1. Nutrition and Cancer Prevention P RESENTED BY J AMES S METANIUK, RD, CDE R EGISTERED D IETITIAN A LLAN B LAIR C ANCER C ENTRE

2. CANCER PREVENTION BASICS WHAT CAN WE CONTROL WHAT ROLE DOES FOOD PLAY IN PREVENTION NUTRITION AFTER DIAGNOSIS Quick Look

3. Cancer Prevention About 1/3 of all cancers can be prevented by lifestyle choices  There is no one food to eat  There is no one exercise to do It’s overall lifestyle choices

4. Cancer Prevention Diet Weight Physical Activity CancerPrevention Adapted from the American Institute for Cancer Reasearch

5. Recommendations for Cancer Prevention Do not smoke or chew tobacco Be sun smart

6. Be as lean as possible 30 mins physical activity everyday. Recommendations for Cancer Prevention

7. Avoid sugary drinks and energy dense foods. Eat a variety of vegetables, fruits, whole grains and legumes Limit red meats and avoid processed meats Recommendations for Cancer Prevention

8. Limit alcohol  2 drinks/day for men, 1 drink/day for women Limit salt and processed foods

9. Don’t use supplements to protect against cancer Breastfeed exclusively to 6 months After treatment, same guidelines apply to cancer survivors. Recommendations for Cancer Prevention

10. Foods Can Fight Cancer…. Directly  Individual vitamins, minerals and phytochemicals have anti- cancer effects  Synergy of compounds in overall diet that have the biggest protective effect Indirectly  Excess body fat increases the risk of seven cancers  Vegetables and fruits are low in calories  Whole grain and beans are rich in fibre and moderate in calories Fill 2/3 of you plate with vegetables, fruits, whole grains and beans

11. Cancer Prevention and Diet ADD Cancer protective foods SUBTRACT foods that increase risk REPLACE large portions of calorie dense foods

12. Phytochemicals – the Cancer Fighters in our Foods Phytochemicals – naturally occurring plant chemicals Provide colour, flavour, odour Influence chemical processes in the body Thousands have been identified

13. Phytochemicals can…. Stimulate immune system Block carcinogens Reduce inflammation Prevent DNA damage and help repair Reduce oxidative cell damage Slow the growth of cancer cells Trigger death of damaged cells Regulate hormones

14. PhytochemicalPlant SourcePossible benefits Carotenoids (beta-carotene, lycopene, lutein, zeaxanthin) Red, orange and green fruits and vegetables May inhibit cancer cell growth, improve immune response and work as antioxidants Flavonoids (anthocyanins and quercetin) Apples, citrus, onions, soybeans, coffee, tea May inhibit inflammation and tumor growth, aid immunity and boost detoxifying enzyme production Indoles and Glucosinolates (sulforaphane) Cruciferous vegetablesMay induce detox of carcinogens, limit cancer-related hormone production, block carcinogens, prevent tumor growth Inositol (phytic acid)Bran from corn, oats, rice, rye and wheat, nuts, soybeans May slow cell growth and work as antioxidant Isoflavones (daidzein and genistein) Soybeans and soy productsMay inhibit tumor growth, cancer related hormone production and work as an antioxidant IsothiocyanatesCruciferous vegetablesMay detox carcinogens, block tumor growth and work as antioxidants Polyphenols (ellagic acid and resveratrol) Green tea, grapes, wine, berries, citrus fruit, apples, whole grains and peanuts May prevent cancer formation, prevent inflammation and work as an antioxidant Terpenes (perilly alcohol, limonene, carnosol) Cherries, citrus fruit peel, rosemary May protect cells from becoming cancerous, slow cell growth, strength immune system, fight viruses, antioxidant

15. Foods that Fight Apples Blueberries Broccoli and cruciferous veg Cherries Coffee Cranberries Flaxseed Grapefruit Legumes (dry beans, peas, lentils)

16. Foods that Fight Soy Squash (winter) Walnuts Whole grains Berries Dark leafy greens Garlic Grapes and grape juice Green Tea Tomatoes

17. Foods that Fight Herbs, Spices and Tea  Turmeric  Ginger  Saffron  Tea

18. What Does it Mean? Eat a variety of vegetables and fruits, whole grains and beans Brightly coloured and strongly flavoured vegetables and fruits are best source of phytochemicals STICK TO FOOD SOURCES

19. WHY IS IT IMPORTANT? Nutrition After Diagnosis

20. Incidence of Malnutrition Up to 80% of cancer patients experience malnutrition during their illness Why?  Increase in energy expenditure  Changes in carbohydrate, protein and lipid metabolism  Decreased intake due to treatment side effects

21. Effects of Malnutrition  treatment complications and delays  hospitalizations  response to treatment  quality of life  survival rates

22. Benefits of Eating Well Improve immune function to help fight infections Promote healing and recovery after treatment Prevent muscle wasting and maintain strength Provide energy to combat fatigue

23. Nutrition Goals During Treatment Maintain or improve nutritional status Maintain or increase current weight Manage symptoms related to cancer and/or treatment

24. Nutrition Recommendations

25. Most Common Side Effects Decreased appetite Weight loss Dry mouth Sore mouth and throat Taste changes Nausea/vomiting Diarrhea Constipation Fatigue

26. QUESTIONS?

27. References American Institute for Cancer Research: Cancer Prevention – Putting it Together http://www.aicr.org/reduce-your-cancer-risk/cancer- prevention/ American Institute for Cancer Research: Diet – What We Eat http://www.aicr.org/reduce-your-cancer-risk/diet/ Canadian Cancer Society: Nutrition and Fitness http://www.cancer.ca/en/prevention-and-screening/live- well/nutrition-and-fitness/?region=sk LaMantia, J.(2012). The Essentials Cancer Treatment Nutrition Guide and Cookbook. Toronto: Robert Rose.