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Cancer-Causing Food Ingredients: Its Prevention and Control Dennis Ramon M. Tudtud, MD, FPCP, FPSMO Diplomate, Philippine Specialty Board of Internal Medicine.

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Presentation on theme: "Cancer-Causing Food Ingredients: Its Prevention and Control Dennis Ramon M. Tudtud, MD, FPCP, FPSMO Diplomate, Philippine Specialty Board of Internal Medicine."— Presentation transcript:

1 Cancer-Causing Food Ingredients: Its Prevention and Control Dennis Ramon M. Tudtud, MD, FPCP, FPSMO Diplomate, Philippine Specialty Board of Internal Medicine Diplomate, Philippine Specialty Board of Medical Oncology President, Philippine Society of Medical Oncology

2 MAGNITUDE OF THE CANCER PROBLEM IN THE PHILIPPINES 3 rd in incidence after communicable & cardiovascular diseases 1 out of 1,800 Filipinos has cancer 114:103 females: males Incidence increases with age

3 MORTALITY FROM CANCER Leading cancer sites of mortality: Females breast cervix uteri lung breast cervix uteri lungMales lungliver colon/rectum lungliver colon/rectum 2005 Phil Cancer Facts & Estimates

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5 DEVELOPMENT of CANCER Healthy cell Dead cell Lose many cells Cell damaged Cell regeneration Impaired cell Regeneration Aging Cancer OXIDANTS

6 Main Causes Of Cancer 1. SMOKING 2. AGING Affected by lifestyle choices ( stress, lack of exercise and sleep) and diet

7 I. Smoking I. Smoking Tobacco use is the most preventable cause of cancer Cigarette smoke has enormous amount of oxidants Most people know smoking causes lung cancer Causes a higher risk of esophageal, stomach, kidney, bladder, pancreas, cervical, uterine, head and neck, tongue Surgeon General of the USA showed that tobacco smoke contains more than 4,000 chemicals, and at least 43 of them cause cancer

8 . AGING 2. AGING Anyone of any age can get cancer Getting older is one of the biggest risk factors Aging is partly caused by oxidants that can damage DNA Antioxidants like vitamins A and C minimize damage from oxidants, but most humans don't get enough nutrients to ward off cancers

9 Aging Aging From Lack of Physical Activity Aging From Lack of Physical Activity Gain weight Too little exercise, lack muscles mass, poor bone health Being overweight increase the risk for Breast, Colon, Kidney, Uterus,Esophageal Cancers Produce too many hormones that cause cancer to grow

10 Aging and Nutrition Aging isn't just the number of yearsAging isn't just the number of years since we were born since we were born It is How quickly the parts of our bodiesIt is How quickly the parts of our bodies wear out wear out Our bodies age partly because itOur bodies age partly because it doesn’t get enough of the right nutrients doesn’t get enough of the right nutrients Too much fat and calories Not eating foods that contain antioxidants which boost the immune system and fight disease--can lead to many forms of cancer. Poor diet is one of the main contributors to agingPoor diet is one of the main contributors to aging

11 CANCER, FOODS and FOOD INGREDIENTS

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13 KEYS to AVOID CANCER-CAUSING FOODS Knowing which ingredients are carcinogens or cancer promotersKnowing which ingredients are carcinogens or cancer promoters Proper handling and preparation of certain foodsProper handling and preparation of certain foods Reading food labels to permanentlyReading food labels to permanently avoid consuming those ingredients avoid consuming those ingredients

14 Common Cancer Causing Substances in Foods Food Additives - BHA, BHT Ÿ Food Additives - BHA, BHT Ÿ Refined Sugar AcrylamidesAcrylamides Omega 6 – vegetable oilsOmega 6 – vegetable oils Sodium NitriteSodium Nitrite Hydrogenated OilsHydrogenated Oils Spoiled corn & peanuts (aflatoxin)Spoiled corn & peanuts (aflatoxin)

15 Food additives Used to prolong shelf life and preserve flavor and colorUsed to prolong shelf life and preserve flavor and color Increases cancer risk and cardiovascular diseaseIncreases cancer risk and cardiovascular disease

16 Generally Recognized as Safe In 1958 US Congress established a GRAS listIn 1958 US Congress established a GRAS list In 1960 the Color Additive Amendment was passed and includes a provision, the Delaney Clause, that prohibits any additives shown to cause cancer in humans or animals to be added to our foodIn 1960 the Color Additive Amendment was passed and includes a provision, the Delaney Clause, that prohibits any additives shown to cause cancer in humans or animals to be added to our food This is not being strictly enforced! Artificial colors proven to increase cancer risks, hyperactivity in children, and allergies, are still found in our food Artificial colors proven to increase cancer risks, hyperactivity in children, and allergies, are still found in our food Some additives are listed as “natural” flavorings or colorings but can contain over 40 chemical compoundsSome additives are listed as “natural” flavorings or colorings but can contain over 40 chemical compounds another misleading label

17 BHT (Butylated Hydroxytoluene) To help protect flavor, retards rancidity in oilsTo help protect flavor, retards rancidity in oils Should be avoided by infants, young children, pregnant women and those sensitive to aspirin, may be toxic to the nervous system, (BHT – banned in England)Should be avoided by infants, young children, pregnant women and those sensitive to aspirin, may be toxic to the nervous system, (BHT – banned in England) BHT is common in potato chips, baked goods, cosmetics and other productsBHT is common in potato chips, baked goods, cosmetics and other products Ÿ A related substance known as butylated hydroxyanisole (BHA) may be used instead of BHT

18 Debate on BHT Some studies linked BHT with an increase in tumors and cancersSome studies linked BHT with an increase in tumors and cancers Other studies suggested that it may protect the body from free radicals which cause other cancersOther studies suggested that it may protect the body from free radicals which cause other cancers BHT seems to have antimicrobial and antiviral activity, and it has in fact been used in medical research for treating conditions related to the herpes virus familyBHT seems to have antimicrobial and antiviral activity, and it has in fact been used in medical research for treating conditions related to the herpes virus family FDA still considers BHT to be safe, although consumers who wish to avoid it may want to check their labels carefullyFDA still considers BHT to be safe, although consumers who wish to avoid it may want to check their labels carefully

19 Refined Sugars Cancer develop, in part,Cancer develop, in part, by feeding on sugar in the by feeding on sugar in the bloodstream bloodstream Solution to an Anti-Cancer Diet:Solution to an Anti-Cancer Diet: eat a low glycemic diet eat a low glycemic diet eat less refined sugars eat less refined sugars consume more dietary fibers

20 Cancer's Molecular Sweet Tooth and the Warburg Effect Cancer's Molecular Sweet Tooth and the Warburg Effect Jung-whan Kim1, and Chi V. Dang1,2 Cancer Res September 15, ; 8927 Jung-whan KimChi V. Dang12

21 Warburg Effect Warburg reported a fundamental difference between normal and cancerous cells to be the ratio of glycolysis to respirationWarburg reported a fundamental difference between normal and cancerous cells to be the ratio of glycolysis to respiration "healthy" cells mainly generate energy from oxidative breakdown of pyruvate which is an end-product of glycolysis, and is oxidized within the mitochondria"healthy" cells mainly generate energy from oxidative breakdown of pyruvate which is an end-product of glycolysis, and is oxidized within the mitochondria In contrast, cancer cells show signs of glycolysis, (the process of sugar breakdown) with lactate secretion even in the presence of oxygenIn contrast, cancer cells show signs of glycolysis, (the process of sugar breakdown) with lactate secretion even in the presence of oxygen Hypothesized that cancer and tumor growth are caused by the fact that tumor cells mainly generate energy (as e.g. ATP) by non-oxidative breakdown of glucose (glycolysis)Hypothesized that cancer and tumor growth are caused by the fact that tumor cells mainly generate energy (as e.g. ATP) by non-oxidative breakdown of glucose (glycolysis)

22 Pancreatic tumor cells use fructose to divide and proliferate These findings show that cancer cells can readily metabolize fructose to increase proliferation” “ These findings show that cancer cells can readily metabolize fructose to increase proliferation” Journal of Cancer Research, Dec “They have major significance for cancer patients given dietary refined fructose consumption, and indicate that efforts to reduce refined fructose intake or inhibit fructose-mediated actions may disrupt cancer growth.” Dr. Anthony Heaney, UCLA’s Jonsson Cancer Center Dr. Anthony Heaney, UCLA’s Jonsson Cancer Center

23 Refined Sugars on Labels high-fructose corn syrup high-fructose corn syrup sugar sugar sucrose sucrose enriched bleached flour enriched bleached flour white rice white rice white pastas white pastas white breads white breads other "white" foods other "white" foods WHITE WHEAT

24 AcrylamideAcrylamide Forms from sugars and an amino acid (asparagine) during certain types of high-temperature cooking Forms from sugars and an amino acid (asparagine) during certain types of high-temperature cooking Frying, roasting, and bakingFrying, roasting, and baking Mainly in foods made from plants, such as potato products, grain products, or coffeeMainly in foods made from plants, such as potato products, grain products, or coffee Does not form, or at lower levels, in dairy, meat, and fish productsDoes not form, or at lower levels, in dairy, meat, and fish products More likely to accumulate when cooking is done for longer periods or at higher temperaturesMore likely to accumulate when cooking is done for longer periods or at higher temperatures

25 ACRYLAMIDE

26 OMEGA 6 FATTY ACIDS Omega-6 fatty acids are one of two groups of essential fatty acids (EFAs) that are required in human nutritionOmega-6 fatty acids are one of two groups of essential fatty acids (EFAs) that are required in human nutrition Omega-6 fatty acids include linoleic acid and its derivativesOmega-6 fatty acids include linoleic acid and its derivatives Excessive levels of certain n−6 fatty acids, relative to certain n−3 (Omega-3) fatty acids, shifts the physiologic state of tissues to prothrombotic, proinflammatory and proconstrictive statesExcessive levels of certain n−6 fatty acids, relative to certain n−3 (Omega-3) fatty acids, shifts the physiologic state of tissues to prothrombotic, proinflammatory and proconstrictive states The optimal ratio (n-6 FA: n-3 FA) : 4 to 1 or lowerThe optimal ratio (n-6 FA: n-3 FA) : 4 to 1 or lower Modern Western diets typically have ratios in excess of 10 to 1, some as high as 30 to 1Modern Western diets typically have ratios in excess of 10 to 1, some as high as 30 to 1

27 Excessive Omega 6 fatty acid Intake A high consumption of omega-6 polyunsaturated fatty acids (PUFAs), found in most types of vegetable oil, may increase the likelihood that postmenopausal women will develop breast cancer. Similar effect was observed on prostate cancer. A high consumption of omega-6 polyunsaturated fatty acids (PUFAs), found in most types of vegetable oil, may increase the likelihood that postmenopausal women will develop breast cancer. Similar effect was observed on prostate cancer. E.Sonestedt et al, Article 1 st published online 17 July 2008, Int’l J Cancer Chronic excessive production of n−6 eicosanoids is associated with heart attacks, thrombotic stroke, arrhythmia, arthritis, osteoporosis, inflammation, mood disorders, obesity, and cancer. Chronic excessive production of n−6 eicosanoids is associated with heart attacks, thrombotic stroke, arrhythmia, arthritis, osteoporosis, inflammation, mood disorders, obesity, and cancer. P. Calder, American Journal of Clinical Nutrition, Vol. 83, No. 6, S S, June 2006 P. Calder, American Journal of Clinical Nutrition, Vol. 83, No. 6, S S, June 2006

28 Omega 6 fatty acids Four major food oils (palm, soybean, rapeseed, and sunflower)Four major food oils (palm, soybean, rapeseed, and sunflower) Poultry and meatPoultry and meat EggsEggs NutsNuts Most vegetable oilsMost vegetable oils

29 OMEGA 6 : OMEGA 3 FATTY ACID RATIO Solution is to balance omega 6 intakes with high omega 3 intakes

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31 Omega 3 Fatty Acids Essential fatty acidsEssential fatty acids Omega-3 FA’s are thought to play an important role in reducing inflammation throughout the body -- in the blood vessels, the joints, and elsewhere.Omega-3 FA’s are thought to play an important role in reducing inflammation throughout the body -- in the blood vessels, the joints, and elsewhere. Rich sources of omega-3 FA’s are from cold water oily fish, such as salmon, herring, mackerel, anchovies, and sardinesRich sources of omega-3 FA’s are from cold water oily fish, such as salmon, herring, mackerel, anchovies, and sardines Recommended Intake for n−3 :Recommended Intake for n−3 : 1.6 gm/day for men and 1.1 gm/day for women

32 An increase in the consumption of fish and fish n-3 polyunsaturated fatty acids in industrialized countries may contribute to lower breast and colorectal cancer risks It is concluded that fish consumption is associated with protection against the later It is concluded that fish consumption is associated with protection against the later promotional stages of colorectal carcinogenesis, but not with the early initiation stages.” Caygill CP, Hill MJ,, Eur J Cancer Prev Aug;4(4): De Deckere, Eur J Cancer Prev Jul, 8(3): Omega 3 Fatty Acids

33 A recent trend has been to fortify food with n−3 fatty acid supplements Global food companies have launched n−3 fatty acid fortified bread, mayonnaise, pizza, yogurt, orange juice, children's pasta, milk, eggs, popcorn, confections, and infant formula

34 Hydrogented Oils ( Trans Fats) Helps prolong shelf life but simultaneously creates trans fats (causes inflammation in the body)Helps prolong shelf life but simultaneously creates trans fats (causes inflammation in the body) Besides being a cancer factor, trans fats promote heart disease, interrupt metabolic processes, and cause belly fat that crowd the organs and strain the heartBesides being a cancer factor, trans fats promote heart disease, interrupt metabolic processes, and cause belly fat that crowd the organs and strain the heart To avoid listing trans fats, or to claim "trans free" on their label, food manufacturers simply adjust the serving size until the trans fat content falls under 0.5 grams per servingTo avoid listing trans fats, or to claim "trans free" on their label, food manufacturers simply adjust the serving size until the trans fat content falls under 0.5 grams per serving

35 European Prospective Investigation into Cancer and Nutrition (EPIC STUDY) European Prospective Investigation into Cancer and Nutrition (EPIC STUDY) An increased intake of trans fatty acids may raise the risk of breast cancer by 75% Chajes V, et al EPIC Study. Am J Epidemiol, 2008 The American Medical Association supports any state and federal efforts to ban the use of artificial trans fats in U.S. restaurants and bakeries

36 FRENCH FRIES made with hydrogenated oil and fried at high temperaturesmade with hydrogenated oil and fried at high temperatures they clog your arteries with saturated fat and trans fat, they also contain acrylamidesthey clog your arteries with saturated fat and trans fat, they also contain acrylamides should be called "cancer fries," not French fries.should be called "cancer fries," not French fries. CHIPS, CRACKERS, COOKIES contain white flour and sugar as well as trans-fatscontain white flour and sugar as well as trans-fats MSG in yeast extract MSG in yeast extract

37 Sodium Nitrites, Nitrosamines Added to processed meats, hot dogs, bacon, and any other meat that needs a reddish color to look "fresh”Added to processed meats, hot dogs, bacon, and any other meat that needs a reddish color to look "fresh” Also found in food items that are pickled, fried, or smoked; in things such as beer, cheese, fish byproducts, and tobacco smokeAlso found in food items that are pickled, fried, or smoked; in things such as beer, cheese, fish byproducts, and tobacco smoke Nitrosamines are extremely carcinogenicNitrosamines are extremely carcinogenic

38 HETEROCYCLIC AROMATIC AMINES (HAA) Charred foods, especially meats, cooked at high temperatures create carcinogens called heterocyclic aromatic aminesCharred foods, especially meats, cooked at high temperatures create carcinogens called heterocyclic aromatic amines When organic plant or animal products are burned, causing them to become blackened, toxins are released and mutagenic byproducts are formedWhen organic plant or animal products are burned, causing them to become blackened, toxins are released and mutagenic byproducts are formed The longer the meat is cooked at high temperature, the higher the production of these compounds will be.The longer the meat is cooked at high temperature, the higher the production of these compounds will be.

39 Journal of the National Cancer Institute Red meat, but not poultry, fish, or dairy consumption, is associated with an increased risk of developing pancreatic cancer. (Oct. 5, 2005 JNCI)

40 SUBSTANCES to DELAY NITROSAMINE FORMATION Ascorbic acid (vitamin C), an antioxidant, inhibits nitrosamine formationAscorbic acid (vitamin C), an antioxidant, inhibits nitrosamine formation Addition of at least 550 ppm of ascorbic acid is required in meatsAddition of at least 550 ppm of ascorbic acid is required in meats Add antioxidants and spices when marinating meat eg. red bell peppers, curry powder, garlic, citrus fruitsAdd antioxidants and spices when marinating meat eg. red bell peppers, curry powder, garlic, citrus fruits è delays the formation of nitrosamines è delays the formation of nitrosamines

41 Hot dogs The Cancer Prevention Coalition recommends that children should not eat >12 hot dogs/month because of the risk of cancer.The Cancer Prevention Coalition recommends that children should not eat >12 hot dogs/month because of the risk of cancer. If you must have your hot dog, look for those without sodium nitriteIf you must have your hot dog, look for those without sodium nitrite These meats almost always contain the same sodium nitrite found in hot dogs. Bacon is also high in saturated fat, which contributes to the risk of cancers, including breast cancer. Processed Meats, Bacon

42 TIPS to Prevent Cancer Through Foods Have a diet rich in fruits and vegetables Minimum of 5 servings a dayHave a diet rich in fruits and vegetables Minimum of 5 servings a day Eat healthy proteins: Beans, Fish, TofuEat healthy proteins: Beans, Fish, Tofu Eat healthy carbohydrates: brown rice, tubers, corn, wheat bread, pasta etcEat healthy carbohydrates: brown rice, tubers, corn, wheat bread, pasta etc A serving for fruits and vegetables, carbohydrates is approximately your fist sizeA serving for fruits and vegetables, carbohydrates is approximately your fist size A serving of your protein is approximately your palm sizeA serving of your protein is approximately your palm size

43 FOOD PYRAMID

44 closeclose or Esc Key

45 Top Cancer Fighting Foods 1. Green tea 2. Curcumin 3. Cruciferous Vegetables 4. Folate Rich Foods 5. Tomatoes 6. Ginger 7. Vitamin D (2,000 IU/day)

46 Green Tea Antioxidant activity :Antioxidant activity : two cups of green tea = four apples, seven glasses of orange juice or 20 glasses of apple juice (Paganga, 1999) (Paganga, 1999) Green tea (GT) contains many polyphenol compounds, with epigallocatechin gallate (EGCG) being the most prominentGreen tea (GT) contains many polyphenol compounds, with epigallocatechin gallate (EGCG) being the most prominent

47 Green Tea and Prostate Cancer EGCG in Green tea have been shown to exhibit a chemopreventive effect against prostate cancer, with studies showing that it inhibits prostate cancer cell growth, induce apoptosis, arrest cell cycle progression, decrease PSA production and inhibit the development and metastasisEGCG in Green tea have been shown to exhibit a chemopreventive effect against prostate cancer, with studies showing that it inhibits prostate cancer cell growth, induce apoptosis, arrest cell cycle progression, decrease PSA production and inhibit the development and metastasis ( Siddiqui, 2006; Adhami, 2003; Sartor, 2004; Ren, 2000) ( Siddiqui, 2006; Adhami, 2003; Sartor, 2004; Ren, 2000) Green Tea and Breast Cancer GT decreased BCA tumor size injected to mice(66%) and weight (68%) GT decreased BCA tumor size injected to mice(66%) and weight (68%) Green tea inhibits VEGF growth, and cell proliferation and migration Green tea inhibits VEGF growth, and cell proliferation and migration ( Experimental Biology 2008 conference. Wei-Gu. )

48 Curcumin Recent studies have shown curcumin to interfere with cell-signaling pathways, thus suppressing the transformation, proliferation, and invasion of cancerous cellsRecent studies have shown curcumin to interfere with cell-signaling pathways, thus suppressing the transformation, proliferation, and invasion of cancerous cells In prostate cancer cell lines, curcumin inhibits cell growth and induces apoptosis, which is programmed cell death (Nakamura, 2002)In prostate cancer cell lines, curcumin inhibits cell growth and induces apoptosis, which is programmed cell death (Nakamura, 2002) These observations have been extended to in vivo animal models (Dorai, 2001)These observations have been extended to in vivo animal models (Dorai, 2001)

49 Cruciferous Vegetables Sources :Sources : arugula, broccoli, brussels sprouts, bok choy, cabbage, canola, cauliflower, collard greens, daikon, horseradish, kale, kohlrabi, mustard, radish, rutabaga, wasabi and watercress Cancer fighting compound : Indole-3-Carbinol ( 13c)Cancer fighting compound : Indole-3-Carbinol ( 13c) Recommendation:Recommendation: 1 serving per day reduces risk for breast cancer 1 serving per day reduces risk for breast cancer

50 Cruciferous Vegetables and Breast Cancer Findings from a large cohort analysis of more than 3000 survivors suggest that higher intake of vegetables in women taking TAMOXIFEN reduced new or recurrent breast cancer events by as much as 52%Findings from a large cohort analysis of more than 3000 survivors suggest that higher intake of vegetables in women taking TAMOXIFEN reduced new or recurrent breast cancer events by as much as 52% This effect was not present for non-tamoxifen usersThis effect was not present for non-tamoxifen users Thomson, 2010 Thomson, 2010

51 Folate Rich Foods Sources: Wheat bread, Pasta, breakfast CerealsSources: Wheat bread, Pasta, breakfast Cereals In a large-scale study, researchers evaluated the effects of folate on more than 27,000 male smokers between ages 50 and 69In a large-scale study, researchers evaluated the effects of folate on more than 27,000 male smokers between ages 50 and 69 Men who consumed at least the recommended daily allowance of folate -- about 400 micrograms -- cut by half their risk of developing pancreatic cancerMen who consumed at least the recommended daily allowance of folate -- about 400 micrograms -- cut by half their risk of developing pancreatic cancer

52 Lycopene Men who consumed 2 or > servings of tomato sauce a week over the course of the 12-year study : Men who consumed 2 or > servings of tomato sauce a week over the course of the 12-year study : 28% lower risk of developing organ-confined prostate cancer, 35% lower risk of developing locally advanced disease, 36% lower risk of developing metastatic disease 28% lower risk of developing organ-confined prostate cancer, 35% lower risk of developing locally advanced disease, 36% lower risk of developing metastatic disease ( Giovannucci, 2002, Health Professionals Follow-Up) ( Giovannucci, 2002, Health Professionals Follow-Up) Another study found that pre-prostatectomy patients who consumed tomato sauce pasta dishes for 3 weeks (containing 30 mg of lycopene per day) demonstrated decreased PSA counts and lower oxidative DNA damage (CHEN, 2001) A similar study showed increased apoptosis in prostatectomy specimens after consuming 3 weeks of tomato sauce pasta dishes (Kim, 2003) (Kim, 2003) )

53 Ginger esearchers discovered ginger's ability to kill cancer cells in two ways: Researchers discovered ginger's ability to kill cancer cells in two ways: 1.In apoptosis, the cancer cells essentially commit suicide without harming surrounding cells 2. In autophagy, "the cells are tricked into digesting themselves" J. Rebecca Liu, the University of Michigan in Ann Arbor

54 Vitamin D Link between increased vitamin D intake &Link between increased vitamin D intake & reduced breast cancer risk by 50% (AACR) reduced breast cancer risk by 50% (AACR) Improved survival rates among lung cancer patients (Harvard study,2005)Improved survival rates among lung cancer patients (Harvard study,2005) Lung Cancer surgery survival rate : Surgery during summer = 56% 5yr SR Surgery during winter = 23% 5yr SR Recommended dose is 2000 IU per dayRecommended dose is 2000 IU per day Good sources: Fish ( tuna, mackerel, herring)Good sources: Fish ( tuna, mackerel, herring) Eel, egg, fortified dairy foodsEel, egg, fortified dairy foods Sunlight exposure before 10 am and after 4pm for 10 minutes a daySunlight exposure before 10 am and after 4pm for 10 minutes a day

55 Lifestyle Modification Tips on Preventing Cancer Drink green teaDrink green tea cups per day green tea is protective against breast and prostate cancer risk breast and prostate cancer risk Drink red wine instead of beerDrink red wine instead of beer daily allowance : 1 glass/day daily allowance : 1 glass/day for women, 2 glasses/daymen for women, 2 glasses/daymen Exercise 30 minutes a dayExercise 30 minutes a day Sleep 7-8 hours a daySleep 7-8 hours a day Manage your stress levelsManage your stress levels

56 Salamat Po Daghang Salamat Thanks for Listening


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