlipped mussel extract

••VEGFVEGF••PDGFPDGF

ANGIOGENICANGIOGENIC SIGNALSSIGNALS

PDGFPDGF••HIFHIF--1alpha1alpha

ANGIOGENICANGIOGENIC SIGNALSSIGNALS

ModifyingModifying Gene Expression Potential Gene Expression Potential Agents: AngiogenesisAgents: Angiogenesis

VEGF (vascular endothelial growth factor)VEGF (vascular endothelial growth factor) flaxseedflaxseed ccurcuminurcumin fish oil EPAfish oil EPA sseleniumelenium grape seed extractgrape seed extract green teagreen tea green teagreen tea ResveratrolResveratrol boswelliaboswellia boswelliaboswellia Baikal skullcap (Baikal skullcap (ScutellariaScutellaria baicalensisbaicalensis))

Natural compounds that suppress Natural compounds that suppress p ppp ppPDGF (PDGF (plateletplatelet--derived growth factor)derived growth factor)

Curcumin Curcumin •• causes an interruption of the PDGF and EGF causes an interruption of the PDGF and EGF

signaling pathwayssignaling pathways BaicaleinBaicalein in Baikal (Chinese) skullcapin Baikal (Chinese) skullcap EGCG, from green tea extract, inhibits PDGFEGCG, from green tea extract, inhibits PDGF--

induced VEGF expression via blocking PDGF induced VEGF expression via blocking PDGF receptorreceptorreceptor .receptor .

Hypoxia-inducing growth factor is involved in cancer angiogenesis

D h R dDanshen or Red sage

Jeanne M Wallace, PhD, CNC, Nutritional Solutions Consulting Group

Support AntiSupport Anti--AngiogenesisAngiogenesisP t ti l A tP t ti l A tPotential AgentsPotential Agents

OTHER POTENTIAL ANTIOTHER POTENTIAL ANTI--ANGIOGENICANGIOGENIC OTHER POTENTIAL ANTIOTHER POTENTIAL ANTI ANGIOGENIC ANGIOGENIC AGENTS:AGENTS:

• Apigenin (mint and • Vitamin A• Apigenin (mint andpropolis)

• Selenium

• Vitamin A • Cordyceps sinensis• Shark liver oil (squalene)

• Vitamin D3• Garlic • Berry flavonoids

• Fresh/frozen shark cartilage • Glycine• Bindweed (Convolvulus y (

arvensis)

Fish oil

From soybeans or supplement

Jeanne M Wallace, PhD, CNC, Nutritional Solutions Consulting Group

Copper & AngiogenesisCopper & AngiogenesisCopper & AngiogenesisCopper & Angiogenesis

Copper increasesCopper increases Copper increases Copper increases proliferation and proliferation and migration of migration of endothelial cellsendothelial cells

Key proKey pro--angiogenicangiogeniccompounds require compounds require copper for their copper for their synthesis / activationsynthesis / activationsynthesis / activationsynthesis / activation

Support AntiSupport Anti--AngiogenesisAngiogenesispppp g gg g DIET: DIET:

LimitLimit high copper foods (and supplements)high copper foods (and supplements) LimitLimit high copper foods (and supplements)high copper foods (and supplements)•• Organ meatsOrgan meats•• ShellfishShellfish•• Prepared chocolatesPrepared chocolates•• WaterWater--soluble chlorella: “soluble chlorella: “chlorophyllinchlorophyllin copper copper

l ”l ”complex”complex”•• RooibosRooibos tea tea

Filter water if copper plumbing and water isFilter water if copper plumbing and water is Filter water if copper plumbing and water is Filter water if copper plumbing and water is acidic acidic pH.pH.

Support AntiSupport Anti--AngiogenesisAngiogenesisSupport AntiSupport Anti AngiogenesisAngiogenesisPotential AgentsPotential Agents

POTENTIAL COPPER LOWERING AGENTS:POTENTIAL COPPER LOWERING AGENTS: Zinc Zinc MolybdenumMolybdenum Chlorella (regular)Chlorella (regular)

S lf d (NAC i )S lf d (NAC i ) Sulfur compounds (NAC, taurine)Sulfur compounds (NAC, taurine) LipoicLipoic acidacid

Vitamin CVitamin C Vitamin CVitamin C Rx: Rx: TetrathiomolybdateTetrathiomolybdate (TM) (TM)

•• Must be carefully monitoredMust be carefully monitoredyy

••EGFREGFR

GROWTH FACTORSGROWTH FACTORS

EGFREGFR••IGFIGF--11

GROWTH FACTORSGROWTH FACTORS

ModifyingModifying Gene ExpressionGene Expression Potential Potential A t G th F tA t G th F tAgents: Growth FactorsAgents: Growth Factors

EGFR (epidermal growthEGFR (epidermal growth green teagreen tea EGFR (epidermal growth EGFR (epidermal growth factor receptor, herfactor receptor, her--1, Erb1, Erb--BB--1)1)

green teagreen tea grape seed grape seed

extractextract Receptor for a cellular Receptor for a cellular

growth factorgrowth factor May play a role in theMay play a role in the

licoricelicorice pycnogenolpycnogenol May play a role in the May play a role in the

maintenance of cancer stem maintenance of cancer stem cellscells

pycnogenolpycnogenol quercetinquercetin soysoy

May play a role in bone May play a role in bone metastases in breast cancermetastases in breast cancer

More important in ERMore important in ER /PR/PR

soy soy (genistein)(genistein)

vitamin Dvitamin D More important in ERMore important in ER--/PR/PR--/Her2/Her2-- breast cancerbreast cancer

vitamin Dvitamin D

Inhibit Invasion and MetastasisInhibit Invasion and MetastasisP t ti l A tP t ti l A tPotential AgentsPotential Agents

G liG li• Arabinogalactans •• GarlicGarlic•• Vitamin C Vitamin C •• Soy esp. genisteinSoy esp. genistein

Arabinogalactans

• Coriolus versicolor(PSK/PSP)

•• BioflavonoidsBioflavonoids•• Vitamin AVitamin A•• AlkylglycerolsAlkylglycerols (in brain(in brain

•Green Tea EGCG

• Flaxseed

• Panax ginseng AlkylglycerolsAlkylglycerols (in brain (in brain tumors)tumors)

•• ProanthocyanidinsProanthocyanidins (GSE, (GSE, PCO)PCO)

• Panax ginseng

• Enzymes

•Bromelain •• Fish oil EPAFish oil EPA•• Melatonin (high dose)Melatonin (high dose)

• Nattokinase

• Lumbrokinase

• Butyrate-fiber and bifidusprobiotic

LL l il i di tdi tLow Low glycemicglycemic dietdietBone brothsBone brothsCultured foodsCultured foodsGarlicGarlicMushroomsMushroomsBrazil nutsBrazil nuts

IMMUNE SUPPORTIMMUNE SUPPORT

Brazil nutsBrazil nutsAstragalusAstragalus

IMMUNE SUPPORTIMMUNE SUPPORT

AstragalusAstragalusDang shen root

Low glycemic load diet

Jeanne M Wallace, PhD, CNC, Nutritional Solutions Consulting Group

BreastBreast

DIET AND NUTRITION FORDIET AND NUTRITION FOR

BreastBreastEndometrialEndometrial

DIET AND NUTRITION FOR DIET AND NUTRITION FOR SPECIFIC CANCERSSPECIFIC CANCERS

Breast Cancer: Diets Associated Breast Cancer: Diets Associated i h Hi h Ri ki h Hi h Ri kwith Higher Riskwith Higher Risk

Red Red meatsmeats WellWell--done and charbroiled meatsdone and charbroiled meats Saturated Saturated fat fat Full fat cow dairy (estrogens)Full fat cow dairy (estrogens) High High glycemicglycemic diet (sugar and refined diet (sugar and refined carbscarbs)) Total calories Total calories Alcohol Alcohol Low betaLow beta--carotene (marker of low veggie intake)carotene (marker of low veggie intake)

Breast Cancer: Diets Associated Breast Cancer: Diets Associated i h D d Ri ki h D d Ri kwith Decreased Riskwith Decreased Risk

Fish, especially those rich in omegaFish, especially those rich in omega--3 fatty acids3 fatty acids Fish, especially those rich in omegaFish, especially those rich in omega 3 fatty acids 3 fatty acids Eggs Eggs Fruits especially citrus fruits and cranberriesFruits especially citrus fruits and cranberries Fruits, especially citrus fruits and cranberries Fruits, especially citrus fruits and cranberries Olive oil Olive oil Whole grainsWhole grains Whole grains Whole grains Soy and other legumes Soy and other legumes Cruciferous vegetables: cabbage broccoli etcCruciferous vegetables: cabbage broccoli etc Cruciferous vegetables: cabbage, broccoli, etc.Cruciferous vegetables: cabbage, broccoli, etc. Vegetables Vegetables

Higher folate intake associated with reduced breastHigher folate intake associated with reduced breast Higher folate intake associated with reduced breast Higher folate intake associated with reduced breast cancer riskcancer risk

Omega 3’s: wild salmonOmega 3’s: wild salmonOmega 3 s: wild salmonOmega 3 s: wild salmon

Jeanne M Wallace, PhD, CNC, Nutritional Solutions Consulting Group

The BAD: Too much omegaThe BAD: Too much omega--66The BAD: Too much omegaThe BAD: Too much omega 66 Animal, dairy and many vegetable oils Animal, dairy and many vegetable oils y y gy y g

(cottonseed, (cottonseed, grapeseedgrapeseed, regular safflower, , regular safflower, corn, peanut, sunflower, soy)corn, peanut, sunflower, soy)

Phytoestrogens modulate estrogenPhytoestrogens modulate estrogen Phytoestrogens are plantPhytoestrogens are plant--based chemicals, found in based chemicals, found in

trace amounts in many foods, and planttrace amounts in many foods, and plant--medicines, medicines, which can harmonize the actions of the body's ownwhich can harmonize the actions of the body's ownwhich can harmonize the actions of the body s own which can harmonize the actions of the body s own estrogenestrogen

More than 300 foods have been shown to contain More than 300 foods have been shown to contain phytoestrogensphytoestrogens and most are sufficiently consumedand most are sufficiently consumedphytoestrogens phytoestrogens and most are sufficiently consumed and most are sufficiently consumed in a healthy and balanced diet and therefore in a healthy and balanced diet and therefore generally don’t need to be supplemented generally don’t need to be supplemented

The estrogenic properties of these The estrogenic properties of these biochemicalsbiochemicals are are g p pg p pthought to be due to their structural similarities to the thought to be due to their structural similarities to the hormone estradiol, of hormone estradiol, of they act about 1/300they act about 1/300--1/400 the 1/400 the potency of estradiol.potency of estradiol.

Most foodMost food--based phytoestrogens come from one of based phytoestrogens come from one of three chemical classes: the three chemical classes: the isoflavonoidsisoflavonoids, , lignanslignans, or , or coumestanscoumestans..

F d hi h iF d hi h i tt i l di l d litlit i t bi t b li bli b dd Food sources high in Food sources high in coumestanscoumestans include include split peassplit peas, , pinto beanspinto beans, , lima beanslima beans, and , and especially especially alfalfaalfalfa and and cloverclover sproutssprouts..

Phytoestrogens inhibits cancer via a Phytoestrogens inhibits cancer via a b f h ib f h inumber of mechanismsnumber of mechanisms

Interaction with estrogen receptors (ER) to modulate Interaction with estrogen receptors (ER) to modulate th i f tth i f t iithe expression of estrogenthe expression of estrogen--responsive genesresponsive genes

Inhibition of enzymes involved in estrogen biosynthesis Inhibition of enzymes involved in estrogen biosynthesis and metabolismand metabolism

Modulation of insulinModulation of insulin Inhibition of protein Inhibition of protein kinaseskinases and interaction with and interaction with

components of the cell cycle as well as proliferationcomponents of the cell cycle as well as proliferationcomponents of the cell cycle as well as proliferation, components of the cell cycle as well as proliferation, differentiation, and apoptotic pathwaysdifferentiation, and apoptotic pathways

Elevate PTEN Elevate PTEN -- a cancer suppressor genea cancer suppressor gene Inhibition of Inhibition of topoisomerasetopoisomerase (involved in DNA (involved in DNA

replication)replication) ProteasomeProteasome inhibition (to promote death in tumor cells)inhibition (to promote death in tumor cells) ProteasomeProteasome inhibition (to promote death in tumor cells)inhibition (to promote death in tumor cells) Redox Redox balance (reduce oxidative stress)balance (reduce oxidative stress)

PhytoestrogensPhytoestrogensPhytoestrogensPhytoestrogens

I t k i i t d ith d d i k f b tI t k i i t d ith d d i k f b t Intake is associated with a reduced risk of breast, Intake is associated with a reduced risk of breast, prostate, colon, endometrial, and other cancers.prostate, colon, endometrial, and other cancers.

Has shown to inhibit many ageHas shown to inhibit many age--related diseases related diseases including osteoporosis, diabetes, and heart disease including osteoporosis, diabetes, and heart disease

The majority of studies have shown that The majority of studies have shown that phytoestrogens have a beneficial effect on relieving phytoestrogens have a beneficial effect on relieving

l tl tmenopausal symptomsmenopausal symptoms

Phytoestrogens have a great safety profilePhytoestrogens have a great safety profiley g g y py g g y p

Soy and IsoflavonesSoy and IsoflavonesSoy and IsoflavonesSoy and Isoflavones Most population studies show a decreased risk and Most population studies show a decreased risk and

some no change of risk for both premenopausal andsome no change of risk for both premenopausal andsome no change of risk for both premenopausal and some no change of risk for both premenopausal and postmenopausal breast cancer incidence and postmenopausal breast cancer incidence and recurrence.recurrence.

Postmenopausal: Reduced risk recurrence with roughly Postmenopausal: Reduced risk recurrence with roughly 2 servings natural soy foods daily (tofu, 2 servings natural soy foods daily (tofu, tempehtempeh, soy , soy milkmilk edamameedamame))milk, milk, edamameedamame). ).

Premenopausal: Mostly a reduced risk or no change. Premenopausal: Mostly a reduced risk or no change. Should not use isolated soy extracts.Should not use isolated soy extracts.

Tamoxifen: 60% decreased risk recurrence with high Tamoxifen: 60% decreased risk recurrence with high intake of soy in American women.intake of soy in American women.

Aromatase Inhibitors: 35% risk reduction in women at 2Aromatase Inhibitors: 35% risk reduction in women at 2 Aromatase Inhibitors: 35% risk reduction in women at 2 Aromatase Inhibitors: 35% risk reduction in women at 2 servings soy/day.servings soy/day.

Natural Soy ServingsNatural Soy ServingsNatural Soy ServingsNatural Soy Servings 1 cup of soy milk1 cup of soy milk

Until we have further Until we have further information avoid soy extractinformation avoid soy extractp yp y

3 ounces of tofu3 ounces of tofu 1/2 cup of 1/2 cup of edamameedamame

information avoid soy extract information avoid soy extract powders with high powders with high isoflavoneisoflavonecontent (more than the usual content (more than the usual 2020--40 mg per serving) and 40 mg per serving) and

3/4 ounce of dry roasted 3/4 ounce of dry roasted soybeanssoybeans

66 8 ounces soy yogurt8 ounces soy yogurt

capsules containing high capsules containing high amounts of genistein and or amounts of genistein and or daidzeindaidzein. .

66--8 ounces soy yogurt8 ounces soy yogurt 22--3 ounces of 3 ounces of tempehtempeh. . Soy is best taken in small Soy is best taken in small

Do NOT start eating a lot of Do NOT start eating a lot of soy products if you are at the soy products if you are at the beginning stages of beginning stages of yy

amounts on a consistent basis, amounts on a consistent basis, as a constant intake appears as a constant intake appears to help change the dynamics of to help change the dynamics of

hypothyroidism. However, hypothyroidism. However, people who are already people who are already hypothyroid should not hypothyroid should not experience any problems withexperience any problems withthe cancer cells.the cancer cells. experience any problems with experience any problems with soy.soy.

Flax: the magical seedFlax: the magical seedFlax: the magical seedFlax: the magical seed LignansLignans: phytoestrogens (plant estrogens). : phytoestrogens (plant estrogens). gg p y g (p g )p y g (p g )

structure similar to human estrogen. structure similar to human estrogen. Flaxseed increased urinary 2Flaxseed increased urinary 2--OHEstrogen OHEstrogen

excretion and the urinary 2/16 alphaexcretion and the urinary 2/16 alpha--OHE1 ratioOHE1 ratioexcretion and the urinary 2/16 alphaexcretion and the urinary 2/16 alpha--OHE1 ratio OHE1 ratio dosedose--response fashion.response fashion.

FlaxseedFlaxseed, in mice with human breast tumors , in mice with human breast tumors d d t th d t t id d t th d t t ireduced tumor growth and metastasis. reduced tumor growth and metastasis.

decreased extracellular levels of Vascular endothelial decreased extracellular levels of Vascular endothelial growth factor growth factor VEGF (VEGF (angiogenicangiogenic) )

OmegaOmega--3 fats associated with a3 fats associated with adecreased risk of breast cancerdecreased risk of breast cancermetastases in humansmetastases in humansmetastases in humans.metastases in humans.

What’s so special about flax, What’s so special about flax, ??anyway? anyway?

Serving size: 1 oz (2 TBS)Serving size: 1 oz (2 TBS) Serving size: 1 oz (2 TBS)Serving size: 1 oz (2 TBS)Calories Calories 152152 ProteinProtein 5 3 grams5 3 grams Protein Protein 5.3 grams5.3 gramsCalcium Calcium 72 mg72 mgM iM i 111111MagnesiumMagnesium 111 mg111 mg Potassium Potassium 232 mg232 mg FatFat 12 grams12 gramsOmega 3’sOmega 3’s 6515 mg6515 mg

Cruciferous VegetablesCruciferous Vegetables

Protective effect from attributed to isothiocyanates present in these vegetables including isothiocyanates present in these vegetables, including sulforaphane

indole-3-carbinol (I3C) Protect through multiple mechanisms

Increase detoxification enzymes protect cell from oxidative damage and promote the removal ofoxidative damage and promote the removal of carcinogens, including estrogens

Interferes with cancer cell metabolism and induces apoptosisapoptosis

Anti-inflammatory Inhibit tumor from forming own blood supply g pp y

(angiogenesis),

Cruciferous VegetablesCruciferous VegetablesCruciferous VegetablesCruciferous Vegetables

Associated with a reduced risk in the Associated with a reduced risk in the occurrence of cancer at various sites, including the prostate lung breast andincluding the prostate, lung, breast and colon.

Broccoli kale collards Chinese broccoli Broccoli, kale, collards, Chinese broccoli, cabbage (regular, Chinese, napa), Brussels sprouts, broccoflower, p , ,cauliflower, bok choy, turnip greens, rutabaga, mustard seeds, daikon, horseradish, wasabi, watercress

Summary: Breast Cancer Dietary Summary: Breast Cancer Dietary R d tiR d tiRecommendationsRecommendations

AvoidAvoid IncludeInclude High High glycemicglycemic foodsfoods High red meat intakeHigh red meat intake

Flax & sesame seedsFlax & sesame seeds SoySoy

Preserved meatsPreserved meats High omegaHigh omega--6 oils, such 6 oils, such

as corn peanutas corn peanut

Cruciferous veggiesCruciferous veggies BerriesBerries LL l il i f df das corn, peanut, as corn, peanut,

cottonseed, sunflower, cottonseed, sunflower, grapeseedgrapeseed

Low Low glycemicglycemic foodsfoods Wild caught salmon, Wild caught salmon,

sardinessardines HighHigh--fat cow dairy (U.S.)fat cow dairy (U.S.) AlcoholAlcohol

Olive oilOlive oil If using dairy, fatIf using dairy, fat--free free

cow or use goat’s milk cow or use goat’s milk

Supplements to ConsiderSupplements to ConsiderSupplements to ConsiderSupplements to ConsiderGeneralGeneral If on TamoxifenIf on Tamoxifen Vitamin D Vitamin D

especially important with especially important with aromatase inhibitorsaromatase inhibitors

CoQ10CoQ10-- 100mg/day100mg/day TocotrienolsTocotrienols

G liG li tt kitt ki Fish oilFish oil CurcuminCurcumin

Garlic or Garlic or nattokinasenattokinase GLA (gamma GLA (gamma linoleiclinoleic

acid) from eveningacid) from evening Resveratrol and/or grape Resveratrol and/or grape

seed extractseed extract Green teaGreen tea

acid) from evening acid) from evening primrose , borage, or primrose , borage, or black currant oilsblack currant oilsBB ll Green teaGreen tea

SilymarinSilymarin (milk thistle)(milk thistle) MultivitaminMultivitamin

BB--complex complex if not taking a more potent if not taking a more potent

multivitaminmultivitamin MultivitaminMultivitamin Iron and copper freeIron and copper free Natural Natural folatesfolates