Eating for Wellness Jennifer Spring, RD, CSO, LDN Outpatient Oncology Dietitian North Carolina Cancer Hospital “What should I eat?” “What’s the best diet?” “What super food is most important?” Nutrition Recommendations The World Cancer Research Fund/AICR Guidelines 1. 2. 3. 4. 5. 6. 7. 8. Be as lean as possible without becoming underweight Be physically active for at least 30 minutes every day Limit intake of energy-dense foods and avoid sugary drinks Eat a variety of vegetables, fruits, whole grains, and legumes/beans Limit intake of red meat and avoid processed meat Limit intake of salty foods and foods processed with salt Limit alcoholic drinks Don’t use supplements to prevent cancer Limit intake of energydense foods and avoid sugary drinks Energy Dense Foods Sugary drinks—soft drinks, sweetened ice tea, juice flavored drinks Baked goods—desserts, cookies, pastries, and cakes Candy Chips—potato, corn, pita Ice cream Processed meat—hot dogs, salami, pepperoni, bologna Fast food—French fries, fried chicken, and burgers Packaged and processed foods high in added sugars and fats Sugar and Cancer Glucose is the primary fuel for the body Glucose comes from foods that contain carbohydrates, including sugar, vegetables, fruits, whole grains and low-fat dairy sources. Our body even produces glucose from protein we eat. Cancer cells need glucose (blood sugar) to grow just like healthy cells Dietary sugar does not preferentially promote cancer growth Insulin Elevated levels of glucose stimulate the release of insulin from the pancreas. Elevated levels of insulin in the blood over a long period of time increase inflammation. Tumor cells use this inflammatory process to signal cells to multiply. Metabolic stress can lead to secretion of insulin-like growth factor (IGF-1) How much is too much sugar? The American Heart Association recommendation for added sugar: Women 6 teaspoons (25 grams) Men 9 teaspoons (37 grams) Three Oreo cookies 14 grams a half cup of marinara sauce 7 grams 1 tablespoon of grape jelly- 12 grams Eat a variety of vegetables, fruits, whole grains, and legumes/beans “Eat food. Not too much. Mostly plants.” Michael Pollan Popular Plant-Based Diets Mediterranean Asian DASH Vegan Vegetarian Colorful Fruits, Vegetables, and Phytochemicals Color Phytochemicals Fruits and Vegetables White and Green allyl sulphides Onions, garlic, chives, leeks Green sulforaphanes, indoles Broccoli, Brussels sprouts, cabbage, cauliflower, kale Yellow and Green lutein, zeanzathin Asparagus, collard greens, spinach, winter squash Orange and Yellow cryptoxanthin, flavinoids Cantaloupe, nectarines, oranges, papaya, peaches Orange alpha and beta carotenes Carrots, mangos, pumpkin Red and Purple anthocyanins, polyphenols Berries, grapes, plums Red lycopene Tomatoes, pink grapefruit, watermelon HEAL Well: A Cancer Nutrition Guide AICR/Livestrong/ Meals-to-Heal ,2013 Antioxidants Organic vs. Conventional Organic foods shown to have more antioxidant activity than their non-organic counterparts Not enough strong evidence to say that organic foods in general contain more vitamins, minerals or other nutrients than non-organic foods EWG’s Dirty Dozen Plus/ Clean Fifteen Herbs Herb Phytochemicals Blends well with: Basil quercetin, camphor, methyl eugenol, kaempferol oregano, parsley, thyme Bay Leaves eugenol, geraniol, limonene, perillyl alcohol oregano, basil, curry, cumin, turmeric Chives allium compounds, kaempferol, saponins dill, marjoram, paprika, savory, thyme Cilantro (a.k.a. coriander) apegenin, beta-carotene, kaemferol, quercetin, rutin chili powder, cumin, garlic, onion, oregano Dill isorhamnetin, kaempferol, limonene, myrcetin celery seed, cumin, thyme Oregano luteolin, myrcetin Parsley apegenin, coumarin, ferulic acid, lutein, luteolin, pthalides, quercetin basil, cumin, chili powder, parsley almost any other herb or spice Rosemary carnosol, fenchon, rosmanol, ursolic acid cumin, parsley, thyme carnosol, limonene, perillyl alcohol, vanillic acid isorhamnetin, terpenoids phenolics ( such as: rosmarinic acid and flavonoids) celery seed, marjoram, savory, thyme parsley basil, chives, dill, paprika, sage Sage Tarragon Thyme Spices Many spices have been shown to decrease inflammation and inhibit the growth of tumors Some spices studied include Turmeric, Garlic, Black Pepper, Cinnamon, Allspice Limit intake of red meat and avoid processed meat Common Food Carcinogens N-nitroso compounds Polycyclic aromatic hydrocarbons (PAHs) Heterocyclic amines (HCAs) Limit intake of salty foods and foods processed with salt Limit alcoholic drinks Alcohol Limit alcoholic drinks to 2 for men and 1 for women a day What is a drink? 12 oz of beer 4-5 oz of wine 1.5 oz of liquor/spirits Alcohol and Cancer Risk Tissues in the body damaged by direct exposure Heavy drinking may lead to liver damage Too much alcohol may reduce folate Excess calories may contribute to weight gain Don’t use supplements to prevent cancer Micronutrient Malnutrition in Older Adults Deficiency in some essential vitamins and trace minerals may be common in older adults. Should older adults use supplements to maintain a healthy immune system? Nutrient supplements, such as vitamin B6, zinc, vitamin C, vitamin E may be important for health promotion and prevention of certain diseases. Probiotics/ Prebiotics and Immune Response Germ free mice can exist and survive, but… Abnormalities of: Immune function Metabolic function Physiological function Trophic function Aging causes an increase in the number of putrefactive bacteria, and a decline in the number of beneficial bacteria groups. Immunosenescence The natural aging process also leads to a marked decline in immune function Probiotics “Good" bacteria and yeast providing benefits to the host Similar to those naturally found in gut Food examples: Kefir, yogurt, miso, tempeh, kimchi, kombucha Supplement examples: Saccharomyces boulardii (a yeast), and Lactobacillus and Bifobacterium Prebiotics Natural, non-digestible food ingredients that are linked to promoting the growth of helpful bacteria in your gut. “Good” bacteria promoters Examples: inulin, FOS, galacto-oligosaccharides, and lactulose Food sources: Jerusalem artichokes, dandelion greens, garlic, onions, asparagus, banana Prebiotics 44, free-living elderly people (28 women and 16 men), average age of 69.3 years were enrolled in the study The study subjects were given a supplement (galactooligosaccharide mixture called Bi2Muno) which they consumed for 10 weeks. Decrease in less beneficial bacteria Increase in beneficial bacteria Hydration Many older people do not drink enough fluids Sense of thirst declines Drink whether or not your feel thirsty Combat fatigue and prevent constipation 8-12 cups of fluid each day. 80/20 Rule 80% of the time eat healthy (AICR guidelines) 20% of the time indulge a little