eating for wellness jennifer spring, rd, cso, ldn outpatient oncology dietitian north carolina...

Eating for Wellness

Jennifer Spring, RD, CSO, LDNOutpatient Oncology DietitianNorth Carolina Cancer Hospital

“What should I eat?”

“What’s the best diet?”

“What super food is most important?”

The World Cancer Research Fund/AICR Guidelines

1. Be as lean as possible without becoming underweight2. Be physically active for at least 30 minutes every day3. Limit intake of energy-dense foods and avoid sugary drinks4. Eat a variety of vegetables, fruits, whole grains, and

legumes/beans5. Limit intake of red meat and avoid processed meat6. Limit intake of salty foods and foods processed with salt7. Limit alcoholic drinks8. Don’t use supplements to prevent cancer

Nutrition Recommendations

Limit intake of energy-dense 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

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

Sugar and Cancer

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)

Insulin

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

How much is too much sugar?

Eat a variety of vegetables, fruits, whole grains, and legumes/beans

“Eat food. Not too much. Mostly plants.”

Michael Pollan

Mediterranean Asian DASH Vegan Vegetarian

Popular Plant-Based Diets

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 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

Organic vs. Conventional

Herb Phytochemicals Blends well with:

Basilquercetin, camphor, methyl eugenol, kaempferol

oregano, parsley, thyme

Bay Leaveseugenol, geraniol, limonene, perillyl alcohol

oregano, basil, curry, cumin, turmeric

Chivesallium 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

Dillisorhamnetin, kaempferol, limonene, myrcetin

celery seed, cumin, thyme

Oregano luteolin, myrcetinbasil, cumin, chili powder, parsley

Parsleyapegenin, coumarin, ferulic acid, lutein, luteolin, pthalides, quercetin

almost any other herb or spice

Rosemarycarnosol, fenchon, rosmanol, ursolic acid

cumin, parsley, thyme

Sagecarnosol, limonene, perillyl alcohol, vanillic acid

celery seed, marjoram, savory, thyme

Tarragon isorhamnetin, terpenoids parsley

Thymephenolics ( such as: rosmarinic acid and flavonoids)

basil, chives, dill, paprika, sage

Herbs

Many spices have been shown to decrease inflammation and inhibit the growth of tumors

Some spices studied include Turmeric, Garlic, Black Pepper, Cinnamon, Allspice

Spices

Limit intake of red meat and avoid processed meat

N-nitroso compounds Polycyclic aromatic hydrocarbons (PAHs) Heterocyclic amines (HCAs)

Common Food Carcinogens

Limit intake of salty foods and foods processed with salt

Limit alcoholic drinks

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

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

Alcohol and Cancer Risk

Don’t use supplements to prevent cancer

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.

Micronutrient Malnutrition in Older Adults

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/ Prebiotics and Immune Response

“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

Probiotics

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

Prebiotics

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.

Hydration

80/20 Rule

80% of the time eat healthy (AICR guidelines)

20% of the time indulge a little