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Cancer-Causing Food Ingredients:
Its Prevention and Control
Dennis Ramon M. Tudtud, MD, FPCP, FPSMO
Diplomate, Philippine Specialty Board of Internal Medicine
Diplomate , Philippine Specialty Board of Medical Oncology
President, Philippine Society of Medical Oncology
MAGNITUDE OF THE CANCER PROBLEM
IN THE PHILIPPINES
• 3rd in incidence after
communicable &
cardiovascular diseases
•1 out of 1,800 Filipinos has
cancer
•114:103 females: males
•Incidence increases with age
MORTALITY FROM CANCER
2005 Phil Cancer Facts & Estimates
Leading cancer sites of mortality:
Females
breast
cervix uteri
lung
Males
lung
liver
colon/rectum
DEVELOPMENT of CANCER
OXIDANTS
Dead cell
Lose many cells
Aging
Healthy cell
Cell regeneration
Cell damaged
Impaired cell
Regeneration
Cancer
Main Causes Of Cancer
1. SMOKING
2. AGING
Affected by lifestyle choices ( stress, lack of
exercise and sleep) and diet
I. Smoking
Tobacco use is the most preventable cause of cancer
Cigarette smoke has enormous amount of oxidants
Most people know smoking causes lung cancer
Causes a higher risk of esophageal, stomach, kidney,
bladder, pancreas, cervical, uterine, head and neck,
tongue
Surgeon General of the USA showed that tobacco smoke
contains more than 4,000 chemicals, and at least 43 of them
cause cancer
2. AGING
• Anyone of any age can get cancer
• Getting older is one of the biggest risk
factors
• Aging is partly caused by oxidants
that can damage DNA
• Antioxidants like vitamins A and C
minimize damage from oxidants, but
most humans don't get enough
nutrients to ward off cancers
Aging
Aging From Lack of Physical Activity
Gain weight
Too little exercise, lack muscles mass, poor bone health
Being overweight increase the risk for Breast, Colon,
Kidney, Uterus ,Esophageal Cancers
Produce too many hormones that cause cancer to grow
Aging and Nutrition
•Aging isn't just the number of years
since we were born
•It is How quickly the parts of our bodies
wear out
•Our bodies age partly because it
doesn’t get enough of the right nutrients
Too much fat and calories
Not eating foods that contain antioxidants
which boost the immune system and fight
disease--can lead to many forms of cancer.
•Poor diet is one of the main contributors to
aging
CANCER, FOODS and FOOD INGREDIENTS
KEYS to AVOID CANCER-CAUSING FOODS
• Knowing which ingredients are carcinogens or
cancer promoters
• Proper handling and preparation of certain foods
• Reading food labels to permanently
avoid consuming those ingredients
Common Cancer Causing Substances
in Foods
ŸFood Additives - BHA, BHT
ŸRefined Sugar
• Acrylamides
• Omega 6 – vegetable oils
• Sodium Nitrite
• Hydrogenated Oils
• Spoiled corn & peanuts (aflatoxin)
Food additives
• Used to prolong shelf life and preserve flavor and color
• Increases cancer risk and cardiovascular disease
Generally Recognized as Safe
•In 1958 US Congress established a GRAS list
•In 1960 the Color Additive Amendment was passed and
includes a provision, the Delaney Clause, that prohibits
any additives shown to cause cancer in humans or
animals to be added to our food
This is not being strictly enforced!
Artificial colors proven to increase cancer risks, hyperactivity in
children, and allergies, are still found in our food
•Some additives are listed as “natural” flavorings or
colorings but can contain over 40 chemical compounds
another misleading label
BHT (Butylated Hydroxytoluene)
• To help protect flavor, retards rancidity in
oils
• Should be avoided by infants, young
children, pregnant women and those
sensitive to aspirin, may be toxic to the
nervous system, (BHT – banned in England)
• BHT is common in potato chips, baked
goods, cosmetics and other products
ŸA related substance known as butylated
hydroxyanisole (BHA) may be used instead
of BHT
Debate on BHT
• Some studies linked BHT with an increase in
tumors and cancers
• Other studies suggested that it may protect
the body from free radicals which cause other
cancers
• BHT seems to have antimicrobial and antiviral
activity, and it has in fact been used in
medical research for treating conditions
related to the herpes virus family
• FDA still considers BHT to be safe, although
consumers who wish to avoid it may want to
check their labels carefully
Refined Sugars
•Cancer develop, in part,
by feeding on sugar in the
bloodstream
•Solution to an Anti-Cancer Diet:
eat a low glycemic diet
eat less refined sugars
consume more dietary fibers
Cancer's Molecular Sweet Tooth
and the Warburg Effect
Jung-whan Kim1, and Chi V. Dang1,2
Cancer Res September 15, 2006 66; 8927
Warburg Effect
• Warburg reported a fundamental difference between
normal and cancerous cells to be the ratio of glycolysis
to respiration
• "healthy" cells mainly generate energy from oxidative
breakdown of pyruvate which is an end-product of
glycolysis, and is oxidized within the mitochondria
• In contrast, cancer cells show signs of glycolysis, (the
process of sugar breakdown) with lactate secretion even in
the presence of oxygen
• Hypothesized that cancer and tumor growth are caused by
the fact that tumor cells mainly generate energy (as e.g. ATP)
by non-oxidative breakdown of glucose (glycolysis)
Pancreatic tumor cells use fructose to
divide and proliferate
“These findings show that cancer cells can readily
metabolize fructose to increase proliferation”
Journal of Cancer Research, Dec. 2010
“They have major significance for cancer patients
given dietary refined fructose consumption, and
indicate that efforts to reduce refined fructose intake
or inhibit fructose-mediated actions may disrupt
cancer growth.”
Dr. Anthony Heaney, UCLA’s Jonsson Cancer Center
Refined Sugars on Labels
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WHITE
WHEAT
high-fructose corn syrup
sugar
sucrose
enriched bleached flour
white rice
white pastas
white breads
other "white" foods
Acrylamide
Forms from sugars and an amino acid (asparagine)
during certain types of high-temperature cooking
• Frying, roasting, and baking
• Mainly in foods made from plants, such as potato
products, grain products, or coffee
• Does not form, or at lower levels, in dairy, meat,
and fish products
• More likely to accumulate when cooking is done for
longer periods or at higher temperatures
ACRYLAMIDE
OMEGA 6 FATTY ACIDS
• Omega-6 fatty acids are one of two groups of essential
fatty acids (EFAs) that are required in human nutrition
• Omega-6 fatty acids include linoleic acid and its
derivatives
• Excessive levels of certain n−6 fatty acids, relative to
certain n−3 (Omega-3) fatty acids, shifts the physiologic
state of tissues to prothrombotic, proinflammatory and
proconstrictive states
• The optimal ratio (n-6 FA: n-3 FA) : 4 to 1 or lower
• Modern Western diets typically have ratios in excess of
10 to 1, some as high as 30 to 1
Excessive Omega 6 fatty acid Intake
A high consumption of omega-6 polyunsaturated
fatty acids (PUFAs), found in most types of vegetable
oil, may increase the likelihood that postmenopausal
women will develop breast cancer. Similar effect was
observed on prostate cancer.
E.Sonestedt et al, Article 1st published online
17 July 2008, Int’l J Cancer
Chronic excessive production of n−6 eicosanoids is
associated with heart attacks, thrombotic stroke,
arrhythmia, arthritis, osteoporosis, inflammation, mood
disorders, obesity, and cancer.
P. Calder, American Journal of Clinical Nutrition, Vol. 83, No. 6, S1505-1519S,
June 2006
Omega 6 fatty acids
• Four major food oils (palm,
soybean, rapeseed, and
sunflower)
• Poultry and meat
• Eggs
• Nuts
• Most vegetable oils
OMEGA 6 : OMEGA 3 FATTY ACID RATIO
Solution is to balance omega 6 intakes with high omega 3 intakes
Omega 3 Fatty Acids
•Essential fatty acids
•Omega-3 FA’s are thought to play an important
role in reducing inflammation throughout the
body -- in the blood vessels, the joints, and
elsewhere.
•Rich sources of omega-3 FA’s are from cold water
oily fish, such as salmon, herring, mackerel,
anchovies, and sardines
•Recommended Intake for n−3 :
1.6 gm/day for men and 1.1 gm/day for women
Omega 3 Fatty Acids
An increase in the consumption of fish and fish n-3
polyunsaturated fatty acids in industrialized countries
may contribute to lower breast and colorectal cancer risks
It is concluded that fish consumption is associated
with protection against the later
promotional stages of
colorectal carcinogenesis,
but not with the early
initiation stages.”
Caygill CP, Hill MJ, , Eur J Cancer Prev.
1995 Aug;4(4):329-32.
De Deckere, Eur J Cancer Prev. 1999 Jul,
8(3): 213-21
Hydrogented Oils ( Trans Fats)
•Helps prolong shelf life but simultaneously creates trans
fats (causes inflammation in the body)
•Besides being a cancer factor, trans fats promote heart
disease, interrupt metabolic processes, and cause belly
fat that crowd the organs and strain the heart
•To avoid listing trans fats, or to claim "trans free" on their
label, food manufacturers simply adjust the serving size
until the trans fat content falls under 0.5 grams per
serving
European Prospective Investigation into Cancer and Nutrition (EPIC STUDY)
Chajes
V, etmay
al raise
EPIC
Am Jcancer
Epidemiol
An increased intake of trans
fatty acids
theStudy.
risk of breast
by 75%
, 2008
The American Medical Association supports any state
and federal efforts to ban the use of artificial trans fats
in U.S. restaurants and bakeries
FRENCH FRIES
• made with hydrogenated oil and fried at high temperatures
• they clog your arteries with saturated fat and trans fat, they
also contain acrylamides
• should be called "cancer fries," not French fries.
CHIPS, CRACKERS, COOKIES
•contain white flour and sugar as well as trans-fats
• MSG in yeast extract
Sodium Nitrites, Nitrosamines
• Added to processed meats, hot dogs, bacon, and any
other meat that needs a reddish color to look "fresh”
• Also found in food items that are pickled, fried, or
smoked; in things such as beer, cheese, fish
byproducts, and tobacco smoke
• Nitrosamines are extremely carcinogenic
HETEROCYCLIC AROMATIC AMINES (HAA)
• Charred foods, especially meats, cooked at high
temperatures create carcinogens called heterocyclic
aromatic amines
• When organic plant or animal products are burned,
causing them to become blackened, toxins are
released and mutagenic byproducts are formed
• The longer the meat is cooked at high temperature,
the higher the production of these compounds will
be.
SUBSTANCES to DELAY
NITROSAMINE FORMATION
• Ascorbic acid (vitamin C), an
antioxidant, inhibits
nitrosamine formation
• Addition of at least 550 ppm of
ascorbic acid is required in
meats
• Add antioxidants and spices
when marinating meat eg. red
bell peppers, curry powder,
garlic, citrus fruits
è delays the formation of
nitrosamines
Hot dogs
Processed Meats, Bacon
• The Cancer Prevention
Coalition recommends that
children should not eat >12 hot
dogs/month because of the
risk of cancer.
• If you must have your hot dog,
look for those without sodium
nitrite
These meats almost always
contain the same sodium
nitrite found in hot dogs.
Bacon is also high in
saturated fat, which
contributes to the risk of
cancers, including breast
cancer.
TIPS to Prevent Cancer Through Foods
• Have a diet rich in fruits and vegetables Minimum
of 5 servings a day
• Eat healthy proteins: Beans, Fish, Tofu
• Eat healthy carbohydrates: brown rice, tubers,
corn, wheat bread, pasta etc
• A serving for fruits and vegetables, carbohydrates
is approximately your fist size
• A serving of your protein is approximately your
palm size
FOOD PYRAMID
close or Esc Key
Top Cancer Fighting Foods
1. Green tea
2. Curcumin
3. Cruciferous Vegetables
4. Folate Rich Foods
5. Tomatoes
6. Ginger
7. Vitamin D (2,000 IU/day)
Green Tea
•Antioxidant activity :
two cups of green tea = four
apples, seven glasses of orange
juice or 20 glasses of apple
juice
(Paganga, 1999)
•Green tea (GT) contains many
polyphenol compounds, with
epigallocatechin gallate (EGCG)
being the most prominent
Green Tea and Prostate Cancer
•EGCG in Green tea have been shown to exhibit a
chemopreventive effect against prostate cancer, with
studies showing that it inhibits prostate cancer cell growth,
induce apoptosis, arrest cell cycle progression, decrease
PSA production and inhibit the development and
metastasis
(Siddiqui, 2006; Adhami, 2003; Sartor, 2004; Ren, 2000)
Green Tea and Breast Cancer
• GT decreased BCA tumor size injected to mice(66%)
and weight (68%)
• Green tea inhibits VEGF growth, and cell proliferation
and migration
( Experimental Biology 2008 conference. Wei-Gu. )
Curcumin
• Recent studies have shown curcumin to interfere with
cell-signaling pathways, thus suppressing the
transformation, proliferation, and invasion of
cancerous cells
• In prostate cancer cell lines, curcumin inhibits cell
growth and induces apoptosis, which is programmed
cell death (Nakamura, 2002)
• These observations have been extended to in vivo
animal models (Dorai, 2001)
Cruciferous Vegetables
•Sources :
arugula, broccoli, brussels
sprouts, bok choy, cabbage,
canola, cauliflower, collard
greens, daikon, horseradish,
kale, kohlrabi, mustard,
radish, rutabaga, wasabi and
watercress
•Cancer fighting compound :
Indole-3-Carbinol ( 13c)
•Recommendation:
1 serving per day reduces
risk for breast cancer
Cruciferous Vegetables and Breast Cancer
•Findings from a large cohort analysis of more than
3000 survivors suggest that higher intake of
vegetables in women taking TAMOXIFEN reduced new
or recurrent breast cancer events by as much as 52%
•This effect was not present for non-tamoxifen users
Thomson, 2010
Folate Rich Foods
• Sources: Wheat bread, Pasta,
breakfast Cereals
• In a large-scale study,
researchers evaluated the
effects of folate on more than
27,000 male smokers between
ages 50 and 69
• Men who consumed at least
the recommended daily
allowance of folate -- about 400
micrograms -- cut by half their
risk of developing pancreatic
cancer
Lycopene
Men who consumed 2 or > servings of tomato sauce a week over
the course of the 12-year study :
28% lower risk of developing organ-confined prostate cancer,
35% lower risk of developing locally advanced disease, 36% lower
risk of developing metastatic disease
(Giovannucci, 2002, Health Professionals Follow-Up)
Another study found that pre-prostatectomy patients who
consumed tomato sauce pasta dishes for 3 weeks (containing 30
mg of lycopene per day) demonstrated decreased PSA counts and
lower oxidative DNA damage
(CHEN, 2001)
A similar study showed increased apoptosis in prostatectomy
specimens after consuming 3 weeks of tomato sauce pasta
dishes
(Kim, 2003)
Ginger
Researchers discovered ginger's ability to kill cancer
cells in two ways:
1.In apoptosis, the cancer cells essentially commit
suicide without harming surrounding cells
2. In autophagy, "the cells are tricked into digesting
themselves"
J. Rebecca Liu, the University of Michigan in Ann Arbor
Vitamin D
• Link between increased vitamin D intake &
reduced breast cancer risk by 50% (AACR)
• Improved survival rates among lung cancer patients
(Harvard study,2005)
Lung Cancer surgery survival rate :
Surgery during summer = 56% 5yr SR
Surgery during winter = 23% 5yr SR
• Recommended dose is 2000 IU per day
• Good sources: Fish ( tuna, mackerel, herring)
• Eel, egg, fortified dairy foods
• Sunlight exposure before 10 am and after 4pm for 10
minutes a day
Lifestyle Modification Tips on
Preventing Cancer
•Drink green tea
2-3 cups per day
green tea is protective against
breast and prostate cancer risk
•Drink red wine instead of beer
daily allowance : 1 glass/day
for women, 2 glasses/daymen
•Exercise 30 minutes a day
•Sleep 7-8 hours a day
•Manage your stress levels
Salamat Po
Daghang Salamat
Thanks for Listening