CANCER PREVENTION
FOOD
Prof. Irena Drmić Hofman
University of Split School of Medicine
University Hospital Split
CROATIA
City of Split, Croatia
Learning with heart
OUTLINE
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Cancer etiology
Pathophysiology
Nutrition and carcinogenesis
Nutrients for cancer prevention
1. CANCER ETIOLOGY
• Cancer involves the abnormal division and
reproduction of cells that can spread
throughout the body
• Usually thought of as a single disease,
actually consists of >100 distinct types
Non-lethal damage of the cell is a basis of cancerogenesis
Let’s start with numbers…
• Am Cancer Soc (2009) Predicts lifetime
risk for developing cancer: ~1/2 men and
little more than 1/3 women
• Although fewer Americans are dying from
cancer (survival rate now 66% vs 50% in
the 1970s)
Data suggests
• 1/3 of 560,000 cancer deaths may be
attributed to nutrition and lifestyle
• Poor diet, physical inactivity, alcohol use,
and overweight and obesity
• Almost an additional 171,000 deaths are
caused by tobacco use (Brawer et al.,
2009)
• 30% of cancer deaths attibuted to poor
nutrition!
• Standards of Practice and Standards of
Professional Performance for Oncology
Nutrition Practice (Robien et al., 2010)
MOST PREVALENT TYPES OF
CANCER IN MEN
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Prostate
Lungs and bronchus
Colorectal
Urinary bladder
MOST PREVALENT TYPES OF
CANCER IN WOMEN
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Breast
Lung and bronchus
Colorectal
Uterine cancer
CANCER PREVENTION
GUIDELINES
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Protection from the sun
Reducing tobacco use
Maintaining a healthy body weight
IMPROVING DIET
Increasing regular physical activity
2. PATHOPHISIOLOGY
• Carcinogenesis is the origin or
development of cancer
• Changes in gene function cause normal
cells to transform into cancerous cells
GENOMICS
• Oncogenes are altered genes that
promote tumor growth and change
programed cell death (apoptosis)
• Tumor supressor genes are the opposite
of oncogenes, they became dactivated in
cancer cells
• Only 5-10% cancers are result of inherited
genetic alteration
CANCEROGENESIS
WHAT IS CARCINOGEN?
• Physical, chemical or viral agent that
induces cancer
• Carcinogenesis is a biologic, multistage
process that proceeds in three distinct
process:
Initiation, promotion and progression
CANCEROGENESIS IS
STEPWISE PROCESS
PHASES OF CARCINOGENESIS
• 1. INITIATION involves transformation of
cells produced by the interaction of
chemicals, radiation or viruses with cellular
DNA
• Transformation occurs rapidly, but cells
can remain dormant for a variable period
until they are activated by a promoting
agent (years or even decades)
PHASES OF CARCINOGENESIS
• 2. PROMOTION: initiated cells multiply
and escape the mehanism set in place to
protect the body from the growth and
spread of such cells
• Neoplasm, new and abnormal tissue with
no useful function, is established
PHASES OF CARCINOGENESIS
• 3. PROGRESSION: tumor cells aggregate
and grow into a fully malignant neoplasm
or a tumor
COLON CANCER
NUTRITION AND
CANCEROGENESIS
• Nutrition may modify the carcinogenic
process at any stage, including carcinogen
metabolism, cellular and host defense, cell
differentiation, and tumor growth
• Nutrition and diet contribute approx. 35%
to causal factors for cancer (Greenwald et
al., 2006)
NUTRITION AND
CANCEROGENESIS
• Diets contain both inhibitors
(antioxidants: vit. C, E, A and carotenoids,
Se and Zn and phytochemicals)
• and enhancers of carcinogenesis
(polycyclic aromatic hydrocarbons-PAH,
that form with a grilling meat at high heat;
alcohol)
CANCER PREVENTING FOOD
PLAN
NUTRITION AND RISK FACTORS
FOR CANCER
OBESITY AND BODY WEIGHT
OBESITY
• Risk factor for cancer and may account for
6% of all cancers (Polednak, 2008)
• Currently, 68% of all American adults are
overweight or obese (Flegal et al., 2010)
• Caloric restriction, without malnutrition,
have a positive effect on cancer
prevention in animals (Longo et al., 2010)
• Translate to humans?
OBESITY
• Positive association of BMI and cancers of
the esophagus, pancreas, gallbladder,
liver, breast (postmenopausal),
endometrium, kidney, colon and rectum
(Toles et al., 2008; WCRF and AICR,
2007)
• BMI should be between 21 and 23
(throughout childhood at lower end of
normal BMI)
• Obesity, age, hyperglycemia and the
incidence of metabolic syndrome play a role
in the circulating levels of insulin-like growth
factor-1 (IGF-1)
• Stimulates the growth of cancer cells
(prostate, breast, lung, colon) and inhibit
their death (Blackburn, 2007; Pollack, 2008)
REDUCE FAT
DIETS HIGH IN FAT
• Often contain significant ammounts of meat
• Link between meat and colorectal cancer:
production of carcinogens from a high-fat
diet, from heterocyclyc amines (HCAs),
and/or polycyclic aromatic hydrocarbons
(PAHs) from cooking; formation of
carcinogenic N-nitroso compounds
(NOCs) from processing (WCRF and
AICR,2007)
DIETS HIGH IN FAT
• Saturated fat in red meats may be
associated with an increased risk of
colorectal, endometrial, and possibly
lymphoid and hematologic cancers
(Ferguson, 2010; WCRF and AICR,
2007)
Reduce Fat
• saturated fats may increase the risk of
developing cancer. Further, diets high in
fat have been linked to obesity which in
turn has been linked with increased risk of
some cancers
Why reduce fat
• Reduce the amount of saturated fat in your
diet by limiting your consumption of red
meat and full-fat dairy products and avoid
foods that trans fats
• Keep your overall fat intake to less 20% of
your total calories each day (for a 2,000calorie diet, < 45 grams) and choose foods
that are rich in -3 essential fatty acids
FRENCH FRIES OR CANCER
FRIES?
French fries are made with hydrogenated oils and then fried at
high temperatures (80X more fat). They also contain cancercausing acryl amides which occur during the frying process.
Consumption of Red Meat
Eliminate or Limit Red Meat
• The China Study and several medical studies
indicate a relationship between consuming
animal proteins and increased risk for cancer
• It's been suggested that diets high in animal fat
may increase the body's levels of bile, which
can feed tumors. In cultures where meat is
minimally consumed or not consumed at all, the
incidences of certain cancers are markedly
lower than in the Western countries
Eliminate or Limit Red Meat
• Consider eliminating or limiting your
consumption of red meat and other animal
proteins, seem to reduce the risk of
developing breast and prostate cancer.
Consider using soy milk?
Processed meats and bacon
Also high in the same sodium nitrates found in hot
dogs, bacon, and other processed meats raise the
risk of heart disease. The saturated fat in bacon also
contributes to cancer
ALCOHOL
• Increased risk for cancers of the mouth,
pharynx, larynx, esophagus, lung, colon,
rectum, liver and breast (World Cancer
Research Fund, and American Institute for
Cancer Research, 2007)
Reduce salt
•Contains 55 mg
Na / bottle ~ as in
1 pizza
•↑ Na, ↑ thirsty
•↑ salt, ↑ sugar to
improve the taste
FOOD ADDITIVES?
SHORT LIST OF DANGEROUS
ADDITIVES
• Artificial Sweeteners (Aspartame, Acesulfame-K ;
Stevia is the choice)
• Monosodium Glutamate
• Artificial Food Colorings
• Sodium Nitrate/Sodium Nitrite
• Sulfur Dioxide and bisulphite
• High Fructose Corn Syrup
• Trans Fats
• Butylated hydroxyanisole (BHA) and butylated
hydrozyttoluene (BHT)
• Potassium Bromate …
Increase Fiber
Increase Fiber
• Help move potential carcinogens through
the intestines faster, lessening the amount
of time the intestinal wall is exposed to
them
• Fiber is also thought to help absorb bile
acids, thus preventing decaying food from
encouraging harmful changes in cells
Increase Fiber
• Try to eat at least 25 gr of fiber today from
a variety of sources, with an emphasis on
whole grains, legumes and fresh
vegetables
• Start by trading your favorite breakfast for
bran cereal or slow-cooked oatmeal,
adding beans to soups and salads and
transitioning from "white foods" like bread
and pasta to their whole-grain counterparts
Eat More Raw Fruits and
Vegetables
More Raw Fruits and Vegetables
• Gradually increase intake until you're
eating 5 to 9 servings daily. If you don't
like your vegetables raw, prepare them
lightly steamed or blanched (3 min)
Eat More Raw Fruits and
Vegetables
• Plants produce phytochemicals to protect
themselves and these phytochemicals
may support the body's immune system
and many have antioxidant properties that
help prevent certain types of cancer.
• FRUITS AND VEGETABLES ALKALIZE
YOUR BODY!
Change Your Oil
Change Your Oil
• Avoid vegetables oils that are high in
saturated fats. Choose cold, expellerpressed olive oil, canola oil, sunflower oil,
flaxseed oil or walnut oils for cooking,
each of which contains good amounts of
heart-healthy monounsaturated fats and
offers a higher ratio of -3 to  -6
essential fatty acids
Change Your Oil
• On the occasions when you do cook with
oil, be sure to cook at medium to mediumlow heats. Heat changes oil's molecular
structure and heating to the point of smoke
may create carcinogenic compounds in
the oil. For high-heat cooking needs look
for specially formulated high-heat canola
oils or choose grapeseed oil which retains
its molecular structure at higher
temperatures
Drink Green Tea
• Green tea and black tea contain the
antioxidant-rich polyphenols, which
appear to prevent cancer cells from
dividing. Dry green tea leaves also
contains catechins, which may inhibit the
growth of cancer cells. Consider
transitioning from coffee to tea or making
hot and cold teas your beverage of choice
throughout the day
DRINK WATER
• 8 glass of water (“daily eight”)
• Important in diet burdened with salt and fat
• Detoxification (meat hormons, pesticide
residues, industrial chemicals, refined
sugars)
Have a Glass of Wine
Have a Glass of Wine
• Red grapes and the wine contain
polyphenols, antioxidants that may protect
against several types of cancer, as well as
resveratrol which blocks a key protein that
cancer cells need to survive. Although
several cancer studies find in favor of
drinking red wine, drinking large amounts
is discouraged. Drink red wine in
moderation by having one 1-2 glasses
daily at mealtime
NUTRITION FOR BREAST
CANCER PREVENTION
1. Broccoli
• Most attention as a breast
cancer prevention food
• Research has shown it
blocks tumor growth,
preventing the further
spread of cancer if it does
occur
• anti-cancer benefit from
other cruciferous veggies,
including cauliflower,
cabbage, Brussels sprouts,
and kale - eat one or more
of these vegetables every
day
2. Garlic
•Garlic seems to have an
impact on cell cycling
(process by which a normal,
healthy cell might become
cancerous)
•Credit for regulating this
goes to the component of
garlic called allyl sulfide Allyl
sulfides are found throughout
the onion family
•Prevents breast cancer
3. Apples
An apple a day may keep
cancer away — but there’s
a catch.
•Peeling apple-tossing away
a rich source of fiber,
antioxidants, and other
compounds needed for anticancer nutrition.
•Lab studies show that
apple peel can actually fight
the spread of cancer cells.
4. Pomegranates
•Early stages research
•Cell culture study suggests
that the fruit contains a
compound that might help
fight cancer’s growth —
especially estrogendependent cancers (breast,
endometrium).
•Also help fight heart disease
and prostate cancer.
5. Walnuts
•Walnuts contain many helpful
nutrients and healthy -3 fatty
acids, which help your body
fight inflammation
•Research also suggests that
walnuts may actually slow the
growth of breast cancer
tumors, so this tasty nut could
play a role in breast cancer
management even after
diagnosis
6. Fish
•Great sources of -3 fatty
acids include certain fish and
fish oil (salmon, mackerel,
sea bass, and tuna)
•Smart protein source since
nutrition recommendations
include limiting intake of red
meat and processed meats,
such as bacon and
packaged deli meats
7. Flaxseed
•Flaxseed oil, or the seed itself,
ground into a flour-like dust
•Milled flaxseed has a
component called lignans
•Lignans may decrease cancer
growth; perfect for a breast
cancer management diet
•Buy ground flaxseed or grind
the seeds using a coffee
grinder, then sprinkle the
flaxseed on salads or in muffins
8. Soybeans
•Mixed reviews regarding
adult breast cancer
prevention, but preteen girls
could eat two servings of
soybean products a day, and
get anti-cancer nutrition
benefits later in life
•On the other hand, against
adult women taking soy or
isoflavone supplements these
products contain estrogen-like
compounds
9.Orange Fruits and Vegetables
•Carrots, cantaloupe, and
sweet potatoes — foods rich
in the form of vitamin A –
carotenoids (and 600 different
carotenoids)
•Higher levels of carotenoids
in a bloodstream- lower risk
for breast cancer
•Increase intake of orange,
red, yellow, and even dark
green foods
10. Berries
•Blueberries, blackberries,
raspberries, and strawberries
add color, variety, and flavor
•Also power-packed with
vitamins, minerals, and
antioxidants
•Recent research suggests that
blueberries enhance the effect
of the often-prescribed drug
tamoxifen in fighting breast
cancer cells.
11. Green Tea
•Green tea and white tea
contain catechins, extracts
that seem to show some
benefit in cancer prevention
•Green tea is particularly
effective at protecting cells
against environmental
exposures that might
increase the risk for cancer
•Drink four or more cups a
day - to achieve this effect
12. Turmeric
•The spice that gives curry its
beautiful yellow color contains
a chemical called curcumin
•Lab studies using curcumin
supplements have shown that
it could play a role in helping
fight tumors when combined
with certain drug-based
therapy
•Also anti-inflammatory effect
that could protect overall
health
A healthy diet isn't a magic bullet
against cancer
CHANGE THE HABITS!