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The fruit is comprised of peel (pericarp), seeds, and aril (outer layer surrounding the seeds).
Arils are mainly composed of water and also contain phenolics and flavonoids.
The peel makes up 50% of the fruit and contains a number of bioactive compounds, including phenolics, flavonoids, and ellagitannins, and minerals such as potassium, magnesium, and sodium.

• A pomegranate can contain 200 – 1400 seeds depending on size (that’s a lot to pick up with a pin!!)
• The seed or Arils is what is consumed, the taste can sometimes be sour from the acidic tannins found in the arils.
• This is what the juice is made from, a glass of pomegranate juice is made from more than one fruit.
• What about Mixed juice drinks – they contain added water and less pomegranate juice but some do contain other healthy berries.

POM
100% Pomegranate Juice from concentrate
Tesco Pomegranate juice drink
Pomegranate Juice
From Concentrate (32%)
Tropicana Trop 50 Pomegranate
& Blueberry Juice
Pomegranate Juice (2.5%)
Sainsbury Pomegranate
& Blueberry Juice Drink
Pomegreat Pomegranate Juice
Drink
Fruit Juices from Concentrate
33% (Pomegranate 30%, Aronia
Berries)
Innocent Pomegranate smoothie
Pomegranate Juice From
Concentrate (25%
PomeGreat 100%
Pomegranate
67 Pressed Red & White Grapes, 2 Mashed Bananas , 1 Squeezed
Oranges, 1 Pressed Pomegranates 14% , 96 Crushed Blueberries
3.5% ,56 Peeled Acai Berries 2% ,And a squeeze of Lemon

• Antioxidant benefits – from phenolics, flavonoids, and ellagitannins
– Antioxidants mop up excess Free Radicals, which are produced by the body as it protects itself from outside invaders, like bacteria, If free radicals get out of control, they can damage normal cells and tissues.
• May help prevent the clogging up of the artery walls - due to Polyphenols, such as tannins and flavonols – which are actually found in many fruit and veg.
• Small studies have shown they may suppress tumour growth and lower Prostate Specific Antigen (PSA) levels
BUT more larger clinical trials are need.
• In these studies the participants consumed 8oz pomegranate juice a day

• In studies the equivalent of a large glass a day was consumed – so not excessive
• Pomegranate juice is higher in natural sugars and energy (Kcal), a possible concern if you have diabetes or are trying to control weight.
• Perhaps spilt into 2 smaller glasses and take with food.
• In 8oz (220ml) there are 150Kcals compared to 77Kcal in Orange Juice and 30Kcal in Tomato juice
• May impact on how some medication is broken down in the body (e.g. Statins, Warfarin) – best speak to your doctor/pharmacist.
• Overall –it is just a fruit with no negative effects if taken in moderation.

The potential benefits are from the antioxidants
• Blueberries
• Goji Berries
• Strawberries
• Cranberries
• Bilberries

• Gives fruit and vegetables the ‘red’ colour
• Antioxidant properties
• Sources: Tomatoes, guava, watermelon, papaya, pink grapefruit, apricots
• Lycopene best absorbed from cooked vegetables and fruits, also aided by a small amount of fat (e.g. pasta mixed with tomato sauce and drizzle olive oil)
• Evidence that Lycopene in fruit and veg probably protects against Prostate cancer.
Inconclusive evidence that it helps slow progression – but doesn’t harm.

• Mix sun-dried tomatoes into bread dough or add them to a sandwich or salad.
• Have Pasta with a tomato sauce
• For a refreshing start to your day, enjoy a pink grapefruit.
• Reach for tomato juice to quench your thirst.
• Make a quick bruschetta by toasting baguette slices and lightly brushing with olive oil. Top with canned, diced tomatoes and a sprinkling of basil.
• Have a few dried apricots as a snack or chop and sprinkle on your cereal
• Have watermelon or papaya as a fruity pudding
– (….with cream or ice-cream)

– By eating more fruit and vegetables (5 a day
(at least))
– Snack on fresh/dried fruit or add to cereal, have a glass of fruit juice a day, have a fruity pudding and have veg / salad with your meals
– Eat a rainbow though…

• Hormone treatment for prostate cancer can cause weight gain and tiredness. In turn these symptoms may make you less active, which may make weight gain worse.
• May be a loss of muscle mass due to lower testosterone levels and an increase in the amount of body fat, so you may have a change to your body shape.
• Some studies show that the weight gain stabilises after first year of treatment (?)

• We have no other tools than trying to:
–Maintain a healthy diet
–Be active
•Exercise can help to maintain muscle strength, especially resistance exercise such as swimming
•Aim for 30mins exercise 5 days a week (but during treatment just do what you can)
•Don’t have to join a gym – take a walk, ride a bike, go swimming, take the stairs in shops rather than escalator, speak to a healthcare professional regarding chair based exercises if needed

• Metabolic system?
• We all need a certain amount of energy to maintain life –
Basel metabolic rate
• If you have a high percentage of body fat you are more likely to store fat more easily, giving a lower metabolic rate
• As people get older they naturally lose muscle mass which reduces metabolic rate slightly
• Exercise is the way to combat this – especially strength exercises to maintain muscle mass.
• If you lose weight too quickly via ‘fad diets’ you lose muscle mass, which lowers your metabolic rate.
• It can be ‘tricked’ by if you become more active and burn off more energy.

• Foods Groups
– Starchy carbohydrate – bread, rice, pasta, potato etc
– Fruit and vegetables (fresh, dried, frozen, canned)
– Dairy – milk, cheese, yoghurt
– Meat, fish, pulses, eggs, nuts – Protein group
– Foods containing fats and sugars
 When looking at a plate of food – ½ should be vegetables or salad, a ¼ starchy carbohydrate and a ¼ protein containing foods.
• Regular meals – don’t skip breakfast

• Eat 5 a day fruit and veg (remember the rainbow)
• Chose high fibre carbohydrates (e.g. wholegrain bread, eat skin on potatoes, wholegrain cereal)
• Remove all visible fat from meat and limit fat used in cooking
• Replace some meat with beans/pulses (if able) to increase dietary fibre.
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Lower fat cheeses (e.g. Edam), choose low fat soft cheese even as an alternative to butter/marg on bread.
• Limit high energy snacks and puddings (e.g. biscuits, cake, gateaux's, ‘stodgy’ puddings)
• Watch alcohol intake (A 250ml glass of wine contains
250Kcals)

• Different types:
• Saturated animal fat – bad for your heart
• Unsaturated (Vegetable) fats
– Polyunsaturated – e.g. sunflower oil rich Omega 6
– Fish Oils – Omega 3 – Anti – Inflammatory
– Monounsaturated – e.g. olive oil healthier fat for you heart
Bottom line – all contain same Kcals -
1 tablespoon oil = 100Kcal
(Equivalent to 3 rich tea biscuits or a crumpet)

• Naan bread ( a large Naan contains 400Kcal compared to 550 in an average curry and rice. – meal total
950Kcal)
• Garlic bread (3 small slices contain ½ Kcals of a portion of lasagne – meal total 750 Kcal)
• Crisps – can vary from 80Kcal – 200Kcal per packet
• A portion of sticky toffee pudding and custard has same
Kcal content as an average meal
• 4 chocolate coated biscuits has same Kcal content as a ham sandwich

• Causes tiredness
• Can irritate your bowel leading to soreness and / or diarrhoea (reported 80% of patients having radiotherapy to pelvis region have stomach upsets
• Stomach cramps
• Can cause inflammation of your bladder
• Can make blood vessel fragile leading to blood on passing stools or urine

• Drink plenty – aim 8 -10 cups of fluid a day
• If you have diarrhoea – speak to your doctor regarding medication to help.
– A Low Fibre diet may help some individuals – no evidence that routine reduction helps alleviate incidence or severity
– Lactose – Some people feel that milk/lactose makes the diarrhoea worse but the enzyme that breaks down lactose is Lactase, found in high in small bowel – Radiation is highest further down.

• Breakfast cereals: Cornflakes, Rice Krispies, Coco Pops,
Special K
• Bread, flour, pasta & rice: White: bread, rolls, pitta, chapatti, crumpets, white rice, white pasta, cornflour, sago, tapioca, semolina, couscous
• Biscuits, cakes, crackers: Biscuits made with white flour:
Rich Tea, Nice, Ginger Nuts, Shortbread, Custard Creams,
Jaffa Cakes, Plain cake e.g. sponge cake, plain scones ,
White crackers or crispbreads e.g. Cream crackers,
• Fruit : Tinned, stewed or fresh fruit without skins or seeds: peeled apples, pears or peaches, melon, ripe bananas
Fruit juice without ‘bits’
• Vegetables: Well-cooked vegetables e.g. carrots, Swede, parsnip, beetroot, cauliflower and broccoli florets
Potatoes without skins

• All Meat, fish, eggs, dairy products are ok.
• Only follow this diet whilst the symptoms of diarrhoea may still be present.
• Re-introduce fibre slowly back into your diet
• Other foods that can aggravate diarrhoea:
– Caffeine drinks: tea, coffee, cola (use decaf versions, herbal teas)
– Alcohol
– Sugar-free products containing Sorbitol eg chewing gum
– Fruit juice (limit to one small glass (150ml) per day)
– Spicy foods
– Fried foods

•Common side effects:
•Poor appetite, Nausea, tiredness, low mood
•Travelling to treatment centres can worsen above symptoms
•Result – reduced oral intake –
• Little and often approach, have energy dense snacks,
Puddings after meal or in between as snacks,
Add fats to foods (e.g. butter in mash potato, cheese sauce on veg, parsley sauce with fish, roasted veg in oil),
Grate cheese onto meals, have milky drinks,
Full fat diary products

• Pomegranates may slow progression of tumour but further studies needed
• Cooked/sun dried tomatoes good source of Lycopene - an antioxidant
• Aim to eat 5 portions of different fruit and veg (a rainbow) to have an antioxidants rich diet (include tomatoes +
Pomegranates as part of a healthy diet).
• A healthy lifestyle helps control weight gain – but it is difficult
• Symptoms of diarrhoea can be helped with a low fibre diet
• If your appetite is poor due to treatment then a ‘little and often’ approach to eating is needed with energy dense foods.
• If you require specific individual dietary support speak to your doctor regarding referral to a Dietitian