Download Food for Thought: Taking a Closer Look at Nutrition and Cancer

Food for Thought: Taking a Closer
Look at Nutrition and Cancer
Messages in the Media
Cancer Connections
July 23, 2016
Jocelyn Lutkus RD, CSO, LDN
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
• Eating Right Shouldn’t Be Complicated
Sugar and Cancer
• Sugar is converted into a substance called
acetyl CoA which fuels healthy cells and
cancer cells alike1
- Cancer cells more active than normal
cells
• No carbohydrate consumed, acetyl CoA is
still produced
- Breakdown of fat/protein
- Cancer cells can’t process breakdown of
fat/protein as well1
Sugar and Cancer
• Investigating the idea that cancer may respond more to insulin in
bloodstream released from eating high carbohydrate foods2
• Insulin is considered a growth factor which can turn on other
reactions and cancer cell growth2
• Increased sugar intake can lead to weight gain2
- Increased weight/obesity can lead to inflammation, release of
hormones (ex: insulin) which promote cell growth
- Higher weight can lead to more insulin available in the
bloodstream
- Inflammation and promotion of cell growth can lead to cancer
formation
Sugar and Cancer
• Critical look:
- How does a cell determine sugar from a piece of cake or an apple?
- Excess sugar can lead to weight gain
• Higher weight can increase risk for various types of cancer
• Bottom line: Everything in moderation
- Save the piece of cake for special occasions, not every day
- Try to choose less refined sugars
- Use the Plate Method3
The Plate Method
http://platemethod.com/
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
Artificial Sweeteners & Cancer
• Synthetic substances as an alternative to sugar
• Types of artificial sweeteners:
- Asparatame (NutraSweet®/Equal®)
- Saccharin (Sweet n’ Low®)
- Sucralose (Splenda®)
Artificial Sweeteners & Cancer
• Aspartame4
- The Food and Drug Administration says aspartame is "one of the
most exhaustively studied substances in the human food supply,
with more than 100 studies supporting its safety.“
- Animal studies
• Showed increased incidence of cancer in mice exposed to 4000 g/kg/day
- Human studies
• Study suggested increased rate of brain tumors in 80’s linked to aspartame
• National Cancer Institute showed evidence that tumors spiked in the 70’s and
often in population >70, a group exposed to the least amount of aspartame
• Aspartame was introduced in the early 80’s
• NCI looked at 500,000 people and cancer incidence; no higher levels found in
those who drank beverages with artificial sweeteners vs those who did not
Artificial Sweeteners & Cancer
• Aspartame4
- Critical look:
• FDA set acceptable daily intake (ADI) for
humans at 50 mg/kg/day (on average
drinking 19 cans of diet soda daily or
using 107 packets of sweetener)
• ADI set to be 100 times less than the
amount which could cause health
concerns
Artificial Sweeteners & Cancer
• Saccharin5
- In 1977, a study was published linking exposure of rats to saccharin caused bladder
cancer
• FDA removed saccharin from market
- Again, rats had been exposed to very high doses of saccharin
• Additional studies found that rats form a substance in their urine when exposed to high levels of
saccharin that can lead to damage to the lining of the bladder and encourage cancer cell growth
• Humans have not been observed to have the same reaction as rats
• Saccharin reintroduced in the early 2000’s
Artificial Sweeteners & Cancer
• Sucralose (Splenda)6
- Relatively new sweetener
- Some studies show health concerns regarding consumption
• Insulin resistance
• May consume more calories, crave sweet foods
- Because it is newer, long term effects unknown
Artificial Sweeteners & Cancer
• Bottom line:
- Research indicates consumption of aspartame and saccharin are safe at
typical levels of consumption
- Some choose to eliminate these substances from their diet altogether out of
caution. Also OK!
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
Alkaline Diet
• An alkaline diet is based off the idea that your body breaks down food and
leaves behind a residue or “ash”. This can be defined as acidic or alkaline. 6
• Proponents of the diet propose that cancer thrives in an acidic environment,
therefore they aim to switch their body to an alkaline environment through the
foods they eat.
Alkaline Diet
• Critical look:
- Blood pH is tightly regulated and is slightly alkaline at 7.46
• Kidneys and lungs work to keep it tightly regulated
• Shifts in blood pH can be due to major medical conditions, not able to be affected by something you ate
- Urine pH may be affected by diet6
• Cancer cells are not affected by urine pH, but blood pH
• Bottom line:
- Plant-based diet can have many health benefits
- Choose more plant-based foods for overall health
- Many “acidic” foods are also nutritious
• Whole grains, blueberries, beans, nuts
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
Juicing and Cancer
• Many people start juicing to dramatically increase their intake of
fruits and vegetables
• Often extract the juice to drink but leave behind the pulp
- Pulp has fiber and other nutrients that aren’t consumed
• Bottom line: Juicing can be part of a healthy regimen, as long as it
complements your intake of fruits and vegetables
- By eating whole fruits/vegetables, you also eat fiber and other
nutrients lost with juicing
- May be beneficial for those with eating difficulty
- Try to eat a protein source if drinking more than 4-6 ounces
• Cheese, yogurt, egg, handful of nuts, peanut butter
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
• Eating Right Isn’t Complicated
Supplements & Cancer
• Various “miracle cures” by using various herbs, vitamins, minerals
• Not regulated by the FDA
- Unsure if they may interact with treatment
- Unsure of effectiveness
- Unsure of purity
- Unsure of truthful amounts on the label
• American Institute for Cancer Research “recommends against relying on
supplements to protect against cancer”. 7
Supplements & Cancer
• Critical look: 7
- Certain nutrients may be better absorbed through whole foods versus in a pill
- Fiber, other nutrients may act together to help increase absorption versus in a
pill alone
- Often lack trials/evidence that they may not interfere with treatment or other
medications
• Bottom line: Discuss any supplement use with your MD and/or dietitian
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
• Eating Right Isn’t Complicated
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
Separating Fact from Fiction in the Media
• Information can often be skewed or sensationalized in the
media
- May not provide an accurate picture
- May not provide the whole picture
• Nutrition is an ever-evolving science
• People’s bodies are different and may respond differently to
different environments/exposures to certain foods
Separating Fact from Fiction in the Media
• When reading or listening to a news story ask yourself:
- Is the information reported based on one study?
• Decisions need to be made based on totality of evidence
Separating Fact from Fiction in the Media
• When reading or listening to a news story ask yourself:
- Is the information reported based on one study?
• Decisions need to be made based on totality of evidence
- Was this a lab study (cells in a petri dish)/animal study/human study?
• Animal studies may help us understand some ways nutrients interact in the body, but not
always exactly the same
Separating Fact from Fiction in the Media
• When reading or listening to a news story ask yourself:
- Is the information reported based on one study?
• Decisions need to be made based on totality of evidence
- Was this a lab study (cells in a petri dish)/animal study/human study?
• Animal studies may help us understand some ways nutrients interact in the body, but not
always exactly the same
- How big was the sample size?
• The bigger the sample size the better
• Reduces likelihood that cause was through chance alone
Separating Fact from Fiction in the Media
•
When reading or listening to a news story ask yourself:
Is the information reported based on one study?
•
-
Was this a lab study (cells in a petri dish)/animal study/human study?
•
-
The bigger the sample size the better
Reduces likelihood that cause was through chance alone
What type of study was it?
•
•
•
-
Animal studies may help us understand some ways nutrients interact in the body, but not always exactly the same
How big was the sample size?
•
•
-
Decisions need to be made based on totality of evidence
Gold standard is a double-blind, randomized, control trial
This allows for comparison between a “treatment” versus “no treatment”
This accounts for a potential for a researcher to intentionally or unintentionally skew data based on their own bias
• Often costly, time-consuming, may be unethical
• Next best is human prospective cohort studies
• Large groups of people observed over time for development of diseases/medical conditions
What else did they look at?
•
•
Could another factor influence?
People who carry lighters are at an increased risk for lung cancer
Talk to a Registered Dietitian
• Registered Dietitians have received unique training
- Only those who have completed at least 4 years of undergraduate coursework, a 1 year supervised
practice, and completed a comprehensive exam to ensure competency may call themselves dietitians
-
Receive training in rigorous courses such as anatomy, physiology, biochemistry, metabolism
-
Take classes in statistics to learn how to decipher results of studies
-
Uniquely trained to take complex scientific information and translate it to the general public to
provide easy-to-understand, evidence-based information
-
Adhere to a strict code of ethics
• Anyone can call themselves a nutritionist
• College educated vs weekend seminar
• Buyer beware
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
How to Evaluate a Nutrition Message
• When listening to a nutrition message, ask yourself:
- Does this person have something to sell/gain by presenting this message?
• Someone promoting a supplement that they sell
• Make sure they are unbiased
- Does this sound too good to be true?
• Anything claiming a cure should be a red flag
- Where is the evidence?
• Are there studies cited that can be reviewed?
Overview
• Review popular nutrition & cancer claims
- Sugar and cancer
- Artificial sweeteners and cancer
- Alkaline diet
- Juicing and cancer
- Supplements and cancer
• Learn how to decipher fact from fiction
- How to evaluate science in the media
- Signs of bogus claims
• Eating Right Isn’t Complicated
Eating Right Isn’t Complicated
Resources for Nutrition and Cancer Risk
Reduction
• American Institute for Cancer Research
- www.aicr.org
• Academy of Nutrition and Dietetics
- www.eatright.org
• International Food Information Council
- www.foodinsight.org
References
1. Klement, R and Kammerer U. Is there a role for carbohydrate restriction in the treatment and
prevention of cancer? Nutr Metab (Lond). 2011; 8: 75.
2. http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=13631&news_iv_ctrl=0&abbr=res_
3. http://www.choosemyplate.gov/
4. http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/aspartame
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198517/
6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/
7. http://preventcancer.aicr.org/site/PageServer?pagename=tellmeabout_supplements
Questions?
Jocelyn Lutkus RD, CSO, LDN
[email protected]
312-695-1192