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King Saud University College of Science Disclaimer Department of Biochemistry The texts, tables and images contained in this course presentation are not my own, they can be found on: – References supplied – Atlases or – The web sites BCH 475 Biochemistry of Carcinogenesis Professor A. S. Alhomida Summer, 2008 Part 4 1 2 Eating to Prevent Cancer How a Healthy Diet and Physical Activity May Help Keep You Cancer-Free 3 The Relationship Between Lifestyle and cancer A total of 60-70% of cancers may be lifestyle related! 30-40% of cancers can be prevented by a healthy diet, healthy weight, and regular physical activity 30% of cancers can be prevented by not using tobacco 4 The Relationship Between Lifestyle and cancer Many foods and nutrients have been linked to cancer prevention For cancer prevention, focus on an overall healthy diet rather than specific foods or nutrients Maintain a healthy weight throughout life 5 The Relationship Between Lifestyle and cancer Adopt a physically active lifestyle Eat a variety of foods, with an emphasis on plant sources Limit consumption of alcoholic beverages 6 Maintain a Healthy Weight Being overweight and inactive accounts for 1/3 of the worldwide cases of breast, colon, endometrial, kidney, and espophageal cancers Balance calorie intake with physical activity 7 Maintain a Healthy Weight Avoid excessive weight gain throughout life Achieve and maintain a healthy weight if currently overweight or obese 8 Body Mass Index (BMI) Body mass index is defined as the individual's body weight divided by the square of their height BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems 9 Body Mass Index (BMI) It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing "social physics" The formulas universally used in medicine produce a unit of measure of kg/m2 Body mass index may be accurately calculated using the formulas below: 10 Maintain a Healthy Weight Body Mass Index (BMI) weight (kg) BMI 2 2 height ( m ) 11 Maintain a Healthy Weight Know your Body Mass Index (BMI) Below 18.5 18.5 – 24.9 25.0 – 29.9 30.0 and Above Underweight Normal weight Overweight Obese 12 Tips for Maintaining a Healthy Weight Eat plenty of fruits and vegetables Limit simple sugars (cakes, cookies, pies, candies, sweetened drinks) Eat smaller portions of everything Add physical activity to your life 13 Adopt a Physically Active Lifestyle Adults: – Get at least 30 minutes or more moderate to vigorous physical activity five or more days of the week, 45-60 minutes if possible Children and adolescents: – Get 60 minutes per day of moderate to vigorous physical activity at least five days per week 14 Healthy Foods Eat a variety of healthy foods with an emphasis on plant foods Plant foods (fruits, vegetables, whole grains, and legumes) are packed with vitamins, minerals, antioxidants, and other substances that work together to lower risks of several cancers 15 Cancers Associated with Low Intake of Plant Foods Lung cancer Mouth cancer Stomach cancer Colon cancer 16 Healthy Foods Eat five or more servings of fruits and vegetables each day Choose whole grains over processed (refined) grains and sugars Limit consumption of processed red meats 17 Healthy Foods Fruits and vegetables are rich in fiber, vitamins, minerals, and phytochemicals Whole grains are rich in fiber, vitamins, minerals, and phytochemicals 18 Healthy Foods They contain several substances that have been linked to lower cancer risk including fiber, antioxidants, phenols, lignans, polyestrogens, and saponins Standard serving sizes: – One cup raw fruit or vegetable, ½ cup canned fruit or cooked vegetable, one medium piece of fruit, ¼ cup dried fruit 19 Fruits and Vegetables Choose five or more servings of fruits and vegetables each day Choose colorful fruits and vegetables for the most nutrient content Choose a variety of fruits and vegetables Enjoy fruits and vegetables prepared and served without added fat or sugar 20 Fruits and Vegetables One serving equals: – ½ cup cooked vegetables – One cup leafy vegetables – ½ cup 100% juice – One medium piece of fruit – ½ cup fresh, frozen, or canned fruit, or ¼ cup dried fruit 21 Cancers Associated with Alcohol Intake Oral (mouth) Pharyngeal (throat) Esophageal Laryngeal (voice box) Breast Liver – Use of tobacco at the same time as alcohol increases your risk for developing these cancers 22 Dietary Factors Associated with Reduced Cancer Risk Dietary fiber – Colorectal, pancreas, breast Folic acid – Cervix, colorectal Vitamin D and calcium – Colorectal, breast 23 Dietary Factors Associated with Reduced Cancer Risk Vitamin C from foods – Oral cavity, esophagus, lung, stomach, pancreas, cervix Tea (flavonoids) Lung, colorectal α-tocopherol Lung Soy isoflavones? Breast 24 Dietary Factors Associated with Reduced Cancer Risk Antioxidants (nutrient and non-nutrient) from foods – Colorectal, lung, breast, cervix, prostate, esophagus, stomach 25 Food Components that May Prevent Cancer Antioxidants – Vitamins A, C, E, cartenoids, selenium – There is no evidence to support taking antioxidant supplements to prevent cancer Dietary fiber – The link between fiber and cancer is weak – Foods that contain fiber are high in other nutrients that may prevent cancer 26 Food Components that May Prevent Cancer Phytochemicals – Compounds made by plants that may prevent cancer (e.g., lycopene in tomato) – There is no evidence that phytochemical supplements prevent cancer – Lycopene is a phytochemical (red-orange carotene pigment found in tomatoes and other pink and red fruits and vegetables) 27 Food Components that May Prevent Cancer Phytochemicals – Several studies report that consuming tomato products reduces the risk of some cancers but the link with lycopene is uncertain – This has been highly touted as preventing prostate cancer based on one study – Further studies are in process 28 Food Components that May Prevent Cancer Vitamin D – There is growing evidence that vitamin D may help prevent colon, prostate, and breast cancer – In some cases supplements are recommended 29 Food Components that May Prevent Cancer Vitamin D – Research is needed to determine how much vitamin D is needed by different populations, but it appears to current Dietary Reference Intakes’ (DRI) may be inadequate to prevent cancer – A balanced diet, moderate supplementation, and frequent sun exposure (small amounts) are preferred method to obtain Vitamin D 30 Do These Foods Prevent Cancer? Cruceriferous vegetables (broccoli, cauliflower, cabbage) These vegetables may contain phytochemicals that reduce cancer risk Eat a wide variety of vegetables, not just cruceriferous vegetables 31 Cruceriferous Vegetables 32 Cruceriferous Vegetables 33 Do These Foods Prevent Cancer? Soy foods – Contain phytochemicals that may fight cancer (based on animal studies) – Soy supplements should not be taken to reduce cancer risk – Women with breast cancer should consume only moderate amounts of soy High doses of soy could increase the risk of estrogen-responsive cancers, such as breast or endrometrial cancer 34 Do These Foods Prevent Cancer? Tea – Some research (animal studies) suggests that tea may have antioxidant properties and prevent cancer – Studies in humans have been less conclusive 35 Do These Foods Prevent Cancer? Garlic – The health benefits of garlic have been widely publicized – There is not enough evidence to support garlic as a food to prevent cancer at this time 36 Things That Don’t Cause Cancer Food additives Irridiated foods Bioengineered foods Aspartame Coffee Dietary fat Pesticides and herbicides (wash thoroughly) 37 Things That Don’t Cause Cancer Based on information provided by the American Cancer Society, there is not evidence to tie any of these items with cancer The low doses of pesticides and herbicides in food do not appear to increase the risk of cancer 38 Dietary Factors Inversely Related to Cancer Risk Alcohol – Mouth, pharnyx, larnyx, esophagus, liverconvincing – Breast, colon, rectum- probable Salt – Stomach- probable Sucrose – Colon, rectum 39 Dietary Factors Inversely Related to Cancer Risk Meat (especially charbroiled) – Colon and rectum- probable Total and saturated fat – Lung, colon, rectum, breast, prostatepossible 40 Chemopreventive Non-nutritive Dietary Factors Compound Food Source Cinnamic acid Fruit, vegetables, coffee beans Flavonoids (catechins, quercitin, isoflavones, anthocyanins) vegetables, fruit, citrus fruit, celery, parsley,onions, grains, tea, soybean Indoles Cruciferous vegetables Isothiocyanates Cruciferous vegetables Lignans Whole grains, flax Organosulfur Garlic, Onion Terpenes Citrus, spices 41 Role of Dietary Factors in Carcinogenesis Exposure to Carcinogen Inhibitors of Activation DNA Binding Blocking Agents Reaction with Cellular Targets DNA Damage, Mutagenesis Suppressing Agents Neoplastic Manifestation 42 Inhibitors of Activation Inducers of Phase I Biotransformation Enzymes – Cytochrome P450 mono-oxygenase system – Converts hydrophobic to hydrophilic compounds for elimination by forming reactive intermediate 43 Phase I Activation and Phase II Detoxification Reactions Bioactivation Carcinogen Phase I Detoxification Primary Metabolite Phase II Reactive Intermediate Secondary Metabolite Excretion Covalent Binding Acute Cellular Injury Delayed Toxicity Mutations & Cancer 44 Blocking Agents Inducers of phase II detoxification Enzymes – Glutathione S-transferases, sulfotransferases, UDP-gluronosyltransferases – Phenols, isothiocyanates, flavones, and coumarins – Affect gene expression at transcriptional level Binders of free radical intermediates – Antioxidants 45 Suppressing Agents Inhibit development of cancer subsequent to administration of carcinogen – Retinoids and carotenoids – Protease inhibitors – Phenols and polyphenols – Selenium Antioxidant protection 46 Role of Antioxidants in Carcinogenesis Normal cell Reactive O2 + O2-Derived Free Radicals Lipid peroxidation in cell membranes Antioxidant Oxidized bases Scavengers & in DNA Enzyme Systems Cell repair Exposure of DNA Cell Death Lipid Peroxides Mutations DNA Repair Normal Cell Compensatory Cellular Hypoproliferation Cell Death No Repair Less regulation of cell growth & differentiation Cell Hyperproliferation Exposure of DNA Further Mutations47 Antioxidant Protection Cellular Antioxidants Enzyme Systems Minerals Catalase Peroxidase Fe Glutathione Peroxidase Se, AA Scavengers Vitamins Superoxide Dismutase Cu/Mn Membrane Lipid Protection Aqueous Comptmts E C CoQ10 Polyphenols Isothiocyanates Non-nutrient Plant Chemicals Lipid Comptmts Carotenoids Other Protective Effects: Folic Acid Thymidine synthesis inhibited Lack of methyl donor from methylene-THF or S-adenosyl-methionine DNA hypomethylation Uracil misincorporation DNA repair by excision Increase in fragile sites and chromosomal breaks 49 Folate Deficiency and DNA Stability CH3 X DNA TMP dUMP U Chromosomal damage double strand break single strand break A DNA repair removes misincorporated uracil 50 Moderators of Insulin Sensitivity and Resistance Moderators of insulin and insulin-like growth factor (IGF-1) – IGF-1 protects against apoptosis – Insulin and IGF-1 increase aberrant crypt foci growth Precursor of colorectal tumors – Insulin resistance associated with increased tumor promotion in animal models (r = 0.67) 51 Insulin Resistance and Relative Risk of Colon Cancer Dietary Glycemic Index Physical Activity Low Medium High High 1.0 1.3 1.4 Medium 1.6 1.8 2.1 Low 1.5 1.9 3.5 52 Other Protective Effects Inhibitors of invasive processes – Stimulate plasminogen activator inhibitors Reduces plasmin-stimulated degradation of extracellular membrane Dietary fiber, low glycemic index sugars 53