1. Trisha Garcia Nutrition & Carcinogenesis Trisha GarciaTrisha Garcia

2. Learning Objectives Define carcinogenesis and carcinogen. Describe the three phases of carcinogenesis. Discuss examples of known carcinogens. Discuss the preventions of carcinogenesis.

3. Overview What is carcinogenesis? Phases of carcinogenesis Factors of carcinogenesis Classification of carcinogens Types of carcinogens Prevention

4. What is carcinogenesis? Carcinogen: a physical, chemical, or viral agent that induces cancer.

5. Phases of carcinogenesis 1. Initiation 2. Promotion 3. Progression

6. Factors for Carcinogenesis

8. Classification of carcinogens 1. Genotoxic agents: cause genetic damage or mutations. Ex.) Polycyclic aromatic hydrocarbons, nitrosamines, mycotoxins, etc. 2. Nongenotoxic agents: do not directly affect DNA, but promote tumor growth in other ways. Ex.) Dioxin, estradiol, asbestos, etc.

9. Carcinogens Heterocyclic amines (HCAs) Polycyclic aromatic hydrocarbons (PAHs) Advanced glycation end products (AGEs)

10. HCAs Heterocyclic amines: formed inside muscle meats during various types of high temperature cooking; when creatine and amino acids react together with heat. Four factors influence HCA formation: 1. Type of food 2. Cooking method 3. Temperature 4. Cooking duration

11. PAHs Polycyclic aromatic hydrocarbons: formed by the incomplete burning of organic matter at temperatures over 392  F PAH formation is influenced by: 1. Temperature of cooking 2. Duration of cooking 3. Type of fuel used in heating 4. Distance from heat source 5. Fat content of the food

12. AGEs Advanced glycation end products: created when sugars and proteins in food react together with heat o Maillard reaction

14. Nitrates

15. BPA

16. Alcohol Alcohol consumption is associated with increased cancer risk for cancers of the mouth, pharynx, larynx, esophagus, lung, colon, rectum, liver, and breast

17. Energy intake & Body Weight Excess calorie intake is a risk factor for cancer Obesity is a risk factor for cancer and may account for 6% of all cancers.

18. Fat Intake Positive correlation exists between fat intake and incidences of breast, colon and prostate cancers.

19. Protein Increased protein intake = enhancement of tumor development

20. Salt Intake A close correlation between daily salt intake and gastric cancer incidence

21. Prevention Cook with low and slow heat: Poaching Stewing Braising Steaming Avoid processed foods Avoid charring foods Avoid direct exposure to open flame

22. Prevention Vitamin D Calcium Coffee & tea Fruits and vegetables Soy and phytoestrogens Omega-3 FA

23. Cancer-Protective Phytochemicals in Vegetables and Fruits ColorPhytochemicalVegetables and Fruits RedLycomeneTomatoes, pink grapefruit, watermelon Red and purpleAnthocyanins, polyphenolsBerries, grapes, red wine, plums Orange  - and  -carotene Carrots, mangos, pumpkin Orange and yellow  -cryptoxanthin, flavonoids Cantaloupe, peaches, oranges, papaya, nectarine Yellow and greenLutein, zeaxanthinSpinach, avocado, honeydew, collard and turnip greens GreenSulforaphhanes, indolesCabbage, broccoli, brussels sprouts, cauliflower White and greenAllyl sulphidesLeeks, onion, garlic, chives

24. Prevention American Cancer Society: Physical activity Healthy body weight Eat healthful, colorful foods (plant based) Limit alcohol American Institute for Cancer Research: Lean body weight Physical activity Limit energy-dense foods Plant foods Limit animal foods Limit alcohol Limit salt intake Meet nutritional needs

25. Asses your risk http://www.diseaseriskindex.harvard.edu/update/hccpquiz.pl? lang=english&func=home&page=cancer_index http://www.diseaseriskindex.harvard.edu/update/hccpquiz.pl? lang=english&func=home&page=cancer_index http://www.cancer.org/healthy/toolsandcalculators/quizzes/n utrition-activity-quiz/index.htm http://www.cancer.org/healthy/toolsandcalculators/quizzes/n utrition-activity-quiz/index.htm

28. References Sugimura T. Nutrition and dietary carcinogens. Oxford journals. 21(3). Prashant T, Shrama G, Hussain S, et al. Magnanimous effects and role of dietary nutrition on carcinogenesis. International medical journal of sifa university. 2014. 1(1). http://www.precisionnutrition.com/all-about-cooking- carcinogens http://www.cancer.org/cancer/cancercauses/othercarcinogens /generalinformationaboutcarcinogens/known-and-probable- human-carcinogens Mahan K, Escott-stump S, Raymond J. Krause’s food and the nutrition care process. St. Louis, MO. Elsevier. 2012. http://www.healthyodds.com/cancerprevention.html