Download Lecture 8 - Vision Institute of Canada

The Fifteen
Supernutrients
Steven G. Pratt, MD, FACS, ABHM
Vision Institute of Canada
Nutrition and Vision Conference
Calgary, Alberta
May 31 & June 1, 2008
Supernutrients
• Found in abundance in SuperFoods
1
Supernutrients
• Vitamin C
• Lutein
• Vitamin D
• Zeaxanthin
• Folic Acid
• Lycopene
• Selenium
• Beta Carotene
• Glutathione
• Alpha Carotene
• Resveratrol
• Beta Cryptozanthin
• Polyphenols
• Fiber
Index for Biological Aging (IBA)
• Biological age is a measure of how well the body is aging
• Key = biological age < chronological age
• ↓ Morbidity in later life
• 4 plasma antioxidants inversely associated with IBA
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Alpha-carotene
Lycopene
Alpha tocopherol
Lutein / zeaxanthin
• n-3’s
Vitamin D
Index for Biological Aging (IBA)
• 4 plasma nutrients associated with a poor health outlook
if low concentration
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Vitamin C
Beta carotene
Selenium
Folate
• NAS
- 15-50 yrs = 200 IU
- 51-70 yrs = 400 IU
- 71 and above = 600 IU
• SuperHealth Recommended /d
- 800-2000 IU????
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Food Sources of Vitamin D
Vitamin D per 3.53 oz
Food
Alaskan Sockeye Salmon
687 IU
Alaskan Albacore Tuna
544 IU
Alaskan Silver Salmon
Alaskan King Salmon
Alaskan Sardines
236 IU
222 IU
Alaskan Halibut
162 IU
1 TBS
1360
3 oz
360
Sardines, canned
3 oz
250
Mackerel, canned
3 oz
214
Tuna, canned
3 oz
200
Milk, fortified
1 cup
100
Orange juice, fortified
1 cup
100
Margarine, fortified
2 tsp
50
Cereal, fortified
1 cup
40
Liver, beef, cooked
* Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006
Egg
Vitamin D
• Deficiency is widespread in all age groups
• Deficiency associated with ↑ risk for cancer (breast,
prostate, colon, NHL, pancreas), ↓ survival from
melanoma, Rheumatoid arthritis, T1DM, macular
degeneration,
degeneration frailty (falls), MS, fibromyalgia, gingivitis,
muscle aches and pains, osteoporosis, HTN
• AntiAnti-inflammatory effect
•
↓ Angiogeneis
• Immune system booster
• Regulate cell growth
Vitamin D
IU
Salmon, canned, pink
Cod liver oil
439 IU
Serving
3.5 oz
30
1 whole
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Vitamin D
•
•
•
•
↑ Vitamin A can ↓ vitamin D absorption
Sunscreen ↓’s vitamin D skin production
↓ skin production of vitamin D as go “North”
Little to no winter production north of a line between San
Francisco & Philadelphia
– 12 mo/yr in San Diego
• ↓ skin production with age and ↑ skin melanin
• 15 minutes sun exposure 3-4x weekly adequate (in SD)
– Pale white skin can produce 20,000 IU vitamin D in 20
minutes (full sunlight)
– Tan white skin ≅10,000 IU in 20 minutes
– Dark brown skin ≅ 5,000 IU in 20 minutes
3
Vitamin D
• Vitamin D3 vs. vitamin D2
– Summer sunlight can produce D3 from 0700 1700 with a
peak synthesis of pre-vitamin D at 1230
• Conversion of 25 hydroxyvitamin D to active hormone;
kidney > immune cells, colon cells, placenta, breast,
prostate, and pancreas
“An estimated 30 people may die of
cancers related to vitamin D deficiency
for every person who dies from skin
cancers caused by excessive sun
exposure.”
--Edward Giovannucci
Vitamin D & the Metabolic
Syndrome
“ I would challenge anyone to find an
area or nutrient or any factor that has
such consistent anti-cancer benefits
as vitamin D”
--Edward Giovannucci
• Metabolic syndrome
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Abdominal obesity
Atherogenic dyslipidemia
↑ BP
Insulin resistance
Proinflammatory state
Prothomotic state
23.1% of adults in NHANE III
>2 million adolescents in U.S.
Low serum 25 hydroxyvitamin D is associated with an ↑ risk
of metabolic syndrome
4
Vitamin D and Melanoma
• Every 10% ↑ in residential UVB
– 19% ↑ risk in males
– 16% ↑ risk in females
Vitamin D and Cancer
• Lower limit for any benefit of Vitamin D
– 1000 I.U.’s D3 for colorectal cancer
– 2000 I.U.’s D3 for breast cancer
Obesity & Vitamin D Status
Vitamin C
• Daily goal from foods 350-400 mg
• Vitamin D plays a role in glucose metabolism and insulin
sensitivity
• The hormonal form of vitamin D can inhibit the production
of proinflammatory cytokines
* Check Your Serum 25 Hydroxyvitamin D
Level !!
-
1 large yellow bell pepper = 341 mg
1 large red bell pepper = 312 mg
1 common guava = 165 mg
1 large green bell pepper = 132 mg
1 cup fresh orange juice = 124 mg
1 cup orange juice from frozen concentrate = 97 mg
1 cup fresh sliced strawberries = 97 mg
1 cup fresh broccoli (chopped) = 79 mg
- “Graze” all day long
- Early AM for first “dose”
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Vitamin C
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The master antioxidant
Cellular concentration important (<400mg)
“Gone in 12 hours”
↓ Risk for cancer, CVD, cataracts, mortality, Alzheimer's
(AZ)
Vitamin C = Ascorbic acid
High serum vitamin C levels associated with ↓ all course
mortality
Some studies show vitamin C may ↓ the duration and
severity of colds
Supplements = ideal 250 mg QID
TUL 2000 mg per day
Folic Acid
• Daily goal from foods 400 mcg
-
1 cup cooked spinach = 263 mcg
1 cup boiled kidney beans = 230 mcg
2 cup boiled green soybeans = 200 mcg
½ cup soy nuts = 177 mcg
1 cup orange juice from frozen concentrate = 110 mcg
4 cooked asparagus spears with ½ in. base = 89 mcg
1 cup (frozen) chopped cooked broccoli = 103 mcg
Selenium
Folic Acid
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•
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•
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Folic acid is folate (food)
≈10 folates in food → 5-methyltetrahydrofolate
↓ Risk for cancer, CVD, AD, birth defects
Folic acid and homocysteine
Folic acid and B12
– May need 300-1000 mcg to prevent B-12 deficiency
• High folic acid intake can mask B12 deficiency
• Homocysteine and folic acid, B6, B12, betaine (spinach)
• > 400 mcg supplemental
• Daily goal from foods 70-100 mcg
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3 oz cooked Pacific oysters = 131 mcg
1 cup whole grain wheat flour = 85 mcg
1 dried Brazil nut = 68-91 mcg
½ can Pacific sardines = 75 mcg
3 oz of canned white tuna = 56 mcg
3 oz cooked clams = 54 mcg
6 farmed oysters = 54 mcg
3 oz roasted skinless turkey breast = 27 mcg
– ? ↑ Risk for breast and colon cancer
6
Vitamin E
Selenium
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•
•
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An essential component of the GSH peroxidase enzyme
↓ Risk for multiple cancers, CHD
Toxicity issues
Supplemental form
– Bioavailability of selenomethionine (90%) twice selenium
selenite (50%)
– Max ≅100 mcg supplemental /d?
– To ↓ cancer may need 200 mcg/d?
• Relation to GSH
• > 25 selenoproteins
• Daily goal from foods 16 mg
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Vitamin E
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Essential to have all 8 forms in a supplement
“Synergy of 8”
↓ Risk for CVD, cancer, AD, degenerative eye disease
Immune system booster
Safety issues??
Bioavailability issues in 10-15% of the population
N-3’s and vitamin E
Gamma tocopherol and inflammation
Don’t forget your tocotrienols
2 tablespoons wheat germ oil = 41 mg
2 tablespoons soybean oil = 2.6 mg
2 tablespoons canola oil = 13.6 mg
2 tablespoons peanut oil = 9.2 mg
2 tablespoons flaxseed oil = 4.8 mg
2 tablespoons olive oil = 4 mg
1 oz raw (23-24 whole kernels) almonds = 7.7 mg
¼ cup hulled dry-roasted sunflower seeds = 6.8 mg
2 tablespoons raw (untoasted) wheat germ = 5 mg
1 medium orange bell pepper = 4.3 mg
1 oz hazelnuts (20-21 kernels) = 4.3 mg
2 tablespoons peanut butter = 3.2 mg
1 cup blueberries = 2.8 mg
* Kiwis also a good source
Gamma Tocopherol
• Best sources
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Perilla seed
Pistachios
Pecans
Walnuts
Pumpkin seeds
Pine nuts
Cashews
Peanuts
• A potent anti-inflammatory
• Primary form in skin “oil”
7
Serum Carotenoids
• ↑ Serum carotenoids associated with…
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↓ Risk for type II DM
↓ Risk for breast cancer
↑ Grip strength
↑ “Quad” strength
↓ Risk for falls
↓ Risk for osteoporosis
↓ Risk for sarcopenia
Lycopene
• #1 in American’s serum
• Lutein “protector”
• Bioavailabilty issues
– Heat
– Oils
– Avocado
Lycopene
• Daily goal from foods 22 mg
- 1 cup tomato sauce (canned) = 37 mg
- 2 cup R.W.Knudsen Very Veggie vegetable cocktail from
concentrate = 22 mg
- 1 cup tomato juice = 22 mg
- 1 watermelon wedge (1/16 of a melon 15 inches long, 7 ½
inches in diameter) = 13 mg
- 1 cup canned stewed tomatoes = 10.3 mg
- 1 tablespoon tomato paste = 4.6 mg
- 1 tablespoon ketchup = 2.9 mg
- ½ pink grapefruit = 1.8 mg
Lycopene
• Oxidative metabolites identified
• ↓ Risk for multiple cancers (prostate, lung, digestive tract,
breast), CVD, AMD
• Relationship with GSH
• Gap junctions
• SPF nutrient
• Plasma ½ life 12-30 days
– High concentrations in testes, adrenal gland, liver, kidney,
lung, cervix, prostate
8
Lutein/Zeaxanthin
• Daily goal from foods 12 mg
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1 cup cooked kale (chopped) = 23.7 mg
1 cup cooked spinach = 20.4 mg
1 cup cooked collard greens (chopped) = 14.6 mg
1 cup cooked turnip greens = 12.1 mg
1 large sweet orange bell pepper = 9.2 mg
1 cup cooked green peas = 4.2 mg
1 cup cooked broccoli = 2.4 mg
Lutein/Zeaxanthin
• ↓ Risk for CVD, cancer, AMD, cataracts
• Obesity and L&Z bioavailability
• Bioavailability
– Oil
– Raw vs. cooked
– Love that egg yolk
• Oxidative metabolites
• Macular pigment
– Blue Light filter
Spinach contains:
Zeaxanthin Superfood
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*
1 large orange bell pepper
1 cup canned yellow corn
1 raw Japanese persimmon
1 cup degermed cornmeal
Gogi Berry
8.0 mg
0.9
0.8
0.7
• A synergy of multiple
nutrients & phytonutrients
• B vitamins (thiamine,
riboflavin, B6, folate)
• Low in calories
• Alpha lipoic acid
• Lutein / zeaxanthin
• Vitamins C & E
• Plant-derived omega-3 fatty
acids
• Minerals (calcium, iron,
magnesium, manganese,
and zinc
• Beta-carotene
• Polyphenols
• Glutathione
• Betaine
• Potassium
9
Alpha-carotene
• Daily goal from foods 2.4 mg
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1 cup canned pumpkin = 11.7 mg
1 cup cooked carrots (slices) = 6.6 mg
10 raw medium baby carrots = 3.8 mg
1 cup cooked butternut squash (cubes) = 2.3 mg
1 large sweet orange bell pepper = .3 mg
1 cup cooked collard greens (chopped) = .2 mg
Beta-carotene
• Daily goal from foods 6 mg
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1 cup cooked sweet potato = 23 mg
1 cup canned pumpkin = 17 mg
1 cup cooked carrots (slices) = 13 mg
1 cup cooked spinach = 11.3 mg
1 cup cooked chopped kale = 10.6 mg
1 cup cooked butternut squash (cubes) = 9.4 mg
1 cup cooked collard greens (chopped) = 9.2 mg
Alpha-carotene
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Keeps “cropping up”
A pro-Vitamin A carotenoid
? Better tumor suppressor than BC
↓ Risk for cataracts, cancers (skin, lung)
↓ Activity of C-450 an activator of pro-carcinogens
Beta-carotene
• Synergy of multiple carotenoids and multiple antioxidants,
phytonutrients
• Beware of supplemental and cigarettes, asbestos, alcohol
• Bioavailability
– Raw carrots vs. cooked
– Carrots vs. supplements
• Degenerative eye disease and BC
• Pro-Vitamin A carotenoid
– Veggies vs. fruit
• Anti-inflammatory effect
10
Beta Cryptoxanthin
• Daily goal from foods 1 mg
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1 cup cooked butternut squash (cubes) = 6.4 mg
1 cup cooked red bell pepper (strips) = 2.8 mg
1 Japanese persimmon (2 ½ in. diameter) = 2.4 mg
1 cup mashed papaya = 1.8 mg
1 large sweet red bell pepper (raw) = .8 mg
1 cup fresh tangerine juice = .5 mg
1 medium tangerine = .3 mg
Glutathione
• Daily goal from foods is not yet known
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Asparagus
Watermelon
Avocado
Walnuts
Grapefruit
Peanut butter
Oatmeal
Broccoli
Oranges
Spinach
Beta Cryptoxanthin
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Pro-Vitamin A carotenoid
One of the “big six”
↓ Risk for polyarthritis
↓ Risk for multiple cancers
Glutathione
• The master intra-cellular antioxidant
• Relationship to vitamin C, A-Lipoic acid, selenium, and
others
• Poorly absorbed in GI tract
• Role of protein & NAC
• DNA protector, immune system booster, detoxifier, ↓
chronic inflammation
• Early AM boost a great anti-aging strategy
• Go for the cysteine
11
Resveratrol
• Daily goal from foods is not yet known
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Blueberries
Peanuts
Purple grape skins
Red wine
Purple grape juice
Cranberries/cranberry juice
Mulberries
Red wine contains 1.2 mg/L
Resveratrol
• Readily absorbed in the gut
• Biological activities include antibacterial, antifungal,
antioxidant, free radical scavenging, vasorelaxation,
chemopreventive, anti-inflammatory
• Role in ↓ risk for cancer and heart disease
• Produced by plants in response to injury, UV-light,
bacteria, fungi
• Role in cell cycle arrest and induction of apoptosis
• Neuroprotective
* Synthesized by >70 edible plants
Resveratrol
• Anti-inflammatory properties
– Suppresses COX-2 expression
• Influence on sirtuin enzymes which slow down the aging
process and extend lifespans – mimic caloric restrictions
• Biological effect at very low dose
• Promising research but many questions remain
Potassium
NAS
• 4700 mg daily
SuperHealth Recommendation
• 8000 mg daily
Sources
Odwalla Blackberry Fruit Shake
1060 mg/8 oz
Medium potato
926 mg
Sweet potato
950 mg
Naked Just Carrot Juice
620 mg/cup
Sunsweet Prune Juice
540 mg/8 oz
R.W. Knudsen Very Veggie Vegetable Cocktail (Low
sodium)
520 mg/cup
Cantaloupe
494 mg/cup
Orange Juice
473 mg/cup
Avocado (1/2)
439 mg
Banana
422 mg/cup
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Potassium
Fiber
• Daily goal from foods:
• Helps decrease risk for hypertension, stroke, cardiac
dysfunction, arrhythmias, kidney damage, osteoporosis.
Females
Males
19-50
51-70
19-50
51-70
25 g
21 g
38 g
30 g
• Fiber power the Superfoods Way =
45 g/d for adult males; 32 gd adult females
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1 cup cooked black beans = 15 g
¼ cup dry pinto beans = 14 g
1 cup cooked garbanzo beans = 13 g
¼ cup dry lentils 9 g
1 cup fresh raspberries = 8 g
Fiber
• Role in preventing
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T2DM
Obesity
CVD / Atherosclerosis
Cancer
Oxidative stress
Constipation
Hemorrhoids
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Synergy of different types
Loaded with phytonutrients
Helps prevent recurrent breast cancer
3 to 4 grams whole grain bran ↓ carotid artery
atherosclerosis
• Weight control
• Anti-inflammatory - ↓ CRP
13
Omega-3 Fatty Acids
Omega-3 Fatty Acids
• Food and Nutrition Board
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1.6 g/d ALA for men
1.1 g/d ALA for women
160 mg/d EPA/DHA for men
110 mg/d EPA/DHA for women
• My goal
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3 oz cooked Chinook (king) salmon = 1.5 g
3 oz sockeye salmon = 1 g
3 oz farmed Rainbow trout = 1 g
1 can sardines = .9 g
3 oz canned white tuna in water = .7 g
1 g/d EPA/DHA for men
0.7 g/d EPA/DHA for women
1-2 TBSP/d ground flaxseed meal
n-3/n-6 ratio between 1/1 → 1/3
Omega-3 Fatty Acids
• ALA
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• EPA/DHA
1 tablespoon canola oil = 1.3 g
1 tablespoon soybean oil = .7 g
1 tablespoon walnut oil = 1.4 g
1 tablespoon flaxseed oil = 7.3 g
1 cup cooked spinach = .2 g
1 cup cooked collard greens = .2 g
½ cup dry roasted soy nuts = 1.2 g
1 tablespoon flaxseed = 2.2 g
½ cup wheat germ = .5 g
1 oz (14 halves) English walnuts = 2.6 g
1 omega-3 “vegetarian” hen egg = amounts vary
Omega-3 Fatty Acids
• EPA/DHA vs. ALA
• ↓ Risk for “everything”
• The easiest way to ↓ risk for sudden cardiac death = 1
gram fish oil/d
• Healthy heart, brain, eyes
• Roll in ↓ Atrial Fibrillation (25% of adults)
• A major anti-inflammatory
• ↓ Triglycerides
• ↓ BP
• ↓ Heart rate
14
Omega-3 Fatty Acids
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A major human deficiency state exists
DHA concentrated in the brain, retina, cardiac muscle
EPA/DHA supplements “work”
Fish protein + EPA/DHA “best”
Safety
Immune system function
– No adverse parameters with 3 or less grams/d
• Risk for hemorrhagic stroke with 10-12g/d
• Omega-3 intake-hypothalamus-obesity
Polyphenols
• Daily goal from foods is not yet known
Whole Foods
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Berries
Dates and figs
Prunes
Kale, spinach
Parsley, dried parsley
Apples with skin
Citrus
Grapes
Cherries
Polyphenols
• A great 21st century Phytonutrient
• Multiple functions
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Anti-oxidant
Anti-mutagenic
Anti-inflammatory
Cell signaling
Metal chelation
– Anti-platlet
– Synergy
– Phytoestrogen
– Vasodilators
– Nutrigenomics
Intake/d
Bioavailability
Safety
Cancer, CVD, neuro-degenerative disorders
AntiAnti-inflammatory!!
Polyphenols
Jams
• Trader Joe’s Organic Blueberry Fruit Spread
• Knott’s Pure Boysenberry Preserves
• Trader Joe’s Organic Blackberry Fruit Spread
Beverages
• Green, black, oolong, white, Rooibus tea
• Soymilk
• 100 percent fruit juices (berry, pomegranate, Concord
grape, cherry, apple, citrus, prune)
15
Polyphenols
Polyphenols
Juices
Mg of polyphenols
per 8 oz serving
Jams
Mg of polyphenols per
20 g—a trace over 1
Tablespoon
Odwalla C Monster
845
Trader Joe’s Organic Blueberry Fruit Spread
400
Trader Joe’s 100% Unfiltered Concord Grape Juice
670
Knott’s Pure Boysenberry Preserves
300
Trader Joe’s Organic Blackberry Fruit Spread
280
Trader Joe’s Organic Strawberry Fruit Spread
120
Trader Joe’s Organic Morello Cherry Fruit Spread
120
Sorrell Ridge Wild Blueberry Spreadable Fruit
100
R.W.Knudsen 100% Pomegranate Juice
639
R.W.Knudsen 100% Cranberry Juice
587
R.W.Knudsen Just Blueberry
425
L&A Black Cherry Juice
345
27% cranberry juice cocktail
137
Knott’s Bing Cherry Pure Preserves
100
100% apple juice
61
Welch’s Concord Grape Jam
60
* Superfoods Rx: Fourteen Foods That Will Change Your Life
* Superfoods Rx: Fourteen Foods That Will Change Your Life
Polyphenol Content of
40g’s Dark Chocolate
•
Newman’s Own
Sweet Dark Dark Chocolate
955mg
•
Dove Silky Dark Chocolate
811mg
•
Endangered Species
Chocolate Company Wolf Bar
811mg
•
Cadbury Royal Dark Indulgent
Dark Chocolate
765mg
•
Hershey’s Special Dark
Mildly Sweet Chocolate
739mg
* Superfoods Health Style: Proven Strategies for Lifelong Health
The Ideal Supplement
• Lutein / Zeaxanthin
• Lycopene, Alpha / Beta
carotene, others
• B-complex
• Vitamins D, K, A
• Glutathione
• N-acetyl-L-cysteine
• Alpha lipoic acid
• CoQ10
• n-3’s
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Polyphenols
Zn, Mn, Se (others)
Vitamin C
Vitamin E (All 8 forms)
Betane
Synergy
Balance
Long-term use (>10 yr)
• A supplement to whole foods
* One a Day is NOT the answer
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Supplements Compliment but
Don’t Replace Healthy Diet
“The whole of the plant is greater than the sum of its
individual parts. The combinations of nutrients as
contained in whole foods seem more effective for
reducing the risk of various chronic diseases. So
maybe Mother Nature does know best. The numerous
other phytochemicals found in foods rich in antioxidant
nutrients may be necessary to act synergistically to
provide effect against chronic disease.”
Susan F. Clark, RD, Ph.D
Sources
•
Murakoshi M, Nishino H, et al. Potent preventive action of alphacarotene against carcinogenesis: spontaneous liver carcinogenesis and
promoting stage of lung and skin carcinogenesis in mice are
suppressed more effectively by alpha-carotene than by beta-carotene.
Cancer Res 1992; 52:6583-7.
•
Thompson H, Heimendinger J, et al. In vivo investigation of changes in
biomarkers of oxidative stress induced by plant food rich diets. J Agric
Food Chem, 2005; 53:6126-32.
•
Astley S, Elliott R, et al. Evidence that dietary supplementation with
carotenoids and carotenoid-rich foods modulates the DNA damage:
repair balance in human lymphocytes. Br J Nutr, 2004; 91:63-72.
•
Pratt S, Matthews K. SuperFoods HealthStyle: Proven Strategies for
Lifelong Health. Harper Collins, New York; 2006.
•
Pratt S, Greenway H, Naugle C. Nutrition and Skin Cancer Risk
Prevention. In: Functional Foods & Nutraceuticals in Cancer
Prevention. Watson, Ronald R. ed., Iowa State Press, Ames,
Iowa, 2003; 105-20.
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Sources
Sources
•
Pratt S, Greenway H, Harris G, Twersky J. Superfoods and
Supernutrients in Nutrition of the Skin. Watson, Ronald R. ed., going to
Press.
•
Kune, G.A. et al. Diet, alcohol, smoking, serum beta-carotene, and
vitamin A in male nonmelanocytic skin cancer patients and controls.
Nutrition and Cancer, 1992; 18(3):237-44.
•
Black, H.S. Pro-carcinogenic activity of beta-carotene, a putative
systemic photoprotectant. Photochemical and Photobiological
Sciences, 2004; 3(8):753-8.
•
Lee EH, et al. Dietary lutein reduces ultraviolet radiation-induced
inflammation and immunosuppression. J Invest Dermatol
2005;122:510-7.
•
Fuchs, J.et al. HPLC analysis of vitamin E isoforms in human
epidermis: correlation with minimal erythema dose and free radical
scavenging activity. Free Radical Biology and Medicine, 2003; 34(3):
330-6.
•
Kuchide M, et al. Cancer chemopreventive effects of oral feeding
alpha-tocopherol on ultraviolet light B induced photocarcinogenesis of
hairless mouse. Cancer Lett 2003;196;169-77.
•
•
Gonzalez, S. et al. Dietary lutein/zeaxanthin decreases ultraviolet Binduced epidermal hyperproliferation and acute inflammation in hairless
mice. Journal of Investigative Dermatology, 2003; 121(2):399-405.
Sies H, Stahl W. Nutritional protection against skin damage from
sunlight. Annu Rev Nutr 2004;24:173-200.
•
Greenway, H.T. and Pratt, S.G. Vitamins and micronutrients in aging
and photoaging skin. In: Watson, R.R. (ed.) Vegetables, Fruits, and
Herbs in Health Promotion. CRC Press LLC, 2001; 109-116.
Pence BC, et al. Effects of dietary selenium on UVB-induced skin
carcinogenesis and epidermal antioxidant status. J Invest Dermatol
1994;102:759-61.
•
Black HS, Rhodes LE. The potential of omega-e fatty acids in the
prevention of non-melanoma skin cancer. Cancer Detect Prev
2006;30:224-32.
•
Sources
•
McNaughton S, et al. Role of dietary factors in the development of
basal cell cancer and squamous cell cancer of the skin. Cancer Epid
Biomarkers Prev 2005;14:1596-607.
•
Hughes MC, et al. Food intake and risk of squamous cell carcinoma of
the skin in a community: the Nabour Skin Cancer Cohort Study. Int J
Cancer 2006;119:1953-60.
•
Moller P, Loft S. Dietary antioxidants and beneficial effect on oxidatively
damaged DNA. Free Rad Biol Med 2006;41:388-415.
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