1. Diet & Lifestyle for Cancer Survivors Nancy Steedman, RD, CD Franciscan Oncology Services

2. Scientists suspect that the same dietary changes recommended for cancer prevention may also help fend off both recurrent and secondary cancers. Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective The World Cancer Research Fund/American Institute of Cancer Research 2008 Update Cancer survivorship research is still in its infancy!

3. AICR Diet & Lifestyle Guidelines Achieve a healthy weight Achieve a healthy weight Be physically active Be physically active Choose a diet rich in plant based foods Choose a diet rich in plant based foods Select foods that are low in fat and salt Select foods that are low in fat and salt Drink alcohol in moderation, if at all Drink alcohol in moderation, if at all Aim to meet you nutritional needs with whole foods Aim to meet you nutritional needs with whole foods All cancer survivors should receive nutritional care from a trained professional (Registered Dietitian)

4. Whats Your Number? BMI = Body Mass Index Ideal = 19 to 25 Underweight = < 18 * Overweight = 25-30 * Obese = 30+ * A weight loss of as little as 10% of your current weight will improve your health & reduce your risk!

5. Alarming Health Epidemic Nearly 60% of the adult population is overweight or obese Nearly 60% of the adult population is overweight or obese Obesity levels in our state have doubled in the last 10 years Obesity levels in our state have doubled in the last 10 years Rapid increase childhood obesity and related illness Rapid increase childhood obesity and related illness

6. Causes of Weight Gain Aging Aging Loss of lean body mass Loss of lean body mass Increasing portion sizes Increasing portion sizes Treatment related fatigue Treatment related fatigue Psychological Psychological Poor body image Poor body image Sedentary lifestyle Sedentary lifestyle Calories In > Calories Out Calories In > Calories Out What are your roadblocks?

8. S tay Hydrated Even mild dehydration can increase fatigue! Drink clean water!!!!! Drink clean water!!!!! Drink tea & coffee, in moderation Drink tea & coffee, in moderation Drink 100% fruit juice, in moderation Drink 100% fruit juice, in moderation Drink low fat dairy/milk alternatives Drink low fat dairy/milk alternatives DO DONT Drink sugary drinks like soda Drink sugary drinks like soda Drink Juice flavored beverages Drink Juice flavored beverages Drink beverages that contain high fructose corn syrup Drink beverages that contain high fructose corn syrup

9. Phytochemicals = Phyto = Greek for plant How to recognize? 1. Color 2. Odor 3. Flavor

10. Plants develop these protective chemicals to protect themselves from: Sunshine/Rain/Drought Sunshine/Rain/Drought Bacteria/bolds/viruses Bacteria/bolds/viruses Temperature extremes Temperature extremes Insects and other predators Insects and other predators Attract insects for pollination Attract insects for pollination They can pass this protection on to YOU!!!

11. Mix it UP & Live it UP!!! Purple, Red, Yellow, Orange & Green Fruits and Vegetables Purple, Red, Yellow, Orange & Green Fruits and Vegetables Cruciferous Vegetables Cruciferous Vegetables Leafy Green Vegetables Leafy Green Vegetables Mushrooms, Garlic & Onions Mushrooms, Garlic & Onions Whole Grains Whole Grains Dry Beans and Peas Dry Beans and Peas Nuts & Sees Nuts & Sees Herbs & Spices Herbs & Spices

12. Arsenal of Protection Whole food with Fiber = Immune Boosting (80% of your immunity starts in your GUT!)

13. Eat Like Your Ancestors Japanese Mediterranean Native Americans African

15. Practical Tips for Increasing Phytochemicals and Fiber Eat the colors of the rainbow every day Eat the colors of the rainbow every day Eat fruits and vegetables at every meal and Eat fruits and vegetables at every meal and snack (Clean and prep once a week) snack (Clean and prep once a week) Try something new for meals (see handout) Try something new for meals (see handout) Clean out your cupboards – start FRESH Clean out your cupboards – start FRESH Stock up on herbs and spices Stock up on herbs and spices Shop for seasonal produce (Farmers Markets, U-Pick) Shop for seasonal produce (Farmers Markets, U-Pick) or start a small garden or start a small garden Combine the best and most affordable of fresh, frozen, Combine the best and most affordable of fresh, frozen, canned in its own juice, dried canned in its own juice, dried Keep a record of your Daily Choices & compare to goals Keep a record of your Daily Choices & compare to goals

16. FAB FOUR Fitness Fitness Phytochemicals Phytochemicals Fiber Fiber Healthy Fats Healthy Fats

17. FAT FACTS (Concentrated Calories) Disease Promoting Disease Promoting (high in Saturated fat and Omega 6 fat) Have legs and a mother Have legs and a mother Tropical Oils Tropical Oils Trans Fatty Acids Trans Fatty Acids Omega 6 Vegetable Oils Omega 6 Vegetable Oils Disease Protective Disease Protective (high in Omega 3 and monounsaturated fat) Fats from Plants (even more phytochemicals!) Fats from Plants (even more phytochemicals!) Wild, cold water fish Wild, cold water fish

18. Cooking & Serving Meats Avoid high temperatures Avoid high temperatures If you must BBQ, marinade meats or grill vegetables/fruit If you must BBQ, marinade meats or grill vegetables/fruit Stew meats at low temperatures (crock-pot cooking or poaching) Stew meats at low temperatures (crock-pot cooking or poaching) Practice portion control Practice portion control 3 oz = size of computer mouse or deck of cards and use meat as a garnish 3 oz = size of computer mouse or deck of cards and use meat as a garnish Double Whammy!

19. Drink alcohol in moderation, if at all. 1 cocktail = 1.5 oz 80 proof spirits 1 regular beer = 12 oz. 5 oz wine *resveratrol = grape juice

20. Aim to meet you nutritional needs primarily through diet Unless you are diagnosed with a nutrient deficiency by a trained professional, dietary supplements are NOT currently recommended for cancer prevention or survivors Unless you are diagnosed with a nutrient deficiency by a trained professional, dietary supplements are NOT currently recommended for cancer prevention or survivors A multivitamin/mineral supplement with 100% RDI is acceptable A multivitamin/mineral supplement with 100% RDI is acceptable Studies of individual vitamin and mineral supplements for cancer protection have been disappointing so far! See handout on Site Specific Diet Recommendations for Survivors

21. Beware of Miracle or Breakthrough Cures There is NO ONE MIRACLE FOOD There is NO ONE MIRACLE FOOD There are NO PROVEN PILLS OR POWDERS There are NO PROVEN PILLS OR POWDERS Research keeps coming back to the same key... 1. Variety of Plant Foods 2. Balance & Moderation 3.Scientific Consensus (see Reputable References handout)

22. These are general guidelines but YOU ARE A UNIQUE INDIVIDUAL! AICR Final Guideline: All cancer survivors should receive nutritional care from a trained professional. Celebrate every day and give thanks for the gifts of family, friends, faith and healthy food