Download CancDiet-Apr04 - Straight Nutrition

HEALING FOODS
PHYTOCHEMICALS
Foods for Cancer Prevention
Focus on Vegetables & Fruits with
“BIG Color & BIG Flavor”
Vicky Newman, MS, RD
Associate Clinical Professor
UCSD School of Medicine
Diet and Cancer
Current Associations
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Breast
Prostate
Colon
Pancreas
Lung
Bladder
Ovary/cervix
Gastric
Oral/esophagus
POSSIBLE WAYS
DIETARY CONSTITUENTS
PROTECT AGAINST CANCER
• Antioxidant effects
• Effects on cell differentiation
• Increased activity of enzymes that
detoxify carcinogens
• Blocked formation of nitrosamines
• Altered estrogen metabolism
POSSIBLE WAYS
DIETARY CONSTITUENTS
PROTECT AGAINST CANCER
• Altered colonic milieu (including bacterial
flora, bile acid composition, pH, fecal bulk)
• Preserved integrity of intracellular matrixes
• Maintenance of normal DNA repair
• Increased destruction of cancer cells
(apoptosis)
• Decreased cell proliferation
PHYTOCHEMICALS
(Plant Protectors)
• Substances produced by plants to protect them
from damage from environment (predators,
pathogens, solar radiation).
• Antioxidants.
• Include toxins produced by plant to fight off
predators. When eaten by humans, these upregulate detoxifying enzymes that help protect
from harmful substances, including carcinogens.
• Considered non-nutritive, because they do not
provide energy, vitamins, or minerals.
• Most are heat stable and not significantly lost in
cooking water.
Increase Proportion Who
CONSUME > 3 DAILY SERVINGS
VEGETABLES
• Healthy People 2010 Target
• All age groups*
75%
49%
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43%
49%
43%
68%
64%
56%
Female 20-39 years*
Female 40-59 years*
Female 60+ years*
Male 20-39 years*
Male 40-59 years*
Male 60+ years*
*CSFII (2-day average), 1994-96.
Increase Proportion Who
CONSUME > 1 DAILY SERVING
DARK GREEN/DEEP YELLOW
VEGETABLES
• Healthy People 2010 Target
• All age groups*
75%
8%
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9%
11%
13%
4%
9%
11%
Female 20-39 years*
Female 40-59 years*
Female 60+ years*
Male 20-39 years*
Male 40-59 years*
Male 60+ years*
*
CSFII (2-day average), 1994-96.
Increase Proportion Who
CONSUME > 2 DAILY SERVINGS
FRUIT
• Healthy People 2010 Target
75%
• All age groups*
28%
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20%
26%
35%
23%
28%
40%
Female 20-39 years*
Female 40-59 years*
Female 60+ years*
Male 20-39 years*
Male 40-59 years*
Male 60+ years*
*
CSFII (2-day average), 1994-96.
Nine are Divine
Go for the BOLD
BIG COLOR
• Pigments give color to food and thus
enhance eating enjoyment.
• Almost 2,000 known plant pigments in our
food, including over:
- 800 flavonoids (yellow)
- 450 carotenoids (orange, red)
- 150 anthocyanins (blue, purple).
• These pigments help protect us from
disease.
CAROTENOIDS
• Powerful antioxidants
• Some metabolized to vitamin A
(retinol):
- stimulate immune function;
- role in differentiation of
normal epithelial cells;
- may further inhibit cell
proliferation;
- may induce increased cellto-cell communication.
DARK-GREEN LEAFY
VEGETABLES
• Contain carotenoid lutein:
- no vitamin A activity, but
antioxidant activity;
- protective against
macular degeneration.
• Rich in folic acid:
- deficiency may lead to
chromosomal damage
(cells less resistant to viral
damage; also necessary
for DNA repair).
LYCOPENE
• Responsible for the red color of tomatoes, also
found in tomato juice, sauce, pink grapefruit, salsa
• The predominant carotenoid in plasma; age and
BMI inversely assoc with lycopene concentrations
• Inverse relationship with prostate cancer (RR
0.65, CI =0.42-0.99) & cancers of GI tract
• Evidence in breast cancer less substantial with
RR of approx. 0.8-1.02.
Giovanucci E. JNCI , 2002; Giovanucci E. JNCI, 1995; La Vecchia C.
PSEBM, 1998; Ching, J Nutr 2002.
TOMOTOES vs LYCOPENE
• Study supports “whole is greater
than sum of its parts”…or food
more effective than an isolated food
component.
• Tomato powder but not lycopene
supplement inhibited prostate cancer
in rats.
Boileau TW-M, JNCI 2003;95:1578-86;
Gann PH, JNCI 2003;95:1563-65).
BERRIES, RED GRAPES,
RED CABBAGE
Contain significant levels
of phenolic flavonoids
(like ellagic acid,
ferulic acid):
• Act as antioxidants;
• Protect against LDL
oxidation;
• Inhibit platelet
aggregation.
ANTHOCYANINS
(red & blue pigments)
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Antioxidant flavonoids.
Anti-inflammatory.
Relax blood vessels.
Inhibit cholesterol
production.
• Inhibit activity of
enzyme that speeds cell
division (potentially
decreasing cancer
risk).
• May protect against
memory loss (aging).
Go for the
BOLD
BIG Flavor
CITRUS FRUIT
(coumarins, D-limonene, glucarates)
• Contain coumarins &
D-limonene, a terpenoid
shown to increase
activity of detoxification
enzyme (glutathione
transferase).
• Citrus pulp & white
inner peel rich in
glucarates (potential to
prevent breast cancer &
lower PMS symptoms).
CITRUS FRUIT
(Rich in Vitamin C)
• Fights infection.
• Antihistamine effects.
• Antioxidant (protects cell
membranes & DNA from
oxidative damage).
• Decreases conversion of nitrate
to nitrite (reducing formation of
nitrosamines).
• Necessary for synthesis of
collagen (deficiency could affect
integrity of inter- cellular
matrixes allowing tumor growth
or hindering tumor
encapsulation).
CITRUS FRUIT
(Rich in Flavonoids)
• Extend activity of vitamin C.
• Antioxidants.
• Protect LDL cholesterol
from oxidation to unsafe
cholesterol oxides.
• Inhibit platelet aggregation
(decreasing blood clotting)
• Anti-inflammatory & antitumor action.
• Bioflavonoids in plants
thought to act as insect
attractants, repellants, &
anti-fungal agents.
CRUCERIFEROUS
VEGETABLES
• Arugula, Watercress
• Broccoli
• Brussels Sprouts
• Cabbage
• Cauliflower
• Greens (Collard, Mustard)
• Kohlrabi
• Kale
• Radishes
• Rutabaga
• Turnips
CRUCIFEROUS VEGETABLES
• Rich in sulfur compounds
(sulphorophane & other
isothiocyanates) that
increase activity of enzymes
involved in detoxification of
carcinogens.
• Contain indole-3-carbinol:
- increases inactivation &
removal of estrogen;
- favors production of
estrogen that is essentially
inactive biologically.
The Anticarcinogenic Mechanisms of
Isothiocyanates (ITCs)
Procarcinogens
Inhibit carcinogenactivating enzymes
e.g., P450s
Ultimate Carcinogens
DNA Damage
Induce carcinogendetoxifying enzymes
e.g., GST
Induce apoptosis &
cell cycle arrest
Inhibit inflammation
Cancer
ITCs
ALLIUM VEGETABLES
Onions, garlic, scallions, leeks, chives
Contain protective sulfur
compounds (allyl
sulfides):
• Enhance enzymatic
detoxification systems;
• Antibacterial activity
may serve to inhibit
bacterial conversion of
nitrate to nitrite in
stomach (reducing
formation of
nitrosamines).
Allium Vegetables, Derivatives
& Breast Cancer
• Inhibition in growth of ER+ and ERbreast cancer cell lines
• Epidemiological evidence: reduced
incidence of breast cancer assoc. with
allium vegetable consumption, but not
garlic supplement (Dorant et al., Brst Ca Res
and Treatment, 1995).
AROMATIC HERBS
• Basil, marjoram, mint, oregano,
rosemary, sage, savory, &
thyme contain potent
antioxidants (some possess
anti-tumor activity.
• Terpenoids, compounds
responsible for flavors of many
common herbs & seasonings,
also useful in cancer
chemoprevention.
PLANT PHENOLICS
Cancer Prevention Agents
• Found in fruits, vegetables, grains.
• Average consumption 1-2 g/day.
• Functions in plants:
- Antioxidant
- Antiviral agents
- Color
- Structural (used to produce lignins)
ANTI-CARCINOGENIC
PROPERTIES
• Antioxidants
• Inhibit production of cancer-causing
nitrosamines
• Inhibit chemical mutagens (protect
DNA)
• Modulate inflammatory response
(arachidonic metabolism)--decreases
growth/spread of cancer cells
HIGHEST IN PHENOLICS
10 Commonly Consumed Vegetables
(Chu YF. J Agric Food Chem 2002 (Nov 6);50(23):6910-6).
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Broccoli (highest)
Spinach
Onion (yellow)
Pepper (red)
Carrot
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Cabbage
Potato
Lettuce
Celery
Cucumber (lowest)
HIGHEST TOTAL
ANTIOXIDANT ACTIVITY
10 Commonly Consumed Vegetables
(Chu YF. J Agric Food Chem 2002 (Nov 6);50(23):6910-6).
• Pepper (red)
(highest)
• Broccoli
• Carrot
• Spinach
• Cabbage
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Onion (yellow)
Celery
Potato
Lettuce
Cucumber
(lowest)
HIGHEST INHIBITORY EFFECT
ON CANCER CELLS
(Chu YF. J Agric Food Chem 2002 (Nov 6);50(23):6910-6).
• Spinach
• Cabbage
• Pepper (red)
• Onion (yellow)
• Broccoli
ANTIOXIDANT - RICH FRUITS
Ranked by ORAC Units/1/2 cup serving
(adapted from Nutr & MD, 8/99)
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• Prunes, dried
Blueberries, fresh
Blackberries, fresh
Strawberries, fresh
• Raisins, dried
• Oranges, fresh
• Plums, fresh
Raspberries, fresh
Grapes, red, fresh
• Cherries, fresh
ANTIOXIDANT- RICH VEGETABLES
Ranked by ORAC Units/1/2 cup serving (adapted from Nutr & MD, 8/99)
• Kale, cooked, fresh
• Brussels sprouts, cooked, fresh
• Beets, cooked, fresh
• Peppers, red bell, raw
• Onions, cooked
• Broccoli florets, cooked, fresh
• Spinach, raw
• Corn, cooked, frozen, kernels
• Alfalfa sprouts, raw
• Eggplant, cooked, fresh
Pesticide Risk
HANDLE WITH CARE
(Environmental Working Group - www.ewg.org)
• Strawberries
• Bell peppers
(green & red)
• Spinach
• Cherries (US)
• Peaches
• Cucumbers
• Cantaloupe
(Mexican)
• Celery
• Apples
• Apricots
• Green beans
• Grapes (Chilean)
Pesticide Risk
SAFE BETS
(Environmental Working Group - www.ewg.org)
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Avocados
Corn
Onions
Cauliflower
Sweet potatoes
Brussels sprouts
Cabbage
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Broccoli
Green peas
Carrots
Bananas
Grapes (US)
Kiwifruit
Plums
FIBER-RICH FOODS
(Vegetables, Fruits, Whole Grains, Beans)
• Rich sources of protective nutrients &
phytochemicals.
• Feel full with fewer calories (lowers risk
obesity & hormone-related cancers).
• Fiber speeds transit through GI tract
(reducing exposure of GI mucosa to cancercausing chemicals).
• Fiber enhances excretion of carcinogens &
excess hormones.
• Bound phenolics released in colon to provide
antioxidant protection.
PHYTIC ACID
in Cancer Prevention
• Phytic acid found in whole grain, beans, nuts,
& seeds.
• Also known as inositol hexaphosphate or IP6.
• In laboratory studies:
- Ability to halt abnormal cell proliferation &
shrink tumors;
- Reduce angiogenesis (creation of new
blood vessels that promote tumor growth).
WHOLE GRAINS
(Adom KK. J Agric Food Chem 2002;50(21):6182-7).
• Antioxidant
phytochemicals
(phenolic compounds,
especially ferulic acid)
• Vitamin E (especially
gamma tocopherol)
• Folate
• Fiber
INCREASE PROPORTION WHO
CONSUME > 3 DAILY SERVINGS
WHOLE GRAIN PRODUCTS
• Healthy People 2010 Target
50%
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7%
5%
5%
6%
11%
10%
12%
All age groups*
Female 20-39 years*
Female 40-59 years*
Female 60+ years*
Male 20-39 years*
Male 40-59 years*
Male 60+ years*
*
CSFII (2-day average), 1994-96.
BEANS
• Protease inhibitors may
increase accuracy of DNA
repair, decrease rate of
tumor cell division, or
decrease destruction of
surrounding tissue.
• Saponins may exert a
preventive effect against
colon cancer by binding bile
acids & cholesterol in colon.
• Rich in fiber (hastens
movement of potentially
irritating substances through
intestines).
BEANS
• Significant inverse relationship between frequency of
legume intake & colon cancer incidence:
Individuals consuming legumes >2 times/week
were 47% less likely to develop colon cancer
than individuals who consumed legumes
<once/week.
• Inverse relationship between non-soy legume
consumption & prostate cancer.
• Data from 41 countries revealed that countries with
greatest consumption of had lowest death rates due
to breast, prostate, & colon cancer.
• One mechanism may be regulation of blood glucose
and insulin (insulin-like growth factor).
SOYBEANS
(Isoflavones)
• Weak phytoestrogens
(compete with more
potent estrogens for
binding sites).
• Genistein inhibits
activity of enzyme
involved in growth of
transformed cells.
• Genistein & biochanin
A increase destruction
of tumor cells.
Best Sources of
PHYTOESTROGENS
Food
Serving
Soybeans, green
½ cup
Daidzein &
Genestein
(mg)
117
Soybean sprouts
½ cup
48
Miso paste
¼ cup
89
Soy nuts
¼ cup
65
Tofu
½ cup
31
FLAXSEEDS
• Rich in alpha-linolenic
(omega-3 fatty acid)-anti-inflammatory.
• Flaxseed meal rich in
lignans (content is 75800 times that of 66
other plant foods).
• Lignans act as
estrogen antagonists
(may decrease risk of
hormone-related
cancers).
LESS IS MORE
Correlated with Less Fat in Diet
• More vegetables
• More fruit
• More fiber
• More carotenoids
• More folate
• More vitamins
• More lowfat milk
Subar AM. Am J Pub Health 1994;84:359-66.
Tea and Breast Cancer
• Breast cell line growth inhibition; apoptosis
• Reduced tumor size and multiplicity in mouse
model of mammary tumor
• Consumption assoc. w/ reduced axillary
lymph node metastases in post-menopausal
women (Fujiki H, J Ca Res Clin Oncol, 1999).
• Case-control study (Asian women in Los
Angeles) found risk of breast cancer not
related to black tea consumption, but 47%
reduction in risk with 3 cups green tea/day
(Wu AH. Int J Cancer 2003;106(4):574-9.
Dietary Recommendations
• Choose predominantly a plant-based diet.
• Maintain a healthy weight & avoid weight gain in
adulthood (<11 pounds)
• Maintain physical activity (1hr/day moderate
activity & 1hr/wk vigorous activity)
• Increase vegetables (3-5 svg/day)
• Increase fruits (2-4 svg/day)
• Increase whole grains & legumes (3+/day)
• Limit red meat (< 3 oz/day)
• Limit dietary fat (15-30% energy)
• Limit alcoholic beverages (<1/day for women)
• Limit charcoaled or smoked foods
UCSD
HEALTHY EATING
PROGRAM
Sponsored by
The American Cancer Society
619-682-7431